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SMP - MCP Exam 2 > Lecture 24: Hematology > Flashcards

Lecture 24: Hematology Flashcards

1
Q

What kind of tissue is blood?

A

Connective

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2
Q

How do we determine the components of blood?

A

First centrifugation, then add anticoagulant, you obtain 3 layers: plasma on top, leukocytes (with platelets top layer) in buffy thin layer, and erythrocytes on bottom

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3
Q

What is the role of the anticoagulant after centrifugation of blood?

A

W/o anticoagulant: clot (bottom) and serum (top)

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4
Q

What makes up the 3 formed elements of blood?

A

RBCs, WBCs, and platelets

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5
Q

What is another name for WBCs?

A

Leukocytes

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6
Q

What does plasma consist of? Provide %s

A

Water (90%) and solute (10%)

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7
Q

What are the 2 types of WBCs?

A

Agranulocytes and granulocytes

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8
Q

What is the differential count?

A

The % of different types of leukocytes in blood

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9
Q

What was used to determine the differential count prior to hospitals having automated hematology blood analysis?

A

Romanovsky-type stain

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10
Q

What is the hematocrit? What is the normal range?

A

The packed cell volume of blood: 40-45% is the normal range

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11
Q

What are the 3 types of solutes in plasma? What does each include?

A
  1. Proteins 2. Small organics: lipids, carbs (mainly glucose), AAs, wastes (urea, creatinine, bilirubin) 3. Inorganics: mainly electrolytes
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12
Q

What are the 3 plasma protein types? Include %s.

A
  1. Albumin (60%) 2. Globulins (35%) 3. Fibrinogen (4%)
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13
Q

What is the role of albumin?

A

Contributes to osmotic pressure and binds loosely to other molecules

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14
Q

What are the 2 types of globulins?

A
  1. Immunoglobulins 2. Transport globulins
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15
Q

What is another name for immunoglobulins?

A

Antibodies

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16
Q

What is the role of fibrinogen?

A

To facilitate the formation of blood clots

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17
Q

What is another name for RBCs?

A

Erythrocytes

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18
Q

Do RBCs have a nucleus? What does this mean for their lifespan?

A

Not in humans Short lifespan of 120 days

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19
Q

What is the shape of RBCs? What does this allow?

A

Drumstick: allows them to squeeze through capillaries

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20
Q

Where are RBCs produced?

A

Bone marrow

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21
Q

How long does it take to produce RBCs?

A

7-8 days

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22
Q

Can RBCs repair their DNA or proteins? Why/Why not?

A

NOPE because they do not have a nucleus

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23
Q

How are RBCs removed from the body?

A

Hemolysis

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24
Q

Where does hemolysis occur? 4 spots

A
  1. Mainly in ECF of spleen 2. Liver 3. Bone marrow 4. Intravascular compartment (by macrophages): 10% of hemolysis
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25
Q

What are the 3 components of the RBCs’ membrane?

A
  1. Glycophorin 2. Anion transporter channel (band 3) 3. Ankyrin
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26
Q

Describe glycophorin.

A

RBC transmembrane protein on outer surface

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27
Q

What is the role of the anion transporter channel (band 3)?

A

RBC membrane channel that allows bicarbonate to cross the membrane in exchange for Cl- allowing the release of CO2 in the lungs

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28
Q

What is the role of ankyrin?

A

RBC membrane protein that anchors band 3 (at the spectrin dimer) to the subcellular cytoskeleton within the cytoplasm

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29
Q

What are the 3 sugar moeities for the ABO blood groups?

A
  • A: N-acetylgalatosamine (GalNac) glycosidically bonded to O antigen (at galactose)
  • B: α-D-galactose glycosidically bonded to O antigen (at galactose)
  • O: Lipid-Glucose-Galactose-N-acetylglucosamine-Galactose-Fusoce (LGGNGF)
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30
Q

What is anemia? What is it caused by (4 causes)?

A

Low hemoglobin concentration in circulatory system Causes: 1. Hemorrhage 2. Insufficient RBC production (kidney damage = lower EPO) 3. RBCs with insufficient Hb (Iron deficiency) 4. Accelerated RBC destruction

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31
Q

What hormone stimulates the production of RBCs? Where is it produced?

A

Erythropoietin (epo) produced by kidneys

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32
Q

In what type of people do we see low levels of RBCs? Why?

A

Old people because their diseased kidneys cannot secrete epo

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33
Q

What disease causes accelerated RBC destruction?

A

SCD

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34
Q

In what type of people is iron deficiency common? Treatment?

