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Hematology Exam 2
STCC, CLLS program, Spring 2014
| Term | Definition |
|---|---|
| Mature Erythrocyte physical characteristics | 6-8 micrometers, Biconcave, Central pallor, no nucleus, stains light red (salmon) |
| Erythrocyte function | Transports oxygen and carbon dioxide |
| "Old" erythrocyte physical characteristics | Rigid cell membrane, bloated |
| Erythrocyte disposal site | Spleen |
| Erythropoiesis | Production of erythrocytes |
| Heme | Pigment portion of hemoglobin, Composed of 4 pyrrole rings |
| Heme function | oxygen and carbon dioxide transport |
| Erythropoietin | Hormone responsible for stimulating erythropiesis,erythoid cell--->proerythroblast, made by kidneys |
| Polycythemia | "many-cells-blood", Increased erythrocyte concentration |
| Polycythemia causes | increased erythropoeitin, tissue hypoxia, increased RBC (not from increase in hormone) |
| Reticulocyte | 7-10 micrometers, no nucleus, polychromic cytoplasm, last phase before mature erythrocyte, in bone marrow for 2.5 days, in circulation for 1 day, forms into erythrocyte when all RNA is catabolized |
| Red Cell size (young to old) | Large to smaller to smallest |
| RBC Nucleus size (young to old) | Large to small to smallest, eventually absent |
| RBC Chromatin pattern (young to old) | loose and delicate to coarse and clumped |
| CFU-GEMM | Colony forming unit granulocyte-erythrocyte-monocyte-megakaryocyte |
| BFU-E | Bursting forming unit-erythrocyte, stored in "cell pool", stimulated by erythropoeitin |
| CFU-E | Colony forming unit-erythrocytes, uni-potential, many erythropoeitin receptors on membrane |
| Rubriblast/Pronormoblast | 12-19 micrometers, N:C 10:1, 0-2 nucleoli, fine chromatin pattern, basophilic cytoplasm, no granules, located ONLY in bone marrow, lasts slightly longer than 24 hours |
| Prorubricyte/Basophilic Normoblast | 12-17 micrometers, smaller than rubriblast, N:C 6:1,clumped coarse chromatin pattern, nucleoli possible, cytoplasm stains deeper blue, located ONLY in bone marrow, lasts slightly longer than 24 hours |
| Rubricyte/Polychromatic Normoblast | 11-15 micrometers, N:C 4:1, Nucleus stains deep purple/red, no nucleoli, clumpy chromatin, cytoplasm pink with blue shading (murky gray), located ONLY in bone marrow, lasts slightly longer than 24 hours |
| Metarubricyte/Orthochromic Normoblast | 8-12 micrometers, N:C 2:1, Dense chromatin (pyknotic), red/pink cytoplasm, last stage with nucleus, located ONLY in bone marrow, Lasts slighty longer than 24 hours |
| reticulocyte stain | Supravital stain - new methylene blue |
| Reticulocyte normal values | Adults - 0.5-1.5%, Children - 2.5-6.5% |
| "Stress-shift reticulocytes" | Occurs in bleeding or infection, body needs more RBCs |
| Felix Seyler | Discovered hemoglobin in 1862 |
| hemoglobin synthesis | during basophilic normoblast erythropoesis |
| 2 major components of hemoglobin | Heme and Globin |
| Ferritin aggregates | excess iron that accumulates in cytoplasm of imature RBCs |
| Hepcedin | Hormone produced by liver, influences intestinal iron absorption and ultimately the iron available for erythropoesis |
| Porphyria | Disease of heme metabolism, wine-red urine |
| Hemoglobin function | Oxygen binding and dissasociation, CO2 transport |
| Hemoglobin F | fetal hemoglobin, made in liver, 5 week gest - few months after birth, increased infinity for oxygen |
| Embryonic hemoglobin | Gower I, II, Portland - exists until week 12 gest |
| Hemoglobin A | 95-97% of adult hemoglobin, starts at 5 week gest, alpha and beta chains (2 each) |
| Hemoglobin A2 | 2-3% of adult hemoglobin, alpha and delta chains (2 each) |
| Hemoglobin A1 (Glycosylated) | found in patients with hyperglycemia, normal - 3-6% |
| Carboxyhemoglobin | Carbon monoxide displaces oxygen, normal - 1-3%, excessive amounts of CO - CO poisoning, death |
| Sulfahemoglobin | hemoglobin combines with sulfer, irreversible change in peptide chain, can result in Heinz Bodies, normal - less than 1%, elevations cause cyanosis |
| Methemoglobin | variant, non-functional form of hemoglobin, normal - 2% formed daily, greater than 10% results in cyanosis |
| Hgb M disease | metabolic disorder or due to structural defect in hemoglobin molecule, acquired or genetic, results in cyanosis |
| deformability | ability to change shapes in order to fit through blood vessels, decreases with age of RBC |
| Pyruvate kinase | enzyme involved in Embden Meyerhof pathway, most common enzyme deficiency |
| Glucose-6-dehydrognease deficiency | render cell vulnerable to denaturation of hemoglobin |
| Embden Meyerhof pathway | Major source of cellular energy, glucose -> 2ATP |
| Oxidative pathway / Hexose monophosphate shunt | Oxidative breakdown of glucose, when defective heinz bobies are seen |
| Methemeglobin Reductase pathway | prevents oxidation of heme iron |
