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Hematopoiesis and Peripheral Blood > Hematopoiesis and Peripheral Blood > Flashcards

Hematopoiesis and Peripheral Blood Flashcards

1
Q

Describe the hematopoietic cell compartment

A

highly vascularized, erythroblastic and myeloid areas

hematopoietic stem cells, committed precursor, maturing cells

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2
Q

Describe the components of the marrow stromal compartment

A

endothelial cells= barrier
adipocytes= energy
stromal and fibroblasts= structure
macrophages, GFs from endo cells

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3
Q

What does SCF do?

A

weak factor but 1st in cascade, produced by fetal tissue and bone marrow, makes stem cells responsive to other cytokines

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4
Q

What does IL-3 do?

A

replication and growth potential of progenitors

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5
Q

What does IL-6 do?

A

stimulates megakarocytes and neutrophil production, key in leukmoid reaction

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6
Q

What is/are the GFs fro T cells?

A

IL-2

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7
Q

What is/are the GFs for B cells?

A

IL2 and IL6

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8
Q

What does M-CSF do?

A

increase monocytes and macrophages

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9
Q

What makes G-CSF? What is it affect? What can it be used for?

A

Macrophages, fibroblasts, and endothelial cells

Increase in neutrophils

Treatment for neutropenia after chemo or none marrow transplant

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10
Q

What makes GM-CSF? What is its affect?

A

Endothelial cells, T cells, fibroblasts, and monocytes
Stimulate formation of leukocytes and reticulocytes
comparable to G-CSF but no used therapeutically in US

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11
Q

Where is EPO made? What does it do?

A

Kidneys

RBC production, treatment for anemia

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12
Q

Where is TPO made? What does it do?

A

Liver

Megakarocytes and platelet production

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13
Q

What are the histological features of proerythroblasts?

A

large round cell, mild basophilia

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14
Q

What are the histological features of basophilic erythroblasts?

A

smaller cells, deeply basophilic cytoplasms

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15
Q

What are the histological features of polychromatophilic erythroblasts?

A

basophilic ribosomes, eosinophilic cytoplasm

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16
Q

What are the histological features of normoblasts?

A

eosinophilic cytoplasm, resembles erythrocytes

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17
Q

What are the histological features of reticulocytes

A

enlarged immature erythrocytes with residual reticular network of RER, light purple, polychromatic
count increased in hemolytic anemia

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18
Q

What is the cell progression in granulocytic leukopesis?

A

Myeloblast= no granules, basophilic cytoplams

Promeylocyte= cytoplasm with large black/purple granules, nucleoi

Myelocyte= eccentric round oval nucleus, primary auzophilic and fine 2’ predominates

Metamyelocyte= juvenile granulocyte, indented nucleus

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19
Q

What are the steps in lymphocytic leukopoiesis?

A

B and T lymphoblasts with no cytoplasmic granules

B and T Cells, T cells mature in thymus

B cells –> plasma cell which are produced from activated B-cells in spleen and LN with help of T cells then go back to bone marrow

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20
Q

What are the histological features of plasma cells?

A

eccentrically placed nucleus with perinuclear hoff

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21
Q

What are the histological features of megakaryoblasts?

A

Large oval or kidney shape nucleus, basophilic cytoplasm

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22
Q

What are the features of megakarocytes?

A

Large multi-lobed nucleus due to endomitosis (nuclear division without cell division)
Plasma membrane invaginate and platelets break off

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23
Q

What is the progression of a stem cell to a macrophage and what compartments does this happen in?

A

Stem cell –> monoblast in bone marrow –> monocyte in blood which travels 24 hrs –> tissue macrophage –> activated macrophage, microglia, kupffer cells, alveolar macrophages, and osteoclasts

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24
Q

What is plasma composed of?

