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30 Cards in this Set
- Front
- Back
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Erythrocytes
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Product: Hemoglobin
Function: CO2 and O2 Transport |
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Neutrophils
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Granulocyte
60-70% of WBC short life - about a week Multi-lobed nucleus - Barr body; "pink / clear" granules Product: Specific granules and modified lysosomes Function: Phagocytosis of bacteria, central role in inflammatory processes. First wave of cells invading infection sites. Have receptors in their membrane allowing them to recognize foreign bodies Further stimulated once invaders are "tagged" Cannot replenish their store of granules. Dead neutrophils major component of "pus" |
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Eosinophils
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Granulocyte
2-4% of WBC 2-lobed nucleus Short life - few days Product: Specific granules, pharmacologically active substances Function: Defense against parasites, modulation of inflammatory process |
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Basophil
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Granulocyte
0.5% of WBC 2 or 3-lobed "S"-shaped nucleus Product: specific granules containing histamine and heparin Function: Release of histamine and other inflammation mediators |
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Monocyte
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Is NOT a terminal cell
Agranulocyte 5% of WBC Kidney or "C"-shaped nucleus Life span: few days in circulation, months in tissues Product: Granules with lysosomal enzymes Function: Generation of mononuclear-phagocyte system cell in tissues, phagocytosis and digestion of protozoa and virus and senescent cells. Function:, become tissue macrophages after migration 1. avid phagocytes (dead cells, antigens, bacteria) 2. produce cytokines -initiate inflammation, etc. 3. antigen-presenting cells 4. foreign body giant cells (multinucleated) |
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B Lymphyocyte
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Agranulocyte
28% of WBC Round, dense nucleus fills whole cell Lifespan: Months to years Product: Immunoglobins Function: Generation of antibody-producing terminal cells (plasma cells) |
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T Lymphocyte
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Product: Substances that kill cells. Substances that control the activity of other leukocytes (interleukins)
Function: Killing of virus-infected cells |
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Natural Killer Cell
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Lacks T and B cell markers
Product: Attacks virus-infected cells and cancer cells without previous stimulation Function: Killing of some tumor and virus-infected cells |
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Platelet
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No nucleus; never had one
Cell fragments from megakaryocyte Hyalomere: outer region, hardly stains, peripheral tubular system, increases surface area Granulomere: dense core with granules and few organelles, stains bluish Granules: alpha, delta, lambda (lysosomes) a. alpha: fibrinogen, platelet derived growth factor, [PDGF]etc. b. delta: calcium, serotonin, ATP, etc. c. lambda: lysosomal(hydrolytic) enzymes Product: Blood-clotting factors Function: Clotting of blood Platelets assist in haemostasis, the arrest of bleeding. Serotonin is a potent vasoconstrictor. The release of serotonin from thrombocytes, which adhere to the walls of a damaged vessels, is sufficient to close even small arteries. Platelets, which come into contact with collagenous fibers in the walls of the vessel (which are not usually exposed to the blood stream), swell, become "sticky" and activate other platelets to undergo the same transformation. This cascade of events results in the formation of a platelet plug (or platelet thrombus). Finally, activating substances are released from the damaged vessel walls and from the platelets. These substances mediate the conversion of the plasma protein prothrombininto thrombin. Thrombin catalyzes the conversion of fibrinogen into fibrin, which polymerizes into fibrils and forms a fibrous net in the arising blood clot. Platelets captured in the fibrin net contract leading to clot retraction, which further assists in haemostasis |
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Blood cell elements
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Acellular 55%
Plasma Serum Water (90%) Plasma Proteins (9%) colloid osmotic pressure Cellular Components (45%) Erythrocytes (44%) Leukocytes and Platelets (1%) |
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Histamine and Heperin
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Vasoactivesubstances. They dilate the blood vessels, make vessel walls more permeable and prevent blood coagulation.
