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Hematalogy Lecture > Hematopoietic Theroy > Flashcards

Hematopoietic Theroy Flashcards

1
Q

Development, production and specialization of blood cells

A

Hematopoiesis

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2
Q

Where does hematopoiesis occur in adults and during fetal development?

A

-bone marrow
-Different areas of the body during fetal development

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3
Q

Hematopoiesis is divided into what three embryonic phases?

A
  1. Metablastic phase
  2. Hepatic phase
  3. Medullary phase

(EZ,AG,AB)

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4
Q

Mesoblastic period: Derived from….

A

Mesodermal tissue from fertilized embryo
19 days after fertilization

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5
Q

What is the site of the mesoblastic phase? 

A

Begins in blood islands cells of yolk sac (intravascular Hematopoiesis)

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6
Q

How long is the mesoblastic phase active for?

A

8 -12 weeks, duration of embryonic stage i.e. first trimester

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7
Q

The mesoblastic phase generates _________ cell lines.
And produces mainly what globin chains? 

A

Primitive
Epsilon and Zeta (EZ)

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8
Q

What are 3 embryonic hemoglobins made from the mesoblastic phase?

A

Gower 1, Gower 2, and Portland

  • Only embryonic
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9
Q

What are the proportions of fetal (F) hemoglobin in newborns and adults?

A

Newborns —— 80%
Adults ————<1%

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10
Q

What is the primary site of cell production during fetal development (Extracellular hematopoiesis)?

A

The liver
-Other active sites in this period are spleen, Kidneys, thymus , and lymph nodes

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11
Q

The hepatic phase produces _____________ globin chains 

A

Alpha and gamma

“Fetal hemoglobin” (Hgb F) 

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12
Q

What phase continue last cell production until 1 to 2 weeks following birth but mostly in the second trimester?

A

Hepatic phase

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13
Q

What is M:E ratio?

A

Myeloid to euthyroid ratio (looked at in the marrow) 

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14
Q

Bone marrow cavities begin to form during ______ month of gestation (medullary hematopoiesis)

A

5th

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15
Q

At what phase does the bone marrow start to become the major active site (Through third trimester and beyond)?

A

Medullary (Myeloid) phase 

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16
Q

What globin chains are produced in the medullary phase?

A

Lots of alpha
Decreasing gamma
And a tiny bit of Beta 

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17
Q

Hemoglobin A1 is Made of? 

A

Alpha and beta globin chains
(Newborns- 20% and Adults-97%)

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18
Q

hemoglobin A2 is made of?

A

Alpha and Delta
(Newborns-<0.5% and adults 2.5%)

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19
Q

M:E ratio reaches adult level of __:__ By 20 weeks gestation

A

3:1

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20
Q

timed “on and off” working of certain genes is regulation of…

A

Gene expression

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21
Q

During which embryonic phase is the majority of cellular production occurring in the bone marrow?

A

Myeloid 

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22
Q

During which embryonic phase is the majority of hemoglobin produced, alpha and gamma? 

A

Hepatic
(But myeloid also) 

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23
Q

Where is marrow is active and which one is inactive?

A

Yellow is inactive
Red is active 

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24
Q

What is the number one and two site for marrow extraction in adults? In children?

A
  1. Iliac crest
  2. Sternum
  3. iliac crest and long bone of leg
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25
Q

Hematopoietic sites are __________ Compared to Children

A

Limited

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26
Q

The fat is found in bone marrow but not in ….

A

The blood 

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27
Q

When does fat cell conversion (yellow marrow) start and end?

A

Starts at age 4 and ends at 18 years of age

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28
Q

The process of replacing the active marrow by fat tissue during development, results in restrictive active marrow sites 

A

Retrogression

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29
Q

What is the structure of bone marrow? 

A

Spoke-like pattern of Venus sinuses and cords of hematopuretic tissue (red marrow) 

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30
Q

Red bone marrow Contains _______ the developing blood cell lines

A

All

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31
Q

What is the minor and major function of bone marrow?

