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1.2 POM Haematology > Red Blood Cells > Flashcards

Red Blood Cells Flashcards

(85 cards)

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1
Q

Where do all blood cells orginate?

A

Bone marrow

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2
Q

Which type of cells are the precursor of all blood cells?

A

Haemopoietic stem cells

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3
Q

Which 2 cell types do pluripotent haemopoietic stem cells give rise to?

A
  1. Lymphoid progenitor cells
  2. Myeloid progenitor cells
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4
Q

What 3 types of cells do common lymphoid progenitor cells differentiate into?

A
  1. T cells
  2. B cells —> plasma
  3. NK cells
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5
Q

What 4 types of cells do common myeloid progenitor cells differentiate into?

A
  1. Megakaryocytes —> platelets
  2. Erythrocytes
  3. Mast cells
  4. Myeloblasts
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6
Q

What 4 types of cells do myeloblasts differentiate into?

A
  1. Basophils
  2. Neutrophils
  3. Eosinophils
  4. Monocytes
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7
Q

What are the 3 types of granulocytes?

A
  1. Basophils
  2. Neutrophils
  3. Eosinophils
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8
Q

What are the 4 cell steps of platelet production?

A
  1. Haemopoietic stem cell
  2. Common myleoid progenitor cell
  3. Megakaryocyte
  4. Platelets
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9
Q

What are the 3 cell steps of erythrocyte production?

A
  1. Haemopoietic stem cell
  2. Common myleoid progenitor cell
  3. Erythrocytes
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10
Q

What are the 3 cell steps of mast cell production?

A
  1. Haemopoietic stem cell
  2. Common myleoid progenitor cell
  3. Mast cell
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11
Q

What are the 4 cell steps of basophil production?

A
  1. Haemopoietic stem cell
  2. Common myleoid progenitor cell
  3. Myeloblast
  4. Basophil
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12
Q

What are the 4 cell steps of neutrophil production?

A
  1. Haemopoietic stem cell
  2. Common myleoid progenitor cell
  3. Myeloblast
  4. Neutrophil
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13
Q

What are the 4 cell steps of eosinophil production?

A
  1. Haemopoietic stem cell
  2. Common myleoid progenitor cell
  3. Myeloblast
  4. Eosinophil
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14
Q

What are the 5 cell steps of macrophage production?

A
  1. Haemopoietic stem cell
  2. Common myleoid progenitor cell
  3. Myeloblast
  4. Monocyte
  5. Macrophage
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15
Q

What are the 3 cell steps of natural killer (NK) cell production?

A
  1. Haemopoietic stem cell
  2. Common lymphoid progenitor cell
  3. NK cell
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16
Q

What are the 4 cell steps of B lymphocyte production?

A
  1. Haemopoietic stem cell
  2. Common lymphoid progenitor cell
  3. Small lymphocyte
  4. B cell
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17
Q

What are the 4 cell steps of T lymphocyte production?

A
  1. Haemopoietic stem cell
  2. Common lymphoid progenitor cell
  3. Small lymphocyte
  4. T cell
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18
Q

What is the lifespan of an erythrocyte?

A

120 days

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19
Q

What are the 2 essential characteristics of HSCs?

A
  1. Self-renew
  2. Differentiate to mature progeny
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20
Q

What are the 3 sites of haemopoiesis and when are they used?

A
  1. Yolk sac - 3 weeks gestation
    —> generate HSCs in mesoderm
  2. Liver - 6-8 weeks genstation
  3. Bone marrow - 10 weeks gestation
    - children —> all bones
    - adults —> pelvis
    —> vertebrae
    —> sternum
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21
Q

What is the difference between the location of haemopoesis in children vs adults?

A

Children —> all bones
Adults —> femur, vertebrae, sternum

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22
Q

What are pluripotent HSCs surrounded by in bone marrow? (3)

A
  1. Mesenchymal cells
  2. Endothelial cells
  3. Vasculature
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23
Q

What can disruption of HSC regulation cause?

A

Unbalanced proliferation and differentiation
1. Leukaemia
2. Bone marrow failure

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24
Q

Which 4 factors regulate haemopoiesis?