Facilitate the access of other lymphocytes and of plasma-borne substances of importance for the immune response (e.g. antibodies) to e.g. a site of infection. Release of the contents of the granules of basophilsis receptor-mediated. Antibodies produced by plasma cells (activated B-lymphocytes) bind to Fc-receptors on the plasma membrane of basophils. If these antibodies come into contact with their antigens, they induce the release of the contents of the basophilgranules. |
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Indentify the principle pleuripotent origin of all blood elements
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<img src="pasteajjpqe.jpg" />
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Describe the principles of Erythropoiesis
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Greater than 109(billion) cells produced daily
Stem cells-pleuripotent, low numbers, give rise to: Multipotentialcells a. colony forming units -spleen (myeloid cell lines) b. colony forming units -lymphocytes (lymphoid cell lines) Progenitor cells-committed to a single cell line, limited self renewal Precursor cells-morphologically distinct, no self renewal a. generally referred to as a "_____blast" which differentiates to a "____cyte" b. as cells develop; decrease in size, nuclei condense Regulation Hematopoietic growth factors (colony stimulating factors) - glycoproteins Interleukins, granulocyte colony stimulating factor, erythropoietin, etc. Stem cell factor (steel factor) - stromalcells of the bone marrow, stimulates division Hematopoietic cells will die unless exposed to growth factors takes about 3 -5 days to complete development |
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Specific pathway of Erythropoeisis
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<img src="paste_ulgms.jpg" />
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Describe the principles of granulopoiesis
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~ 800,000 neutrophils, 170,000 eosinophils, 60,000 basophilsper day, controlled by cytokines; takes about 11 days
<img src="pastefu3t_b.jpg" /> |
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Describe the thrombopoeitis
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Controlled by thrombopoietin
Megakaryoblast: 25 -40 um, endomitosis, polyploid( ~ 32N) Megakaryocyte: 40 -100 um, large multi-lobed nucleus Platelets are formed from fragments of megakaryocytecytoplasm (1000's per cell) Platelet demarcation channels |
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Identify reticulocytes, band cells and megakaryoctyes in the normal development of erythroctyes, granulocytes and platelets
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<img src="pastetik3wo.jpg" /><img src="paste0z_l3q.jpg" /><img src="pastel8fyu4.jpg" />
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Describe the changes of antigens on the surface of red blood corpuscles that may lead to Rh incompatibility and erythroblastosis fetalis
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A mother is exposed to a foreign antigen and produces IgG, which will target the antigen, if present in the fetus, attacking its erythrocytes and causing anemia.
If a mother has anti-RhD (D being the major Rhesus antigen) IgG antibodies as a result of previously carrying a RhD-positive fetus, this antibody will only affect a fetus with RhD-positive blood. |
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List different clinical conditions where neutrophils, eosinophils and basophils are elevated in peripheral smear, respectively.
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Neutrophil - bacterial infection
Eosinophil - parasitic infection Basophil - alergic reaction (histamine) |
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Interpret the changes that constitute Pancytopenia (Bone Marrow Failure)
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anemia: hemoglobin < 13.5 g/dL (male) or 12 g/dL (female)
neutropenia: Absolute Neutrophil Count (ANC) < 1.5×103/microliter thrombocytopenia: platelet count < 150×109/L |
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Describe the changes involved in the hemoglobin molecule that results in thalassemia
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A genetic defect, which could be either mutation or deletion, results in reduced rate of synthesis or no synthesis of one of the globin chains that make up hemoglobin. This can cause the formation of abnormal hemoglobin molecules, thus causing anemia, the characteristic presenting symptom of the thalassemias.
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Describe the clinical significance of HbA1c (Glycosylated Hb)
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A form of hemoglobin which is measured primarily to identify the average plasma glucose concentration over prolonged periods of time. It is formed in a non-enzymatic glycation pathway by hemoglobin's exposure to plasma glucose. Normal levels of glucose produce a normal amount of glycated hemoglobin. As the average amount of plasma glucose increases, the fraction of glycated hemoglobin increases in a predictable way. This serves as a marker for average blood glucose levels over the previous months prior to the measurement.
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List a minimum of four causes for anemia.
