-
Acanthocyte
Cell with irregular, long, asymmetrical projections; s
-
Anisocytosis
Variation in size of RBC's
-
Basophilic stippling
Small aggregates of RNA are seen as small blue dots in the RBC
-
Elliptocyte
Elongated, elliptical cell; non-specific when occasionally seen; rare disorder of hereditary elliptocytosis
-
Heinz body
Precipitated Hgb seen as a perimembranous blue dot only after supravital staining
-
Howell-Jolly body
Small, round deeply basophilic nuclear remnant; seen when spleen is absent
-
Pappenheimer body
Multiple, tiny iron containing granular blue dots; seen when spleen is absent and with iron overload
-
Poikilocytosis
Variation in shape of RBC's
-
Spherocyte
Small, round dense cell without central pallor; suggests extravascular (splenic) hemolysis in previously normal persons; with hereditary spherocytosis there is increased osmotic fragility
-
Schistocyte
Fragmented, irregularly shaped seen with intravascular hemolysis such as microangiopathic hemolytic anemias (DIC, TTP). A variant called a "helmet cell" appears cut in half
-
Sickle cell
Curved, banana-shaped cell with pointed ends found in sickle cell disease from aggregation of Hgb S
-
Target cell codocyte
Cell with central and peripheral staining with intervening pallor due to increased redundancy of RBC membrane; seen with liver disease, in some thalassemias, and with Hgb C
-
Tear drop cell dacryocyte
Cell pinched at one end, prominent in myelofibrosis and myelophthisic conditions
-
Neutrophils
in response to bacterial infection or inflammatory disease
-
Eosinophils
in response to allergic disorders, inflammation of the skin, and parasitic infections
-
Basophils
increase in cases of leukemia, chronic inflammation, the presence of a hypersensitivity
-
Lymphocytes
increase in cases of viral infection, leukemia, cancer of the bone marrow,
-
Monocyte
in response to infection of all kinds
-
Neutrophils
(10-12 um diameter)
-
Eosinophils
larger than PMNs 12-17 um diameter
-
Basophils
0.5% of the WBCs are difficult to find. They are 10-12 um diameter
-
Monocytes
the largest WBC 14-20 um diameter
-
Platelets
small (2-5 um) fragments of cytoplasm detached from Megakaryocytes in the bone marrow.
-
Lymphocytes
both small (slightly larger than an Rbc 7-8 um) and medium to large (up to 12 um
-
Hematopoiesis
The process responsible for the replacement of circulating cells, governed by multiple cytokines
-
Commitment
When two cells derived from the same precursor take a separate route of development
-
Circulating cells are
Mature ,Incapable of mitosis
-
CFU-GEMM
Granulocytes, erythroid cells, monocytes, megakaryocytes
-
CFU-GM
Granulocytes, monocytes
-
-
Pluripotential hematopoietic stem cell
self renewal
-
Earliest differentiation daughter cells give rise to
Common lymphoid progenitor cell (CLP), Common myeloid progenitor cell (CMP)
-
CLP gives rise to
T and B cells, natural killer cells, lymphoid dendritic cells
-
CMP gives rise to
Neutrophils, monocytes, eosinophils, basophils, erythrocytes, megakaryocytes
-
Growth factor cytokines
Most are produced by stromal cells in the hematopoietic microenvironment
-
Later acting growth factors to maturation
- Granulocyte stimulating factor (G-CSF)
- Monocyte stimulating factor (M-CSF)
- Erythropoietin (EPO) – erythrocytes
-
Erythropoiesis –Progenitor cells give rise to
BFU-E, Regulated by IL-3, GM-CSF
-
Erythropoiesis –Progenitor cells give rise to
CFU-E- Depends primarily on EPO
-
-
Gives rise to the first recognizable erythrocyte precursor-Pronomoblast
-
Extracellular Matrix (ECM)
Composed of-Collagen,Glycoproteins,Glycosaminoglycans
-
hematopoietic microenvironment
PCs can interact with only some types of ECM components
-
Leukocytes diapedese
pass through the vessel walls.
