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Haematology Sahils questions > Red Blood Cells > Flashcards

Red Blood Cells Flashcards

1
Q

What is haemopoeisis?

A

Formation of blood cellular components

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2
Q

What is another name for red blood cells?

A

Erythrocyte

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3
Q

Where are red blood cells produced and what are they derived from?

A

Produced in the bone marrow.
Derived from Haematopoietic stem cells - myeloid progenitor

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4
Q

How many blood cells does the human body produce per day?

A

173 billion blood cells

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5
Q

What do haematopoietic stem cells have the ability to do?

A

Self renew: some daughter cells remain as haematopoietic stem cells
Differentiate into mature progeny

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6
Q

Where are HSCs derived from in embryonic development?

A

Yolk sac in early embryo development.
Liver around 6-8 weeks
Bone marrow

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7
Q

How long does it take bone marrow to develop haematopoietic development?

A

10 weeks

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8
Q

Where does haemopoiesis occur in adults?

A

Long bones such as pelvis, sternum and femur.

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9
Q

What is haemolysis?

A

Rupture and disruption of RBCs

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10
Q

What is erythropoiesis?

A

Production of RBCs

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11
Q

Where is Erythropoietin synthesised?

A

Kidney

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12
Q

What do haemopoietic growth factors regulate?

A

Haemopoiesis

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13
Q

What gives rise to a pro-erythroblast?

A

common myeloid progenitor

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14
Q

What are the 4 things required for erythropoiesis?

A

Iron
Vitamin B12
Folate
Erythropoietin

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15
Q

What causes microcytic anaemia?

A

Lack of iron (iron deficiency)

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16
Q

What cause macrocytic anaemia?

A

Vitamin B12 or folate deficiency

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17
Q

What is erythropoietin and when would it produce RBCs

A

Glycoprotein cytokine that regulates erythropoiesis
In response to hypoxia, it stimulates bone marrow to produce more RBCs when low O2 to kidney, in order to increase O2

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18
Q

What are the major functions of iron?

A

transport of O2 in haemoglobin
Mitochondrial proteins cytochrome a, b and c

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19
Q

List 3 signs that may indicate a person has iron deficiency.

A

koilonychia- spooning of nails
Glossitis- inflammation of the tongue
Angular stomatitis- inflammation of corners of the mouth

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20
Q

What is the best absorbed form of iron?

A

Ferrous iron (Fe 2+)

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21
Q

Why is excess iron bad?

A

There is no physiological mechanism by which iron is excreted

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22
Q

What regulates the absorption or iron in the gut?

A

Hepcidin

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23
Q

What is an enterocyte?

A

intestinal absorptive cell

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24
Q

What suppresses hepcidin synthesis?

