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Haematology > Structure and Function of RBC's > Flashcards

Structure and Function of RBC's Flashcards

1
Q

3 cell types in blood

A

RBCs
platelets
Leukocytes

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2
Q

normal RBC count for Male/Female

A

> 4.7-6.1 x 10^6/microliter

>4.2-5.4

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3
Q

Normal Hgb for male/female

A

> 14-18

>12-16

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4
Q

Normal Hct for male/female

A

> 42-52 male

>37-47 female

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5
Q

MCV < 80

A

microcytic

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6
Q

MCV >100

A

macrocytic

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7
Q

MCV 80-100

A

normocytic

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8
Q

MCV<70

A

thalassemia

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9
Q

definition of anemia

A

reduction in the mass of RBC’s

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10
Q

Hematocrit=

A

Total RBC count x MCV

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11
Q

Normal hematocrit shortcut

A

3 x Hgb

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12
Q

differnces in shape

A

anisocytosis

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13
Q

differences in size

A

poikilocytosis

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14
Q

normal RDW range

A

11.5-14.5%

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15
Q

How to keep blood sample from clotting

A

EDTA (lavender top)

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16
Q

Stain used in periph. smear

A

“wright-giemsa”

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17
Q

EOSIN CHARACTERISTICS

A 
**STAINS HEMOGLOBIN**
>ACIDIC/AROMATIC
>STAINS HYDROPHOBIC BASIC MACROMOLECULES 
>soluble in ethanol
>insoluble in water
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18
Q

CELL with clearly defined pink cytoplasmic granules

>segmented nucleus

A

EOSIN-ophil

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19
Q

Characters of Methylene Blue stains

A

> BINDS NUCLEIC ACIDS (HYDROPHOBIC ACIDS)
aromatic/basic
positively charged
SOLUBLE IN WATER OR METHANOL

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20
Q

RELATED TO TISSUE MAST CELLS

A

basophils

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21
Q

list cells in order of their prevalence

A

neutrophils (40-70%), lymphocytes(20-30%), monocytes (3-8%), eosinophils (5%), basophils (1%)

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22
Q

cells that bind little eosin of methylene blue

A

neutrophils

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23
Q

describe neutrophil appearance

A

neutral cells with salmon pink cytoplasmic granules

SEGMENTED NUCLEI

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24
Q

LIFESPAN OF NEUTROPHILS

A

1 DAY

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25
Q

NEUTROPHILS INCREASE IN RESPONSE TO

A

BACTERIAL INFECTIONS

*10 FOLD

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26
Q

Weapons employed by neutrophils during bacterial infections

A
  1. phagocytosis
  2. degranulation–>so will have granules
  3. Extracellular NETS
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27
Q

secondary neutrophil granules

A

salmon pink

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28
Q

How to separate monocytes from lymphocytes

A

indented “ameboid” nucleus in a mono

> lymphocyte will have a rounded nucleus

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29
Q

how to separate monocytes from BANDS or granulocytes

A

–>absence of granules in mono (but nuclei will look similar)

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30
Q

2 conditions under which lymphocytes increase in number

A
  1. viral syndromes

2. neoplastic events (leukemia)

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31
Q

life span of a lymphocyte

A

months-years

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32
Q

distribution of lymphocytes

A

T cells–>B cells–>NK cells

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33
Q

reactive lymphocytes

A

increase in viral syndromes

more cytoplasm, prominent nucleoli

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34
Q

“large granular lymphocytes”

A

NK and CTL’s with basophillic cytoplasmic granules

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35
Q

SMall fragments that lack nuclei

A

plastelets
(100 x more prevalent than white cell population)
*400 Billion/person

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36
Q

4 functions of platelets

A
  1. primary hemostatic plug
  2. stimulate coagulation cascade–>fibrin clot formation
  3. recruit fibroblasts and promote wound repair
  4. secrete platelet factor 4 to inactivate pathogens
  5. antigen presentation
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37
Q

platelet response in IDA

A

platelets increase

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38
Q

lifespan of platelets

A

9-10 days

39
Q

90% of the time: reactive Left Shift indicates

A

bacterial infection

40
Q

cells seen in a left shift

A

bands, metamyelocytes, myelocytes

41
Q

What is toxic granulation

A

Increase in PRIMARY (basophillic) cytoplasmic granules in neutrophils seen in bacterial infection

42
Q

primary granules/toxic granulation is only present in

A

early myeloid precursors in the bone marrow

43
Q

eosinophils increase…

A

in response to allergic reactions and infection with parasites

44
Q

Anion exchanger

A

band 3

45
Q

Methemoglobin

A

hemoglobin with oxidized iron Fe+++ that cannot carry O2

46
Q

describe the RBC antioxidant system

A

02 spontaneously converted to H2O2 (toxic free radical)–> converted to the inert molecule water by GSH–>to replanich GSH…NADPH is required!!!!