-
The greatest difference between reference intervals occur between
Newborns and adults
-
clinical pathways refer to plans
developed by physicians
-
critical pathways refer to care and service
provided by interdisciplinary health care team
-
follow-up testing based on screening test is
reflex testing
-
Plasma makes of __ blood volume
55%
-
Erythrocytes __ blood volume
45%
-
fee for service
chose there own health care
-
capitated payment plans
for defined population per member fee
-
Prospective payement system
fixed amount for services
-
-
MPP gives rise to
CLP and CMP
-
-
CFU-EMk gives rise to
BFU-E and BFU-Mk
-
BFU give rise to
CFU E and Mk
-
Neutrophils and monocytes derived from the common committed bipotential progenitor cell
CFU-GM
-
the growth of hematopoietic precursor cells requires the continous presence of
growth factors
-
the first effects of GF is to promote
cell survival
-
BFU form large colonies after
14 days
-
CFU grow to maximum size in
7 to 8 days and depends on EPO
-
all hematopoietic cells are derived from the CFU-GEMM except
lymphocytes
-
the following cell is most sensitive to EPO
CFU-E
-
Pleiotrophy refers to
act on one or more cell type
-
-
Erython
delivery of O2 from lungs to the tissues and transfer of CO2 from tissues to lungs
-
RBC is a
7-8 µm,80-100 fl
-
Average adult RBC
2.2 L of rbcs 100-120 days
-
BFU-E
1st progenitor committed to RBC line
-
CFU-E
high concentration of EPO receptors
-
Normoblasts
5-7 days maturing in BM
-
Reticulocyte
Matures in 2-3 days, first 1-2 days spent in BM, remainder in circulation
-
Pronormoblast also known as
Rubriblast
-
Pronormoblast
20-25 µm, fine chromatin (“lacy” appearance, 1-3 faint nucleoli
-
Pronormoblast produces
8-32 mature RBCs
-
Pronormoblast cytoplasm stains
deeply blue (basophilic)
-
Basophilic normoblast is also known as
Prorubricyte
-
Basophilic normoblast
16-18 µm
-
Basophilic normoblast
chromatin is coarser than the Pronormoblast
-
Prorubricyte/basophilic normoblast are nucleoli apparent?
-
nucleoli are usually not apparent
-
Basophilic normoblast nucleus is
wheel-spoke appearance
-
Polychromatophillic normoblast is also known as
Rubricyte
-
Polychromatophillic normoblast size is
12-15 µm
-
Polychromatophillic normoblast/rubricyte cytoplasm is
gray-blue cytoplasm
-
Rubricyte chromatin is
chromatin irregular and coarsely clumped, shrinking nucleus
-
What stage does hemoglobin start to synthesize?
