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HEMA 256 > Module 1: Normal Blood Component, Production and Erythrocytes > Flashcards

Module 1: Normal Blood Component, Production and Erythrocytes Flashcards

1
Q

Interleukin-1

A

Produced by monocytes and macrophages

Activate and stimulate cytokine production by T lymphocytes and bone marrow stromal cells

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2
Q

Interleukin-3

A

Produced by T lymphocytes

Induce differentiation and mitosis of the CFU-S into either the CFU-GEMM or CFU-L

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3
Q

Interleukin-5

A

Produced by T lymphocytes

Induces eosinophil growth and function

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4
Q

Granulocyte/Monocyte Stimulating Factor

A

Produced by bone marrow stromal cells
Induces differentiation and mitosis of the CFU-GEMM into CFU-Eo, CFU-GM, CFU-baso, BFU-E, and BFU-meg
Stimulates phagocytic and cytotoxic functions of neutrophils and macrophages

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5
Q

Erythropoietin (EPO)

A

Produced by kidney cells in response to low O2
Induces maturation and mitosis in the erythroid line of cells
EPO over long time periods induces increased production of other myeloid cells

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6
Q

Thrombopoietin (TPO)

A

Produced by liver cells

Induces maturation and mitosis in the megakaryoblasts

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7
Q

Myeloid cells

A

Normally produced exclusively in bone marrow

All cells except lymphocytes (erythrocytes, platelets, neutrophils, eosinophils, basophils, monocytes)

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8
Q

Non-myeloid cells

A

Mature outside the bone marrow

Lymphocytes

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9
Q

Granulocytes

A

Neutrophils, eosinophils, basophils

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10
Q

Agranulocytes

A

Monocytes, lymphocytes (T cells, B cells)

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11
Q

Medullary hematopoiesis

A

Normal production of myeloid cells in bone marrow

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12
Q

Extra-medullary hematopoiesis

A

Production of myeloid cells outside the marrow
Abnormal in adults
Back up system
Liver and spleen become enlarged

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13
Q

Mesoblastic phase

A

2-12 weeks gestation
Primitive blood cells formed in yolk sac
By end of 4th week: blood vessels and heart grow, heart pumps blood

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14
Q

Hepatic phase

A 
6 weeks gestation - 2 weeks postpartum
Liver and spleen
RBCs, then granulocytes, then monocytes
Start of lymphocytes in lymph nodes
8th week - start of bone marrow formation
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15
Q

Myeloid phase

A

20 weeks gestation - death
Lymphocytes in lymph nodes
All other cells in bone marrow
Liver and spleen retain potential for hematopoiesis, inactive

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16
Q

Location of red bone marrow in adults

A

Iliac crests of pelvis
Sternum
Proximal ends of long bones
Spinous processes of vertebrae

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17
Q

Red bone marrow

A

Active - much hematopoiesis

Fat cells ~= developing blood cells

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18
Q

Yellow bone marrow

A

Inactive - little hematopoiesis

Few blood cells, lots of fat

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19
Q

Liver functions in adults

A

Extra-medullary hematopoiesis
Protein synthesis and transport
Vitamin and mineral storage for DNA/RNA synthesis
Hemoglobin breakdown

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20
Q

Spleen

A

Largest lymphoid organ
Cell production in hepatic phase + extra-medullary hematopoiesis
Removal of old/damaged RBCs (discriminating filter)
Platelet storage

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21
Q

Findings in post-splenectomy stained blood

A

^ platelet count
^ damaged cells (poikilocytosis)
^ denatured Hb inside RBCs (bite cells, Heinz bodies)
^ retained nuclear material in young cells (Howell-Jolly bodies)

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22
Q

Thymus

A

T-lymphocyte production and maturation

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23
Q

Lymph nodes

A

Formation of new lymphocytes

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24
Q

Reticulum cell

A

Most immature

Mesenchymal stem cell

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25
Q

CFU-S

A

Colony forming unit - stem

Pluripotential blood stem cell

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26
Q

CFU-L

A

Colony forming unit - lymphoid

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27
Q

CFU-GEMM

A

Colony forming unit - granulocyte, erythroid, monocyte, megakaryocyte
Also called myeloid stem cell

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28
Q

Blast cells

A

Earliest stages of blood cells recognizable as precursor to a particular cell line
Undergo periodic mitosis
Indicate serious disorder if found in blood

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29
Q

Growth factors

A

Proteins that bind to specific receptors

Activate proliferation and/or maturation

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30
Q

Cytokines

A

Multi-function chemical mediators

Locally secreted

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31
Q

Lymphokine

A

Cytokine produced by lymphocytes

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32
Q

Monokine

A

Cytokine produced by monocytes and macrophages

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33
Q

Colony stimulating factor (CSF) and interleukins (IL)