A

Minor: antigen processing of cellular and humoral immunity
Major: production and proliferation of blood cells

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32
Q

What do megakaryocytes produce?

A

Platelets

  • Most won’t be used but may just in case the body needs it (injury) 
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33
Q

The marrow micronenvironment includes supportive _________ matrix That is responsible for differentiation and proliferation of stem cell development. This includes stomal cells

A

Semi-fluid

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34
Q

Why are the stromal cells?

A

-endothelial cells
-macrophages
-Osteoblasts
-osteoclasts
-Reticular cells (Fibroblasts) 

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35
Q

Broad, flat cells that line the inner surface of the marrow, regulate the flow of particles

A

Endothelial cells

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36
Q

Large cells with flat vacuole, they secrete steroids and maintain bone integrity

A

Adipocyte 

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37
Q

Phagocytic cells that regulate Hematopoiesis by secretion of cytokines

A

Macrophages

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38
Q

Bone forming cells

A

Osteoblast

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39
Q

Bone-reabsorbing cells

A

Osteoclasts (Counteracts osteoblasts)

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40
Q

Associated with the formation of structural fibers, which support hematopoietic environment

A

Reticular cells (Fibroblast)

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41
Q

Lymphatic tissue is divided into what two areas?

A
  1. primary lymphatic tissue
  2. Secondary lymphatic tissue
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42
Q

What includes The primary lymphatic tissue?

A

Bone marrow for B-lymphocytes
The thymus for T-lymphocytes
And sites of active hematopoiesis in the fetus

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43
Q

What is included as secondary lymphatic tissue? 

A

lymph nodes
Spleen
GALT

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44
Q

These sites serves as reservoirs for already differentiated lymphocytes

A

Secondary lymphatic tissue

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45
Q

What is the primary tissue for T-lymphocytes development?

A

Thymus (Contains a cortex and medulla)

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46
Q

Cells enter the thymus with no ___________ Surface markers, but mature to T cells with specific immune differentiation

A

Identifiable

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47
Q

T-lymphocytes maturation progresses from cortex to the medulla and this is regulated by what two hormones?

A

Thymopoietin and thymosin

48
Q

When does the thymus reach its largest size?

A

At puberty

49
Q

Portion of the spleen that contains concentrations of WBCs (Lymphocytes and macrophages)

A

White pulp

50
Q

Portion of the spleen that contains venous sinuses and cords of Billroth

A

Red pulp

51
Q

This area contains the marginal zone and germinal center

A

Lymphatic nodules in the white pulp

52
Q

This area of the spleen is rich in specialized B-lymph, macrophages, and blood vessels

A

 marginal zone

(Located in the lymphatic nodules of white pulp) 

53
Q

Area in the spleen that houses the cell division and maturation of B-lymph and macrophages

A

Geminal center

(Located in lymphatic nodules of white pulp)

54
Q

-Contain specialized macrophasis that create a filter system for RBC’s
- Old, damaged cells are removed, and/or inclusions on cells are removed

A

Red pulp of the spleen

55
Q

What is the MAIN function of the spleen?

A

RBC Filtration

56
Q

The spleen receives ______mL/min of blood.
Required to squeeze through narrow cords.

A

350

57
Q

The spleen is a reservoir for ____% of circulating platelets.

A

30

Also a reservoir for lymphocytes

58
Q

10-15% of peripheral B-lymph’s Found in nodules of spleen. The spleen is a place for ______ Production by B-lymph’s 

A

IgM

59
Q

What are immature red blood cells?

A

Reticulocytes

60
Q

What are the four functions of the spleen?

A
  1. RBC filtration
  2. Cell grooming or restructuring
  3. Reservoir for platelets and lymphocytes
  4. Immunity involvement
61
Q

What are some symptoms of asplenia?

