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Hematology
FA complete review part 1
| Question | Answer |
|---|---|
| Primary function of erythrocytes? | Carry O2 to tissues and CO2 to lungs |
| Which cells are in charge of carrying oxygen to tissues and carbon dioxide to the lungs? | Erythrocytes (RBCs) |
| Biconcave; anucleate and lack organelles; large surface area to volume | Erythrocytes (RBCs) |
| What is the reason for the large surface area-to-volume of red blood cells? | Rapid gas exchange |
| What is the average lifespan of Red blood cells? | 120 days |
| What is the source of energy of erythrocytes? | Glucose |
| What is the common way to refer to erythrocytes? | Red blood cells |
| What is a very important structure found in the membrane of erythrocytes? | Cl-/HCO3- antiporter |
| What is the role or function of the Cl-/HCO3- antiporter found ne the membrane of RBCs? | 1. Allow RBCs to export HCO3- and, 2. Transport CO2 from the periphery to the lungs for elimination |
| Erythrocytosis = | Polycythemia |
| Polycythemia = | Increased levels of hematocrit (Hct) |
| What does anisocytosis mean? | Varying sizes of cell |
| What does a poikilocytosis mean? | Varying shapes of a cell |
| What term is used to describe different shapes of a cell? | Poikilocytosis |
| What is the definition of a Reticulocyte? | Immature RBC |
| What does an increase in reticulocyte count mean? | Erythroid proliferation |
| What cell (differentiation/growth level) refers erythroid proliferation? | Reticulocyte |
| What does the blue color of Reticulocytes on Wright-Giemsa stain represent? | Residual ribosomal RNA |
| What cells are involved in primary hemostasis? | Thrombocytes |
| What are Thrombocytes? | Small cytoplasmic fragments derived form megakaryocytes |
| What is the predecessor or thrombocytes? | Megakaryocytes |
| What is the name of cells that are due to fragmented megakaryocytes? | Thrombocytes |
| What is a more common name for Thrombocytes? | Platelets |
| What is the common lifespan of an platelet or thrombocyte? | 8-10 days |
| What type of cells aggregate after endothelial injury to form a plug? | Platelets |
| How is a platelet plug formed? | Platelets are activated by endothelial injury, leading to aggregate with other platelets and interact with fibrinogen to form plug. |
| What are the two types of granules contained in a Thrombocyte? | Dense and alpha granules |
| What is contained in the Dense granules of Thrombocytes? | ADP and Ca2+ |
| Calcium cation and ADP are found inside: | Dense granules of thrombocytes |
| What are the contents of alpha-granules of thrombocytes? | vWF, fibrinogen, and fibronectin |
| Which organ stores 1/3 of the platelet pool? | Spleen |
| What is a common clinical manifestation of thrombocytopenia? | Petechiae |
| What is the vWF receptor? | GpIb |
| What is the Fibrinogen receptor? | GpIIb/IIIa |
| GpIb is the ______________________ receptor. | vWF |
| GpIIb/IIIa is the __________________ receptor. | Fibrinogen |
| What stimulates megakaryocyte proliferation? | Thrombopoietin |
| What is the role of Thrombopoietin? | Stimulation of megakaryocyte proliferation |
| How are the leukocytes divided or categorized? | Into granulocytes and mononuclear cells |
| What specific cells account for granulocytes? | Neutrophils, eosinophils, basophils, and mast cells |
| Monocytes and lymphocytes are ----> | Mononuclear cells |
| What leukocyte has the highest WBC count? | Neutrophils (60%) |
| Neutrophils Like Making Everything Better | Mnemonic for ordering from highest to lowest the WBC differential count. Neutrophils> Lymphocytes> Monocytes> Eosinophils > Basophils |
| What type of mononuclear cell has the second highest WBC count? | Lymphocytes |
| What are the acute inflammatory response cells? | Neutrophils |