A

Pregnant women because the fetus is using all of the iron

Treatment: iron supplement

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35
Q

What are the 3 types of granulocytes?

A
  1. Neutrophils 2. Eosinophils 3. Basophils
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36
Q

What is another name for neutrophils?

A

Polymorphonuclear leukocytes

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37
Q

What is the differential count of neutrophils?

A

60-70%

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38
Q

How can one identify neutrophils?

A

They have a lobulated nucleus when they are first formed and as they age there are more lobulations

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39
Q

How many neutrophil lobulations mean they are at the end of their lifespan?

A

5-6

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40
Q

What are the 2 types of neutrophil granules?

A
  1. Non-specific granules = AZUROPHILIC 2. Specific granules
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41
Q

Describe the non-specific granules of neutrophils. What do they contain?

A

Primary lysosomes that contain myeloperoxidase and acid hydrolases

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42
Q

What color do non-specific neutrophil granules stain?

A

Purple

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43
Q

What does it mean for a cellular object to be azurophilic?

A

Readily stainable with a Romanowsky stain

44
Q

Describe the specific granules of neutrophils. What do they contain?

A

Contain proteases and lysosymes

45
Q

What color do specific neutrophil granules stain?

46
Q

Are neutrophilic specific granules visible under a microscope?

A

Yes, but at the resolution limit

47
Q

What is a Barr body?

A

Distinguishing feature of neutrophils which is an injected piece of nucleus: inactive X chromosome

48
Q

What does the presence of a Barr body on a neutrophil indicate?

A

The sample is from a female

49
Q

What is the main function of neutrophils?

A

Phagocytose and kill bacteria

50
Q

What is diapedesis?

A

The way neutrophils and eosinophils exit the vasculature by squeezing through spaces between endothelial cells

51
Q

What is chemotaxis?

A

The way neutrophils and eosinophils can migrate in response to chemotactic factors to the site of infection

52
Q

What are the 2 mechanisms neutrophils use to kill bacteria? Describe each.

A
  1. Oxygen-dependent: O2 is converted to superoxide radicals who are converted to hydrogen peroxide, which can be converted to hypochlorous acid (bleach) in the presence of myeloperoxidase (MPO) ⇒ BASICALLY BLEACHING BACTERIA
  2. Oxygen-independent: lysosomal degradation
53
Q

What can the production of superoxide radicals by neutrophils and macrophages (inflammatory cells) cause? How?

A

Cancer through inflammation: they leak out of the cell and damage cells in the infected area, when cells repair there may be a mismatch repair leading to genetic mutation and if enough of them, cancer

54
Q

What is another name for superoxide radicals?

A

Reactive oxygen species

55
Q

What can reduce the presence of ROS and therefore cancer?

A

Anti-oxidants and NSAIDS (this is used as a chronic treatment for risk of colorectal cancer)

56
Q

What is the differential count of eosinophils?

57
Q

How can one identify eosinophils?

A

Prominent colored STRIPED granules in nucleus and not as lobulated as neutrophils

58
Q

What is the internum? What is it composed of (3 elements)?

A

The stripe of the eosinophil granule Composed of: 1. Major basic protein that attacks parasites 2. Eosinophil cationic protein 3. Neurotoxin

59
Q

What is the externum? What does it contain?

A

The part of the eosinophil granule that surrounds the internum and contains peroxidase and hydrolytic enzymes

60
Q

What is the major function of eosinophils?

A

To attack parasites and limit inflammation

61
Q

How do eosinophils downregulate inflammations?

A

By inactivating leukotrienes and histamine

62
Q

What is the role of leukotrienes?

A

They stimulate smooth muscle contraction in the lungs

63
Q

How does chemotaxis happen for eosinophils?

A

They are recruited by eosinophil chemotactic factor secreted by basophils

64
Q

What is the differential count of basophils?

65
Q

How can one identify basophils?

A

They have a lobulated nucleus but lobules are hard to see because of darkly stained basophilic granules

66
Q

What do the granules of basophils contain? 4 elements.

A
  1. Heparin (anticoagulant) 2. Proteases 3. Histamine 4. Eosinophil chemotactic factor
67
Q

What do histamines cause? What can this result in?

A

Vascular permeability which can result in localized edema making it easier for molecules to make it to the site of infection

68
Q

What is the role of basophils? Explain how this works.

A

Major role in inflammation: they have IgE molecules on their surface that acts as a receptor and binds antigens/allergens (2 IgE for 1 antigen) which leads to a transduction cascade with calcium mobilization to release basophilic factors that facilitate the inflammatory response (usually after exposure to allergen):

  • Granule mediators
  • Lipid mediators
  • Cytokines
69
Q

What are the 3 types of agranulocytes?

