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EXAM 4
| Question | Answer |
|---|---|
| RBC Maturation Purpose | Maintain RBC population for oxygen transport |
| RBC Maturation Location | Bone marrow (hematopoietic tissue) |
| RBC Maturation Duration | ~5 days in marrow + 1-2 days in peripheral blood for final maturation |
| RBC Maturation Stimulus | Erythropoietin (EPO), produced by kidneys in response to hypoxia |
| Erythroblastic islands | Clusters of developing RBCs around a macrophage ('nurse cell') supplying iron |
| Stem Cell Lineage | HSC → MPP → CMP → MEP → Pronormoblast → Basophilic Normoblast → Polychromatophilic Normoblast → Orthochromic Normoblast → Reticulocyte → Erythrocyte |
| Pronormoblast | Large nucleus, 1-2 nucleoli, fine chromatin, Deep blue cytoplasm (RNA), N:C ratio 8:1-6:1, 1% of bone marrow population |
| Basophilic Normoblast | Coarser chromatin, smaller nucleus, Blue cytoplasm with pink tinge (hemoglobin forming), 1-4% of bone marrow |
| Polychromatophilic Normoblast | Thick, irregular chromatin, Bluish-pink cytoplasm (increased hemoglobin), 10-20% of bone marrow |
| Orthochromic Normoblast | Pyknotic (solid) nucleus, very condensed chromatin, Pink-red cytoplasm (hemoglobin rich), 5-10% of bone marrow |
| Reticulocyte | No nucleus, Slight bluish tinge from RNA, Seen with supravital stain, 0.5-2% of peripheral blood |
| Erythrocyte | No nucleus, Pink with central pallor, Biconcave disk shape, Lifespan ~120 days |
| Hemoglobin synthesis requirements | Adequate iron (Fe²⁺), Protoporphyrin (heme precursor), Globin protein chains |
| Iron transport and storage | Transferrin - iron transport, Ferritin - iron storage (serum), Hemosiderin - storage in bone marrow (less available) |
| RBC Senescence | RBC lifespan = 120 days, Removal by Reticuloendothelial System (RES) → macrophages (mainly spleen) |
| RBC destruction | 90% of RBC destruction = extravascular hemolysis |
| RBC removal rate | ~1% RBCs removed daily = equal number of reticulocytes released |
| Granulocyte Maturation Granulocytes include: | Neutrophils, Eosinophils, Basophils |
| Granulocyte Maturation Process | Myelopoiesis (Granulocytopoiesis) |
| Granulocyte Maturation Duration | 7-11 days |
| Granulocyte Lineage | HSC → MPP → CMP → GMP → Myeloblast → Promyelocyte → Myelocyte → Metamyelocyte → Band → Segmented Granulocyte |
| Mitotic Pool | Myeloblast, Promyelocyte, Myelocyte → capable of DNA synthesis and division |
| Maturation Pool | Metamyelocyte, Band, Segmented Neutrophil → stored and ready for release |
| Myeloblast | Earliest recognizable cell, Round nucleus, 1-5 nucleoli, fine chromatin, Basophilic cytoplasm, may have Auer rods, 0-2% of bone marrow, ~1 day maturation |
| Promyelocyte | Primary (azurophilic) granules appear. Granules may obscure nucleus. Round nucleus, fine chromatin. 1-4% of bone marrow. 1-3 days maturation. |
| Myelocyte | Secondary (specific) granules form. Cytoplasm turns pinkish. Round/eccentric nucleus, no nucleoli. Last stage capable of division. 5-20% of bone marrow. 1-5 days maturation. |
| Metamyelocyte | Kidney bean-shaped nucleus (<50% indentation). Coarse chromatin. Pale pink cytoplasm with fine granules. 5-20% of bone marrow. 0.5-4 days maturation. |
| Band Neutrophil | Nucleus indentation >50%. Uniform thickness, no filaments. Pale pink/light blue cytoplasm. 0-6% in peripheral blood. 0.5-4 days maturation. |
| Segmented Neutrophil (PMN) | Nucleus with 2-5 lobes connected by filaments. Coarse, clumped chromatin. Light pink cytoplasm with fine granules. 5-15% bone marrow. Circulates ~9 hours; lives 1-5 days in tissue. Function: phagocytosis, first line of defense, chemotaxis. |
| Eosinophilic Myelocyte | Pale to dark orange granules (acidophilic). Contain MBP, ECP, EPO. |
| Eosinophilic Metamyelocyte | Gradual nuclear indentation and segmentation. Nucleus: 2-4 lobes (usually two). Coarse orange-red granules. Function: defense against parasites, allergic and inflammatory responses. Lifespan: 8-18 hours in blood, 12-14 days in tissue. |
| Basophilic Myelocyte | Large deep purple granules. Granules may obscure nucleus. |
| Basophil | 2-3 lobed nucleus. Deep purple granules (may "wash out" during staining). Contain histamine. Function: allergic/hypersensitivity reactions, degranulation. Lifespan: 1-2 days in blood. Tissue equivalent = Mast Cell (lifespan weeks to months). |
| Myelopoiesis Summary | General precursor sequence: HSC → MPP → CMP → GMP → Myeloblast → Promyelocyte → Myelocyte → Metamyelocyte → Band → Mature granulocyte. |
| Morphologic changes during maturation | Reduction in nuclear volume. Chromatin condenses. Nuclear shape changes (round → indented → segmented). Cytoplasm turns pink as granules appear. Cell size decreases. |
