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Year 2 haem mine > physiology of blood cellsand haematological terminology > Flashcards

physiology of blood cellsand haematological terminology Flashcards

1
Q

where do blood cells originate?

A

bone marrow

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2
Q

what are RBCs derived from?

A

They are ultimately derived from multipotent haemopoietic stem cells

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3
Q

what do the multipotent stem cells give rise to?

A

The multipotent stem cells gives rise to lymphoid stem cells and myeloid stem cells, from which red cells, granulocytes, monocytes and platelets are derived

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4
Q

what is the stem cell hierarchy?

A

There are two branches of differentiation.
The multipotent lymphoid myeloid stem cell differentiates into myeloid stem cell (precursor) or lymphoid stem cells.

myeloid stem cell (precursor) differentiates into granulocyte-monocyte, erythroid, megakaryocyte

lymphoid stem cells differentiates into T cell, B cell or NK cell

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5
Q

what are essential stem cell characteristics?

and how is that achieved?

A

Ability to self-renew and produce mature progeny

Ability to divide into two cells with different characteristics, one another stem cell and the other a cell capable of differentiating to mature progeny

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6
Q

how does a myeloid stem cell turn unto an erythrocyte?

A

The myeloid stem cell/precursor can give rise to a proerythroblast
This in turn gives rise to erythroblasts and then erythrocytes or red cells

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7
Q

what is the process of producing RBCs called?

A

The process of producing red cells is called erythropoiesis

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8
Q

what does the process of forming RBCs required?

A

Normal erythropoiesis requires the presence of erythropoietin

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9
Q

where is erythropoietin synthesised?

A

Erythropoietin is synthesized mainly by the kidney, in response to hypoxia, by juxtatubular interstitial cells.

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10
Q

what is the process that occurs to increase red cell production?

A 
Hypoxia is detected by the kidneys 
This leads to an increase in erythropoietin synthesis 
This increases bone marrow activity 
This leads to an 
increase in red cell product
ion
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11
Q

how long do erythrocytes last?

A

The erythrocyte survives about 120 days in the blood stream

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12
Q

what are the functions of erythrocytes?

A

Its main function is oxygen transport

It also transports some carbon dioxide

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13
Q

how are erythrocytes destroyed?

A

Ultimately it is destroyed by phagocytic cells of the spleen

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14
Q

how does a multipotent haemopoietic stem cell give rise to granulocytes and monocytes?

A

The multipotent haemopoietic stem cell can also give rise to a myeloblast and a monoblast, which in turn give rise to granulocytes and monocytes
Cytokines such as G-CSF, M-CSF, GM-CSF and various interleukins are needed

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15
Q

how long can the neutrophil survive?

A

The neutrophil granulocyte survives 7–10 hours in the circulation before migrating to tissues

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16
Q

what is the main function of the neutrophil?

A

Its main function is defence against infection; it phagocytoses and then kills micro-organisms.

  • adhesion and margination
  • rolling
  • diapedesis
  • migration
  • phagocytosis
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17
Q

what is the function of the eosinophils?

A

A myeloblast can also give rise to eosinophil granulocytes
The eosinophil spends less time in the circulation than does the neutrophil
Its main function is defence against parasitic infection

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18
Q

what do basophils do?

A

A myeloblast can also give rise to basophil granulocytes

Basophils have a role in allergic responses

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19
Q

what do monocytes do?

A

The myeloid stem cell can also give rise to monocyte precursors and thence monocytes
Monocytes spend several days in the circulation
Monocytes migrate to tissues where they develop into macrophages and other specialized cells that have a phagocytic and scavenging function
Macrophages also store and release iron

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20
Q

how long do the platelets survive?

what do the platelets do?

A

The haemopoietic stem cell can also give rise to megakaryocytes and hence platelets
Platelets survive about 10 days in the circulation
Platelets have a role in primary haemostasis
Platelets contribute phospholipid, which promotes blood coagulation

21
Q

what do the lymphocytes work?

A

The lymphoid stem cell gives rise to T cells, B cells and natural killer (NK) cells
Lymphocytes recirculate to lymph nodes and other tissues and then back to the blood stream
Intravascular life span is very variable

22
Q

define:
- anisocytosis
- poikilocytosis

A

Anisocytosis – red cells show more variation in size than is normal
Poikilocytosis – red cells show more variation in shape than is normal

23
Q

define:
- microcytosis
- macrocytosis

A

Microcytosis – red cells are smaller than normal

Macrocytosis – red cells are larger than normal

24
Q

macrocytes can be pf specific types

-what are they?

A

Macrocytes can be of specific types
Round macrocytes
Oval macrocytes
Polychromatic macrocytes

25
Q

define:
- microcytic
- normocytic
- macrocytic

A

Microcytic – describes red cells that are smaller than normal or an anaemia with small red cells
Normocytic – describes red cells that are of normal size or an anaemia with normal sized red cells
Macrocytic – describes red cells that are larger than normal or an anaemia with large red cells

26
Q

define hypochromia and what does it result from?