| Phagocytic. Multilobed nucleus; LAP containing granules. | Neutrophils |
| How is the nucleus of the neutrophils? | Multilobed |
| What is contained in the specific granules of Neutrophils? | Leukocyte alkaline phosphatase (LAP), collagenase, lysozyme, and lactoferrin. |
| What cells contain Azurophilic granules? | Lysosomes |
| What does Azurophilic granules contain? | Proteinases, acid phosphatase, myeloperoxidase, and B-glucuronidase. |
| Which conditions are seen with Hypersegmented neutrophils? | Vitamin B12/Folate deficiency |
| What are band cells? | Immature neutrophils |
| What is the name given to immature neutrophils? | Band cells |
| Elevated levels of band cells indicate what condition? | Increase myeloid proliferation |
| What are common examples of increased myeloid proliferation? | CML and bacterial infections |
| What type of infections increase neutrophil levels the most? | Bacterial infections |
| What are the most important neutrophil chemotactic agents? | C5a, IL-8, LTB4, and platelet-activating factor. |
| Monocytes are found in the ________________. | Blood |
| What do monocytes differentiate into? | Macrophages |
| What is the physical description of a monocyte? | Large, kidney-shaped nucleus. Extensieve "frosted glass" cytoplasm |
| What does the "mono" in monocyte refer to? | One nucleus |
| Large, kidney-shaped cells with a large "frosted glass" cytoplasm? | Monocyte |
| What do Macrophages phagocytose? | Bacteria, cellular debris, and senescent RBCs. |
| What cytokine activates macrophages? | Gamma-interferon |
| Besides phagocytosis of bacteria, what is another important function of macrophages? | Act as antigen-presenting cell (APC) via the MHC II |
| What MHC is used by macrophages? | MHC II |
| Macrophages in the liver are named? | Kupffer cells |
| Macrophages in the skin are known as? | Langerhans cells |
| What is the name given to macrophages in connective tissue? | Histiocytes |
| Name of macrophages in the bone | Osteoclast |
| The osteoclasts are: | Macrophages of the bone |
| What is the name of macrophages in the brain? | Microglial cells |
| Which leukocyte is important in granuloma formation? | Macrophages |
| CD associated with macrophages? | CD14 |
| What happens when Lipid A from bacterial LPS binds to CD14 on macrophages? | Initiate septic shock |
| Cells that defend against helminthic infections? | Eosinophils |
| Major basic protein is associated with what leukocytes? | Eosinophils |
| Nucleus of eosinophils is __________. | Bilobate |
| Eosinophils are highly phagocytic for: | Antigen-antibody complexes |
| What is produced by Eosinophils? | - Histamine - Major basic protein (MBP) - Eosinophil peroxidase - Eosinophil cationic protein - Eosinophil-derived neurotoxin |
| What is the Major Basic protein (MBP) produced by eosinophils? | Helminthotoxin |
| What does Eosin mean? | Pink dye |
| What are common causes of Eosinophilia? | Parasites, Asthma, Churg-Strauss syndrome Chronic adrenal insufficiency Myeloproliferative disorders Allergic processes Neoplasia |
| Example of neoplasia that causes Eosinophilia? | Hodgkin lymphoma |
| Which endocrine condition may lead to eosinophilia? | Chronic adrenal insufficiency |
| Densely basophilic granules contain heparin and histamine. | Basophils |
| What is contained in the granules of Basophils? | Heparin and Histamine |
| Important vasodilator contained in basophil granules? | Histamine |
| Relative uncommon, basophilia, may be seen with: | Myeloproliferative disease, especially CML. |
| What is the role of Mast cells? | Mediate allergic reaction in local tissues. |
| At which part do Mast cells bind to? | Fc portion of IgE to membrane. |
| At what point (time) does fetal erythropoiesis occur in the Yolk sac? | 3-8 weeks |
| In which organ does fetal erythropoiesis occur between 6 weeks to birth? | Liver |