47
Q

Mutations in anti-oxidant system results in…

A

bit cells–>tissue macrophages take chunks out of RBC to remove the ROS’s

48
Q

enzyme required to reduce methemoglobin

hemoglobin with iron in the ferric /fe+++ state

A

Cytochrome B5 reductase

49
Q

Cytochrome B5 reductase requires

A

NADH

50
Q

How does free radicals affect Hgb in a RBS

A

oxidized Hgb molecules (oxidizes SH groups) crosslink and cause hemoglobin to denature and/or precipitate

51
Q

do mature RBC’s have nucleus or mitochondria

A

NO

to make room for HGb and they only rely on glycolysis

52
Q

Glycolysis within the RBC provides

A

ATP (though inneficiently) and NADH (for Cytochrome b5 reducatase)

53
Q

Pentose phosphate shunt within the RBC is used for

A

repletion of NADPH so that the cell can replentish GSH for H2O2-H2o reaction

54
Q

first enzyme in pentose phophate shunt pathway

A

g6pd

55
Q

G6pd deficiency will show what on blood smear

A

bite cells and blister cells
(SH groups are cross linked and precipitate out–>tissue based macrophages remove the membrane+ cytoplasmic arease affected by the ROS

56
Q

slow the process of compliment fixation on a normal RBC–>

A

Decay Accelerating Factor

57
Q

DAF counteracts which compliment fixation process

A

alternative

58
Q

definition of hypochromia

A

greater than one third of the cytoplasm on Peripheral Blood Smear is taken up by area of central pallor

59
Q

Define polychromasia and when it is usually seen

A

Bluish tinge caused by methylene blue binding to residual RNA in a newly formed RBC
>usually seen when RAPID production of RBC’s is required–>due to rapid blood loss

60
Q

Rapidly produced RBC’s are usually

A

biger than more mature counterparts and hypochromatic

61
Q

genetic defect in hemoglobin structure

A

hemoglobinopathy

62
Q

Heinz bodies

A

small clumps within the cytoplasm of an RBC that indicated oxidized and denatured hemoglobin–> LEADS TO BITE CELLS

63
Q

conditions which would give you heinz bodies

A
  1. G6pd deficiency
  2. NADPH deficiency
  3. Chronic liver disease
  4. alpha thalassemia
64
Q

Cleaved RBC’s

A

schistocytes

65
Q

Schistocytes tell you what?

A

microangiopathic hemolytic anemia

*there are many things that can cause/lead to this finding

66
Q

supernatant of clotted blood

A

serum

67
Q

supernatant of unclotted blood

A

plasma

68
Q

manual hematocrit=

A

RBC volume/ Total blood volume

69
Q

hematology analyzer hematocrit

A

= MCV x TOTAl RBC count

70
Q

estimate of hematocrit=

A

normally should be Hgb x 3

71
Q

how to correct for reticulocyte count

A

total retic x (hct/45)

*should be less than 1.7

72
Q

What methods does a hematology analyzer measure

A
  1. Spectophotometry (assesses number)
  2. CONDUCTIVITY-Coulter Chamber- (assesses number, COMPLEXITY and volume/size
  3. FLOW CYTOMETRY
73
Q

Hgb concentration is measured via

A

spectophotometry

*add cyanide and measure % absoprtion

74
Q

most reliable measure of anemia

A

Hgb because it is measured directly and is not dependent on two measured variables as Hct is

75
Q

How are reticulocytes counted

A

SPECTOPHOTOMETRY

>add methylene blue–>analyzer will measure recently made (larger than usual) RBC’s containing residual RNA)

76
Q

reticulocytes seen on a peripheral smear should elicit

A

a “polychromasia” comment

*RNA is a fine network staining blue–>reticular network

77
Q

Routine CBC WILL measure…

A 
>Hgb concentration
>RBC count
>MCV
>RDW-->indicates anisocytosis
>platelet count
>MOV
78
Q

Caculated value that the CBC also spits out but doesnt measure directly

A

hematocrit
mch (hgb/RBC)
mchc (hgb/hct)

79
Q

In pt.s with anemia which value do you being with for DX

A

MCV

*will tell you micro vs macrocytic

80
Q

A patient who for any reason is making red cells rapidly will have

A

increased MCV

*Macrocytic, polychromatic, reticulocytes

81
Q

Coulter chamber can also count leukocytes how?

A

separate set of electrodes measures complexity as they pass thru aperture–>more lobulated nuclei will diff. poly’s vs. mono’s etc

82
Q

flow cytometry in a CBC is used for

A
  • -> separating out leukocyte cell populations even further than the conduction study
  • ->Immature Platelet Fraction (platelets with excess RNA)
83
Q

What the hematology analyzer will NOT count

A 
>bands
>blasts-->wil not catch acute leukemias
>Red Cell fragments
>platelet clumps
*therefore these measurements require a manual differntial!!!!
84
Q

bands usually charcterized as

A

neutrophils by most analyzers

85
Q

blasts usually counted as

A

lymphocytes or monocytes

86
Q

red cell frags usually counted as

A

pletelets

87
Q

platelet clumps usualy counted as

A

not always counted and can result in artifactual thrompocytopenia

88
Q

what causes hypochromia in RBC’s

A

lack of hemoglobin

89
Q

oxidized HGhg will lead to what to peripheal smear findings

A
  1. heinz bodies

2. bit cells–>tissue macrophages take out chunks of a cell that has been damaged by ROS

90
Q

polychromasia is usally seen with?

A

accelerated prodcution

91
Q

main function of monocyte

A

antigen presentation to lymphocytes

92
Q

eosinophils increase with

A

parasite infections, drugs and allergic reactions

93
Q

starting point for Dx of ay increase in any cell type

A

reactive vs. neoplastic

Haematology (7 decks)

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