Rubricyte
-
Orthrochromic normoblast is also know as
Metarubricyte
-
Orthrochromic normoblast/metarubricyte size is
10-15 µm
-
Orthrochromic normoblast nucleus occupies
1/4 of the cell, chromatin heavily condensed
-
Orthrochromic normoblast/metarubricyte cytoplasm is
pink or salmon color with hint of blue
-
Reticulocytes size is
7-10 µm
-
remaining 20% of hemoglobin,
–2-3 days (in marrow and circulation)
Reticulocyte
-
Responsible for net negative charge of rbc
Zeta potential
-
hemoglobin concentration Female =
12.0 – 16.0 g/dL
-
normal hemoglobin concentration male =
14.0 – 17.4 g/dL
-
normal hemoglobin concentration newborn
13.5 – 20.0 g/dL
-
Each heme contains___ ferrous (Fe++) iron in its center
1
-
one Fe++ iron molecule binds to____ molecule of O2
1
-
1 Hb molecule can carry __ O2 molecules
4
-
Embryonic hemoglobin types
- Gower I (ζ2ε2), Gower II (α2ε2),
- Portland (ζ2y2)
-
Hg type 1 year- adulthood
HbA (α2β2) 97%, HbA2 (α2δ2) 2.5%
-
oxygen transport–Curve shifts to right
p50 increased O2 affinity has decreased
-
oxygen transport–Curve shifts to left
p50 is decreased, O2 affinity has increased
-
Methemoglobin
Hb has the ferric Fe3+
-
Conditions that stimulate erythropoiesis
anemia, cardiac or pulmonary disorders, abnormal hemoglobins,high altitude
-
Destruction of senescent rbcs
90% extravascularly 10% intravascularly
-
extravascular destruction
Occurs in the macrophages of *spleen, liver, BM
-
Innate immune response
nonspecific defense mechanism, neutrophil, monocyte, macrophage
-
Acquired (adaptive) immune response
antigen-specific response initiated in lymphoid tissue à contact with lymphocytes
-
EPO is a thermostable ______ hormone
renal glycoprotein
-
higher altitudes affect what is the range
3,000-10,000
-
Ribosomes
Assemble amino acids into protein Free and Fixed
-
Golgi apparatus
Packages proteins, forms lysosomes
-
Euchromatin
unwound and loosely twsisted Transcriptionally active
-
Heterochromatin
Transcriptionally inactive
-
The chromatin structure of a cell's nucleus is light staining, loosely coiled in appearance is
An immature cell transcriptionally active
-
Nuclear condensation and blebbing occurs during necrosis or apoptosis
apoptosis
-
Do necrotic cells initiate the inflammatory response?
yes
-
Is necrosis energy dependent
no
-
Programmed cell death (suicide) is
apoptosis
-
Removal of excess neutrophils and b lymphocytes after an event is regulated by
apoptosis
-
Rough ER important in
synthezing and assembly of proteins.
-
Assemble amino acids into proteins
Ribosomes
-
Lipids are synthesized by
smooth ER
-
More test are ordered based on screening test is
reflex testing
-
Caused by external injurious agent, passive event, effects large number of cells
necrosis
-
energy dependent, Caused by the cell itself, single cell
Apoptosis
-
Microscope condenser directs
light beam on to sample
-
Hemoglobin curve on spectrophotometer is a
Logarithimic
-
R represents the restriction point in cell cycle that
after which the cell no longer depends on extracellular signals
-
Period of nuclear division
Mitosis
-
DNA synthesis (duplicated) is what phase
S
-
-
Period after DNA is duplicated
time between the completion of S and the onset of mitosis G2
-
Period of cell growth before DNA is duplicated
The time between the end of mitosis and the next round of DNA replication G1
-
-
-
-
-
Factor V
ProACCELERIN labile
-
Factor VII
proconvertin stable factor
-
Factor VIII
Antihemolytic factor
-
Factor IX
Plasma thromboplastin component, christmas factor
-
-
Factor Xi
Plasma thromboplastin antecedent
-
Factor XII
Hageman factor
-
XIII
Fibrin stabilizing factor
-
Which factors have not activated form
TF (III) and Calcium
-
Intrinsic pathway factors?
XII, XI, IX, VIII, PK, HK
-
Extrinsic pathway
TF (III) not normally found in blood, VII
-
Common pathway factors
X, V, II, I
-
Prothrombin group
Vitamin K dependent
Prothrombin, Proconvertin, plasma thromboplastin (christmas), Stuart
-
Prothrombin group
proteins C, S and Z
-
Prothrombin group
All synthesized by liver, all factors but prothrombin found in serum.
