L24 - peripheral blood Flashcards
functions of blood?
transport, hemostasis, immunity, regulation of temp/pH/osmolality
pH of arterial blood vs. venous blood?
7.4 arterial, 7.35 venous
describe blood after centrifugation
3 layers
heaviest = RBCs
middle buffy coat = WBCs/platelets
lightest = plasma (has many fibrinogen)
what is blood serum?
plasma minus fibrinogen
hematocrit percentages?
female - 40%
male - 45%
newborn - 55% then 35% until puberty
describe plasma color changes
yellow - bilirubin, fasting
white - chylomicrons, fatty diet
describe blood plasma and its components
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
function of albumin
regulates colloid osmotic pressure low albumin (liver failure) = edema
name three alpha and three beta globulins
alpha = ceruloplasmin, AAT, protein C beta = transferrin, angiostatins, plasminogen
describe erythrocyte #s inclusions diameter shape transmembrane proteins
- 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
describe polcythemia and anemia
polycythemia - elevated erthrocytes
anemia - low packed volume of erythrocytes or reduced hemoglobin concentration
describe 2 major transmembrane protein complexes of erythrocytes
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:
what facilitates spectrin-actin association?
adducin, a calmodulin-binding protein
heredity spherocytosis
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
hereditary elliptocytosis
mutation involving glycoprotein complex, including spectrin, protein 4.1 or glycophorin C
leads elliptical RBC
erythroblastosis fetalis
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
name other RBC antigens
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)
Howell-Jolly bodies
- small basophilic nuclear fragments in RBC cytoplasm
- pitted out by spleen macrophages
- prevalent with hemolytic anemia, spleen disorders, post-splenectomy
Heinz bodies and G6PD deficiency
- damaged Hg inclusions due to oxidative damage from G6PD deficiency
- spleen macrophages remove Heinz bodies, forming bite cells
Reticulocytes
- 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.
tell me about leukocytes
#s
name granulocytes vs. agran.
all have what granules?
- 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)
tell me about neutrophils
- nuclei
- size
- job
- granules
- disease state
- 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
what’s a shift to the left?
increase in band cells aka neutrophil precursors, indicating acute bacterial infection
Dohle body
- basophilic
- dilated rER
- infections, bacterial sepsis
- left shift
tell me about eosinophils
- nucleus
- job
- granules
- 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
tell me about basophils
- nucleus
- granules
- 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
tell me about the two agranulocytes
- size
- nuclei
- elevation
- granules
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
tell me about thrombocytes
- 4 zones
- function
- size
- 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
anisocyosis
different sizes of RBCs
clinical teaser: \+ Romberg smooth tongue paresthesias, wt loss, jaundice anemia
what’s going on and what will labs show?
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