A

-increase platelets
-Increase lymphocytes
-Increase inclusions, or abnormal forms of RBCs
-Increase susceptibility to infection

62
Q

Reduction of all three blood cell types

A

Pancytopenia

63
Q

What are symptoms of splenomegaly and hypersplenism? 

A

-vascular congestion and portal hypertension
-Trapping of RBC’s, WBCs, and platelets (as many as 95%) 
-hyperactive bone marrow in response to pancytopenia

64
Q

The liver begins a significant role in the _____ trimester 

A

2nd

65
Q

a fixed phagocytic cell which forms the lining of the sinusoids of the liver and is involved in the breakdown of red blood cells

A

Kupffer cells

66
Q

What are two cells that are found between the sinusoids of the 2 lobes of the liver?

A

Kupffer cells and epithelial cells

67
Q

Remove debris from the blood, and are responsible for protein synthesis

A

Kupffer cells (macrophages) 

68
Q

These cells are arranged carefully with spaces contained with interstitial fluid (Involved in the transfer of nutrients and waste products) 

A

Epithelial cells 

69
Q

What are the functions of the liver?

A

-synthesize transport proteins
-Store essential minerals and vitamins that are used in DNA and RNA synthesis
-conjugated bilirubin from Hgb degradation
-Transports bilirubin to the small intestine for Excretion

70
Q

Lymph nodes occurr in ______ and _______

A

Groups, chains

71
Q

What are the two regions of lymph nodes?

A

• cortex
• Medela

72
Q

This is between the medulla and cortex. Contains T cells and macrophages

A

Paracortex

73
Q

Area on lymph nodes that…
focus of B cell proliferation (Germinal centers) 

A

Cortical nodules (Arranged in circles in outer cortex)

74
Q

Area in lymph node…
B lymphs and plasma cells

A

Medullary cords (of the medulla) 

75
Q

Lymph includes everything but…?

A

Red blood cells

76
Q

What are three functions of the lymph nodes?

A

• role in the formation of new B lymphocytes from germinal centers
• Involved in the processing of specific immunoglobulins
• Involved in the filtration of matter, debris, and bacteria

77
Q

Name two primary lymphatic tissues

A

Thymus and bone marrow

78
Q

Clear fluid derive from blood, comprised of WBCs

A

Lymph

79
Q

Patients with splenectomy, can have ________ RBCs

A

Flawed 

80
Q

Hematopoiesis is generated from _______ cells

A

Stem

81
Q

What are three characteristics of stem cells?

A

• capable of self renewal
• Give rise to differentiated prodigy
• Able to reconstitute The hematopoietic system

82
Q

What are the two major types of stem cells?

A

• Non-committed or undifferentiated stem cells (monophyletic theory)
• Multi potential and committed cells (polyphyletic theory)

83
Q

Undifferentiated “grandparents cell” that divides to give rise to prodigy cells committed to either my myeloid or lymphoid stem cell lineage

A

Undifferentiated stem cells, (HSCs) hematopoietic stem cells at the top

84
Q

Multi potential stem cells that are the prodigy of myeloid stem cells; they are partially committed, but still retain some multipotancy, and will give rise to more differentiated prodigy

A

Colony-forming unit (CFU)

85
Q

Any soluble proteins whose function is as yet unclear 

A

Factor

86
Q

A factor that stimulates mitosis

A

Growth factor (GF) 
-AKA a mitogen

87
Q

Regulatory proteins produced by cells that acts as intracellular messenger for many functions; Some are GFs (includes CSFs, Lymphokines, interleukins, interference, etc.) 