A

Hypochromia means that the cells have a larger area of central pallor than normal
This results from a lower haemoglobin content and concentration and a flatter cell
Red cells that show hypochromia are described as hypochromic
Hypochromia and microcytosis often go together

27
Q

normally which part of the RBC should look pale?

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

28
Q

define hyperchromia

A

Hyperchromia means that cells lack central pallor
This can occur because they are thicker than normal or because their shape is abnormal
Cells showing hyperchromia can be described as hyperchromatic or hyperchromic

29
Q

what are the causes of hyperchromia?

A

Hyperchromia has many causes since many abnormally shaped cells lack the central thinner area

30
Q

what are the two types of hyperchromia?

A

However there are only two important types, spherocytes and irregularly contracted cells

31
Q

define spherocytes and how are they formed?

A

Spherocytes are cells that are approximately spherical in shape
They therefore have a round, regular outline and lack central pallor
They result from the loss of cell membrane without the loss of an equivalent amount of cytoplasm so the cell is forced to round up
Spherocytes in hereditary spherocytosis – but not all the cells are spherical

32
Q

define irregularly contracted cells and how are they formed?

A

Irregularly contracted cells are irregular in outline but are smaller than normal cells and have lost their central pallor
They usually result from oxidant damage to the cell membrane and to the haemoglobin

33
Q

what is polychromasia?

A

Polychromasia describes an increased blue tinge to the cytoplasm of a red cell
It indicates that the red cell is young. As a RBC ages, it turns from dark blue to pink

34
Q

what is another way to detect young cells?

A

Another way to detect young cells is to do a reticulocyte stain. Reticulocytes are RBCs that are slightly younger than the proper mature cells. They can be stained with methylene blue.
This exposes living red cells to new methylene blue, which precipitates as a network or ‘reticulum’

35
Q

Polychromasia vs reticulocyte staining- which one is better for detecting young cells?

A

Detecting polychromasia or increased numbers of reticulocytes gives you similar information
However, identification of reticulocytes is more reliable so they can be counted

36
Q

what are the different types in poikilocytosis?

A 
Spherocytes
Irregularly contracted cells
Sickle cells
Target cells 
Elliptocytes
Fragments
37
Q

what are target cells and when do they occur?

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

38
Q

define elliptocytes and when do they occur?

A

Elliptocytes are elliptical in shape

They occur in hereditary elliptocytosis and in iron deficiency

39
Q

define sickle cells and when do they occur?

A

Sickle cells are sickle or crescent shaped

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

40
Q

what are fragments and what do they indicate?

A

Fragments or schistocytes are small pieces of red cells

They indicate that a red cell has fragmented

41
Q

define rouleaux and when do they occur?

A

Rouleaux are stacks of red cells
The resemble a pile of coins
They result from alterations in plasma proteins

42
Q

define agglutinates and when do they occur?

A

Red cell agglutinates differ from rouleaux in that they are irregular clumps, rather than tidy stacks
They usually result from antibody on the surface of the cells

43
Q

define howell-jolly body and when does it occur?

A

A Howell‒Jolly body is a nuclear remnant in a red cell

The commonest cause is lack of splenic function

44
Q

terminology:

Leucocytosis — 
Leucopenia — 
Neutrophilia — 
Neutropenia — 
Lymphocytosis —
Eosinophilia —
A 
Leucocytosis — too many white cells
Leucopenia — too few white cells
Neutrophilia — too many neutrophils
Neutropenia — too few neutrophils
Lymphocytosis — too many lymphocytes
Eosinophilia — too many eosinophils
45
Q

terminology:

Thrombocytosis — 
Thrombocytopenia — 
Erythrocytosis — 
Reticulocytosis — 
Lymphopenia —
A

Thrombocytosis
-too many platelets

Thrombocytopenia
too few platelets

Erythrocytosis
lots of red blood cells

Reticulocytosis
-lots of reticulocytes

Lymphopenia
-decrease in the number of lymphocytes

46
Q

define atypical lymphocyte

A

An atypical lymphocyte is an 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

47
Q

define left shift

A

Left shift means that there is an increase in non-segmented neutrophils or that there are neutrophil precursors in the blood
An increase in non-segmented neutrophils

48
Q

what is toxic granulation

A

Toxic granulation is heavy granulation of neutrophils

It results from infection, inflammation and tissue necrosis (but is also a normal feature of pregnancy)

49
Q

define hypersegmented neutrophil

A

Neutrophil hypersegmentation means that there is an increase in the average number of neutrophil lobes or segments
It usually results from a lack of vitamin B12 or folic acid

Year 2 haem mine (11 decks)

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