| Erythrocyte life span | 120 days (adults), 60-70 days (fetus), 35-50 days (premature infants) |
| Aging erythrocyte | decreased in deformability, cellular hemoglobin increases, enzyme activity decreases -> less energy produced |
| Extravascular hemolysis | most common method, happens in spleen, iron goes to bone marrow, globin goes to amino acid pool in liver, porphryin ring is broken and excreted as bile and urobiliginen |
| Intravascular hemolysis | less than 10% of RBC breakdown, mechanical or traumatic causes |
| Red blood cell count | expressed as 10^6/microliter, affected by sex, age, body mass, psychic, pressure, muscular activity |
| hemoglobin count | expressed in g/dL, results depend on age and sex, measured mainly by spectophotometry |
| Hematocrit | Measures packed RBCs vs. total volume of blood, expressed in %, results depend on age and sex, simplest and most accurate test |
| causes for hematocrit elevation | Polycythemia (physiological or pathological), surgery or trauma, dehydration |
| causes for decreased hematocrit | anemia, over-hydration, pregnancy, poor circulation |
| Rules of three | used to verify the validity of RBC counts, hemoglobin and hematocrit values... RBCx3=hemoglobin, hemoglobinx3=hematocrit, hematocrit/3=hemoglobin, hemoglobin/3=RBC count |
| RBC indices | defines the size and hemoglobin content of erythrocytes.. MCV, MCH, MCHC |
| MCV | measures average size of RBCs, Mean corpuscular volume = hematocrit/RBC count, expressedin femtoliters (fL) |
| MCH | measures average weight of RBCs, Mean corpuscular hemoglobin = hemoglobin/RBC count, expressed in picograms (pg) |
| MCHC | Measures concentration hemoglobin in terms of average weight of RBC, Mean corpuscular hemoglobin concentration = hemoglobin/hematocrit, expressed in % |
| RDW | Red cell distribution width, measures variation in RBC volume distribution, RDW=SD/Mean sizex100, Expressed as % |
| reticulocyte count | measures percentage of retics vs. total population of RBCs, expressed as a %, retic count = # retics / 1000 x 100 |
| ESR | Erythrocyte sedimentation rate, measures distance that RBCs settle in unclotted blood, measured in millimeters (mm), directly proportional to RBC mass, indirectly proportionate to plasma viscosity |
| Anisocytosis | increased variation in cell size, seen in severe anemia |
| macrocytosis | increased size of most cells |
| Microcytosis | decreased size of most cells, this means less hemoglobin |
| Poikilocytosis | Many shapes, caused by chemical or physical alteration of either cell membrane or cell contents |
| Acanthocytosis | multiple thorny like projections, irregularly distributed, heredity disorder and irreversible |
| Blister cell | containing one or more vacuoles, also known as Pyknocytes |
| Burr cells | knobby projections, regularly distributed, also called echinocytes |
| Elliptocytes | elongated, narrow cells (rod or sausage shaped), due to abnormalities of proteins in membrane |
| helmet cells | large, scooped out appearance, result from rupture of blister cell, also known as schizocytes |
| Schistocytes | fragments of RBCs, intervascular hemolysis |
| Sickle cells | drepanocytes, crescent shaped with one pointed corner, caused by polarization of hemoglobin |
| spherocytes | round, compact RBC, no longer bi-concave |
| stomatocytes | slit like central pallor, coffee bean shaped, due to the expansion of inner level of lipid bilayer |
| Target cells | codocytes, looks like a bullseye, due to too much membrane |
| teardrop cells | dacryocytes, shaped like a tear drop, due to membrane damage at exit from bone marrow or being crowded in marrow |
| Anisochromia | variant in cell color |
| hypochromia | paler color with large central pallor |
| polychromasia | stains blue-orange, lacks full hemoglobin |
| basophilic | stains blue/gray, no pink color |
| basophilic stippling | blue/gray speckles over entire cell |
| cabot rings | ring or loop shaped inclusions in cell, remnants of mitotic spindles, seen in lead poisoning and pernicios anemia |
| crystals | rodlike or angular opaque structures, stains with brilliant crysel blue |
| heinz bodies | denatured hemoglobin, visible with brilliant crysel blue or crystal violet |
| Howell-Jolly bodies | solid dark blue round inclusions, made from remnants of DNA, 1-2 per cell, occur during increased erythropoiesis |
| Pappenheimer bodies | purple dots, stain with prussion blue, seen in Iron-loading disease, hyposlenism, meolytic anemias |
| agglutination | clumping of RBCs, indicates reaction with antibodies with RBC antigens |
| Rouleaux | cells arranged like a stack of coins, occurs in presence of cryoglobulins or excessive proteins |
| Parasitic inclusions | Malaria, Babeosis, disease caused by blood parasite |
Created by:
sjwagner
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