Red cells (3) Flashcards

(37 cards)

1
Q

Where are all blood cells derived from?

A
  • bone marrow

- multipotent haemopoietic stem cells (HSCs), which give rise to lymphoid stem cells and myeloid stem cells

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2
Q

What is haemopoiesis?

A
  • the process by which the body produces blood cells
  • haem= blood… poiesis= making
  • occurs in adults mainly in bone marrow, esp. pelvis, femur and sternum
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3
Q

What follows the myeloid stem cell/precursor in the origin of blood cells?

A

granulocyte (–> basophil, eosinophil, neutrophil), monocyte (–> macrophage), mast cell, erythrocyte, megakaryocyte (–> thrombocyte)

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4
Q

What follows the lymphoid stem cell in the origin of blood cells?

A

B cell/ B lymphocyte (–>plasma cell), T cell/T lymphocyte, NK cell

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5
Q

What are the 2 essential characteristics of HSCs?

A
  • can self-renew–> some daughter cells remain as HSCs, a pool is not depleted
  • can differentiate to mature progeny–> other daughter cells follow a differentiation pathway
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6
Q

How does a myeloid stem cell/precursor give rise to erythrocytes?

A

myeloid stem cell–> proerythroblast–> early, intermediate, late erythroblast–> erythrocytes

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7
Q

How does a myeloid stem cell/precursor give rise to erythrocytes?

A

myeloid stem cell–> proerythroblast–> erythroblasts–> erythrocytes

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8
Q

What is erythropoietin?

A
  • glycoprotein synthesised mainly in kidney (also in liver) in response to hypoxia
  • growth factor for normal erythropoiesis
  • stimulates bone marrow to produce more RBCs
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9
Q

What is the main function of erythrocytes?

A

transport oxygen from lungs to tissues- binds to Fe2+ in haem groups of haemoglobin

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10
Q

What is the structure of adult haemoglobin?

A
  • made up of 4 subunits
  • 2 alpha globin chains, 2 beta
  • each chain bounds to a haem group, consisting of a ferrous iron held in a porphyrin ring
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11
Q

How does haemoglobin differ at birth?

A

fetal haemoglobin (F) has 2 alpha and 2 gamma globin chains

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12
Q

What are the sources of iron and their comparative absorption?

A
  • haem iron (ferrous Fe2+) from animal products- best absorbed
  • non-haem (ferric Fe3+) iron from food- requires reducing substances (vit C, ascorbic acid) for absorption
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13
Q

Why is iron absorption tightly controlled by hepcidin?

A
  • only 1-2mg per day absorbed, bc no physiological mechanism to excrete iron
  • excess iron can be toxic to heart and liver
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14
Q

Why are vitamin B12 and folate needed for the development of red blood cells?

A
  • they are needed for dTTP synthesis (necessary for making thymidine)
  • DNA synthesis needs 4 immediate precursors, including dTTP
  • therefore, deficiency affects DNA synthesis and thus, cell division
  • cells larger than normal, and not enough cells
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15
Q

What are sources of vitamin B12?

A
  • meat
  • liver and kidney
  • fish
  • oysters and clams
  • eggs
  • milk and cheese
  • fortified cereals
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16
Q

What are sources of folic acid?

A
  • green leafy vegetables
  • cauliflower
  • brussels sprouts
  • liver and kidney
  • whole grain cereals
  • yeast
  • fruit
17
Q

How is vitamin B12 absorbed?

A
  • in stomach, B12 combines w/ IF made in gastric parietal cells
  • in small intestine, B12-IF binds to receptors in ileum then is absorbed
18
Q

What are causes of vitamin B12 deficiency?

A
  • inadequate intake
  • inadequate secretion of IF e.g. pernicious anaemia
  • malabsorption
19
Q

Where are red blood cells destroyed and what happens to the iron inside?

A

RBCs destroyed after 120 days by macrophages in the spleen–> macrophages store the iron released from haemoglobin breakdown–> transferred as ferritin–> returns to bone marrow

20
Q

What is a microcyte?

A

a RBC that is smaller than normal

21
Q

What does normocytic mean?

A

describes RBCs that are of normal size or anaemia w/ normal sized RBCs

22
Q

What is a macrocyte?

A

a red cell that is larger than normal

23
Q

What are the 3 types of macrocyte?

A
  • round macrocyte
  • oval macrocyte
  • polychromatic macrocyte
24
Q

What is the area of central pallor?

A
  • cells shaped like discs
  • not much Hb in middle
  • about 1/3 of diameter is pale
25
What is hypochromia?
cells have a larger area of central pallor than normal--> indicates lower Hb content and flatter cells (often goes w/ microcytosis)
26
What is polychromasia?
inc. blue tinge in cytoplasm of RBC--> indicates that cell is young (also macrocytic)
27
What special stain is used to detect reticulocytes?
new methylene blue- stains for higher RNA content | less subjective than detecting polychromasia
28
What is reticulocytosis?
inc. numbers of reticulocytes (immature RBCs) | - -> may occur as a response to bleeding or RBC destruction
29
What is anisocytosis?
RBCs show more variation in size than is normal- some macrocytic, some microcytic
30
What is poikilocytosis?
RBCs show more variation in shape than is normal
31
What are some examples of poikilocytes?
- spherocyte - irregularly contracted cell - sickle cell - target cell (has a dot in middle) - elliptocyte - fragment (piece of RBC)
32
What are target cells?
RBCs w/ an accumulation of Hb in area of central pallor | --> may indicate obstructive jaundice, liver disease, haemoglobinopathies, hyposplenism
33
What are sickle cells?
RBC in crescent shape | --> results from polymerisation of HbS, which is much less soluble thatn HbA in deoxygenated form
34
When does HbS occur?
when 1 or 2 copies of an abnormal beta globin gene are inherited
35
What affects 'normal'?
- age - gender - ethnic origin - physiological status - altitude - nutritional status - cigarette smoking - alcohol intake
36
What is a reference range?
derived from a carefully defined reference population - samples collected from healthy volunteers w/ defined characteristics - analysed using same instrument and techniques that will be used for patient samples - data analysed by appropriate statistical technique
37
How do we determine the 95% range of data with a normal/Gaussian distribution?
mean value +- 2SD