Unit 1: Review of Normal Blood Cell Maturation COPY Flashcards

Question

New Methylene Blue

Answer 1

Retic Stain

Answer 2

* Cell size: 7 - 8 μm * Nucleus: none present * Cytoplasm: has distinctive central pallor; no protein or Hgb made; no mitochondria present

Answer 3

120 days 300 miles

Answer 4

-Cluster of Differentiation (CD) 34 antigen * Undergoes stimulation, mitosis, and maturation in a stem cell (CFU-GEMM) that’s specific for myeloid cells

Answer 5

* CD34 and CD33 antigens * Matures into CFU-GM

Answer 6

* ILs and CSFs control the stability of cell numbers and their functions * Matures into a myeloblast

Answer 7

(i.e., IL-3) production is stimulated by endotoxin released from infection * Source – secreted by marrow fibroblasts, T-lymphs, macrophages, and monocytes * Function – stimulates regeneration, maturation, and differentiation of multipotential and unipotential stem cells

Answer 8

is important for myeloid maturation in the marrow * Source – secreted by T-lymphs, marrow fibroblasts, marrow endothelial cells and monocytes * Function – stimulates neutrophils, eosinophils, and monocyte growth

Answer 9

is a more specific granulocyte growth factor * Source – monocytes, marrow fibroblasts and endothelial cells * Function – stimulates neutrophils, and enhances functional response of neutrophils

Answer 10

(i.e., CSF-1) is the primary monocytic growth factor * Source – secreted by mature monocytes, marrow fibroblasts, and marrow endothelial cells * Function – stimulates macrophages and the release of G- CSF from monocytes. Stimulates the release of tumor necrosis factor (TNF), interferon, and IL-1 from macrophages

Answer 11

dark blue to blue cytoplasm

Answer 12

Primary granules may begin to appear

Answer 13

lacy, smooth, delicate, & uniformly distributed chromatin

Answer 14

1-2 distinct nucleoli

Answer 15

A large cell (15-20 μm)

Answer 16

* high N:C ratio of 4:1 (so not much cytoplasm)

Answer 17

1-2% normal in bone marrow (none are normal in peripheral blood (p.b.)

Answer 18

CD13 and CD33

Answer 19

non-experts to differentiate myeloblasts/monoblasts / lymphoblasts

Answer 20

primary granules (described as azurophilic)*

Answer 21

nucleoli, but still may be present

Answer 22

blast form (approx. 20 μm)

Answer 23

2-5% Thus used to help distinguish blasts from pros. (Primary = pro = red-purple)

Answer 24

pinkish secondary/specific granules now visible*; 1o granules less visible “Specific = Secondary

Answer 25

occurs: specific granules tend to form in Golgi area causing pink arc

Answer 26

cytoplasm losing blue color due to decreased RNA synthesis

Answer 27

condensed, with chromatin clumped; nucleus starting to “round up” with one flatter side

Answer 28

<10% normal in bone marrow, none normal in p.b.

Answer 29

Neutrophils Thus used to help tell pros from myelocytes!

Answer 30

Red-purple color= Become light blue as cell mature mostly visible in (blast &) Start at myelocyte stage Appear very late stages promyelocyte stages Lysosomes; contains lysozyme, acid hydrolases, myeloperoxidase (MPO)*, proteases, & superoxide Stain pos. for peroxidase

Answer 31

Color: Pale lavender-pink Start at myelocyte stage Cause “dawn of neutrophilia Lysosomes; contain lysozyme, Lactoferrin**, collagenases, & complement activators But no peroxidase

Answer 32

Color- Invisible on Wright’s stain) blue-purple with special LAP*** stain Appear very late stages Lysosomes; contain lysozyme, DAF, gelatinase, & LAP NO peroxidase

Answer 33

more coarsely clumped

Answer 34

Uniformly pink with secondary -purple pink granules.

Answer 35

pink with pinky-purple 20 granules (aka. ? _____Specific___) (1o granules still present but don’t stain as intensely)

Answer 36

* normal in small %'s in p.b., at about 5-10% in normal adults * Constitutes 40% normal in bone marrow * curved, band-like nucleus (C or S shape) with no segmentation * Possess full motility, active adhesion properties, and some phagocytic ability * A maturation “shift to the left” occurs when neutrophil bands are increased in p.b., in comparison to the number of segs

Answer 37

* comprise 50-70% of total WBC population in normal adult p.b. * Nucleus continues indentation to form segments, a lobed nucleus * Cell is completely functional * should have _2-5_____ lobes * A maturation “shift to the right” occurs w/ increased number of segs, or hypersegmentation (>5 lobes) ]

Answer 38

For a neutrophil, about 10 days from myeloblast to maturation.

