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MOD Final > Hematopoiesis (Part III) > Flashcards

Hematopoiesis (Part III) Flashcards

1
Q

What is the MCV like in Megaloblastic Hyperplasia?

A

it is greater than 100

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2
Q

what does the bone marrow look like in megaloblastic hyperplasia?

A

it is hypercellular with giant metamyelocytes and band forms

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3
Q

what commonly causes megaloblastic hyperplasia?

A

folate or vitamin B12 deficiency

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4
Q

what causes a deficiency in vitamin B12?

A

vegetarianism or an intrinsic factor deficiency

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5
Q

what causes a deficiency in folate?

A

alcoholics or increased metabolic needs for folate such as in pregnancy

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6
Q

What causes an intrinsic factor deficiency?

A

gastrectomy and pernicious anemia

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7
Q

how does the peripheral blood look in megaloblastic hyperplasia/anemia?

A

anemia is present with enlarged oval red blood cells and hypersegmented neutrophils

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8
Q

in megaloblastic anemia, the bone marrow is hypercellular- so why do you have an anemia?

A

well the megaloblastic erythro forms are actually destroyed at a higher rate, so we have decreased bone marrow production and decreased reticulocytes

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9
Q

What could cause a macrocytic anemia?

A

megaloblastic anemia, B12 deficiency, Folate deficiency, and alcoholic liver disease

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10
Q

What does the bone marrow look like in aplastic anemia?

A

there is pancytopenia of all cell lines- hypocellular bone marrow

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11
Q

what causes aplastic anemia?

A

toxins or certain drugs (especially chemotherapy agents)

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12
Q

Under which MCV classification and reticulocyte count is aplastic anemia under?

A

normocytic with a low reticulocyte count

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13
Q

what are the most common forms of metastatic carcinoma to go to the bone?

A

breast, prostate, lung, and kidney

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14
Q

what happens whenever a tumor or other process crowds the bone marrow?

A

hematopoietic elements are displaced or destroyed

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15
Q

under which MCV classification would leukemia/ metastasis be under?

A

normocytic with a low reticulocyte count

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16
Q

what can bone marrow replacement result in?

A

myelophthisic anemia where there is mechanical crowding which causes nucleated RBCs and granulocyte precursors

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17
Q

what does a peripheral blood smear look like in myelophthisic anemia?

A

leukoerythroblastosis–> nucleated and tear drop RBCs and immature WBCs; suggestive of displacement of hematopoietic elements by another process

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18
Q

what is extramedullary hematopoiesis?

A

when hematopoiesis occurs in organs outside of the bone marrow

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19
Q

where does extramedullary hematopoiesis frequently occur?

A

spleen, liver, and lymph nodes; occurs in normal fetal development

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20
Q

when does extramedullary hematopoiesis occur (not in fetal development)?

A

in chronic and severe anemic states from a variety of causes, extramedullary hematopoiesis can occur as a compensatory response

21
Q

how does extramedullary hematopoiesis present?

A

as a discrete mass-like lesion which can cause local issues or it can present more diffusely without a well defined mass

22
Q

what is a big histological clue that extramedullary hematopoiesis is occurring?

A

the presence of multiple megakaryocytes (cells that are readily identifiable by their large size and large multilobated nuclei

23
Q

what are schistocytes and when are they seen?

A

they are fragmented RBCs; seen in microangiopathic hemolytic anemia such as DIC or TTP/HUS

24
Q

what occurs in the microangiopathic hemolytic anemias?

A

small thrombi form within blood vessels, decreasing platelets, and causing blood cells to fragment as they travel through vessels

25
Q

What causes “bite” cells and Heinz bodies?

A

G6PD deficiency

26
Q

What is sickle cell anemia?

A

deformed erythrocytes due to polymerized abnormal hemoglobin S

27
Q

What causes spherocytes to appear on a peripheral blood smear?

A

hereditary spherocytosis caused by a genetic abnormality in the structural components of the red blood cell membrane

28
Q

what do both sickle cell anemia and hereditary spherocytosis lead to?

A

increased destruction of red blood cells

29
Q

what is a good reference range for WBCs?

A

4.8-10.8 x 10^3/ML

30
Q

what makes up the majority of the WBC constituents in the peripheral blood of adults?

A

neutrophils

31
Q

what makes up the majority of the WBC constituents in the peripheral blood of children?

A

lymphocytes

32
Q

of the lymphocytes, which count is higher?

A

T lymphocytes

33
Q

what are 5 causes of neutrophilia?

A

acute bacterial infection, medications (glucocorticoids, catecholamines), cigarette smoking, physical stress, and myeloproliferative neoplasms/leukemia

34
Q

What are bacterial infections associated with?and what is this?

A

left shift- when immature leukocytes, especially band neutrophil forms are released from the bone marrow into the peripheral blood due to increased cytokine activity

35
Q

What are bands hematpoietically derived from?

A

metamyelocytes and metamyelocytes are derived from even more immature granulocytes

36
Q

What could happen if the left shift is severe enough?

A

metamyelocytes are also identified along with bands

37
Q

What is frequently seen in conjunction with left shifts?

A

toxic granulation

38
Q

what is toxic granulation due to?

A

accelerated neutrophil maturation as the bone marrow tries to pump out more and more acute inflammatory cells to fight the infection

39
Q

How can toxic granulation be seen?

A

as dark coarse granules within neutrophils, especially in inflammatory conditions

40
Q

what is a leukemoid reaction?

A

marked leukocytosis with increased neutrophilia not due to leukemia; overactive inflammatory reactions driven by increased interleukin production, especially IL-6

41
Q

how do leukemia and leukemoid reactions differentiate?

A

the enzyme leukocyte alkaline phosphatase is typically elevated in leukemoid reactions unlike in leukemia

42
Q

what could cause leukemoid reactions?

A

drugs, infection, or carcinoma

43
Q

what does the bone marrow look like in leukemoid reactions?

A

the bone marrow would show complete maturation without increased myeloblasts

44
Q

what is the WBC count in leukemoid reactions?

A

> 50000 with increased neutrophils

45
Q

What is the chief differential of leukemoid reaction?

A

a leukemic process such as chronic myelogenous leukemia

46
Q

how is chronic myelogenous leukemia characterized?

A

by a spectrum of differentiation with myeloblast cells

47
Q

what is the median WBC count seen in chronic myelogenous leukemia?

A

100,000

48
Q

what are the phases of chronic myelogenous leukemia (CML)?

A

chronic phase–>accelerated phase–> blast phase

49
Q

what is the end result of CML?

A

pancytopenia

MOD Final (11 decks)

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