Intro to Hematology Flashcards
What’s on a CBC with diff?
WBC > Hgb/Hct < Plt
What are all blood cells derived from?
- Hematopoietic stem cell can become 1 of 10 blood lineages.
- Stem cells maintained at constant rate in bondy
Hematopoietic Family Tree
Pluripotent Stem Cell –> Lymphoid stem cell –> B-lymphocyte, T lymphocyte, Plasma Cell
Pluripotent Stem Cell –> Myeloid stem cell –> All the rest of the cells
2 characteristics of stem cells
1) Plasticity/pleuripotential: can generate all types of blood cells
2) Self Renewal: maintained at constant rate
2 types of Progenitor Cells
1) Early Progenitor (more like a stem cell)
2) Late Progenitor (restricted to one cell lineage).
Regulation of Hematopoiesis
Balance b/t programmed cell death (apoptosis) and Bone Marrow Production –> Results in imbalance (anemia vs polycythemia)
Colony stimulating factors
-Made by pharmaceuticals
-Able to grow many types of specific cells lines
(M-CSF = macrophage colony stimulating factor)
Erythropoietin
- Erythropoiesis stimulating hormone
- Produced in kidneys
- Pts with renal failure are anemic
Thrombopoietin
- Makes bone marrow cells
- pts with cirrhosis have low platelets
Sites of hematopoiesis (3)
1) Yolk sac (pre-fetus)
2) Liver and spleen (fetus)
3) Bone Marrow (after birth)
Bone Marrow characteristics
- TONS of erythrocytes and leukocytes
- After 18y/o, bone marrow becomes “inactive”
- Only 1/2 of bone marrow in adults is “active”
Hemoglobin is made of______and______.
Heme and Globin
Heme is a ring structure centered on a ______atom. It is made in the _______.
Fe atom, Mitochondria
Globin is synthesized in the ________.
Ribosomes.
One RBC can carry > 1 billion______moleclues
oxygen
Common types of hemoglobin –> Differ by chains
A/A2 (adult) –>98% is Hgb A
F (fetal)
S (sickle cell)
Fetal Hgb Chains
2 alpha, 2 gammas –> fetal Hgb has greater affinity for oxygen so it can extract O2 from placental blood flow
Oxygen-Hgb Dissociation Curve
- Right shift = easy O2 delivery; acidosis, high 2,3-DPG, Hgb S
- Left shift = give up O2 less readily; low 2,3-DPG, alkolosis
2,3 - DPG/BPG
Facilitates unloading of oxygen
Erythrocyte is the most ______cell in body. It is _____but transports_______via Hgb. It’s shape is ______discs. It is extremely _______.
Abundant; anaerobic; oxygen; biconcave; pliable.
Reticulocyte
Immature RBC
Stains blue
RBC production depends on 3 supplies for production:
Fe, Folate, B-12
Erythropoietin made by kidneys in response to ______.
hypoxia
RBC production also stimulated by: (3)
Thyroxin
Testosterone
Growth Hormone
Lifespan is of erythrocyte is______days. That is why diabetic A1C is measured every 3 months.
90-120.
Shape of erythrocyte allows it to ______on top of one another. The pliability allows it to pass through______beds.
stack; capillary
RBC functionality and lifespan depends on 3 things:
shape
viscosity
pliability
Where do retired RBCs go?
Spleen! And Liver!
Extravascular Hemolysis
RBC destruction in spleen and liver. Normal phenomenon.
Intravascular Hemolysis
RBC destruction in the blood vessels. Not normal! Pathologic. RBCs are lysing in blood vessels.
Hgb catabolism results in _____returned to bone marrow to make more RBCs. And the protopophyrin ring is broken into ______in liver and excreted.
Fe, Bilirubin
Hematocrit measures:
% of RBCs in whole blood volume
Hgb measures:
Measurement of main transport molecule of RBCs
Hct should be ______times higher than Hgb.
3
MCV
MEAN CELL VOLUME
-average volume of an RBC
Small RBC = low MCV; microcidic anemia
Large RBC = high MCV; macrocidic anemia
Normal = 80-100
RDW
red blood cell distribution
- indicator of the degree of variation in the size of RBCs
- Small RDW (more uniform)
- Large RDW (more variation)
MCH and MCHC
Mean Corpuscular Hgb
Mean Corpuscular Hgb conc.
Both test concentration of Hgb in RBCs
Elevated Hematocrit
Polycythemia (too many RBCs in blood)
Depressed Hematocrit
Anemia
With anemia think: (5)
Problem with Production? Bone marrow defect? Defective production? Decreased RBC lifespan? Blood loss?
WBC are major cells of ______ response.
Immune
Neutrophils stain______. They attack _____. First to respond to site of _______. Attack _____cells. Elevated from ________, surgical stress, _______, and corticosteroids.
neutral, bacteria, injury, marked, infection, trauma
Eosinophils stain ______. Attack objects covered in ______. Attack all sorts…including ________. Elevated in_________.
Red, antibodies, flukes and parasites, allergies
Basophils stain_______. Eat up damaged ______. Release granules that contain _______and______. Play a role in ______ and anaphylaxis.
Blue, tissue, histamine and heparin, allergies
Monocytes become_______, and eat up ______.
Macrophages, foreign material.
Lymphocytes are elevated in _______infections. Can be suppressed by _______.
Viral, steroids.
T-Cells are _____mediated immunity. Stimulated by recognition of _____on cell membranes. Use______ on cell membrane to distinguish b/t self and non-self.
cell, antigen, Major Histocompatibility Complex
Killer T-Cells attack______cells in body. They can kill_____,_____,_____ infected cells.
infected, virus-bacteria-cancer infected cells
Drugs used to target T-Cell supression can lead to_____, or development of _______.
increase risk of infection, development of cancer.
B-lymphocytes when stimulated lead to ______B-Cells, and ______B-cells.
memory, activated
IgG (3)
- Most abundant
- Crosses placenta
- Presence indicates past infection
IgM (2)
- First antibody produced = acute infection
2. Tends to remain in blood stream
IgA (2)
- Guards mucosal membranes
2. Secreted in breast milk
IgE (2)
- Anaphylaxis
2. Attaches to Basophils and Mast Cells
Complement (2)
Free circulating proteins
Poke holes in cells causing them to lyse
Platelets are _______. They are stored in the _______. And their lifespan is _______.
Flat, spleen, short.
Platelets have ________on their surface that allows them to ________. _________ made in liver. Liver disease usually leads to low_____
Glycoproteins, adhere, platelet count.
Platelet Count:
> 800K can be associated with increased risk of clotting (STROKES)
50K no problem
30-50K increased risk of bleeding
10-30K severely increased risk of bleeding.
<10K severe risk, transfuse 1 unit platelets
A patients coaguable state is determined via a balance of _______count. The extent of ______damage. Availability of ________factors.
platelet, tissue, clotting