A

50% of blood sample

dissolved porteins, glucose, ions, hormones, clotting factors,

25
What is the buffy coat composed of?
1% of blood sample | Leukocytes and platelets
26
What does Hg measure?
Concentration of hemoglobin per unit volume
27
What does Hct measure?
volume % of RBCs in blood
28
What does RDW measure?
range of variation of RBC volume | increases with anicosytosis aka variation in size
29
What does MCV measure?
Average volume of RBCs= Hct/RBC | Determines if microcytic, normocytic or macrocytic anemia
30
What does MCH measure?
average mass of Hb in erythrocytes= Hb x 10/RBC
31
What does MCHC measure?
Concentration of Hb in a given volume= Hb/Hct | Determines power aka if hyperchromic, normochromic, or hypochromic
32
What does RPI measure?
Corrected % of reticulocyte based on RBC volume, increase with destruction of RBCs Reticulocyte % x Hct/ normal Hct
33
What disease should we suspect if someone has an MCV < 80 aka microcytic?
iron deficiency thalassemia anemia of chronic disease
34
What diseases should we suspect if someone has a normal MCV (80-100) but a low reticulocyte count?
marrow failure aplastic anemia leukemia or metastatic disease renal failure
35
What disease should we suspect if someone has a normal MCV with a high reticulocyte count?
``` erythroid hyperplasia in bone marrow G6PD def. hereditary spherocytosis Autoimmune hemolytic anemia paroxysmal nocturnal hemoglobinuria ```
36
What disease should we suspect if someone has a high MCV aka macrocytic (>100)?
megablastic anemia due to a B12 or folate def. | alcoholic liver disease
37
What are 2 distinct histological features of G6PD anemia?
bite cells and heinz bodies
38
What are histological features of megablastic anemia?
hyper-segmented neutrophil | hypercell bone marrow with metamelocytes and band forms can lead to erthyroid hyperplasia
39
What are the 3 causes of iron deficiency anemia?
dietary lack or decreased absorption due to diet, cows milk to infant, etc impaired absorption due to spure, partial gastrectomy etc chronic blood or iron loss due to tumor, ulcer, menomettornagia, etxreme distance running
40
What are characteristics that can lead you to a diagnosis of iron deficiency anemia?
microcytic with elevated RDW | no changes in RBC shape
41
What can cause aplastic anemia?
Hypocellular bone marrow --> reduced hematopoiesis | ex. chemo --> pancytopenia of all cell lines
42
What is compensatory erythropoiesis caused by?
sever anemia and chronic hypoxemia
43
What can cause hyposplenism or asplenia?
Sickle cell, traumatic splenectomy
44
What can cause marrow deplacement/invasion?
tumor infection (Tb granulomas, fungal) myelofibrosis (idiopathic, chronic toxin or radiation) meyloproliferatiave disorder
45
How do leukoerythroblastosis appear and what do they suggest?
nucleated and teardrop RBCs, immature WBCs | displacement of hematopoietic elements by another process
46
What are instances where extramedullary hematopoiesis is a compensatory mechanism?
``` severe chronic thalassemia sickle cell stem cell failure (toxic, aplastic) infection (parovirus B19) B12 or folate deficiency malignant transformation and replacement ```
47
What is a "left shift"
increased immature leukocytes especially band forms | neutrophilia with infection
48
How does toxic granulation appear and what is it caused by?
dark coarse granules with neutrophils | common in inflammation reactions due to accelerated neutrophil differentation
49
What is the criteria for a leukmoid rxn and how does the bone marrow appear?
WBCs > 50,000 with increased neutrophils and no evidence of leukemia as determined by leukocyte phosphatase levels Bone shows complete maturation without blasts
50
What are the phases of CML? Is it more common in children or adults?
chronic phase --> accelerated phase with 10-19% blasts in marrow --> blast phase with > 20% blasts in marrow Adults
51
What is AML? What is the peak age for it?
accumulation of immature myoblasts, anemia thrombocytopenia and neutropenia due to bone marrow crowding, R rods of primary granules 60
52
What can causes inadequate granulopoiesis leading to neutropenia?
suppression of granulocytic precursors due to chemo, drugs, and toxins suppression of hematopoietic stem cells due to aplastic anemia or marrow replacement/ invasion ineffective hematopoiesis due to B12 or folate megablastic anemia
53
What can cause increased destruction leading to neutropenia?
immune injuries to neutrophils like in lupus or autoimmune disease splenomegaly due to portal hypertension increased peripheral utilization due to overwhelming bacteria of fungi
54
What causes mono and what are characteristics of it?
epstein barr virus atypical t-lymphocytes, tonsillar abscess, fever, lymphogatosis
55
What are defining features of chronic lymphocytic leukemia?
older >500 ALC lymphadenopathy hepatosplenomegaly
56
What are defining features of acute lymphoblastic leukemia?
Children | numerous blast on peripheral smear or bone marrow
57
What are signs of thrombocytopenia?
Mucocutaneous bleeding petichae ecchymosis
58
What can cause thrombocytopenia? (3 main causes)
increased platelet destruction due to ITP, HIT, autoimmune (SLE, HIV), DIC, TTP/HUS decreased production due to bone marrow replacement or liver disease (decreased EPO) sequestering leading to hypersplenism

Hematopoiesis and Peripheral Blood (1 decks)

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