Hematopoiesis and benign conditions

Question 1

HSC

Answer 1

during 3rd month migrate to liver
also take up residence in fetal placenta (can be harvested)
by 4th month reside in marrow
after puberty hematopoiesis restricted to axial skeleton

Question 2

GFs of very early committed progenitors

Answer 2

Stem cell factor (KitL)

FLT3-L

Question 3

GFs of committed progenitors

Answer 3

erythropoietin
GM-CSF
G-CSF
Thrombopoietin

Question 4

Bone Marrow

Answer 4

thin walled sinusoids
lined by single layer of endothelium
discontinuous BM and adventitial cells
hematopoietic cells and fat cells 1:1

Question 5

megakaryocytes

Answer 5

lie next to sinusoids and extend cytoplasmic processes that bud off into blood stream

Question 6

nurse cells

Answer 6

surround RBC precursors

are specialized macrophages

Question 7

leukoerythroblastosis

Answer 7

process which disrupts architecture of marrow causing abnormal release of immature precursors into periphery

Question 8

sequence of RBC production

Answer 8

proerythroblasts -> basophilic erythroblast -> polychromatophilic erythroblast -> nucleated red cells -> reticulocyte -> mature erythrocytes

Question 9

proerythroblast

Answer 9

large round cell
mild basophilia
only in marrow

Question 10

basophilic erythroblast

Answer 10

smaller
deeply basophilic
only in marrow

Question 11

polychromatophilic erythroblast

Answer 11

basophilic ribosomes
eosinophilic cyto
only in marrow

Question 12

nucleated red cells

Answer 12

should only in marrow

Question 13

normal MCV

Answer 13

80-100

Question 14

RBC normal

Answer 14

4. 1-5 men

3. 5-5 women

Question 15

normal platelets

Answer 15

150-450

Question 16

normal WBC

Answer 16

4.8-10.8

granulocytes 40-70%

Question 17

disease states associated w/ineffective hematopoiesis

Answer 17

megaloblastic anemia

myeloid dysplastic syndrome

Question 18

immunologically mediated injury to neutrophils

Answer 18

idiopathic
SLE or other autoimmune conditions
drugs

Question 19

most common cause of agranulocytosis

Answer 19

drug toxicity

alkylating agents and antimetabolites used in chemo

Question 20

infections due to agranulocytosis

Answer 20

ulcerating necrotizing lesions of oral cavity characteristic
can progress to death in hours to days
high risk for candida and aspergillus
most serious when neutrophils <500

Question 21

leukocytosis

Answer 21

increase in WBCs

Question 22

acute infection leukocytosis

Answer 22

may be due to TNF and IL1

Question 23

prolonged infection leukocytosis

Answer 23

TNF and IL1 stimulate macros, bone marrow stromal cells, T cells -> produce hematopoietic GFs `

Question 24

IL5

Answer 24

eos

Question 25

G-CSF

Answer 25

neutrophils

Question 26

leukocytosis neutrophil changes

Answer 26

toxic granulations Dohle bodies cytoplasmic vaculoles

Question 27

Toxic granulations

Answer 27

coarser and darker then normal granules | abnormal azurophilic granules

Question 28

Dohle bodies

Answer 28

patches of blue dilated ER that appear as sky-blue cytoplasmic puddles

Question 29

neutrophilic leukocytosis

Answer 29

actue bacterial infections

Question 30

esosinophilic leukocytosis

Answer 30

``` allergic disorders parasitic infections drug rxns malignaces (NHLs and HLs) autoimmune disorders vasculitides ```

Question 31

basophilic leukocytosis

Answer 31

rare | MPD

Question 32

Monocytosis

Answer 32

``` chronic infections (TB) bacterial endocarditis ricketsial and malaria autoimmune ```

Question 33

lymphocytosis

Answer 33

chronic infections | viral infections

Question 34

follicular hyperplasia

Answer 34

due to activation of humoral response RA Toxoplasmosis early HIV

Question 35

follicular hyperplasia morphology

Answer 35

dark zone light zones DCs tangible-body macrophages

Question 36

reactive hyperplasia

Answer 36

preservation of lymph node architecture frequent mitotic figures phagocytic macros light and dark zones

Question 37

paracortical hyperplasia

Answer 37

due to activation of T-cell mediated immune response

Question 38

sinus histiocytosis

Answer 38

aka reticular hyperplasia | increase in number and size of cells that line lymphatic sinusoids

Question 39

tertiary lymph organs

Answer 39

chronic immune rxns promote appearance of organized collections of immune cells in non-lymphoidal tissue H.pylori at peyers patches RA in inflamed synovium due to lymphotoxin

Question 40

HLH

Answer 40

hemophagocytic lymphohistoiocytosis aka macrophage activation syndrome can be familial appearing early in like triggered by infection (EBV) marked cytopenia and systemic inflammation

Question 41

HLH pathogenesis

Answer 41

activation of macros and CD8 T cells -> release mediators -> suppress hematopoiesis and produce systemic inflammation -> cytokine storm -> shock like syndrome

Question 42

HLH presentation

Answer 42

acute febrile illness splenomegaly and hepatomegaly hemophagocytosis in bone marrow rapidly progress to shock and death