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Year 2 - MCD - Haematology > Physiology of Blood Cells and Haematological Terminology > Flashcards

Physiology of Blood Cells and Haematological Terminology Flashcards

21.10.2019

1
Q

Where do blood cells come from?

A

Multipotent haematopoietic stem cells in the bone marrow.

  • > myeloid (megakaryocytes, erythroid, granulocyte-monocyte)
  • > lymphoid (T,B, NK cells)
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2
Q

What are some essential stem cell characteristics?

A

Ability to self-renew and produce mature progeny

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3
Q

Normal erythroid maturation

A
  1. Myeloid stem cell
  2. proerythroblast
  3. early, intermediate and late erythroblast (division between each)
  4. erythrocyte
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4
Q

What is the process of producing red cells called?

A

erythropoiesis

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5
Q

What does normal erythropoiesis require?

A
  • presence of erythropoietin

- synthesised mainly by the kidney in response to hypoxia

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6
Q

Synthesis of erythropoietin

A
  • 90% synthesised in juxtotubular interstitial cells in the kidney
  • 10% made in the liver (hepatocyte and interstitial cells)
  • erythropoietin reaches the bone marrow through circulation.
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7
Q

RBC

A
  • lifespan ~120d
  • main function: Oxygen transport
  • also transports som CO2
  • ultimately destroyed by phagocytic cells of the spleen
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8
Q

What is needed for the development of granulocytes and monocytes?

A

Cytokines such as G-CSF, M-CSF, GM-CSF and various interleukins are needed

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9
Q

What are the different types of granulocytes?

A
  • neutrophils
  • basophils
  • eosinophils
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10
Q

Anisocytosis

A

red cells show more variation in size than is normal

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11
Q

Poikilocytosis

A

red cells show more variation in shape than is normal

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12
Q

Microcytosis

A

red cells are smaller than normal

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13
Q

Macrocytosis

A

red cells are larger than normal

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14
Q

Microcyte

A

a red cell that is smaller than normal

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15
Q

Macrocyte

A

a red cell that is larger than normal

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16
Q

Macrocyte types

A
  • Round macrocytes
  • Oval macrocytes
  • Polychromatic macrocytes

=> determined by shape and staining

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17
Q

Microcytic

A

describes red cells that are smaller than normal or an anaemia with small red cells

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18
Q

Normocytic

A

describes red cells that are of normal size or an anaemia with normal sized red cells

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19
Q

Macrocytic

A

describes red cells that are larger than normal or an anaemia with large red cells

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20
Q

Normal paleness of RBCs

A
  • Normal red cells have about a third of the diameter that is pale
  • This is a result of the disk shape of the red cell; the centre has less haemoglobin and is therefore paler
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21
Q

Hypochromia

A
  • cells have a larger area of central pallor than normal
  • results from a lower Hb content and concentration and a flatter cell
  • RBCs that show hypochromia are described as hypochromic
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22
Q

What does Hypochromia often go together with?

A

Microcytosis

-> often have the same cause, e.g. iron deficiency

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23
Q

Hyperchromia

A
  • cells lack central pallor
  • can occur because they are thicker than normal or because their shape is abnormal
  • cells showing hyperchromia can be described as hyper chromatic or hyperchromic
  • the cells may be irregular in shape
  • many causes since many abnormally shaped cells lack the central thinner area
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24
Q

What cells do myeloblasts give rise to?

A

granulocytes

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25
Q

What cells do monoblasts give rise to?

A

Monocytes

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26
Q

G-CSF

A

granulocyte colony-stimulating factor

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27
Q

GM-CSF

A

granulocyte-macrophage colony-stimulating factor

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28
Q

M-CSF

A

macrophage colony-stimulating factor

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29
Q

Normal Granulocyte Maturation

A
  • starts with myeloblast
  • granules develop
  • promyeloblast: primary granules, golgi zone (=clear area), extensive nucleus)
  • same things happen in N, E and B pathway
  • nucleus more condensed with maturation
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30
Q

How can you see how many immature RBC there are?

A
  • look at blood stain for blue tinge and larger cells

- specific reticulocyte stain - allows to count the reticulocytes

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31
Q

Neutrophil

A
  • lifespan ~7-10h in circulaition before migrating to tissues
  • main function: defence against infection
  • phagocytosis and then kills microorganisms
32
Q

Movement of neutrophils into tissues

A
  1. adhesion and margination
  2. rolling
  3. diapedesis
  4. migration
  5. phagocytosis

Chemotaxis - attracted by chemokines

33
Q

Eosinophils

A
  • spends less time in the circulation than the neutrophil

- main function: defence against parasitic infection

34
Q

Basophils

A
  • A myeloblast can also give rise to basophil granulocytes
  • allergic responses
  • takes up BASic dye
35
Q

Monocyte

A
  • spend several days in the circulation
  • migrate to tissues where they develop into macrophages and other specialized cells that have a phagocytic and scavenging function
  • store and release iron
  • cytoplasm can contain a lot of debris
  • nucleus of RBC precursor can be taken up by macrophage or takes up erythroblasts that die in the bone marrow
  • larger than granulocytes

WHAT IS RELEASED FOT HAEMATOPOISES??

36
Q

Platelet

A
  • lifespan: ~10 days in circulation
  • primary haemostasis
  • contribute phospholipid, which promotes blood coagulation
37
Q

What cells does the lymphoid stem cell give rise to?

A
  • T, B, NK cells
  • recirculate lymph nodes and other tissues and the back to the bloodstream
  • intravascular life span variable
38
Q

Where are oval macrocytes common?