| After birth and all the way to week 28 after birth, which organ is in charge of erythropoiesis? | Spleen |
| Where does adult erythropoiesis occur? | Bone marrow |
| What does HbF stand for? | Fetal hemoglobin |
| What are the components of Fetal hemoglobin? | 2 alpha and 2 gamma chains. |
| What is the abbreviation used for adult hemoglobin? | HbA1 |
| What are the chains of adult hemoglobin? | 2 alpha and 2 beta chains |
| Which type of hemoglobin, HbF or HbA1, has higher oxygen affinity? | HbF |
| Why does HbF has a higher oxygen affinity that HbA1? | Due to less avid binding of 2,3- BPG, allowing HbF to extract O2 from maternal hemoglobin across the placenta |
| What does the weaker attachment of HbF to 2, 3-BPG, cause to the features of HbF? | To have MORE affinity to oxygen |
| What is a form of hemoglobin present in adults but in small quantities? | HbA2 |
| Blood type A has what type of group antigens on surface? | A |
| What type of antibodies are found in blood type A, in the plasma? | Anti-B |
| Anti-B (+) blood, group antigen "A". Blood type? | Blood type A |
| Which blood types would cause a hemolytic reaction if given to a A+ person? | B or AB blood types |
| Which blood type is known as the universal recipient? | AB blood type |
| AB blood type is the ______________ _________________. | Universal recipient |
| Blood type B: | 1. Antigens ---> B 2. Antibodies ---> Anti-A (IgM) |
| Which blood types should not be given to a Blood type B? | A or AB blood types |
| Which blood type has A and B group antigens on RBC surface? | AB blood type |
| What antibodies are found in the plasma of AB blood group? | None |
| Which blood type is the universal donor of plasma? | AB blood type |
| ________ is the universal donor of RBCs. | O blood group |
| What is the result of a O blood type person receiving a non-O blood transfusion? | Hemolytic reaction |
| Which blood group is found with no antigens on RBC surface? | O blood type |
| What antibodies are on the plasma of O-blood group? | Anti-A (IgM) and Anti-B (IgG) |
| If blood sample is positive for Anti-A and Anti-B, it is ________ blood type. | O |
| Rh (+) indicates: | Antigen on RBC surface and NO antibody. |
| Rh (-) indicates: | No antigen (Rh), but, present (+) Anti-D antibody (IgM) |
| What is the antibody seen in Rh(-) persons? | Anti-D antibody (IgG) |
| Rh (+) person may receive: | Rh(+) or Rh (-) blood groups |
| What is the purpose to treat pregnant mother with anti-D IgG? | Prevent anti-D IgG formation. |
| What is another name given to Hemolytic disease of the Newborn? | Erythroblastosis fetalis |
| What are the two types of Hemolytic disease of the Newborn? | 1. Rh hemolytic disease of the newborn 2. ABO hemolytic disease of the newborn |
| Rh (-) mother; Rh (+) fetus. Dx? | Rh hemolytic disease of the newborn |
| Type O mother; type A or B fetus. Dx? | ABO hemolytic disease of the newborn |
| What happens in the first pregnancy in the pathogenesis of Rh hemolytic of the newborn? | Mother exposed to fetal blood leading to formation of maternal anti-D IgG. |
| What occurs, pathologically, in second pregnancy of a mother of a Rh hemolytic disease of the newborn? | Anti-D IgG crosses the placenta which then attacks fetal RBCs leading to hemolysis in the fetus. |
| What is the clinical presentation of Rh hemolytic disease of the newborn? | Hydrops fetalis, jaundice shortly after birth, and Kernicterus. |
| Pre-Existing maternal anti-A and/or anti-B IgG antibodies cross placenta leading to hemolysis in the fetus. | Pathogenesis of ABO hemolytic disease of the newborn |
| What is the treatment of Rh erythroblastosis fetalis? | Administration with anti-D IgG to Rh (-) pregnant women during third trimester and early postpartum period (if fetus is Rh (+)) |