-
Fibrinogen group
- Thrombin sensitive clotting factors(activated by thrombin)
- I, V, VIII, XIII
- Not found in serum consumed during clotting
-
Contact group
XII, PK, HK
-
Contact group is activated by
negatively charged surfaces, found in serum, also involved in fibrinolysis
-
Cofactors
TF, V, VIII, HK, protein S
-
Enzymes
- serine XIIa, XIa, Xa, IXa, VIIa, IIa
- transgluta.. XIIIa
-
-
Deficiency of VIII
Hemophilia A, gene on X chromosome
-
VIII circulates in plasma in a complex with___ in secondary hemostasis
VVF
-
VWF is synthesizd by
endothelial cells and megakaryocytes
-
VWF role in primary hemostasis
mediates adhesion of platelets to vessel wall
-
Fibrinogen is synthesized by
Liver
-
3 stages of coverting fibrinogen to fibrin
thrombin cleavage of fibrinogen into a fibrin monomer, polymeraization of monors to polymers, stabilization of fibrin polymers XIIIa
-
stem cells have 3 possible fates
Self renewal, commitment CLP,CMP, apoptosis
-
Cell membrane has bilayer of phopholipid
hydrophobic tails, hydrophilic heads
-
Blood coagulation is the
- formation of hemostatic plug
- convert fibrinogen to insoluble fibrin
-
Hemostasis is a complex between
Blood vessels, platelets, soluble plasma proteins
-
Fibrin forming
procoagulant
-
Fibrin lysing
Anticoagulant
-
Primary hemostasis
formation of platelet plug
-
Secondary hemostasis
Reinforcement of platelet plug
-
hemostasis occurs in
Venules and arterioles
-
Injured endothelial lining
promotes platelet adhesion, activatges coagulation factors initiatng both intrinsic and extrinsic pathways, inhibits fibrinolysis
-
Megakaryocytes 4 stages
Megakaryoblast, promegakaryocyte, granular megakaryocyte, mature magakaryocyte
-
Endomitosis is
Double DNA content without division nuclear division or cell division
-
Platelets are released in ___ and 1 megakaryocyte can produce
BM and 1000-3000 platelets
-
Regulation of platelet production
Thrombopoietin, cytokines
-
Platelet life span
9-12 days, removed by spleen and liver
-
Platelets released in BM 2/3 circulate or stay in spleen
Circulate, 1/3 stays in spleen.
-
Platelets not activated are in the ____ state and shaped
resting, discoid
-
Upon activation platelets shape changes to
Round and sticky.
-
Upon activation platelets requires _____to adhere to the collagen in the subendothelial vessel wall.
VWF
-
Agonist are
the granules to activate platelets from resting state
-
Myeloblast cytoplasm is
agranular
-
promyelocyte nucleoli
still visible and primary granules in cytoplasm
-
Myelocyte nucleoli are ___ present and cytoplasm contains
not visible and secondary granules dawn of neutrophilia, last stage of mitosis
-
metamyelocyte nucleus is
kidneyben shaped,
-
In the neutrophil is an X chromatin body
Barr body
-
Total leukocyte count for adult
4.5-11.0 x 109/L
-
Monocyte maturation
Monoblast, promonocyte, monocyte, macrophage
-
differentiatng myelocytes from promyelocytes is
secondary granules
-
primary granules appear in
promyelocyte
-
The first heavy Ig chain produced in b lymphocyte
mu
-
Neutrophils regulated by 3 cytokines
Interleukin-3 (IL-3), GM-CSF and G-CSF
-
Neutrophils
- Mitotic pool – 3-6 days, 4-5 cell division
- Myeloblasts, promyelocytes, myelocytes
-
Neutrophils in the post mitotic pool life span
5-7 days, Metamyelocytes, bands, segs, 3 times the size of mitotic pool
-
Neutrophils spend how many hours before moving into tissues
7.5
-
Neutrophil normal range
1.8 - 7 x 10(9)/L
-
Life span of eosinophil PB and then tissues
18 hours, several weeks
-
Eosinophils function
allergic disease, parasitic infection or chronic inflammation
-
Charcot-Leyden cyrstals are the breakdown of
eosinophils
-
basophils are associated with _____ and spend only ____ in PB
Asthma and only hours
-
monocytes lifespan
54 hours in BM, 8 hours in PB
-
80% of lymphs are
long lived
-
-
absolute counts
whole WBC + diff % would be 0.54
|
|