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Haematology > physiology of blood cells and haematological terminology > Flashcards

physiology of blood cells and haematological terminology Flashcards

1
Q

summarise the physiology of all blood cells *

A

origenate in bone marrow

derived form multipotent haemopoetic stem cells

they give rise to lymphoid and myeloid stem cells

myeloid goive rise to - granulocyte (monocyte), erythroid, megakaryocyte

lymphpoid - T B and NK cell

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2
Q

what are the essential characteristics of stem cells

A

abiliuty to self renew

ability to make new mature progeny

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3
Q

describe the origen of RBC *

A

myeloid stem cell give rise to 2 proerythroblasts (earliest RBC)

gives rise to 2 erythroblasts (has nucleus)

gives rise to early, intermediate and late erythroblasts

give rise to 2 erythrocytes (lost nucleus) - the cytoplasm is squezed through the endothelium to the sinusoid, leaving nucleus to be ingested by macrophage

this process is erythropoesis

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4
Q

what is needed for erythropoesis and what stimulates it *

A

erythorpoeitin

stimulated by hypoxia

90% synthesised in the kidney by juxtatubular interstitial cell, 10% synthesised by hepatocytes and interstitial cells in liver - all pass into capillaries and enter marrow through blood

increased erythropoetin = increased bone marrow activity = increased red cell production

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5
Q

what is the intravascular life span of erythrocytes *

A

120 days

ultimately destroyed by the phagocytic cells (macrophages) of the spleen and liver and reticuloendothelial system

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6
Q

what is the function of RBC *

A

main - O2 transport

some CO2 transport (mainly in plasma though)

nitric oxide transport

Hb acts as buffer

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7
Q

describe the origen of WBC *

A

myeloblast -> granulocyte and monocytes

chromatin gets more condensed and nucleus gets indented

cytokines influence the pathwya of stem cells

granulocyte colonly stim factor, macrophage - CSF, granulocyte macrophage CSF and inbterleukins stim the granulocyte and monocyte pathway

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8
Q

describe polychromatic erythrocytes *

A

they are in circulation

larger and have ribosomes in cytoplasm that control Hb synth

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9
Q

how can you see if there are young red cells

A

reticulocyte stain - reticulocytes take up methylene blue and it pptes into reticulum/network

or stain normal film see if there are any blue/larger cells

detecting reticulocytes is more reliable

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10
Q

what is the lifespan of a neutrophil *

A

7-10 hrs in circulation before entering tissues

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11
Q

function of neutrophil*

A

defence against infection - phagocytosis

2 pools:

circulating - flows down blood stream

marginating - adherent to endothelium, start to enter tissues - enter by diapedesis then chemotaxis in tissue under influence of chemokines

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12
Q

what is the origen of eosinophils *

A

myeloblast

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13
Q

what is the life span of an eosinophil *

A

less than neutrophil

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14
Q

function of eosinophil *

A

fight paracytic infection by releasing granule contents

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15
Q

describ ethe origin of basophils *

A

myeloblasts

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16
Q

describe the function of basophils *

A

allergic responses - infective and inflammatory aspects

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17
Q

describe the lifespan of monocytes *

A

several days in the circulation then migrate into tissues - become monlyctes

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18
Q

function of macrophages *

A

phagocytic and scavenging

they take up erythrocytes that die, break down ferritin store as haemosiderin - provides a store of iron in the bone marrow when needed

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19
Q

what is the lifespan for a platelet *

A

10 days in circulation

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20
Q

describe the origin of platelets *

A

fragmentation of the cytoplasm of megakaryocytes

leave the nucleus in marrow to be destroyed

they are under the influence of thrombopoietin

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21
Q

what is the function of platelets *

A

primary haemostasis

contribute phospholipid which promotes blood coagulation

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22
Q

what is the life span for lymphocytes *

A

variable

they recirculate between the blood, lymph nodes and other tissues so provide host defence across whole body

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23
Q

define anisocytosis *

A

RBC show more variation in size than is normal

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24
Q

define poikilocytosis *

A

RBC show more variation in shape than is normal

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25
Q

define microcytosis *

A

RBC smaller than normal

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26
Q

define macrocytosis *

A

red cells are larger than normal

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27
Q

how do you identify the size of red cells

A

compare diamter with nucleus of leukocytes - should be similar

or use automated size counters

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28
Q

what is a microcyte *

A

a red cell that is smaller than normal

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29
Q

what is a macrocyte *

A

a red cell that is larger than normal

30
Q

describe the different types of macrocytes *

A

depend on shape and staining characteristics

  • round macrocytes
  • oval macrocytes - indicative of B12 or folic acid deficiency
  • polychromatic macrocytes - young cell, present in response to heamorrage or administration of a vitamin that was lacking
31
Q

define microcytic *

A

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

32
Q

define normocytic *

A

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

33
Q

describe macrocytic *

A

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

34
Q

desribe hypochromia in comparison to normal red cells *

A

normal red cells have 1/3 diameter pale - because of disk shape centre has less Hb than edge therefore paler - this is central pallor

in hypochromia - larger than normal central pallor - because of low Hb content, conc and a flatter cell - red cells are hypochromic

hypochromia and microcytosis go together (same underlying condition eg Fe deficiency or thalassaemia)