A
  1. Genes
  2. Transcription factors
  3. Growth factors
  4. Microenvironment
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25
What are haemopoietic growth factors?
Glycoprotein hormones - Erythrocytes ---> erythropoietin (EPO) - Granulocytes and monocytes ---> G-CSF ---> G-M CSF ---> cytokines - Platelets ---> thrombopoietin (TPO)
26
Where are haemopoietic growth factors produced?
Bone marrow except EPO (kidney)
27
Where are B, T and NK cell progenitors found?
1. B ---> bone marrow 2. T ---> thymus 3. NK ---> bone marrow
28
What do mature B cells produce for immunity?
Antibodies ---> humoral immunity
29
What do mature T and NK cells produce for immunity?
Cytokines ---> cellular immunity
30
What are the 4 steps of erythrocyte differentiation?
1. Proerythroblast 2. Erythroblast 3. Reticulocyte 4. Erythrocyte
31
Which stain is used to see erythroblasts and why?
New methylene blue - stains RNA ---> can see maturing as nucleus lost
32
What are reticulocytes and how are they identified on a blood film?
Immature erythrocyte - circle with coloured dots ---> RNA content
33
Which 4 nutrients/chemicals are a necessity for erythropoiesis?
1. Iron 2. Folic acid 3. Vit B12 4. EPO
34
What are small erythrocytes described as? (diameter)
Microcytic - <6μm - iron deficieny anaemia - anaemia of chronic disease
35
What are large erythrocytes described as?
Macrocytic - >9μm - megaloblastic anaemia
36
What are 3 causes of iron deficiency?
1. Blood loss 2. Insufficient dietary intake 3. Increased requirement
37
Which disease leads to decreased iron availability?
Anaemia of chronic disease/inflammation
38
Which 2 diseases can be identified by microcytic erythrocytes?
1. Iron deficieny anaemia 2. Anaemia of chronic disease
39
What disease does iron/vit B12/folic acid deficiency lead to?
Megaloblastic anaemia
40
Why does vit B12/folic acid deficiency create macrocytic erythrocytes?
Dec B12 and folate ---> dec thymidine production ---> dec DNA synthesis ---> dec cell division (cells keep growing and don't split)
41
What is the cause of megaloblastic anaemia?
B12 or folic acid deficiency
42
What stimulates erythropoietin production in the kidneys?
Hypoxia
43
What are the 2 major functions of iron?
1. Hb oxygen transport 2. Mitochondrial proteins - cytochrome a, b, c ---> ATP production - cytochrome P450 ---> hydroxylation
44
What are 3 symptoms of iron-deficiency anaemia?
1. Koilonychia ---> spoon shaped nails 2. Glossitis ---> inflammed tongue 3. Angular stomatitis ---> sores at mouth corners + hypochromic, macrocytic erythrocytes
45
What is the cause of iron-deficiency anaemia?
46
What is the average consumed vs absorbed mass of iron per day and why is there a difference?
10-20 mg/day ---> 1-2 mg
47
What foods are high in iron?
Haem - animal-products Non-haem - soya beans
48
What is haem iron?
Ferrous iron (Fe2+)
49
What is non-haem iron and what must be done to absorb it?
Ferric iron (Fe3+) - must be reduced (eg. by vit C) to be absorbed
50
Why is consuming excess iron bad?
Toxic to heart and liver - not excreted
51
Where is iron stored in the body? (5)
1. Bone marrow 2. Red blood cells 3. Spleen 4. Muscle 5. Liver ---> ferritin
52
How is iron lost during everyday life?
Skin shedding ---> unregulated
53
In what form is iron transported round the body?
Transferrin in plasma
54
Which chemical inhibits iron absorption and storage?
Hepcidin
55
When is hepcidin secreted and where from?
Secreted from liver when iron storage levels are high
56
Where is iron absorbed from?
Duodenum
57
Which 4 pro-inflammatory cytokines inhibit erythropoietin production?
1. IL-1 2. TNFα 3. IL-6 4. IFNγ
58
Which 3 pro-inflammatory cytokines aid hepcidin production?
1. IL-1 2. TNFα 3. IL-6
59
What are the 2 major functions of vit B12?
1. DNA synthesis 2. Nervous system