A
  • e.g. Vit B12 deficiency
39
Q

Spherocytes

A
  • approximately spherical in shape
  • round, regular outline and lack central pallor
  • result from the loss of cell membrane without the loss of an equivalent amount of cytoplasm so the cell is forced to round up
40
Q

Hereditary spherocytosis

A
  • not all cells are spherical
41
Q

Hyperchromia - irregularly contracted cells

A
  • irregular in outline
  • smaller than normal cells
  • have lost their central pallor
  • usually result from oxidant damage to the cell membrane and to the haemoglobin
42
Q

Polychromasia

A
  • increased blue tinge to the cytoplasm of a red cell

- indicates that the red cell is young

43
Q

Reticulocytes and Reticulocytosis

A
  • Another way to detect young cells: reticulocyte stain

- exposes living red cells to new methylene blue, which precipitates as a network or ‘reticulum’

44
Q

Polychromasia and reticulocytes

A
  • Detecting polychromasia or increased numbers of reticulocytes gives you similar information
  • identification of reticulocytes is more reliable so they can be counted
45
Q

Types of poikilocytes

A
  • Spherocytes
  • Irregularly contracted cells
  • Sickle cells
  • Target cells
  • Elliptocytes
  • Fragments
46
Q

Target cells

A
  • cells with an accumulation of Hb in the centre of the area of central pallor
  • occur in:
    • jaundice
    • liver disease
    • hameoglobinopathies
    • hyposplenism
47
Q

Elliptocytes

A
  • elliptical in shape
  • They occur in hereditary elliptocytosis and in iron deficiency
  • in iron deficiency they have a larger area of central pallor because of the hypochromia in iron deficiency anaemia; also microcytes can be found in iron deficiency
48
Q

Sickle cell

A
  • crescent / boat shaped

- They result from the polymerisation of haemoglobin S when it is present in a high concentration

49
Q

Fragments

A
  • Fragments or schistocytes are small pieces of red cells

- indicate that a red cell has fragmented

50
Q

Rouleaux

A
  • stacks of red cells
  • resemble a pile of coins
  • result from alterations in plasma proteins
  • common finding in infection and inflammation
51
Q

Agglutinates

A
  • differ from rouleaux in that they are irregular clumps, rather than tidy stacks
  • usually result from antibody on the surface of the red cells making RBCs clump together
52
Q

Howell‒Jolly body

A
  • red cells can also include remnants
  • HJB: remnant of nucleus in RBC
  • commonest cause: lack of splenic function (e.g. spelectomy or spleen atrophy)
53
Q

Leucocytosis

A

too many white cells

54
Q

Leucopenia

A

too few white cells

55
Q

Neutrophilia

A

too many neutrophils

56
Q

Neutropenia

A

too few neutrophils

57
Q

Lymphocytosis

A

too many lymphocytes

58
Q

Eosinophilia

A

too many eosinophils

59
Q

Atipical Lymphocyte

A
  • abnormal lymphocyte
  • Often the term is used to describe the abnormal cells present in infectious mononucleosis (‘glandular fever’)
  • ‘Atypical mononuclear cell’ is an alternative term
60
Q

Left shift

A
  • Left shift means that there is an increase in non-segmented neutrophils or that there are neutrophil precursors in the blood
  • many less mature cells
  • suggests infection and inflammation
  • increase in non-segmented neutrophils
61
Q

Toxic granulation

A
  • heavy granulation of neutrophils
  • results from infection, inflammation and tissue necrosis
  • also a normal feature of pregnancy
62
Q

Hypersegmented neutrophil

A
  • increase in the average number of neutrophil lobes or segments
  • usually results from a lack of Vit B12 or folic acid
  • 6 or more lobes -> hypersegmentation
63
Q

What are the 2 important types of hyperchromic cells?

A
  • spherocytes

- irregularly contracted cells

64
Q

Why does hyperchromia have many causes?

A

many abnormally shaped cells lack the central thinner area

65
Q

What is more reliable - polychrmasia or reticulocytes?

A

identification of reticulocytes is more reliable so so they can be counted

66
Q

Thrombocytosis

A

Too many platelets

67
Q

Thrombocytopenia

A

not enough platelets

68
Q

Erythrocytosis

A

too many erythrocytes

69
Q

Reticulocytosis

A

increased number of reticulocytes

70
Q

Lymphopenia

A

not enough lymphocytes

should mean not enough lymph, but means not enough lymphocytes

71
Q

Reticulocyte

A

an immature red blood cell without a nucleus, having a granular or reticulated appearance when suitably stained.

72
Q

Macrophages

A

= Monocytes in tissues

  • phagocytic and scavenging role
  • iron storage
73
Q

How can macrophages store iron?

A
  • ingest erythroblasts that die in the bone marrow
  • macrophage breaks down iron (from Hb) -> synthesises ferritin, stores as hemosiderin
  • iron can be released when needed for erythropoises in the bone marrow
74
Q

How can macrophages store iron?

A
  • ingest erythroblasts that die in the bone marrow
  • macrophage breaks down iron (from Hb) -> synthesises ferritin, stores as hemosiderin
  • iron can be released when needed for erythropoises in the bone marrow
75
Q

Pencil cell

A

long thin elliptocye

76
Q

Pencil cell

A

long thin elliptocye

77
Q

Hereditary elliptocytosis

A
  • hereditary disorder of red cell membrane

- elliptical cells

Year 2 - MCD - Haematology (11 decks)

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