35
Q

describe hyperchromia *

A

cells lack central pallor

because they are thicker (macrocytes) or because shape is abnormal

cells are called hyperchromatic/hyperchromic

36
Q

2 main causes of hyperchromia *

A

spherocytes (round outline)

and irregularly contracted cells (Hb all in 1 place)

37
Q

cause of spherocytes *

A

hereditory spherocytosis - membrane not tethered to the cytoskeleton so lose membrane

loss of membrane w/o loss of equivalent amount of cytoplasm - so cell is forced to round up to enclose cytoplasm in remaining membrane

38
Q

describe irregularly contracted cells *

A

irregular outline

smaller than normal

lost central pallor

because of oxidant damage to the membrane and Hb because of foreign chemical or food eg broad beans - if dont have normal enzymes this causes haemolytic anaemia

39
Q

describe polychromasia *

A

blue tinge to red cell cytoplasm - mean cell is young

40
Q

descirbe the different shapes of poikilocytes *

A

spherocytes

irregularly contracted cells

sickle cells

target cells - blob of Hb in central pallor

elliptocytes

fragments- angular

41
Q

the causes of target cells *

A

obstructive jaundice

liver disease

haemoglobinopathies

hyposplenism

42
Q

causes of elliptocytes *

A

hereditory elliptocytosis

iron deficiency

43
Q

cause of sickle cells *

A

HbS polymerisation when present in high conc

44
Q

describe boat cells *

A

some polymerisation of HbS - not enough to form sickle

45
Q

describe fragments *

A

also called schistocytes

small pieces of red cells

indicate that a cell has fragmented

46
Q

describe rouleaux *

A

stacks of red cells

resemble a pile of coins

result from alterations in plasma proteins eg increase in Ig (M - big molecular weight) mean neutralising force is negated = stack

normally red cells repel each other

47
Q

describe agglutins *

A

irregular clumps of red cells

because of Ab on surface of red cells cause them to stick together

48
Q

what is a Howell-Jolly body and what is the cause *

A

a nuclear remnant in a red cell

commonest cause - lack of splenic func eg atrophy

49
Q

define leucocytosis *

A

too many white cells

50
Q

define leucopinea *

A

too few white cells

51
Q

define neutrophilia *

A

too many neutrophils

52
Q

define neutropenia *

A

too few neutrophils

53
Q

define lymphocytosis *

A

too many lymphocytes

54
Q

describe eosinophilia *

A

too many eosinophils

55
Q

define thrombocytosis *

A

too many platelets

56
Q

define thrombocytopenia *

A

too few platelets

57
Q

define erythrocytosis *

A

too many RBC

58
Q

define reticulocytosis *

A

too many reticulocyts

59
Q

define lymphopenia *

A

too few lymphocytes

60
Q

what is an atypical lymphocyte *

A

describes the abnormal cells present in infectious mononucleosis - glandular fever

atypicalk mononuclear cell is anotehr term

61
Q

summarise left shift *

A

there is an increase in non-segmented neutrophils or that there are neutrophil precursers in the blood

sign of infection/inflammatiom

62
Q

summarise R shift *

A

increase in segments or lobules in nucleus of neutrophils

63
Q

describe toxic granulation *

A

heavy granulation of neutrophils

from infection, inflammation and tissue necrosis

normal feature of preg

64
Q

describe hypersegmented nuclei *

A

there is increases in average number of neutrophil lobes or segments

because of lack of B12 or folic acid

65
Q

How can you tell there is anaemia from a blood film *

A

anaemia reduces the viscocity of the blood so cells are more spread out on the film

66
Q

how can sickle cell lead to Howell-Jolly bodies

A

polymerisation causes recurrant infarction of spleen = howell-jolly bodies

67
Q

what does a tetraploid neutrophil look like

A

–

68
Q

what is the function of lymphocytes *

A

humoral and cellular immunity

69
Q

list the physiological factors that influence the rate of red cell production *

A

anaemia

hypoxia

increased androgens

70
Q

what fascilitates oxygen delivery

A

teh sigmoid oxygen dissociation curve

a lower pH reduces oxygen affinity to Hb = more offloading in met actiuve tissues

Haematology (11 decks)

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