| How are Mast cells activated? | Tissue trauma, C3a and C5a, surface IgE cross-linking by antigen leading to degranulation which causes release of histamine, heparin, tryptase, and eosinophil chemotactic factors |
| What substances are released by Mast cells after they are activated? | Histamine, Heparin, tryptase, and eosinophil chemotactic factors. |
| Mast cells are involved in type _____ hypersensitivity reactions. | I |
| What drug is used to prevent mast cell degranulation? | Cromolyn sodium |
| What is prevented with Cromolyn sodium? | Mast cell degranulation |
| What is a common use for Cromolyn sodium? | Asthma prophylaxis |
| What substances and/or medications can elicit an IgE-independent mast cell degranulation? | Vancomycin, Opioids, and radiocontrast dye |
| Highly phagocytic antigen-presenting cells. | Dendritic cells |
| What APCs are known to function as a link between innate and adaptive immune systems? | Dendritic cells |
| What kind of MHC are expressed on dendritic cells? | MHC II |
| What is expressed on surface of Dendritic cells? | 1. MHC II receptors and, 2. Fc receptors |
| What cells are specifically refer when mentioning Lymphocytes? | B cells, T cells, and NK cells |
| Which lymphocytes mediate the adaptive immune system? | B cells and T cells |
| NK cells are part of the ___________ immune system. | Innate |
| Histological description of lymphocytes: | Round, densely staining nucleus with small amount of pale cytoplasm |
| What part of the immune system are B cell part of? | Humoral immune response |
| Where do B cells originate and mature in? | Bone marrow |
| Where do mature B cells migrate to? | Peripheral lymph tissue (follicles of lymph nodes, white pulp of spleen, and encapsulated lymphoid tissue) |
| Where in the lymph node are B cells? | Follicles |
| Which pulp of the spleen contains B cells? | White pulp |
| Upon encounter with antigens, the B cells differentiate into: | Plasma cells and Memory cells |
| What is a secondary (immune) function of B cells? | Function as APC |
| Which cells (lymphocytes) mediate cellular immune response? | T cells |
| Where do T cells originate from? | Bone marrow |
| Where do T cells mature? | Thymus |
| Which type of T cells are the primary target of HIV? | CD4+ |
| T cells can differentiate into: | 1. Cytotoxic T cells 2. Helper T cells 3. Regulartory T cells |
| What is expressed in Cytotoxic T cells? | CD8 |
| What receptor recognizes cytotoxic T cells? | MHC I |
| What CD is expressed by helper T cells? | CD4 |
| Which MHC recognizes helper T cells? | MHC II |
| Which is the costimulatory signal needed for T-cell activation? | CD28 |
| What is the majority of circulating lymphocytes? | T cells (80%) |
| CD28? | Co-stimulatory signal required for T-cell activation |
| What is produced by Plasma cells? | Large amounts of antibody specific to a particular antigen |
| Which cells produce antibodies? | Plasma cells |
| "Clock-face" chromatin distribution and eccentric nucleus, abundant RER, and well-developed Golgi apparatus. | Plasma cells |
| What is the most common plasma cell cancer? | Multiple myeloma |
| Where are most plasma cells found? | Bone marrow |
| Multiple myeloma is a cancer of ___________ cells. | Plasma cells |
| Which type of hemoglobin travels the farthest in a gel electrophoresis? | HbA |
| A Fat Santa Claus. It is a mnemonic used for? | Order of hemoglobin types traveling in a gel electrophoresis. HbA > HbF > HbS > HbC |
| Why do HbS and HbC travel the least in gel electrophoresis? | Due to missense mutations replacing glutamic acid (-) with valine (neutral) and lysine (+), respectively. |
| Creating a "more" positive net protein charge to hemoglobin, will cause to travel ________________ in a gel electrophoresis. | Less |
Created by:
rakomi
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