A
  1. Lymphocytes 2. Monocytes 3. Mastocytes
70
Q

What is the differential count of lymphocytes?

71
Q

How can one identify lymphocytes?

A

Nucleus fills almost the entire cytoplasm and is round or oval and no granules

72
Q

What is the function of lymphocytes?

A

They mediate both humoral and cellular immunity (B and T cells)

73
Q

How will the number of lymphocytes be affected by infection?

74
Q

How will the number of lymphocytes be affected by an autoimmune disease?

75
Q

What is the differential count of monocytes?

76
Q

How can one identify monocytes?

A

By process of elimination: no granules, nucleus not as big as lymphocytes, and has weird shapes for its nucleus

77
Q

What is the function of macrophages? How does this work?

A

Help stimulate the immune response as part of the antigen presenting cell family: phagocytose an antigen, break it down with lysosymes, and present on MHC-II complex on surface to helped T-cells which stimulate B cells to secrete antibodies

78
Q

What do the monocytes differentiate into once they are out of the vasculature?

A

Macrophages

79
Q

What cells have an MHC-II complex?

A

Antigen Presenting Cells (APCs)

80
Q

What cells have an MHC-I complex?

81
Q

What are platelets?

A

Cell fragments

82
Q

What are the 2 parts of a platelet? What does each consist of?

A
  1. Hyalomere: peripheral microtubules and microfilaments around the outside
  2. Granulomere: central portion with granules and lysosomes
83
Q

What are the 3 types of granules contained in the granulomere of a platelet? What does each secrete and for what?

A
  1. Alpha granules: secrete PDGF which promotes endothelial cell mitosis at vascular injury site 2. Delta granules = dense core granules: secrete serotonin to promote vasoconstriction 3. Lambda granules = lysosomes
84
Q

What happens when there is a vascular injury?

A
  1. Blood vessel constricts to reduce blood loss (thanks to serotonin) 2. Collagen fibers exposed and sticky 3. Platelets stick to fibers (subendothelial collagen) to form a plug 4. Clotting cascade where fibrinogen is converted to fibrin 5. Fibrin binds to platelets to form a definitive hemostatic plug
85
Q

What causes hemophilia A?

A

Genetic disease: absence of factor VIII (Von Willebran’s factor), a clotting cascade protein

86
Q

What does blood transport?

A
  1. O2 and nutrients 2. Wastes 3. Hormones 4. Heat 5. Cells
87
Q

What is it called when your hematocrit is too high?

A

Polycythermia

88
Q

What is it called when your hematocrit is too low?

89
Q

What color do eosinophils stain?

90
Q

What color do basophils stain?

91
Q

How to prepare a romanovsky type stain?

A

Put a drop on one slide and then pull a slide back on it and then in the other direction: causes the feathered edge (density is thicker at the base of it and end of it is one single layer)

92
Q

What does a lower differential count for any of the leukocytes indicate?

A

Possible leukemya

93
Q

What do transport globulins bind?

A
  • Small ions
  • Hormones
  • Others
94
Q

Do all organisms have RBCs without nuclei?

A

Nope, chichens do for example

95
Q

What does the integrity of an RBC during its lifespan depend on? 3 things

A
  1. Cell membrane
  2. Hb
  3. Metabolic enzymes
96
Q

What is SCD caused by?

A

Point mutation in Hb changing Glu to Val

97
Q

What are the different layers the O2 has to pass through from the lungs to the RBC? 7 of them

A
  1. Fluid and surfactant layer
  2. Alveolar epithelium
  3. Epithelial basement membrane
  4. Interstitial space
  5. Capillary basement membrane
  6. Capillary endothelium
  7. RBC plasma membrane
98
Q

Where are sickled RBCs hemolysed?

99
Q

Do all neutrophils have a Barr body? Always visible?

A

Yes in women, but sometimes hiding under lobulated nuclei

100
Q

What are 2 examples of parasites? What attacks it?

A

Helminthic worms or shistosome larva

Eosinophils

101
Q

Which element of the internum of eosinophils attacks parasites?

A

Major basic protein

102
Q

Other than basophils, what other cells secrete eosinophil chemotactic factors?

A

Mast cells

103
Q

What is hemostasis?

A

The stopping of a flow of blood.

104
Q

What system are monocytes part of?

A

The mononuclear phagocyte system

105
Q

What is the earliest stage at which specific granulocyte types can be distinguished from one another?

SMP - MCP Exam 2 (13 decks)

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