Intro Flashcards
_____ cells contain histamine and proteins important for killing parasites, increased in allergies
_____ cells contain histamine and vast-active inflammatory mediators, and are responsible for hypersensitivity rxns (like anaphylaxis to a BEE)
- eosinophils
- basophils (and mast)
Granulocytes are of _____ (lymphoid or myeloid) lineage (i.e., come from lymphoid or myeloid progenitors) and are classified as _______(leukocytes, myelocytes )
Come from MYELOID (myeloid stem cell»_space; myeloid progenitor»_space; myeloblast» eos/basis/neutros)
But are classified as LEUKOCYTES (i.e., a WBC)
What cells are granulocytes (4)
- myelocytes» neutrophils, basophils, eosinophils
- monocytes (»macrophages)
Neutrophilic granulocytopenia are at risk of ______ (viral, bacterial, fungal, all, none?) infection
-bacteria and fungi
- **pathogenesis of granulocytopenia (3 categories)
- production?
- loss?
- ______(organ) problem?
*how does bone marrow exam assist in dx?
1-decreased production
2-increased loss (infection, autoimmune prob)
3-increased sequestration (big spleen)
*marrow aspiration (fatty/periphery) or biopsy (core): about 60% should be blood-forming cells(pink/purple), if LOTs of fat (white blobs) = PRODUCTION PROB
Lymphoid stem cells come from ______ while myeloid stem cells come from ______
*both come from MARROW!
Stem cells»_space; ____ cells which form “colony forming cells” (CFU)
Stem cells = undifferentiated, potential to differentiate to multiple lineages, self-renewing, can replicate without differentiating
Progenitor cell = ability to form colonies in tissue culture
*cytokines that drive differentiation from myeloid progenitor cells (CSF, E, TPO):
_____»_space; RBC
____»_space; monocytes/granulocytes
_____»_space; platelet
E = erythropoietin (stim by low o2 for ex) CSF = colony stimulating factor (G-CSF = granulocytes; M-CSF = macrophages) TPO = thrombopoeitin-induced differentiation
***what causes marrow failure (decreased production of hemato cells) (3-4)
- chemo and/or radiation (very common)
- colonial myeloid hemopathies affecting marrow fxn (AML, MDS) - less common
- invading malignancies (lymphoma, myeloma, metastasis etc)
- aplastic anemia (extremely rare)
Post-splenectomy can lead to ______(Inc or dec) granulocytes
- increased
- spleen can “sequester” these cells so big spleen can lead to neutropenia
Elevated eosinophil count maybe due to IL-_____ or due to _________ (ex?) neoplasms
IL- 5! - produced by Th2 helper cells (important for eosin chemotaxis)
Or MYELOPROLIFERATIVE NEOPLASM = neoplastic lymphoid cells (T-cell lymphoma, leukemia, Hodgkins)»_space; also produce Il-5
1 Hemoglobin has ____(#) of heme molecules
4 heme units … In each of the 4 chains (2 alpha, 2 bet)
T/F - hemoglobin does not affect the solubility of o2 in blood, just helps with transferring of o2 to tissues
FALSE …. Increases o2 in blood by 70x
3 types of hemoglobin (A, F, A2?)
A = 2 alpha, 2 beta chains (>95%) F = 2 alpha, 2 gamma A2 = 2 alpha, 2 delta
Describe cooperative o2 binding in hgb
Increased amount of binding»_space; helps more bind
Also helps with getting o2 off (more that is off, easier it comes off)
**makes the curve s-shaped, in stead of linear
How does 2,3 - BPG affect hgb and o2 binding?
- increased in ______(lungs or tissue)
- increase causes curve to shift to ____(L or R)
- converts from relaxed (R) structure to tight (T) structure = low o2 affinity state»_space; FAVORS UNLOADING (shifts curves to RIGHT)
- produced in areas of high metabolism
Will Inc or dec of each cause LEFT SHIFT of O2 curve:
- temp
- H+
- CO2
- 2,3 BPG
Left shift = favors ____(loading or unloading)
Left shift (favor loading, LUNGS) = decreased temp, decreased H+ (higher pH), less CO2, less 2,3 BPG
Person living in very high altitude will have o2 dissociation curve shifted to _____(L or R)
LEFT (like LLAMAS) … Less pO2 in atmosphere … So need to bind given % (y-axis) at lower po2 level (X-axis)
Iron needs to be in _____(ferrous or ferric) state which is ______(Fe2, or 3) to bind o2
Ferrous, FE2
“Porphyrias” are disorders Chx by defect in _______ synthesis
HEME synthesis (lots of different enzymes involved in mitochondria)
Dx?
- episodic severe abdominal pain, muscle weakness, personality change and seizures
- alcoholic with hepC, no dark urine, only cutaneous symptoms (painful blistering lesions)
- Acute intermittent porphyria
- porphyria cutaneous tarda
T/F - hemoglobinopathies are exceedingly rare and are characterized by defects in beta or alpha chain production
T/F- majority of hemoglobinopathies have little clinical significance
FALSE … ~500k born with it (most as evolutionary way to get around malaria) = defects concerning hgb structure and or red cell membrane or enzyme defect
TRUE (100s of mutations described - make high or low affinity hgb usually as evo advantage)
Thalassemia
- definition
- is alpha or beta thal more common
- alpha or beta chain production problem
- alpha rarely a problem due to gene duplication
- beta due to multiple mutations (promoter, frame shift, splicing etc) = MORE COMMON
Does each produce mild, severe or no anemia:
- silent alpha carrier (alphaalpha, alpha-)
- beta thalassemia major (beta0, beta0)
- alpha thalassemia trait (alpha-, alpha-)
- none
- severe
- mild
1 and 3 very common in African American!