Answer 39

3 main areas of the body, moving from 1) bone marrow to 2) p.b. to 3) tissues (& movement from endothelium to tissues does not reverse itself.)

Answer 40

* Proliferation (i.e. myeloblasts, promyelocytes, and myelocytes) * Mitotic pool – 2 to 3 days * Maturation (i.e. metamyelocytes and bands) * Storage (bands and polymorphonuclear leukocytes) * Storage pool – 5 to 7 days Bone marrow holds 4-10 day supply of WBCs – about 25x amount in circulation!

Answer 41

Process of moving from bone marrow to tissues can speed up under stress (physical or emotional), causing "shift to the left": an accelerated release of immature forms into the p.b.

Answer 42

* Circulating Pool (CP) – These are counted in a WBC count * Marginating Pool (MP) - Lies against the endothelial lining of blood vessels

Answer 43

There’s constant exchange between these 2 pools. Marginating cells can be mobilized into p.b. circulating pool during stress or exercise

Answer 44

epinephrine

Answer 45

6-10 hrs., then move randomly into tissues via? __diapedesis_______, perform their job (1-5 days), & die.

Answer 46

Endothelial cells of the blood vessel walls, & exit into the tissues. Once in the tissues, they do not return!

Answer 47

are monocytes & neutrophils, but eos & Basos ARE capable of limited phagocytosis!

Answer 48

* Directed Motility (Migration) M * Recognition & Attachment R * Ingestion & Phagocytosis I * Degranulation/Digestion & Killing D (K) * Exocytosis E

Answer 49

process of phagocytic movement along gradient of increasing [chemotaxin] (molecules generated by infection &/or inflammation.)

Answer 50

chemotaxins/chemotactic factors, Abs, & fixed complement. Thus they migrate through p.b. & diapedese into tissues to reach site of infection/ inflammation

Answer 51

Opsonization facilitates recognition & attachment by marking microorganisms for ingestion

Answer 52

* In an amoeboid motion, phagocyte uses rapid microfilament rearrangement to extend pseudopodia & surround foreign particle . . . * Endocytose it, * And then form vacuole around it (called a phagosome).

Answer 53

WBC granules = tiny lysosomes containing lysozyme & acid hydrolases such as myeloperoxidase (MPO); these fuse with phagosome membrane to form a phagolysosome (functions as a ? _____Garbage disposal ________________) * Bacterial killing occurs in the phagosome by processes that are either oxygen-dependent or oxygen-independent

Answer 54

* The burst is triggered by superoxide (generated from MPO) in primary granules (which are still present in a mature seg, just not visible.) * Segs’ 1 o granules color is? ___________ * Segs’ 1 o granules specific or nonspecific? __________

Answer 55

* Accomplished by hydrogen ions (alters the pH), lysozymes , and bactericidal proteins (cleave segments of bacterial cell wall). garbage disposal

Answer 56

* Essentially consists of dumping trash left over from the battle! FYI: Degranulation can also be triggered when seg (or to a lesser extent, a mono) gets “hung up” on an atherosclerotic plaque inside a blood vessel, causing release of MPO & localized inflammatory reaction. Thus MPO & other markers of inflammation are gaining interest as possible CVD markers.

Answer 57

Structurally similar to neutrophils, but differ in their unique cytoplasmic granules

Answer 58

2o granules = large red-orange lysosomes containing very small [peroxidase] & some acid phosphatase. These granules contain mostly crystalloid form of Major Basic Protein (MBP), which is lysine & arginine-rich (& cytotoxic to Schisto-soma.) Granules may overlie nucleus, but usually don’t

Answer 59

less blue than neutrophils, and can be segmented (mature) or band-like (immature)

Answer 60

Move very slowly, have less intracellular killing ability than segs

Answer 61

* Control parasitic infections (damage larval stages of parasitic helminthic worms: flukes, tapeworms, & roundworms). * Dampen hypersensitivity reactions (allergies).

Answer 62

Eos remain < 1 week in p.b

Answer 63

egs & eos. Classified only into immature or mature forms (based upon degree of nuclear segmentation.)