A

Cytokine

88
Q

Growth factor responsible for maintenance and continued Proliferation of granulocytes & monocyte/macrophage

A

GM-CSF- granulocyte macrophage colony stimulating factor

89
Q

Glycoprotein GF endocrine hormone; Produce by kidneys in response to degree of blood oxygenation; Major erythropoietic regulator targeting CFU-E

A

Erythropoietin (EPO)

90
Q

Growth factor that regulates Megakaryopoiesis (Production of megakaryocytes) 

A

Thrombopoietin (TPO, aka mpl ligand) 

91
Q

GFs that simulate proliferation and differentiation on specific cell lines;  they work in conjunction with CSFs; At least 18 identified so far

A

Interleukins (IL) 

92
Q

What are the major hematopoetic cytokines? 

A

GM-CSF
EPO
TPO
IL

93
Q

How is bone marrow examination done?

A

Aspirate, which is most common or biopsy

94
Q

The weight of adult marrow is? 

A

1300 to 1500 grams

95
Q

Marrow can undergo complete transformation within…

A

Hours to days

96
Q

The aspirate of marrow Is added to EDTA, mix in centrifuge in a __________ Hematocrit tube. 

A

Wintrobe

97
Q

What are the four layers of marrow aspirate? 

A

•fat layer (1-3%)
• plasma layer (% varies with hematocrit)
• myeloid /erythroid cellular layer (5-8%)
• RBC layer (Varies patient to patient)

98
Q

For what use is marrow Preparation Staind?  what stain is used?

A

For cell morphology (Wright stain)

For iron content (Prussian blue stain)

99
Q

When Prussian blue stain is used to determine iron content of marrow,  it is graded from ____- ____. What is the normal range? 

A

1+ to 4+

2+ to 4+ is normal

100
Q

What does Prussian blue stain in marrow? 

A

Hemosiderin or ferritin

101
Q

marrow preparation:
Examination of cellularity is expressed as the ratio of the Volume of ______________ to Volume of ___________ space for the patient’s age. 

A

Hematopoetic cells, marrow

102
Q

What color is a positive Prussian blue stain? Negative? 

A

Blue

Yellow

103
Q

What should be included with a marrow examination for comparison?

A

-peripheral blood cell count
-Platelet count
-reticulocyte count

104
Q

Cellularity is estimated from gross ____________ Study and histological section of marrow biopsy

A

Quantitative

105
Q

Examination of cellularity:

Irregularities of cellular distribution are first made with a low power scan of the slides and then estimated at _____ or _____X For cellular characteristics.

A

500, 1000

106
Q

Marrow Examination of cellularity:

Differential count of how many cells completed? 

A

300-1000 (A higher number because it is marrow)

107
Q

What is the normal M:E Ratio in adults?

A

1.5:1 to 3.3:1

(Old range- 2:1 to 4:1)

108
Q

As normal cell matures for both RBCs and WBCs what trends are generally observed? 

A

-cell size decreases
-Nuclear chromatin pattern becomes denser
-Nucleoli disappear
-Amount and color of cytoplasm changes
-ratio of nucleus to cytoplasm changes (N:C ratio) 

109
Q

Three signs of cytoplasmic maturation..

A

-deep blue color (high RNA content)
-Granules may appear
-Amount increases

110
Q

Four signs of nuclear materation?

A

-nucleus decreases in size (Exits entirely in RBCs!)
-Chromatin becomes more condensed or clumped
-Color changes from reddish to bluish-purple
-nucleoli may decrease in number or become absent

111
Q

Which globin chains are present in Hgb F?

A

Alpha and gamma

112
Q

Where is globin chains make up adult hemoglobin? 

A

Alpha and beta

113
Q

______________ is an endocrine hormone produced by kidneys in response to blood oxygen hypoxia

A

Erythropoietin 

114
Q

Are macrophages or monocyte seen in blood?

A

Only monocytes, macrophages are never in blood! 

115
Q

Colony forming factors are produced by _______ cells. 

A

Many

116
Q

Where are developing red cells located in the bone marrow?

A

Adjacent to the outer surface of the vascular sinuses

Complete outer surface is the mature ones

Hematalogy Lecture (35 decks)

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