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Haematology > Physiology > Flashcards

Physiology Flashcards

1
Q

What is blood?

A

Cells suspended in plasma

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2
Q

What is the purpose of blood?

A

Fight infection
Transport Oxygen
Prevent bleeding

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3
Q

Define haematopoiesis

A

Production of blood from pluripotent stem cells in bone marrow

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4
Q

In an embryo where does haematopoiesis occur?

A

Yolk sac
Liver
Marrow

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5
Q

In a baby/young child where does haematopoiesis occur?

A

Bone marrow

Spleen and liver

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6
Q

As we mature what happens to the bone marrow?

A

The sites remain in the axial skeleton as the bones grow it decreases in size

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7
Q

Describe the first three steps of the haematopoeisis tree

A
  1. LT HSC
  2. ST HSC
  3. Multilineage progenitor
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8
Q

What two precursors can the multilineage progenitor become?

A

Myeloid

Lymphoid

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9
Q

Describe the fate of the myeloid precursor

A

Megakaryocyte erythrocyte precursor
- erythrocyte or platelet
Granulocyte monocyte precursor
- granulocyte or macrophage

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10
Q

What is the fate of the lymphoid precursor?

A

B cell
T cell
NK cells

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11
Q

What is the key difference between the precursors and mature cells?

A

Precursors - morphologically unremarkable and infrequent

Mature - specific characteristics and frequent

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12
Q

What happens to the cell morphology as the cell divides?

A

It gets smaller, the nucleus condenses and eventually is removed

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13
Q

Describe the characteristics of platelets

A

Lots of nuclei in one big cell, bud off to form platelets

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14
Q

Name the three types of granulocyte

A

Eosinophil
Basophil
Neutrophil

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15
Q

Describe neutrophils

A

Segmented nucleus with neutral staining granules
Phagocytose invaders and kill with granule contents
Attract other cells - complement and chemokine causing body stress

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16
Q

What situations cause an increase in neutrophils?

A

Infection
Infarction
Trauma

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17
Q

Describe eosinophils

A

Bi lobed with red staining granules

Fight parasitic infections and involved in hypersensitivity

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18
Q

What type of patients often have high eosinophils?

A

Patients with allergies

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19
Q

Describe basophils

A

Infrequent, purple granules with obscuring nucleus

IgE receptors and histamine - involved in hypersensitivity

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20
Q

What are monocytes?

A

Single nucleated cells often with vacuoles

Circulate for a week and then enter tissues to become macrophages which phagocytose and attract other cells

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21
Q

What type of immune molecule are macrophage?

A

MHC class II

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22
Q

Name two methods of assessing blood constituents

A

Immunophenotyping
Bio-assays
Examination

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23
Q

What is immunophenotyping?

A

Surface proteins, monoclonal antibodies with tags

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24
Q

What is bio-assay?

A

Culture in vitro and show lineage of progeny in different growth conditions

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25
Q

What can be examined to determine blood constituents?

A

Blood
Bone marrow
Special tests of bone marrow
Spleen, liver, lymph nodes

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26
Q

Name two methods to obtain bone marrow sample

A

Posterior iliac crest aspiration

Core biopsy

27
Q

What is the difference between the two bone marrow sampling techniques?

A

Aspiration - see individual cells

Biopsy - can see cells in context and structure of marrow

28
Q

Describe the structure and function of RBC

A

Biconcave, full of Hb
No nucleus or mitochondria with a high SA to volume ratio
Flexible

29
Q

What does the high SA to volume ratio allow?

A

Gas exchange

30
Q

What aspects of the RBC membrane help with its function?

A

Lipid bilayer
Protein spars
Protein anchor
Sodium potassium pump

31
Q

Describe the structure of haemoglobin

A

Tetrameric globular protein with 2 alpha and 2 beta

Heme Fe2+ in a flat porphyrin ring - one heme per subgroup binds to one oxygen

32
Q

What is the function of haemoglobin?

A

Delivers oxygen
Buffers hydrogen ions
Carbon dioxide transport

33
Q

What is the name for the cellular mechanisms that generate RBC?

A

Erythron

34
Q

What are the raw materials of RBC?

A

Iron B12 folate

35
Q

What is the immediate cell before a RBC?

A

Reticulocyte

36
Q

What is the key difference between a RBC and reticulocyte?

A

There is some RNA in reticulocyte and so it acts as a marker of bone marrow function

37
Q

Name the hormone that senses hypoxia in the kidneys

A

Erythropoietin

38
Q

What is the effect of erythropoietin on bone marrow function?

A

Stimulates the erythron to increase red cell production

39
Q

State the average life span of an RBC

A

120 days

40
Q

How are red cells removed from the body?

A

Taken up by macrophage in the spleen and broken down into heme and globin

41
Q

What happens to the heme?

A

Iron can be stored as ferritin or related to transferrin for future use

42
Q

What happens to the globin?

A

recirculated

43
Q

What happens to the porphyrin ring?

A

Unconjugated bilirubin taken up in the liver and excreted in bile

44
Q

How do RBC produce energy?

A

Glycolysis

45
Q

What are the problems with glycolysis?

A

Low energy yield

Lots of free radicals produced

46
Q

State the net generation from glycolysis

A

ATP - energy

NADH - electron donor to stop oxidation

47
Q

What are reactive oxygen species?

A

Hydrogen peroxide/superoxide have unpaired free electrons that interact with DNA and proteins

48
Q

How are reactive oxygen species dealt with?

A

Glutathione reacts with hydrogen peroxide to form water and an oxidised glutathione

49
Q

How is oxidised glutathione converted back to glutathione?

A

NADPH

50
Q

What enzyme is needed to produce NADPH?

A

Glucose 6 phosphate dehydrogenase

51
Q

Name the shunt where NADPH is produced?

A

Hexose Monophosphate

52
Q

Name three ways carbon dioxide can be removed from the body

A

Dissolves
Binds to haemoglobin
Bicarbonate

53
Q

What ion is exchanged for bicarbonate in the red blood cell?

A

Chloride

54
Q

How is fetal haemoglobin different to adult?

A

Higher affinity - saturates more at the same oxygen concentration

55
Q

What shape is the oxygen/saturation curve?

A

Sigmoidal

56
Q

Describe the allosteric effect

A

As one oxygen binds to haem the Hb changes shape - this interacts with the adjacent globin and changes its shape and thus affinity

57
Q

Other than oxygen what else can alter the shape/position of haemoglobin?

A

Small molecules e.g 2,3 BPG

58
Q

Describe 2,3, BPG

A

Produced in glycolysis it interacts with Hb and shifts the curve to the right to allow higher release of oxygen into tissues

59
Q

What shifts the curve to the right?

A

Decreased pH, increased temp, increased CO2 (Bohr)

60
Q

What shifts the curve to the left?

A

Increased pH, reduced temp, increased oxygen (haldane)

61
Q

What would cause a reduced cell count?

A

Increased distribution e.g haemorrhage
Reduced production e.g iron deficiency
Redistribution e.g liver disease

62
Q

What would cause an increased cell count?

A

Stimulus e.g altitudes, hypoxia, allergy
Malignancy
Redistribution e.g splenic, trauma, steroids

63
Q

How do steroids cause an increased cell count?

A

Demargination - they move neutrophils away from the vessel wall

Haematology (18 decks)

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