A

Erythropoetic activity

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25
What does Ferric Iron (Fe 3+) need to be absorbed?
Vitamin C (Ascorbic acid)
26
What are folate and Vitamin B12 needed for?
For dTTP synthesis needed for synthesis of thymidine
27
What does vitamin B12 bind to in the stomach during its absorption?
Intrinsic Factor
28
What is pernicious anaemia?
Anaemia caused by a deficiency in Intrinsic Factor
29
Where is IF made?
Gastric Parietal Cells
30
A lack of which foods in diet can lead to a vitamin B12 deficiency/
Meat Fish Eggs
31
Where does the absorption of folate take place?
Duodenum and jejunum
32
When do the requirements for folate increase?
Pregnancy Low RBC count (sickle cell anaemia)
33
How long do red cells circulate for?
120 days
34
Where do red cells undergo phagocytosis?
spleen
35
What is released from the haem (porphyrin ring) when it is recycled?
Fe 2+
36
What is iron bound to on its way back to the bone marrow?
Transferrin
37
What does the catabolism of haem produce and where is the product excreted?
Globin is broken down into bilirubin Excreted in bile
38
Describe the red cell membrane?
Made up for lipid bilayer supported by protein cytoskeleton Contains transmembrane proteins to maintain shape and flexibility.
39
What happens to red blood cells during hereditary spherocytosis?
The vertical linkages made by spectrin and ankyrin are disturbed. Cells become spherical and lose central pallor.
40
What causes hereditary spherocytosis>
Disruption of vertical linkages. Loss of cell membrane without loss of cytoplasm RBCs become less flexible.
41
What happens to spherocytes
Prematurely removed by the spleen due to less flexibility
42
What causes hereditary elliptocytosis?
Disruption of horizontal linkages Lack of Iron
43
What is a haem group made out of?
Fe 2+ 1 porphyrin ring
44
What is the difference in composition between adult and foetal haemoglobin?
Adult- 2 alpha 2 beta chains Foetal- 2 alpha 2 gamma chains
45
What is co-operativity?
Binding of first O2 to Hb changes the structure so that it is easier to add another O2 molecule
46
Explain the Bohr effect.
High CO2 Low pH More dissociation and so easy offloading of O2 to respiring cells (right shift)
47
Which shift of the sigmoid curve showing saturation of Hb at different ppO2 does HbF give?
Left shift (as HbF has a higher affinity for oxygen)
48
What is 2,3 DPG and how does it work
Organic phosphate product Modulates O2 affinity of Hb by binding to Hb in response to anaemia, hypoxia and high altitude.
49
Factors causing a Left shift of O2 dissociation curve.
HbF Myoglobin Carbon Monoxide
50
Factors causing a Right Shift of O2 dissociation curve
Carbon Dioxide inc Decrease in pH 2,3 DPG inc Temperature inc HbS
51
What is G6PD
Glucose-6-phosphate dehydrogenase is an enzyme in the hexose monophosphate shunt
52
Why is the hexose monophosphate shunt important
The shunt is lightly coupled to glutathione metabolism to protect RBCs from oxidant damage
53
When are oxidants generated in the blood?
During infection Exogenous (drugs/broad beans)
54
What does G6PD deficiency cause?
Causes severe intravascular haemolysis from oxidant damage.
55
How can you tell there is a G6PD deficiency from looking under a microscope
Bite cells- irregular contracted with no central pallor Hb is denatured and forms inclusions called Heinz Bodies.
56
What are some causes of microcytosis?
Iron Deficiency Anaemia of Chronic Disease Defect in Globin Synthesis
57
What is anaemia of chronic disease?
When there is inflammation, hepcidin is increased. This decreases the Iron supply as ferroportin is blocked in duodenum and jejunum enterocytes.
58
What is thalassemia
Defect in globin synthesis
59
What is Beta-thalassemia
Defect in the Beta Globin Chain Synthesis
60
What is Alpha-thalassemia
Defect in the Alpha globin chain synthesis
61
What does the term 'major' refer to in thalassemia?
A significant impairment in the alpha/beta chain synthesis
62
What specific types can macrocytes be?
Round Oval Polychromatic
63
What are the causes of macrocytosis?
Lack of Vitamin B12 or folic acid Liver Disease and ethanol toxicity Haemolysis (polychromasia) Pregnancy
64
What portion of the red blood cell has less haemoglobin and is therefore paler.
A third of the diameter from the centre (less Hb therefore less red)
65
What does the term hypochromia refer to?
Erythrocytes have a larger area f central pallor than normal.
66
What often comes with hypochromia?
Microcytosis (iron deficiency and thalassemiaP
67
What does the term polychromasia mean?
Increased blue tinge to the cytoplasm of the cell
68
What does a blue tinge in a blood film indicate?
Red cell is young (erythocyte)
69
What is polychromasia associated with?
Macrocytosis
70
What is reticulocytosis.
Presence of increased number of reticulocytes
71
When may reticulocytosis occur
Response to bleeding Response to red cell destruction (haemolysis)
72
What does the term anosocytosis refer to
Red cells showing more variation in size than usual.
73
What does the term poikilocytosis refer to>
Red cells showing more variation in shape than usual.
74
What is meant by haematocrit.
The proportion of red blood cells in your blood Same as Packed cell volume however not measured through centrifugation
75
What is mean by the term packed cell volume.
Proportion of a column of centrifuged blood occupied by red blood cells.

Haematology Sahils questions (4 decks)

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