Physiology of blood cells and heamatological terminology

Question 1

Where do blood cells originate?

Answer 1

From multipotent heamatopoetic (can be both lymphoid and myeloid) stem cells in the bone marrow. Blood cells are from the Myeloid precursors (along with Granulocytes and megakaryocytes) (decided with cytokines (Colony stimulating factors-CSF) and various interleukins)

Question 2

What are the essential characteristics of Hematopoietic stem cells?

Answer 2

Can both self revew and produce a mature progeny (as so the population stays constant-and can create new cells)

Question 3

What are the steps of differentiation of erythrocytes?

Answer 3

Start as pro-erythropblast (with nucleus)-then early, intermediate and late erythroblasts (still nucleus)-then squeeze cytosol out into sinus producing a erythrocyte (no nucleus)-circulate as polychromatic erythrocytes (has ribosomes for heam-goes for a few days)-then becomes mature erythrocytes (20% smaller) -can also differenciate with reticolocytes stain

Question 4

What homones are required for erythropoesis?

Answer 4

In kindeys (juxtaglomerulus), in response to Hypoxia and aneamia -> produce erythropoetin-and that increases bone marrow erythropoesis
10% are produced in the liver-either by hepatocytes or interstilial cells

Question 5

How long do red blood cells survive in vivo? What is their main functionS? Where does it end?

Answer 5

Around 120 days in the blood stream
Mainly carries oxygen, but also has a role in CO2 carrying and pH regulation
End in the spleen, destroyed by macrophages

Question 6

How long do neutrophils survive in vivo? What is its main function

Answer 6

About 7-10h before moving to tissue (main place where its active)
Mainly protect infection-phagocytosis/killing microorganism

Question 7

How do neutrophils enter tissue?

Answer 7

Adhesion, Flotting, diapedisis, migration to site of infection
2 pools of neutrophils, circulating and adhering

Question 8

What are eosinophils?What is their function?

Answer 8

Granules of red/orange, bilobed nucleus
Even less time in circulation than neutrophils
Mainly defends against parasitic infection and allergies

Question 9

what are basophils?What is their function?

Answer 9

Very granulated cell, round-role in allergy and inflamation regulation

Question 10

what are monocytes? What is their function?

Answer 10

Precursors to macrophages. lobed nucleus with fine granules
spend a few days in circulation
As macrophages, have a phagocytic and scavenging function (tissue repair, infection control, etc) and can help store iron

Question 11

What do monocytes, basophils, eosinophils and neutrophils and megakaryocytes have in common?

Answer 11

Innate immune system all coming from myoblast stem cell precursors

Question 12

What are megakaryocytes? What is their function?

Answer 12

Large cells, which via segmentation make platelets (no nulceus)-these survive about 10 days
Used in both 1ary and 2nd ary heamostasis (WVF, but also FX, etc)

Question 13

What do lymphoid stem cells bring rise to? how long does these rise? Where are they found?

Answer 13

T cells, B cells and NK cells
Variable life span but all recirculate-via lymph and lymph nodes and other tissues and back to blood
Most look same before they expand

Question 14

What is anisocytosis? and Poikicytosis?

Answer 14

ani-size vary more than they should

poik-shape varies more than they should

Question 15

What is microcytosis and macrocytosis?

Answer 15

Micro-smaller than normal
Macro-larger than normal
Microcyte-smaller cell. macrocyte-larger

Question 16

What are the different types of macrocytes?

Answer 16

Can be specific from shape/size
Round, Oval and Polychromatic (normal precursors-suggest recent bleed)
Oval-suggest B12 deficiency

Question 17

What are microcytic, normacytic and macrocytic aneamie?

Answer 17

1st year lol

Smaller, normal are larger

Question 18

What is Hypochromia? and Hyperchromia?

Answer 18

Normally, RBC have 1/3 diameter which is pale (the inside disc) - Hypo means larger disc area than usual (means less heamoglobin, or more flat)-hyperchromic (often with microcytosis-bleeds)
Hyperchromia-lacks central pale–can be thicker, or have weird shape (like sphere)-hyperchromatic

Question 19

What are the main subtypes of hyperchromia>

Answer 19

Spherocytes and ireegulaly contracted cells
Spherocytes-sphere cells-loss cell membrane but not cytoplasm (can be inherited
ICC-heamoglobin is stacked in different places of cell-usually caused by oxidisation of heam-by foreign agent

Question 20

What is Polychromasia?

Answer 20

Young cells have a blue hue-tells you lot of early cells

Can also be measured with reticulocyte stain - then depending on how much their is-

Question 21

What are the different shypes of Poikolicytes?

Answer 21

Spherocytes, ICC, sickle cells, target cells (some dark in the white), Elliptocytes, Fragments

Question 22

What causes Target cells?

Answer 22

Usuallt caused by obstrutive jaundice, Liver disease and spleen issues

Question 23

What causes Elliptocytes?

Answer 23

Elliptical shape-usually iron deficient (usually larger central palor cell with it)

Question 24

What causes a sickle shaped cell?

Answer 24

Sickle cell aneamia-result in polymerisation of Heam S when in hich conc (happen after hypoxia)

Question 25

What causes fragments cells?

Answer 25

Fragments/Schistocytes -indicate fagments-mechanical damage

Question 26

What is Rouleaux in term of RBC?

Answer 26

Stacks of red cells, ressembling a pile of coins

Result in alteration of plasma proteins (normally repel each other), can result from inflam/infection

Question 27

What are aggultinates for RBC?

Answer 27

Irregular clumps of RBC, rather than tidy stacks
usualt results from AB on the surface of cells
W

Question 28

What is a Howell-Jolly body in RBC?

Answer 28

Nuclear Remnant in a red cell-usually removed by spleen

If can see, something very wrong with spleen

Question 29

What is leukocytosis? LEucopenia? Neutrophilia? Neutropenia? Lymphocytosis? Eosinophilia, Trhombocytosis> THrymbocypenia> Erthyrocytsis, Reticulocytosis? Lymphopenia?

Answer 29

Leukocytosis-too much WBC leukocytes, Penia-not enough
Neutrophilia-too much neutrophilsm penia, not enough
Lymphocytosis-too many lymphoids, easoninphilia-too many eosinophils

Question 30

What is an atypical lymphocytes?

Answer 30

Abnjormal lymphocytes which can result from some infection, like mononucleosis (glandulat fever)

Question 31

What is left shift?

Answer 31

If see in blood early precursors (like non segmented neutrophils and other)-usually signals of infection, like sepsis

Question 32

What is toxic granulation?

Answer 32

Heavy granulation of neutrophils

Results from infection, inflamation, but can be normal in pregancy

Question 33

What is Hypersegmentation/Right shift?

Answer 33

too many lobes (like more than 4) in neutrophils-usually results from lack of B12 or folic acid

Question 34

In what situtation would you get a thin film with a lot of space between cells?

Answer 34

If blood is thin, then aneamia, if thick then usually higher than usual heam