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MOD Exam 1 > Hematopoiesis > Flashcards

Hematopoiesis Flashcards

1
Q

Hematopoiesis

A

the process by which blood cells are formed from hematopoietic stem cells (HSCs)

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2
Q

HSC to myeloid stem cell stimuli

A

IL-1

IL-3

IL-6

SCF

G-CSF

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3
Q

HSC to lymphoid stem cell stimuli

A

IL-1

IL-6

SCF

FLT-3L

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4
Q

Myeloid lineage

A

RBC

Platelets

Monocytes

Neutrophils

Eosinophils

Basophils

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5
Q

RBC formation pathway

A

BFU-E –> Proerythroblast –> RBC

*IL-3 and EPO

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6
Q

Platelet formation pathway

A

CFU-Mega –> Megakaryocyte –> Platelet

*IL-3, IL-11, and TPO

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7
Q

Monocyte formation pathway

A

CFU-GM –> Monoblast –> Monocyte

*IL-3, GM-CSF, and M-CSF

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8
Q

Neutrophil formation pathway

A

CFU-GM –> Myeloblast –> Neutrophil

*IL-3, GM-CSF, and G-CSF

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9
Q

Eosinophil formation pathway

A

Eosinophilic myeloblast –> Eosinophil

*IL-3, IL-5, and GM-CSF

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10
Q

Basophil formation pathway

A

Basophilic myeloblast –> Basophil

*IL-3 and IL-4

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11
Q

Lymphoid lineage

A

B cells

T cells

NK cells

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12
Q

B cell formation pathway

A

Pre-B cell –> B Lymphoblast –> B cell

*IL-1, IL-2, IL-4, IL-5, and IL-6

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13
Q

T cell formation pathway

A

Prothymocyte –> T Lymphoblast –> T cell

*IL-2 and IL-4

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14
Q

Prenatal hematopoiesis

A

Yolk sac (early)

Liver**

Spleen*

Bone marrow (late)

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15
Q

Postnatal hematopoiesis (child)

A

*before puberty

Tibia

Femur

Ribs

Sternum

Vertebrae and pelvis

Skull

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16
Q

Postnatal hematopoiesis (adult)

A

*after puberty

Ribs

Sternum

Vertebrae and pelvis

Skull

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17
Q

Hematopoietic cell compartment of bone marrow

A

highly vascular

contains hematopoietic stem cells (duh)

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18
Q

Marrow stromal compartment of bone marrow

A

Endothelial cell barrier (fenestrated)

Adipocytes for energy

Stromal cells and fibroblasts for structure

Macrophages to remove dead cells

Hematopoietic growth factors produced here

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19
Q

G-CSF

A

Given as treatment for neutropenia after chemotherapy or bone marrow transplant

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20
Q

Erythropoietin (EPO)

A

Produced by the kidneys

RBC formation

Agonists used as anemia treatment

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21
Q

Thrombopoietin (TPO)

A

Produced by the liver

Megakaryocyte and platelet formation

Agonists used as clotting disorder treatment

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22
Q

Reticulocyte

A

enlarged immature erythrocytes with residual RER

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23
Q

Metamyelocyte

A

Juvenile granulocyte with an indented nucleus

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24
Q

Buffy coat

A

Leukocytes and platelets

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25
Q

Plasma cell

A

Antibody producing cell

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26
Q

Types of macrophages

A

Microglia (CNS)

Kupffer cells (Liver)

Alveolar macrophages (Lungs)

Osteoclasts (Bone)

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27
Q

Band Neutrophils

A

Immature neutrophils

Present in “left shift” leukocytosis associated with bacterial infections

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28
Q

Hemoglobin (Hg) lab value

A

Concentration of Hg per unit volume of blood

  1. 5-17.5 for males
  2. 3-15.3 for females
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29
Q

Hematocrit (Hct)

A

Volume percent of RBC in blood

40-52 in males

36-48 in females

30
Q

Red cell distribution width (RDW)

A

measure of range in variation of RBC volume

31
Q

Mean corpuscular volume (MCV)

A

Average volume of RBC –> Size of RBC

MCV = Hct/RBC

determines macrocytic vs normocytic vs microcytic

normocytic = 80-100

32
Q

Mean corpuscular hemoglobin (MCH)

A

Average mass of hgb in RBC

MCH = Hb x 10/RBC

33
Q

Mean corpuscular hemoglobin concentration (MCHC)

A

Concentration of hemoglobin in given volume –> color of RBC

determines hypochromic vs normochromic vs hyperchromic

MCHC = Hb/Hct

34
Q

Reticulocyte production index (RPI)