60
What are the 2 major functions of folic acid?
1. DNA synthesis 2. Homocysteine metabolism
61
Why are vit B12 and folic acid essential for DNA synthesis?
Needed for dTTP synthesis ---> needed for thymidine synthesis
62
Why does a vit B12 or folic acid deficiency effect the bone marrow and how?
Effect all rapidly divinding cells (bone marrow, epithelial, gonads) - megaloblastic erythropoiesis
63
What are sources of vit B12?
Animal products - fish, crab, chicken, eggs, milk etc.
64
What are sources of folic acid?
Plant products - citrus fruit, dark leafy greens, avocado, broccoli etc.
65
When do folic acid requirements increase?
1. Pregnancy 2. Increased erythrocyte production (eg. haemolytic anaemias like sickle cell)
66
What are the 2 steps of vit B12 absorption?
1. Stomach ---> combines with IF from gastric parietal cells 2. Small intestine ---> B12-IF binds to ileum receptors
67
What are the 4 causes of vit B12 deficiency and why?
1. Insufficient intake (eg. veganism) 2. Pernicious anaemia ---> autoimmune dec IF 3. Malabsorption (eg. coeliac, surgery) 4. Achlorhydria ---> lack of stomach acid
68
Where are erythrocytes destroyed?
Spleen ---> by splenic macrophages after 120 days
69
What happens to the haemoglobin of destroyed erythrocytes?
Haem ---> bilirub - excreted in bile ---> iron back to bone marrow Globin ---> hydrolysed to amino acids
70
What does erythrocyte survival depend on? (3)
1. Membrane integrity 2. Haemoglobin 3. Cellular metabolism - issues ---> haemolysis
71
What causes pernicious anaemia?
72
What is the shape of erythrocytes and why?
Biconcave discs - no nucleus ---> manoeuvre in small blood vessels ---> space for Hb to carry oxygen - diameter: 7.5 µm depth: 2 µm
73
What does damage to vertical linkages in erythrocyte membranes cause them to become and why?
Spherocytes - vertical linkages (ankyrin/spectrin) damaged ---> lose membrane ---> too much cytoplasm ---> swell ---> spherocytes ---> haemolysis - cause ---> hereditary spherocytosis (auto dom)
74
What does damage to horizontal linkages in erythrocyte membranes cause them to become?
Elliptocytes - cause ---> hereditary elliptocytosis ---> iron deficiency
75
Why is the PPP important to erythrocytes?
Mode 3 of PPP ---> NADPH produced ---> reduces glutathione ---> reduced glutathione = vital antioxidant in erythrocytes
76
Why does G6PD deficiency affect erythrocytes?
Rate-limiting enzyme in PPP ---> maintains NADPH reducing power - G6PD deficiency ---> less reduced glutathione ---> erythrocytes vulnerable to oxidant damage ---> severe intravascular haemolysis
77
Which disease does the distribution of G6PD deficiency parallel and why?
Malaria - hostile environment
78
How can G6PD deficiency be identified on a blood film?
1. Bite cells - oxidant damage to membrane and Hb 2. Heinz bodies - Hb denatured
79
What is polycythaemia?
Too many erythrocytes - blood hyperviscosity ---> vascular obstruction ---> thrombosis
80
How is polycythaemia detected on a blood count?
1. Hb inc 2. RBC inc 3. Hct inc
81
What are the 2 types of polycythaemia?
1. Pseudo - dec plasma volume ---> high conc of erythrocytes 2. Vera - actually inc in erythrocytes
82
What causes pseudo-polycythaemia
Dec plasma volume
83
What are the 4 causes of vera-polycythaemia?
1. Blood doping/ overtransfusion 2. Hypoxia - inc altitude - cardiac/respiratory disorders ---> inc EPO 3. Inappropriate EPO inc - renal tumour - administered (athletes) 4. Myeloproliferation - bone marrow issue
84
What is a visible symptom of hypoxia?
Central cyanosis ---> blue tongue/lips
85
How can polycythaemia be treated? (2)
1. Venesection ---> dec blood viscosity 2. Drugs ---> inhibit bone marrow erythropoiesis

1.2 POM Haematology (7 decks)

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