Answer 64

* Mediate inflammatory responses via IgE receptors on their plasma membrane (including allergies)

Answer 65

Large bluish-black lysosomes containing histamine and heparin(released in allergic reactions). These are water-soluble, so may disintegrate during staining (& so may appear as empty areas)

Answer 66

overlie nucleus

Answer 67

The first major function is phagocytosis - even though a monocyte’s speed of mobility is slow compared to that of segs * Even though the speed of mobility is slower, phagocytosis is much quicker * Require less opsonization, and phagocytosis can be initiated by contact

Answer 68

Play a minor role in processing specific antigens for lymphocyte recognition

Answer 69

macrophage, either free or fixed

Answer 70

~ 3 d., then move into tissues & stay several months or more.

Answer 71

Same stimulating factors active for maturation, are involved in osteoclast activity, suggesting link in certain malignant marrow diseases (i.e. Multiple Myeloma)

Answer 72

Also pos. for CD4 (seen in T-lymphs)

Answer 73

Capable of some phagocytosis, but lack range of activity

Answer 74

* Monos contain MANY lysosomal enzymes: includes lysozyme (released continuously), acid phosphatase (where was alk. phosphatase? ______in 3 degree granules of segs___________), & a small amount of peroxidase (< << < seg contains!) * Monos also stain + for nonspecific esterases (NSEs.)

Answer 75

4+ in early segs , 2+ in later segs, 1+ in monos

Answer 76

* Nucleus is indented or curved * Chromatin is lacy w/ small clumps * Largest-sized cell in p.b. * Phagocytic vacuoles are common * Regarded as a transitional cell

Answer 77

variant / atypical lymphs or large bands. (Always look at nuclear chromatin pattern: is it frilly or chunky?)

Answer 78

lysozyme-filled macrophage

Answer 79

metabolic energy, phagocytic activity, lysosomes, IgG surface receptors, and mobility

Answer 80

highly vacuolated and has foamy appearance

Answer 81

free and fixed * Free macrophages are found in various sites of inflammation and repair, and body fluids * Fixed macrophages are fund in specific sites of concentration (i.e., Kupffer cells, bone marrow, and lymph nodes) * Develop different minor characteristics depending upon the organ they occupy

Answer 82

as a secondary line of defense to clean-up and remove microbial organisms or cellular debris, and to remove the bodies own aged and damaged cells * Some macrophages are motile and respond to chemotactic factors such as complement and factors from activated lymphs * Monocytes become immobilized by migration-inhibition factor (MIF) released from activated lymphs * Become activated to phagocytize by complement, prostaglandins, or in response to previously phagocytized material

Answer 83

* A defense against microorganisms * Monocytes present and deliver IL-1 (a T-lymphocyte activating factor) to specific membrane surface receptor sites * Have a role in the daily destruction of aged blood cells, denatured plasma proteins, and lipids * Macrophages possess heme oxidase activity, which enables them to break down hemoglobin, and store iron * Serve as important effector cells by secreting IL-1, and regulators and complement, coagulation, and Kinin cascades

Answer 84

* Bone marrow & thymus (“BMT”) * Lymphocyte production from these sites is continuous & Ag-independent. These send partially differentiated lymphs to The Secondary Lymphoid Tissues .

Answer 85

* The Secondary Lymphoid Tissues: * Lymph nodes, spleen, tonsils, & MALT (Mucosal Associated Lymphoid Tissues in respiratory & GI tracts, such as Peyer's patches (in ? __The small intestines _________________). * These act as main repositories for already differentiated lymphs

Answer 86

* Small to medium sized cell * Round-to-oval nucleus containing loose chromatin and one or more active nucleoli * Cytoplasm is scanty and has basophilia in proportion to amount of RNA

Answer 87

* Clumped chromatin * Cytoplasm is more abundant than blast, but deeply basophilic

Answer 88

* Can vary in size from 9 μm to 15 μm * Small (resting) lymphs - 7-10 μm; scanty cytoplasm, large N:C ratio. * Large lymphs - 11-25 μm; have abundant cytoplasm

Answer 89

* Both have round or oval nuclei * Chromatin appears blocked or “smudgy” * Cytoplasm stains blue; may include some azurophilic granules * Both types are NORMAL

Answer 90

* 8-12μm in diameter with high N:C ratio * nucleus is round with coarse, dense chromatin * cytoplasm is weakly basophilic, homogenous and clear without inclusions * plays a big role in the body’s immune response, particularly in viral infections

