Physiology of blood cells and haematological terminology

Question 1

What are the 2 main types of stem cell in the bone marrow?

Answer 1

1. Pluripotent haemopoietic

2. Pluripotent lymphoid-myeloid

Question 2

Recall the pathway of blood cell production from pluripotent haemotopoeitic stem cells

Answer 2

PHSC –> multipotent myeloid stem cell (MYELOBLAST) –> erythrocyte/ megakaryocyte/ granulocytes/ monocytes

Question 3

Recall the pathway of blood cell production from pluripotent lymphoid-myeloid stem cell

Answer 3

PLMSC –> lymphoid stem cell (LYMPHOBLAST) –> T/B/ NK cell

Question 4

What are the 2 pathways of stem cells following division?

Answer 4

1. Self-renew

2. Produce mature progeny

Question 5

Recall the location of erythropoietin production and the relative amounts produced in each location

Answer 5

90% - juxtatubular interstitial cells in kidney

10% - hepatocytes and liver interstitial cells

Question 6

How is erythropoietin destroyed?

Answer 6

Phagocytic spleen cells

Question 7

What 2 conditions can increase erythropoietin production?

Answer 7

Anaemia

Hypoxia

Question 8

What is the intravascular life span of neutrophils?

Answer 8

7-10 hours

Question 9

How are neutrophils attracted to sites of inflammation?

Answer 9

Chemotaxis (cytokines)

Question 10

What is the main role of eosinophils?

Answer 10

Protection against parasitic infection

Question 11

What is the main role of basophils?

Answer 11

Allergy

Question 12

What is the origin of monocytes?

Answer 12

Myeloblasts

Question 13

Recall the 2 functions of monocytes

Answer 13

1. Scavenger/ phagocytic function

2. Storage and release of iron

Question 14

What sort of cells do monocytes give rise to in the liver?

Answer 14

Kuppfer cells

Question 15

How long do platelets last in the circulation?

Answer 15

10 days

Question 16

What are the 3 main roles of platelets in primary haemostatis?

Answer 16

1. Contribution of phospholipid
2. Maintain integrity of endothelium
3. Plug formation

Question 17

Recall the life span of lymphocytes

Answer 17

Highly variable

Question 18

What is the immediate precursor of platelets?

Answer 18

megakaryocytes

Question 19

Define “anisocytosis”

Answer 19

Red cells showing more variation in SIZE than is normal

Question 20

Define “poiklocytosis”

Answer 20

Red cells showing more variation in SHAPE than is normal

Question 21

What is a “target cell”?

Answer 21

Red cell with an accumulation of Hb in the centre of the pale area

Question 22

Recall 4 causes of target cells in blood

Answer 22

1. Obstructive jaundice
2. Liver disease
3. Haemaglobinopathy
4. Hyposplenism

Question 23

What is a Howell-Jolly body and in what sort of cells do they appear?

Answer 23

Remnants of nucleus - target cell erythrocytes

Question 24

Give 2 causes of elliptocytic red cells

Answer 24

1. Hereditary elliptocytosis

2. Iron deficiency

Question 25

What proportion of the red cell surface is “central pallor” in normal cells, and what terms are used to describe red cells that have a too high/ too low proportion of central pallor?

Answer 25

1/3

Hypochromia (too large an area) and hyperchromia (lack central pallor)

Question 26

What does hypochromia usually go together with?

Answer 26

Microcytosis

Question 27

What are the 2 main causes of hyperchromia?

Answer 27

1. Spherocytes

2. irregularly contracted cells

Question 28

What causes spherocyte formation?

Answer 28

Loss of membrane without equivalent loss of cytoplasm

Question 29

What is the usual cause of irregularly contracted cells?

Answer 29

Oxidant damage to the cell membrane and Hb

Question 30

What is “polychromasia” and when is it seen?

Answer 30

Increased blue tinge to red cell cytoplasm

Indicates red cell is young

Question 31

What stain can be used to detect young cells?

Answer 31

Methylene blue

Question 32

What terminology is given to there being too much/ too many types of a type of blood cell?

Answer 32

Cytosis or philia

Question 33

What are the 2 methods of counting young cells?

Answer 33

1. Count polychromatic cells

2. Methylene blue

Question 34

What is the cause of sickle cells?

Answer 34

Polymerisation of HbS when it’s in a high concentration

Question 35

What is a fragment of a red cell referred to as?

Answer 35

Schistocyte

Question 36

What is rouleaux?

Answer 36

Stacks of red cells

Question 37

What is rouleux the result of?

Answer 37

Alteration in plasma proteins that makes erythrocytes adherent (eg in multiple myeloma)

Question 38

How do agglutinates differ from rouleaux?

Answer 38

Irregular clumping

Question 39

What causes agglutinates to form?

Answer 39

IgM on surface

Question 40

Why are Howel-Jolly bodies linked to hyposlenism?

Answer 40

In a normally functionning spleen they are also produced but are removed by the spleen

Question 41

What are the terms used to refer to too many/ too few white cells?

Answer 41

Leucosytosis

Leucopenia

Question 42

What are the terms used to refer to too many/ too few neutrophils?

Answer 42

Neutropenia

Neutrophilia

Question 43

What are the terms used to refer to too many/ too few thrombocytes?

Answer 43

Thrombocytopenia

Thrombocytosis

Question 44

What is infectious mononucleosis?

Answer 44

Glandular fever

Question 45

What is left shift?

Answer 45

There are things in the blood from further back than there ought to be, more immature cells + band forms

Question 46

What might cause left shift?

Answer 46

Infection

Question 47

What pathology is toxic granulation a sign of, and when is it normal?

Answer 47

Infection

Pregnancy

Question 48

In someone with a B12/ folic acid deficiency, how might neutrophils appear?

Answer 48

Hypersegmented nuclei