| RBC vs Granulocyte Comparison | RBC Line Origin: MEP (Megakaryocyte-Erythroid Precursor). Granulocyte Line Origin: GMP (Granulocyte-Monocyte Precursor). |
| RBC Hormone | Erythropoietin (EPO). |
| Granulocyte Hormone | GM-CSF, G-CSF. |
| RBC Division Stops | Orthochromic Normoblast. |
| Granulocyte Division Stops. | Myelocyte |
| RBC Released as | Reticulocyte. |
| Granulocyte Released as | Band or Segmented Neutrophil. |
| RBC Function | Oxygen transport. |
| Granulocyte Function | Immune defense. |
| RBC Cytoplasm Change | Blue → Pink (Hb increase). |
| Granulocyte Cytoplasm Change | Blue → Pink (granules increase). |
| RBC Nuclear Change | Condensation → extrusion. |
| Granulocyte Nuclear Change | Condensation → segmentation. |
| Monopoiesis | Production of monocytes/macrophages (mononuclear phagocyte system - MPS) |
| Site of Monopoiesis | Bone marrow (maturation), tissues (macrophage transformation) |
| Stimulated by | M-CSF, GM-CSF |
| Lineage of Monocytes | CMP → GMP → Monoblast → Promonocyte → Monocyte → Macrophage |
| Monoblast | Round/slightly irregular nucleus, 1-2 nucleoli; Fine/lacy chromatin, light-deep blue cytoplasm (non-granular); Difficult to distinguish from myeloblast/lymphoblast; Nonphagocytic, capable of division; ~0-1% BM |
| Promonocyte | Irregular/folded "brain-like" nucleus; Fine/lacy chromatin; Light blue-gray cytoplasm, few azurophilic granules; Pseudopodia extensions possible; ~0-1% BM |
| Monocyte | Largest WBC; variable/indented "chewed gum" nucleus; Blue-gray "dirty" cytoplasm, vacuoles, fine granules (ground-glass); Lifespan: 8 hrs-3 days in circulation; Function: phagocytosis, immune activation |
| Macrophage | Tissue form of monocyte (not in PB); Eccentric nucleus, vacuolated cytoplasm; Function: phagocytosis, antigen presentation, cytotoxicity; Found in liver (Kupffer cells), spleen, lungs (alveolar macrophages) |
| Lymphopoiesis | Production of lymphocytes (B cells, T cells, NK cells) |
| Origin of Lymphocytes | MPP → CLP → (T, B, or NK precursors) |
| T cells | Mature in thymus |
| B cells | Mature in bone marrow |
| NK cells | Originate in bone marrow |
| Phases of Lymphopoiesis | Antigen-independent: before antigen exposure (primary lymphoid tissue); Antigen-dependent: after antigen exposure (secondary lymphoid tissue—lymph nodes, spleen, tonsils) |
| Sequence of Lymphocyte Development | CLP → Lymphoblast → Prolymphocyte → Lymphocyte → Plasma Cell (for B lineage) |
| Lymphoblast | Large round nucleus, fine chromatin, 1-2 nucleoli; Scant light-blue cytoplasm, no granules; Can resemble myeloblast |
| Prolymphocyte | Round or indented nucleus, slightly clumped chromatin; Prominent nucleolus; Light-blue cytoplasm, no granules |
| Lymphocyte | Small or large, round or indented nucleus; Clumped, condensed chromatin; Sky-blue cytoplasm, may have few azurophilic granules/vacuoles; Function: antibody production (B), cytotoxic/helper roles (T), immune surveillance (NK) |
| Plasma Cell | End-stage of B cell, not in PB; Eccentric nucleus, coarse "cartwheel" chromatin, no nucleolus; Deeply basophilic cytoplasm with perinuclear clearing (Golgi zone); Function: antibody (Ig) secretion; ~1% BM |
| Reactive (Atypical) Lymphocyte | Larger than small lymphocytes; Abundant, clear to deep blue cytoplasm (often hugs RBCs); Few granules or vacuoles; Seen in viral infections (e.g., mononucleosis) |
| Thrombopoiesis | Production of megakaryocytes and platelets |
| Site of Thrombopoiesis | Bone marrow |
| Stimulated by | Thrombopoietin (TPO) |
| Lineage of Thrombopoiesis | MPP → CMP → MEP → Megakaryoblast → Promegakaryocyte → Megakaryocyte → Platelet |
| Megakaryoblast | Round/indented nucleus, 1-4 nucleoli; Loose chromatin, scant basophilic cytoplasm (nongranular); Not easily recognizable morphologically |
| Promegakaryocyte | Indented, eccentric nucleus with condensed chromatin; Increased cytoplasmic basophilia; Fine azurophilic granules visible; Undergoes endomitosis (nuclear replication without cell division) → polyploidy; Endomitosis stops at the end of this stage |
| Megakaryocyte | Very large cell; multilobed nucleus (2-32 lobes, usually 8); Abundant blue to pink cytoplasm with azurophilic granules; Platelets seen budding from cytoplasmic edges; Produces 1000-3000 platelets per cell |
| Variant of Megakaryocyte | Micromegakaryocyte (abnormal, seen in myeloid neoplasms) |
| Platelet (Thrombocyte) | Cytoplasmic fragment of megakaryocyte; No nucleus, light blue cytoplasm, red-violet granules; Smaller than RBC |
| Platelet Reference Range | 150-450 × 10⁹/L |
| Platelet Storage | 1/3 stored in spleen, rest circulate |
| Platelet Lifespan | 7-10 days, removed by spleen and liver |
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