Answer 91

* 12-16μm in diameter with an irregular outline * nucleus can appear irregular and the chromatin is not as coarse as in small lymphocytes * cytoplasm is abundant and tends to be light blue * plays a big role in the body’s immune response, particularly in viral infection

Answer 92

secrete Igs. & responsible for antibody production

Answer 93

* Differentiation occurs in the adult bone marrow * Seen primarily in p.b. as small, resting lymphs. * Upon Ag exposure in the 2o lymphoid tissues, these enlarge, differentiate into

Answer 94

1. Plasma cells - secrete Igs. & responsible for antibody production 2. Memory cells

Answer 95

Effector cells - responsible for cell- mediated immunity: defense vs. which 5 major types of “not-self pathogens"? viruses, fungi, bacteria, parasites, & tumor cells * Ex., Cytotoxic T cells (Tcyto ) – usually CD8+. Destroy Ag-specific target cells on contact.

Answer 96

induce or suppress proliferation / differentiation of effector cells; for example

Answer 97

TH ) - CD4+. Induce other lymph to carry out certain functions (Ex., inducing B cells to produce Abs.)

Answer 98

pro-duce chemotactic lymphokines in response to Ags.

Answer 99

CD8 +; regulate humoral & cell-mediated responses. (Not solely suppressive, despite name.)

Answer 100

type of large granular lymphocyte, or LGL (LGL is a descriptive term derived from flow cytometry studies; it may NOT be obviously granular on Wright’s stain!)

Answer 101

Lyses some tumor cells & virus-infected cells

Answer 102

D56+ CD16+

Answer 103

Not all LGLs seen in p.b. are NK cells, but some are. You couldn’t tell unless you did flow analysis

Answer 104

(also “atypical” due to number of granules

Answer 105

* Large lymphs may be similar in size to blasts, & occa- sionally may even contain nucleoli

Answer 106

* Have lacy chromatin (with brain-like convolutions); the nucleus is not stained as darkly as it does in lymphs. Monocyte cytoplasm tends towards blue-gray, & has an opaque, “ground-glass appearance.”

Answer 107

Similar in size to lymphs, but rubricyte cytoplasm has a grayish-blue appearance, whereas lymph cytoplasm is a clearer blue. Also, rubricyte chromatin is much denser than lymphocytes’ chromatin.

Answer 108

absolute ↑ in # of circulating lymphs above normal range: * ↑ 4.0 x 10 3/uL in adults * ↑ 9.0 x 10 3/uL in children (Note difference!)

Answer 109

absolute ↓ in # of circulating lymphs below normal range (due to ↓ production, alterations in lymph traffic, and/or ↑ lymph destruction.)

Answer 110

– some call this “Plasmacytoid lymph” * Smallest of the atypicals (9-20 um). * Variable basophilic cytoplasm; vacuolated, may contain granules. * “Foamy” or “frilly” nuclear appearance, but chromatin still dense. Most likely a triggered (i.e., immunocompetent) B cell. * Classically, this is type most commonly confused with monocytes, but it can also appear in an easier to ID form . . .cytoplasm is

Answer 111

aka. “Downey cells”. * These are the classical reactive or atypical lymphs * Classically seen in Infectious Mononucleosis! * Abundant cytoplasm, irregularly- shaped & edges indented by surrounding structures. * Overall “fried egg” or “flared skirt” type of appearance. * No nucleoli No what

Answer 112

Largest of the atypicals (12-35 um). * Vacuolated, very basophilic cytoplasm. * Immature chromatin with nucleoli! * So how do you tell these highly reactive lymphs (reactive lymphocytosis) from blasts (in a malignant lymphocytosis)? The extreme pleomorphism of the reactive lymphs - a malignant lymphocytosis looks more clonal, with a more homogeneous cell population.

Answer 113

generally smaller than Type III atypicals (10-28 um). * Abundant, deep blue, & agranular cytoplasm. * Eccentrically located nucleus. * General “cometary” type appearance.

Answer 114

Megakaryoblast Promegakaryocyte Basophilic/Granular Megakaryocyte Megakaryocyte

Answer 115

* A normal platelet measures 1,5–3 μm in diameter. * round or oval in EDTA-anticoagulated blood. In blood films made directly from capillary blood they appear aggregated. * Thrombocytes are fragments of the of the megakaryocyte cytoplasm. * Platelet size is of diagnostic significance particularly when considered in relation to the platelet count. * Thrombocytes play a big role in the body coagulation process