A

Secreted by macrophages, lymphocytes, bone, marrow stromal cells

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34
Q

Effective hematopoiesis

A

85% or more of developing blood cells successfully produced and released into blood

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35
Q

4 ways bone marrow increases cell production

A

Releasing immature forms
Increasing number of mitoses
Decreasing maturation time between mitoses from 8 to 5 days
Expanding to extramedullary

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36
Q

Blood cell size increases/decreases with maturation

A

Decreases

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37
Q

Nucleoli in mature cells

A

Not present

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38
Q

Colour change during cellular maturation

A

Progresses from darker blue to lighter blue, blue-gray or pink

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39
Q

Granulation changes during maturation

A

Progresses from no granules to nonspecific to specific granules

40
Q

Changes in vacuoles during maturation

A

Increase

41
Q

Nuclear/cytoplasmic (N/C) asynchrony or dyspoiesis

A

Development out of sync

Suggests metabolic disorder in developing cells

42
Q

Order of cells in erythrocyte series

A 
Pronormoblast
Basophilic normoblast
Polychromatic normoblast
Orthochromatic normoblast
Polychromatophilic 
Erythrocyte
43
Q

Pronormoblast - size, nucleus, cytoplasm

A 
Also called rubriblast - 1st stage
14-24 um
Nucleus: reddish-purple unclumped chromatin 0-2 nucleoli
N/C ratio: 8:1-6:1
Cytoplasm: Small, deep blue, no granules
44
Q

Basophilic normoblast - size, nucleus, cytoplasm

A

Also called prorubricyte - 2nd stage
12-17 um
Nucleus: parachromatin, nucleoli not visible
N/C ratio: 6:1-4:1
Cytoplasm: Small, deep blue or purplish, no granules

45
Q

Polychromatic normoblast - size, nucleus, cytoplasm

A

Also called rubricyte - 3rd stage
10-15 um
Nucleus: Deep purple/black, heavily condensed chromatin, parachromatin
N/C ratio: 4:1-2:1
Cytoplasm: Decreased in size but increased relative to nucleus, polychromatic, no granules

46
Q

Orthochromatic normoblast - size, nucleus, cytoplasm

A

Also called metarubricyte - 4th stage
8-12 um
Nucleus: Pyknotic, dense, homogenous, black-brown, not chromatin structure
N/C ratio: 2:1-1:1
Cytoplasm: Moderate amount, bluish-pink, no granules

47
Q

Polychromatophilic - size, nucleus, cytoplasm

A

Also called reticulocyte - 5th stage
7-10 um
Nucleus: Extruded, some remnants
Cytoplasm: Clear gray-blue, polychromatic to pink

48
Q

Erythrocyte - size, nucleus, cytoplasm

A

6th stage
7-8 um
No nucleus
Cytoplasm: pink

49
Q

Hemoglobin production

A

65% in developing normoblasts (first 4 stages)
35% in reticulocyte
Dependent of adequate supply of iron

50
Q

Globin

A

Spherical protein with 4 polypeptide chains

51
Q

Heme

A

Non-protein protoprophyrin ring compounds with an iron atom

One one each polypeptide chain

52
Q

Types of polypeptide chains

A

Alpha (α), beta (β), gamma (γ), delta (δ), epsilon (ε), zeta (ζ)

53
Q

Hemoglobin assembly

A

4 heme/Hb
2 bonds/heme - 1 permanent, 1 reversible - can bind water or O2
All Hb molecules contain 4 identical hemes

54
Q

Embryonic hemoglobins

A 
Hb Gower1 - ε4 or ζ2ε2
Hb Gower2 - α2ε2
Hb Portland - ζ2γ2
First 12 weeks of gestation
No beta chains
Do not participate in oxygen delivery
55
Q

Fetal hemoglobin

A

HbF - α2γ2
At birth, > 75% of total Hb
In adults,

56
Q

HbA2

A

α2δ2

Adult hemoglobin, minor component

57
Q

HbA

A

α2β2
Adult hemoglobin, major component
96-98% of total Hb
Best for carrying and delivering O2

58
Q

Reduced Hb

A

HbA with iron atoms in ferrous state (Fe2+)

Reduced state required for binding O2

59
Q

Oxyhemoglobin (HbO2)

A

Reduced HbA carrying O2 on some or all of iron atoms

60
Q

Deoxyhemoglobin (Hb)

