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Heme/Lymph 1 > Red Blood Cells > Flashcards

Red Blood Cells Flashcards

1
Q

Sites of production throughout the life

A

Embryo - Yolk sac during 3rd week
Liver - chief site from 3rd month til late pregnancy
Bone marrow - begins 4th month and is sole source in normal term baby
Spleen, lymph node, thymus - small
Infants, children - all skeleton active
Adults - axial skeleton

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2
Q

Increased demand can cause

A

Fatty marrow to become active
7-8 fold increase possible
Extramedullary hematopoiesis can occur

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3
Q

Common origin for cells we are talking about

A

Hematopoietic pluripotent stem cell

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4
Q

Stems cells have

A

Capcity for self-renewal as well as giving rise to committed stem cells

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5
Q

Earliest precursors can

A

Actively divide but NOT self replicate

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6
Q

Erythroid pathway

A

BFU-E - burst forming unit
CFU-E - colony forming unit
Stem cell factor and IL3,6 are grwoth factors
EPO affects

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7
Q

Normal adult bone marrow

A

1:1 ratio of fat to cells

Children have more cells, elderly may have less

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8
Q

When might marrow be more cellular

A

Stress, megaloblastic anemia and hemolytic anemias, and other dz

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9
Q

Aplastic anemia marrow appearance

A

Hypocellular with decreased precurosors and patients have low blood counts

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10
Q

Myeloid to erythroid ratio is

A

3:1

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11
Q

Red cell devleopment results in

A

Decreased size and loss of nucleus…increasing redness of cytoplasm

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12
Q

B-12 and folate importance

A

Needed for DNA replication…def cause arrest during S phase and death during maturation (ineffective erythropoiesis)

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13
Q

B-12 and folate cell appearance

A

Hypercellular marrow, hypersegemented neutrophils, cytoplasmic asyncrhony and macrocytic megaloblastic cells

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14
Q

Iron importance

A

Used to form heme or stored as ferritin…sideroblastic anemia is ferritin accumulation in mitochondria

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15
Q

Normal hemoglobin structure

A

4 globin chains and heme molecule
Adult has 2 alpha and 2 beta
Fetal has 2 alpha and 2 gamma
A2 has 2 alpha and 2 delta

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16
Q

Anemia

A

Decreased red cells

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17
Q

Polycythemia

A

Increased red cells
Primary - myeloproliferative disorders
Secondary - to increased erythropoietin

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18
Q

Measurement of hemoglobin, hematocrit and RBC count

A

Hemoglobin - spectrophotometry
Hematocrit - calculated or spun value
RBC count - electrical impedence

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19
Q

MVC, MHC, MCHC, RDW

A

Mean cell volume
Mean cell hemoglobin
Mean cell hemoglobin concentration
Red cell distribution width

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20
Q

MCV equation and how to read RDW and MCV

A

Width - RDW
Peak - MCV

MCV = (HCT*10)/RBC

21
Q

Special equation

A

RBCMCV=Hct10

22
Q

MCH vs MCHC

A 
MCH= (Hb*10)/RBC 
MCHC = (Hb*100)/HCT

MCHC more helpful because takes into account cell size

23
Q

Newborns have

A

Higher hemoglobin and hematocrit…decreases during childhood then rises again

24
Q

Reticulocyte count and interpretation

A

Could seem elevated in anemia even if insufficienct because there are fewer RBCs….Convert to mature RBCs in 1 day unless shift (2)

25
Q

Corrected reticulocyte count and why correct?

A

=(retic%hct%)/(451)

Corrects for anemia since there are fewer RBCs

26
Q

Reticulocyte production index and interpretation

A

Corrected reticulocyte count/2

2 or less - hypoproliferative anemias
3 or more - hemolytic anemia

27
Q

Reticulocyte index with types of anemias

A

Can’t tell with erythropoiesis
Elevated in hemolytic
Decreased in hypoproliferative

28
Q

Anisocytosis and when we see

A

Variation in size
Sideroblastic anemia
Increased RDW

29
Q

Microcytosis and when we see

A

Small size
Low MCV
Iron def and thalassemia
Also often hypochromatic (decreased MCHC)
Normochromic microcytic sometimes seen in hemolytic anemias

30
Q

Macrocytosis and when we see

A

High MCV

Folate, B12 def

31
Q

Hypochromia and when we see

A

Often with microcytosis
MCV, MCH, and MCHC all decreased
Often with microcytosis

32
Q

Hyperchromia and when we see

A

Increased Hb content
Large macrocytic may have increased MCH but MCHC is normal
True hyperchromia (MCHC increased) is associated with spehrocytosis

33
Q

POlychromasia and when we see

A

Use Wright’s stain…hemolysis and recent blood loss

34
Q

Poikilocytosis

A

Variations in shape

35
Q

Elliptocyte and ovalocytes and when we see

A

If mostly elliptocyte - hereditary elliptocytosis
Maccroovalocytes - B12 and folate def
Ellipto in small numbers - iron def, thalassemias, hemoglobinopathies

36
Q

Target cells and when we see

A

Thalassemias, hemoglobinopathies, iron def, and oher hypochromic states
Also with liver dz and after splenectomy

37
Q

Spherocytes and when we see

A

Have less SA/membrane, increased MCHC, and increased fragility
Hereditary speherocytosis and some types of hemolysis (warm antibody immune hemolysis)

38
Q

Schistocytes and when we see

A

Hemolytic conditions like microangiopathic hemolytic anemia

39
Q

Echinocytes and when we see

A

Artifact or hyperosmolairty/renal failure

40
Q

Acanthocytes and when we see

A

Liver dz and post-splenectomy

41
Q

Teardrop cells and when we see

A

Myeloproliferative dz, megaloblastic anemias, and thalassemias

42
Q

SIckle cells

A

Polymerize into rigid crystal when exposed to decreased oxygen or pH

43
Q

Hwoell-Jolly Bodies and when we see

A

Remnants of nucelar chromatin

Splenectomy, megaloblastic anemia, abnormal erythropoiesis, or severe hemolytic anemias

44
Q

Heinz bodies and when we see

A

Denatured hemoglobin

G6PD

45
Q

Basophilic stippling and when we see

A

Disorders of hemoglobin synthesis (like thalassemia)
Blue granules (RNA)
Reticulocytes

46
Q

Pappenheimer bodies and when we see

A

Sideroblasdtic anemias and splenectomy

Fewer number than stippling

47
Q

Normoblasts and when we see

A

Normal in fetus and young

Pathologic denoting excess demand on marrow (hemolytic disease like erythroblastosis fatalis or transfusions)

48
Q

Rouleax formation and when we see

A

Stack of coins with increased plasma protein like plasma cell myeloma

Heme/Lymph 1 (14 decks)

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