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Erythropoietin (hormone)
- Produced in the kidneys.
- Stimulates Production or RBCs
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Blood cell formation begins when?
2 Weeks after conception.
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Blood cell formation begins where?
Mesenchymal Cells (blood islands in the yolk sac)
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3 Phases of blood cell production
- Mesoblastic
- Hapatic
- Medullary
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3 Layers of cells that develope in the blastocyst stage of the zygote.
- Mesodermal
- Peripheral
- Central Cells
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Mesoblastic Stage
Undifferentiated stem cells differentiate into primitive erythroblasts.
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Mesodermal Cells
Gives rise to blood islands.
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Peripheral Cells
Flatten to become blood vessels.
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Central Cells
Detach and enter primitive plasma to become undifferentiated stem cells.
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Hepatic stage begins when?
- Primitive Erythroblasts migrate to liver.
- Peaks during 3rd month.
- Primitive cells disappear by 4th month.
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RBC production continues in liver until when?
8th month.
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Medullary Stage
At 6th month red bone marrow is primary site of hematopoiesis.
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Newborn's and children's bone marrow is?
All red
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By Adulthood red bone marrow is?
Only in the axial skeleton.
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Loss of RBCs decreases?
O2 Level
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P O2 receptors in the brain stem stimulates.
Kidneys to release erythropoietin.
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CFU-S
Pluripotential Stem Cell (uncomitted)
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Erythropoiesis Maturation Stages
- Rubriblast
- Prorubricyte
- Rubricyte
- Metarubricyte.
- Reticulocyte (nucleated red)
- Erythrocyte
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RBC Formation Time Tables
- Bone Marrow 3 days
- Spleen 1-3 Days (reticulocytes)
- Circulation 120 days (erythrocytes)
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Anemia
RBC Values below normal.
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Polycythemia
RBC Values above normal.
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MCV
Mean Cell Volume (Cell Size)
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MCH
Mean Cell Hemoglobin ( Cell Color )
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MCHC
Ratio of HGB to cell size (color)
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RDW
- Red Cell Distribution Width
- Cell size variation
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Normal RBC size
- 6-8 microns
- 80-100fl
- About the size of the nucleus of a small lymph.
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Microcytes
- Less than 6 microns
- Less than 80fl
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Microcytic Anemia Causes
- Iron deficiency Anemia
- Thalessemia
- Chronic Blood Loss
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Macrocytes
- Greater than 8 microns
- Greater than 100fl
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Grading Anisocytosis
- WNL = 0-5 / 10 oil
- 1+ = 6-15 / 10oil
- 2+ = 15-30 / 10oil
- 3+ = > 30 / 10 oil
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Anisochromia
Variation in RBC color
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Hypochromia Causes...
- Fe Deficiency Anemia
- Anemia Associated with leukemia
- Some Hemoglobinopathies (Thalassemias)
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Hyperchromia causes...
- Poikilocytosis (spherocytes, target , helmet)
- Hereditary Spherocytosis.
- Autoimmune Hemolytic Anemia
- Hemoglobinopathies (sickle cells, target cells)
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Target Cells
- Take on target shape when slide dries.
- Too much cell membrane for the HGB.
- Associated with ABN.
- HGB and chronic liver cells.
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Helmet Cells
- Shistocyte precursor.
- Fracture of cells metabolic injury or toxicity.
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Sperocytes
Ascociated with hemolytic anemia and heretitary spreocytosis.
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Anisochromia grading
- WNL 0-2 / 10 oil
- 1+ 2-3 / 10 oil
- 2+ 3-4 / 10 oil
- 3+ >4 / 10 oil
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Tear Drop cell
- Dacrocyte
- Results from "squeezing" through spleen
- Anemias
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Ovalocytes/ Eliptocytes
- Oval Egg Shaped
- Eliptical
- Assoc with hereditary elliptocytosis.
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Stomatocyte
- Fishmouth cell
- Chronic Liver Disease
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Aconthocyte
- Cell deformed with irregular spiny projection.
- Connot revert to normal cell.
- Denotes serious pathological condition.
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Echinocytes or Burr Cells
- Regular distribution of spiny projections.
- Can revert back to normal cell
- Crenated: Artifact from slide drying too fast.
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Keratocyte
- Deformed Cell appears half moon or spindle shaped.
- Appears to have 2 or more spicules.
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Shiztocyte
- Irregularly Shaped RBC fragment with jagged pointed projections.
- Due to mechanical trauma or RBC defect
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Rouleaux
- RBC stacks or rolls
- May be an Artifact from not preparing slide soon enough after placing blood on slide.
- May be due to high concentration abnormal proteins or fibrinogen.
- Associated with multiple myelomas and macroglobulinemias.
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Poikilocytosis Grading (sickle, sperocytes, acanthocytes, rouleaux)
- WNL Never Normal
- 1+ 1-5 / 10 oil
- 2+ 6-15 / 10 oil
- 3+ >15 / 10 oil
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Poikilocytosis Grading (lesser Shapes)
- WNL 0-1 Normal
- 1+ 2-5 / 10 oil
- 2+ 6-15 / 10 oil
- 3+ >15 / 10 oil
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Basophilic Stippling
- Fine dark blue Granules
- Only Found in smear not circulation
- PPT Ribosomes & RNA
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Howell Jolly Bodies
- Round densly staining purple granules.
- Ussually 1-2 seen off center.
- Remnant of Nucleus DNA
- Post Splenectomy and Hemolytic Anemias
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Pappenheimer Bodies
- 1-2 Small Dense Blue Purple Granulesat periphery of cell.
- IRON Deposits
- Sideroblastic Anemias & Post Splenectomy
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Cabot rings
- Lead Poisoning
- twisted or figure 8 shape
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Leukopoeitin
Stimulates production of
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