A

Reduced HbA that is not carrying O2

61
Q

Methemoglobin (MetHb) or oxidized hemoglobin

A

HbA with iron atoms in ferric state (Fe3+)

Cannot bind O2

62
Q

Methemoglobin (MetHb) and Methemoglobinemia is formed in excess in red cells when

A

Normal reducing systems are overwhelmed by excessive oxidation or,
Reducing systems fail, or are inhibited and can’t keep up with normal amounts of oxidation

63
Q

Carboxyhemoglobin (HbCO)

A

Combination of HbA with carbon monoxide instead of oxygen
Maraschino cherry red cyanosis develops in the skin
CO binds heme ~200x tighter than O2

64
Q

Sulfhemoglobin

A

Also called Verdoglobin
sulfHb NOT HbS
Formed from the reaction of HbA with soluble inorganic sulphides and H2O2
Irreversible (covalent) bond prevents O2 binding

65
Q

NADH

A

Reduced nicotinamide adenine dinucleotide

66
Q

NADPH

A

Reduced nicotinamide adenine dinucleotide phosphate

67
Q

What is hematopoiesis?

A

Production and development of blood cells

68
Q

What makes up to hematopoietic system?

A

Bone marrow, liver, spleen, thymus, and lymphoid tissue

69
Q

Which cell has the potential to become any type of blood cell?

A

CFU-S: Colony forming unit-stem

70
Q

What is the Nuclear/Cytoplasmic Ratio and what normally occurs to it in developing cells?

A

Ratio of volume of of the nucleus to the volume of the cytoplasm
N/C ratio decreases

71
Q

What is chromatin and how does it change in the developing cell?

A

Genetic material made up of DNA and protein

Becomes increasingly clumped, coarse, and darker staining

72
Q

What is the other name for a Polychromatic normoblast?

A

Rubricyte

73
Q

What is the other name for a Pronormoblast?

A

Rubriblast

74
Q

What is the other name for a Basophilic normoblast?

A

Prorubricyte

75
Q

What is the other name for a Orthochromatic normoblast?

A

Metarubricyte

76
Q

What is the other name for a Polychromatophilic cell?

A

Reticulocyte

77
Q

Which cells in the erythrocyte series do not contain a nucleus?

A

Polychromatophilic (reticulocyte)

Mature erythrocyte

78
Q

Which erythrocyte cell has a nucleus that is described as being pyknotic?

A

Orthchromatic normoblast (metarubricyte)

79
Q

Where does heme synthesis begin?

A

In the mitochondria

80
Q

What is the most critical ingredient in the formation of heme?

A

Iron

81
Q

To bind oxygen the iron atom must be in which state?

A

Reduced Fe2+ (Ferrous)

82
Q

What hemoglobin types are found in the adult?

A

HbF
HbA
HbA2

83
Q

What is different in the different types of hemoglobin?

A

The polypeptide chains that make up the globin

84
Q

What is the polypeptide formula for HbF?

A

α2γ2

Alpha 2 gamma 2

85
Q

What metabolic pathway produces ATP in the red cell?

A

Embden-Meyerhof pathway

86
Q

Which pathway produces NADPH and what is it used for?

A 
Pentose shunt (hexose monophosphate pathway)
Reduces glutathione, which protects the cell from oxidative injury
87
Q

What are the 3 functions of erythrocytes?

A

Oxygen transport
Carbon dioxide transport/buffering of hydrogen ions
Nitric oxide transport

88
Q

How does increasing temperature affect oxygen affinity?

A

Decreases oxygen affinity causing the release of oxygen

89
Q

Which factor effects the oxygen affinity of hemoglobin directly (not inversely)?

A

The Bohr Effect

pH is the most important factor to ensure adequate delivery of oxygen to the tissues

90
Q

What is the name of the molecule when hemoglobin binds CO2?

A

Carbaminohemoglobin

91
Q

In intravascular hemolysis, where are the red cells hemolyzed?

A

In the blood vessels

92
Q

In extravascular hemolysis, what cells hemolyze red cells?

A

Hepatic and splenic macrophages

93
Q

What substance binds free hemoglobin in the plasma during normal intravascular hemolysis?

A

Haptoglobin

94
Q

During extravascular hemolysis what is protoporphyrin oxidized into?

A

Biliverdin

95
Q

What are the functions of the spleen?

A

Discriminating filter for red cells
Reservoir for storage of platelets
Extramedullary hematopoiesis

96
Q

Products of the Embden-Meyerhof Pathway

A

2 ATP

2 NADH

97
Q

Products of the Pentose Shunt Pathway

A

1 NADPH

HEMA 256 (5 decks)

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