L24 - peripheral blood Flashcards

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1
Q

functions of blood?

A

transport, hemostasis, immunity, regulation of temp/pH/osmolality

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2
Q

pH of arterial blood vs. venous blood?

A

7.4 arterial, 7.35 venous

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3
Q

describe blood after centrifugation

A

3 layers
heaviest = RBCs
middle buffy coat = WBCs/platelets
lightest = plasma (has many fibrinogen)

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4
Q

what is blood serum?

A

plasma minus fibrinogen

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5
Q

hematocrit percentages?

A

female - 40%
male - 45%
newborn - 55% then 35% until puberty

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6
Q

describe plasma color changes

A

yellow - bilirubin, fasting

white - chylomicrons, fatty diet

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7
Q

describe blood plasma and its components

A

90% water

  • albumin from liver
  • clotting proteins - prothrombin, fibrinogen, accelerator globulin (factor VII)
  • complement proteins from liver for immunity/inflammation
  • lipoproteins
  • alpha and beta globulins from liver

plasma also has hormones, other signaling molecules, electrolytes, dissolved gases

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8
Q

function of albumin

A
regulates colloid osmotic pressure
low albumin (liver failure) = edema
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9
Q

name three alpha and three beta globulins

A
alpha = ceruloplasmin, AAT, protein C
beta = transferrin, angiostatins, plasminogen
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10
Q
describe erythrocyte
#s
inclusions
diameter
shape
transmembrane proteins
A
  • 7.5 micrometers diameter
  • biconcave disc for higher SA to V for gas exchange
  • hemoglobin, endogenous pigment
  • males have 5M vs. female 4M per mm3
  • glycophorins and band 3
  • Howell-Jolly bodies ad Heinz bodies
  • immature - reticulocyte
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11
Q

describe polcythemia and anemia

A

polycythemia - elevated erthrocytes

anemia - low packed volume of erythrocytes or reduced hemoglobin concentration

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12
Q

describe 2 major transmembrane protein complexes of erythrocytes

A

1) glycophorins (A, B, C)
- GP+ band 4.1 protein complexes with actin and spectrin (int. filament)

2) Band 3 - HCO3/Cl antiporter
- binds with band 4.2 complex, ankyrin and spectrin
- increases amt of CO2 in blood to lungs:

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13
Q

what facilitates spectrin-actin association?

A

adducin, a calmodulin-binding protein

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14
Q

heredity spherocytosis

A

mutations in ankyrin, band 3, spectrin or band 4.2 leading to disruption of tethering interactions

spherical shaped erythrocytes are then destroyed by the spleen –> anemia, jaundice, and splenomegaly

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15
Q

hereditary elliptocytosis

A

mutation involving glycoprotein complex, including spectrin, protein 4.1 or glycophorin C

leads elliptical RBC

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16
Q

erythroblastosis fetalis

A

Rh- mother builds antibodies against the Rh+ baby after first childbirth; antibodies attack subsequent pregnancies

RhoGAM contains antibodies against Rh antigen to eliminate Rh+ RBCs from fetus before mother develops antibodies

17
Q

name other RBC antigens

A

Kelly (kills) - 3rd most immunogenic after AB and Rh
Duffy (dies) - receptors for malaria parasites (plasmodium vivax and knowlesi)
- rare in African Am. so resistant to malarial infection
Lewis (lives)

18
Q

Howell-Jolly bodies

A
  • small basophilic nuclear fragments in RBC cytoplasm
  • pitted out by spleen macrophages
  • prevalent with hemolytic anemia, spleen disorders, post-splenectomy
19
Q

Heinz bodies and G6PD deficiency

A
  • damaged Hg inclusions due to oxidative damage from G6PD deficiency
  • spleen macrophages remove Heinz bodies, forming bite cells
20
Q

Reticulocytes

A
  • immediate precursor to erythrocyte
  • basophilic specs in cytoplasm = clusters of ribosomes
  • still some Hg synth
  • increased #s indicate demand for oxygen not being fully met (making new RBCs)
  • perhaps increased altitude, hemorrhage, etc.
21
Q

tell me about leukocytes
#s
name granulocytes vs. agran.
all have what granules?

A
  • 5k to 10k/mm3
  • granulocytes B/E/N - contain additional secondary granules
  • agranulocytes L/M - contain only primary granules
  • ALL have azurophilic primary granules (lysosomes)
22
Q

tell me about neutrophils

  • nuclei
  • size
  • job
  • granules
  • disease state
A
  • lobated nuclei (3-6, +more-age)
  • double RBC size
  • highest # leuks
  • high count indicates bacterial infection
  • job professional phagocytic
  • immature = band cell
  • have primary (azurophilic) granules - lysosomes
  • have secondary (specific) granules that are light pink and antimicrobial enzymes
  • have tertiary granules (gelatinase/cathepsin/GP)
  • have Dohle bodies
23
Q

what’s a shift to the left?

A

increase in band cells aka neutrophil precursors, indicating acute bacterial infection

24
Q

Dohle body

A
  • basophilic
  • dilated rER
  • infections, bacterial sepsis
  • left shift
25
Q

tell me about eosinophils

  • nucleus
  • job
  • granules
A
  • bilobed nucleus
  • specific granules: dark pink to red stain in LM
  • signature EM pattern is dark with white stripe in middle
  • elevation = allergic reaction, IBD, parasitic infection
26
Q

tell me about basophils

  • nucleus
  • granules
A
  • S-shaped nucleus, obscured by basophilic granules
  • lowest # leuks
  • specific granules are dark blue (histamine/heparin/eosinophilic and neutrophilic chemotaxic factor/peroxidase)
  • azurophilic granules (lysosomes)
  • same precursor cell as mast cell but very different mature cell
27
Q

tell me about the two agranulocytes

  • size
  • nuclei
  • elevation
  • granules
A

lymphocytes

  • same size as RBC
  • prominent nucleus fills most of cytoplasm
  • narrow rim of baso cyto + abundant ribos
  • 3 types: B, T and NK
  • high in viral infxns (no abx)
  • 25% leuks, extra high in children <8yo

monocytes

  • large cell, large kidney nucleus
  • blue-gray cytoplasm
  • differentiate into macrophages in tissues
28
Q

tell me about thrombocytes

  • 4 zones
  • function
  • size
A
  • aka platelets/thromboplastids
  • fractured megakaryocytes
  • tiny
  • four zones:
    + peripheral (plasmalemma and glycocalyx)
    + structural (microtubular array for shape plus actin/myosin for contraction)
    + membrane (open cannalicular system, dense tubular system)
    + organelles (mitochrondria, glycogen, peroxisomes, 3 granules - alpha/delta/lambda - lysosomes)
  • function = blood clotting and tissue repair
29
Q

anisocyosis

A

different sizes of RBCs

30
Q
clinical teaser:
\+ Romberg
smooth tongue
paresthesias, wt loss, jaundice
anemia

what’s going on and what will labs show?

A

low hematocrit, Hb, anisocytosis, oval macrocytes, hypersegmented neutrophils, low B12

need B12 for neuro and tongue health

atrophy of gastric mucosa, intestinal metaplasia, pseudopyloric metaplasia - autoimmune gastritis