A

Corrected reticulocyte % based on RBC volume

35
Q

Anisocytosis

A

Variation in RBC size with increased RDW

36
Q

Poikilocytosis

A

Variation in RBC shape

37
Q

Anemia

A

decreased RBC volume or Hgb

38
Q

Polycythemia

A

Increased RBC or Hgb

39
Q

Thrombocytopenia

A

Decreased platelets

40
Q

Thrombocythemia

A

increased platelets

41
Q

Leukocytosis

A

Increased WBC

42
Q

Leukopenia

A

Decreased WBC

43
Q

Lymphocytosis

A

Increased lymphocytes

44
Q

Lymphopenia

A

Decreased lymphocytes

45
Q

Neutropenia

A

Decreased neutrophils

46
Q

Neutrophilia

A

Increased Neutrophils

47
Q

Eosinophilia

A

Increased eosinophils due to allergic reaction or parasites

48
Q

Pancytopenia

A

Decrease of all cell lines (RBC, platelets and WBCs)

49
Q

Iron deficiency anemia

A

Anisocytosis, poikilocytosis, microcytic and hypochromic

Increased RDW

Decreased MCV

Decreased MCH

Decreased MCHC

Decreased RBC count

Decreased retic count

Decreased Hct

50
Q

Lab evaluation of anemia

A
  1. CBC and RPI
  2. categorize as microcytic, macrocytic or normocytic
  3. exam peripheral blood smear
  4. serum iron level, total iron-binding capacity, and serum ferritin level
  5. RDW to determine iron deficiency vs thalassemia
51
Q

Nucleated RBC

A

Created during compensatory erythropoiesis (anemia or chronic hypoxemia)

Occur with sickle cell anemia or splenic injury

52
Q

Microcytic conditions

A

MCV < 80

Iron deficiency anemia

Thalassemia

Anemia of chronic disease

Sideroblastic anemia

53
Q

Normocytic conditions with low reticulocyte count

A

Marrow failure

Aplastic anemia

Myelofibrosis

Leukemia/metastasis

Renal failure

Anemia of chronic disease

54
Q

Normocytic conditions with high reticulocyte count

A

Sickle cell anemia

G6PD deficiency

Hereditary Spherocytosis

Autoimmune hemolytic anemia

Paroxysmal nocturnal hemoglobinuria

55
Q

Macrocytic conditions

A

MCV > 100

Megaloblastic anemia (B12 or folate deficiency)

Alcoholic liver disease

56
Q

Marrow replacement/invasion

A

Caused by malignancy, infection, myelofibrosis, or myeloproliferative disorder

Leukoerythroblastosis: Nucleated and teardrop RBC with immature WBC

57
Q

Extramedullary hematopoiesis

A

Hematopoiesis occurring outside the bone marrow

Usually spleen, liver or lymph nodes

Occurs in normal fetal development

A compensatory mechanism for abnormal hematopoiesis

58
Q

Schistocytes

A

RBC type found in microangiopathic hemolytic anemia (DIC and TTP)

Thrombocytopenia with anemia

59
Q

Bite cells and Heinz bodies

A

Indicate G6PD deficiency

Caused by oxidative stress

60
Q

Sickle cells

A

deformed erythrocytes due to polymerized abnormal hemoglobin S

61
Q

Spherocytes

A

Associated with hereditary spherocytosis

62
Q

WBC Count normal values

A

Total: 4.8-10.8

Neutrophils: 1.4-6.5 (40-60%)

Lymphocytes: 1.2-3.4 (20-40%) *CD4 T cells

Monocytes: 0.1-0.6 (2-10%)

Eosinophils: 0-0.5 (<1-6%)

Basophils: 0-0.2 (<1-2%)

63
Q

Causes of Neutrophilia

A

**Bacterial infection

Medications (steroids)

Smoking

Physical stress

Leukemia

64
Q

Left shift

A

Increased immature leukocyte production primarily band neutrophils and metamyelocytes

Indicates neutrophilia and acute bacterial infection

65
Q

Leukemoid reaction

A

WBC count > 50,000 with neutropenia

No evidence of leukemia

Due to infection, drugs or cancer

Elevated leukocyte alkaline phosphatase

Bone marrow would show complete maturation without increased blasts

66
Q

Chronic myelogenous leukemia (CML)

A

Low blast count at first but increases with disease progression

Pancytopenia

67
Q

Acute Myeloid Leukemia

A

All ages

Accumulation of immature myeloid blasts in bone marrow

anemia, thrombocytopenia and neutropenia due to bone marrow crowding

68
Q

Chronic lymphocytic anemia

A

older adults

lymphadenopathy

hepatosplenomegaly

69
Q

Acute lymphoblastic leukemia

A

children

many blasts on peripheral smear or bone marrow

70
Q

Basophilia

A

Rare but can be seen with leukemia

71
Q

Monocytosis

A

Seen with atypical bacterial infections and autoimmune diseases

72
Q

Platelet mechanism of action

A

Gp1b binds to von Willebrand factor on exposed collagen

Platelets release ADP and TxA2 to recruit more platelets

GpIIb-IIIa receptor binds to fibrinogen for platelet aggregation

MOD Exam 1 (5 decks)

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