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Haematology > Physiology of blood cells and haematological terminology > Flashcards

Physiology of blood cells and haematological terminology Flashcards

1
Q

What are all blood cells ultimately derived from? What two lineages can this give rise to?

A

Multipotent haemopoietic stem cells (in bone marrow)

=> lymphoid stem cells and myeloid stem cells

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2
Q

What cells are derived from the multipotent myeloid precursor?

A

Megakaryocytes (and thence platelets)

Granulocyte-Monocyte

Erythroid precursors (proerythroblast => early, middle and late erythroblasts => erythrocytes)

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3
Q

What cells are derived from the multipotent lymphoid precursor?

A

T cell
B cell
NK cell

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4
Q

How are stem cells able to self renew and produce mature progeny?

A

Able to divide into two cells with different characteristics; another stem cell + a cell capable of differentiating to mature progeny

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5
Q

Which cells produce erythropoietin? What can trigger the production of erythropoietin? What effect does it have?

A
  • 90% from kidney Juxtatubular Interstitial Cells
  • 10% from liver Hepatocytes and Interstitial Cells
  • Triggered by hypoxia, anaemia
  • Causes increased erythropoiesis in bone marrow
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6
Q

What is the approximate life span of a red blood cell in the blood stream?

A

120 days

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7
Q

How and why do old red blood cells get destroyed in the spleen

A

As the cells get older, they becomes less flexible and less able to pass through the capillaries into the sinuses in the spleen
This means that they are more likely to be retained in the spleen and phagocytosed

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8
Q

How does the colour of red cells change as they mature?

A

When they are immature they are more blue/purple

As they mature they become pinker

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9
Q

Briefly state the cell lineage from multipotent haemopoietic stem cells to granulocytes and monocytes. What molecules are needed to mediate this process?

A

Multipotent haemopoietic stem => myeloblast + monoblast
Myeloblast => granulocytes (neutrophils, eosinophils, basophils)
Monoblast => monocytes

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

G-CSF = granulocyte colony-stimulating factor;                   GM-CSF = granulocyte-macrophage colony-stimulating factor
M-CSF = macrophage colony-stimulating factor
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10
Q

The neutrophil granulocyte survives for how long in the circulation before migrating to tissues?

A

7–10 hours

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11
Q

Recall the different stages involved in neutrophil function

A 
Adhesion and margination
Rolling
Diapedesis
Migration (chemotaxis)
Phagocytosis
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12
Q

Compare eosinophils and neutrophils in terms of their appearance and life span in circulation

A
  • Eosinophils spends less time in the circulation than do neutrophils
  • Eosinophils: bi-lobed nucleus;
    Neutrophils: tri-lobed nucleus
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13
Q

State the main role of eosinophils

A

Defence against parasitic infection

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14
Q

State the main role of basophils

A

Involved in allergic responses

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15
Q

Describe the appearance of basophils

A

They have lots of dark blue/purple dots in the cytoplasm (granules)

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16
Q

Describe the appearance of monocytes.

A

Large cell with a kidney bean shaped nucleus

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17
Q

How long do monocytes spend in the circulation, and what do they develop into when they migrate into tissues?

A

Several days

Macrophages and other specialised cells that have a phagocytic and scavenging function

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18
Q

Other than phagocytosis, what is another role of macrophages?

A

Store and release iron

19
Q

How long do platelets survive for in the circulation?

A

About 10 days

20
Q

Define Anisocytosis and Poikilocytosis

A

Anisocytosis = red cells show more variation in SIZE than is normal

Poikilocytosis = red cells show more variation in SHAPE than is normal

21
Q

Define Microcytosis and Macrocytosis

A

Microcytosis = red cells are smaller than normal

Macrocytosis = red cells are larger than normal

22
Q

Macrocytes can be of three specific types. Name them.

A

Round macrocytes
Oval macrocytes
Polychromatic macrocytes

23
Q

Recall the three types of anaemia

A 
Microcytic = anaemia with small red cells
Normocytic = anaemia with normal sized red cells 
Macrocytic = anaemia with large red cells
24
Q

What can be used as a reference in a blood film to determine whether the red blood cells are microcytic or macrocytic?

A

Lymphocytes are generally all the same size

25
Q

Define hypochromia

A

Red cells have a larger area of central pallor than normal (normally should be 1/3 of the red cell diameter); indicative of a lower haemoglobin content and concentration and a flatter cell
NOTE: hypochromia and microcytosis tend to go together

26
Q

Define hyperchromia

A

Red cells lack central pallor

27
Q

State the two important types of hyperchromic cells.

A

Spherocytes

Irregularly Contracted Cells

28
Q

Describe and explain the appearance of spherocytes

A

They have a round, regular outline and lack central pallor

  • It is caused by a loss of cell membrane that is not accompanied by an equivalent loss of cytoplasm
29
Q

State a cause of spherocytosis.

A

Hereditary spherocytosis

30
Q

Describe and explain the appearance of irregularly contracted cells

A

Irregular in outline but are smaller than normal cells and have lost their central pallor

  • Usually caused by oxidant damage to the cell membrane and to the haemoglobin
31
Q

Define polychromasia

A

Polychromasia describes an increased blue tinge to the cytoplasm of a red cell, indicating that the red cell is young (reticulocyte)

32
Q

How can detect reticulocytes experimentally?

A

Do a reticulocyte stain - expose living red cells to new methylene blue

33
Q

State six different types of poikilocytosis

A 
Spherocytes
Irregularly contracted cells
Sickle cells
Target cells 
Elliptocytes
Fragments
34
Q

What are target cells? State some causes of target cells in the blood film.

A

Target cells are cells with an accumulation of haemoglobin in the centre of the area of central pallor

They occur in obstructive jaundice, liver disease, haemoglobinopathies and hyposplenism

35
Q

State two causes of eliptocytosis (elliptical shaped cells)

A 
Hereditary eliptocytosis 
Iron deficiency (cells are also hypochromic)
36
Q

What biochemical phenomenon causes the sickling of red blood cells?

A

Polymerisation of haemoglobin S when present in a high concentration

37
Q

What is another name for fragments? What does it indicate?

A

Schistocytes

  • Small pieces of red cells indicate that a red cell has fragmented
38
Q

State two different ways in which red blood cells can clump together and describe why they happen.

A

Rouleaux (like a pile of staggered coins) - caused by a change in plasma proteins pushing the red cells together

Agglutinates (irregular clumps) - caused by antibodies on the cell surface making the cells stick together

39
Q

What is a Howell-Jolly Body and what is it usually caused by?

A

It is a nuclear remnant in a red cell

The commonest cause is lack of splenic function

40
Q

What to the suffixes -cytosis, -penia, and -philia indicate?

A
  • cytosis = too many
  • penia = too few
  • philia = too many
41
Q

Describe the appearance of an atypical lymphocyte/mononuclear cell. What can cause these to appear in a blood film?

A

Large nucleus and a large amount of faint cytoplasm

  • This is typical of having a viral infection and is seen in glandular fever (infectious mononucleosis)
42
Q

What is Left Shift?

A

Left shift = there is an increase in non-segmented neutrophils/ there are neutrophil precursors in the blood

43
Q

What is toxic granulation? What can cause it?

A

This is the heavy granulation of neutrophils

  • It results from infection, inflammation and tissue necrosis
  • It is also a feature of normal pregnancy
44
Q

What is hypersegmentation of neutrophils? What can cause it?

A

An increase in the average number of neutrophil lobes or segments
- It usually results from a lack of Vitamin B12 or folic acid

Haematology (11 decks)

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