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Impaired production
Disturbance of proliferation and differentiation of stem cells. Pure red cell aplasia Aplastic anemia, affecting all kinds of blood cells. Fanconi anemia is a hereditary disorder or defect featuring aplastic anemia and various other abnormalities. Anemia of renal failure, by insufficient erythropoietin production Anemia of endocrine disorders Disturbance of proliferation and maturation of erythroblasts Pernicious anemia is a form of megaloblastic anemia due to vitamin B12 deficiency dependent on impaired absorption of vitamin B12. Anemia of folic acid deficiency. As with vitamin B12, it causes megaloblastic anemia Anemia of prematurity, by diminished erythropoietin response to declining hematocrit levels, combined with blood loss from laboratory testing. It generally occurs in premature infants at 2 to 6 weeks of age. Iron deficiency anemia, resulting in deficient heme synthesis Thalassemias, causing deficient globin synthesis Anemia of renal failure (also causing stem cell dysfunction) Other mechanisms of impaired RBC production Myelophthisic anemia or Myelophthisis is a severe type of anemia resulting from the replacement of bone marrow by other materials, such as malignant tumors or granulomas. Myelodysplastic syndrome Anemia of chronic inflammation Increased destruction Hemolytic anemia Anemias of increased red blood cell destruction are generally classified as hemolytic anemias. These are generally featuring jaundice and elevated LDH levels. Intrinsic (intracorpuscular) abnormalities, where there the red blood cells have defects that cause premature destruction. All of these, except paroxysmal nocturnal hemoglobinuria, are hereditary genetic disorders. Hereditary spherocytosis is a hereditary defect that results in defects in the RBC cell membrane, causing the erythrocytes to be sequestered and destroyed by the spleen. Hereditary elliptocytosis, another defect in membrane skeleton proteins Abetalipoproteinemia, causing defects in membrane lipids Enzyme deficiencies Pyruvate kinase and hexokinase deficiencies, causing defect glycolysis Glucose-6-phosphate dehydrogenase deficiency and glutathione synthetase deficiency, causing increased oxidative stress Hemoglobinopathies Sickle cell anemia Hemoglobinopathies causing unstable hemoglobins paroxysmal nocturnal hemoglobinuria Extrinsic (extracorpuscular) abnormalities Antibody-mediated Warm autoimmune hemolytic anemia is an anemia caused by autoimmune attack against red blood cells, primarily by IgG. It is the most common of the autoimmune hemolytic diseases. It can be idiopathic, that is, without any known cause, drug-associated or secondary to another disease such as systemic lupus erythematosus, or a malignancy, such as chronic lymphocytic leukemia (CLL) Cold agglutinin hemolytic anemia is primarily mediated by IgM. It can be idiopathic or result from an underlying condition. Rh disease, one of the causes of hemolytic disease of the newborn Transfusion reaction to blood transfusions Mechanical trauma to red cells Microangiopathic hemolytic anemias, including thrombotic thrombocytopenic purpura and disseminated intravascular coagulation Infections, including malaria heart surgery Blood loss Anemia of prematurity from frequent blood sampling for laboratory testing, combined with insufficient RBC production. Trauma or surgery, causing acute blood loss Gastrointestinal tract lesions, causing a rather chronic blood loss Gynecologic disturbances, also generally causing chronic blood loss Fluid overload (hypervolemia) causes decreased hemoglobin concentration and apparent anemia: General causes of hypervolemia include excessive sodium or fluid intake, sodium or water retention and fluid shift into the intravascular space. Anemia of pregnancy is anemia that is induced by blood volume expansion experienced in pregnancy. |
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List the basic classification of leukemia and the major difference between them
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Acute leukemia is characterized by a rapid increase in the numbers of immature blood cells. Crowding due to such cells makes the bone marrow unable to produce healthy blood cells. Acute forms of leukemia are the most common forms of leukemia in children.
Chronic leukemia is characterized by the excessive build up of relatively mature, but still abnormal, white blood cells. Typically taking months or years to progress, the cells are produced at a much higher rate than normal cells, resulting in many abnormal white blood cells in the blood. Chronic leukemia mostly occurs in older people, but can theoretically occur in any age group. Additionally, the diseases are subdivided according to which kind of blood cell is affected. This split divides leukemias into lymphoblastic or lymphocytic leukemias and myeloid or myelogenous leukemias: In lymphoblastic or lymphocytic leukemias, the cancerous change takes place in a precursor to B lymphocytes. In myeloid or myelogenous leukemias, the cancerous change takes place a precursor to other WBCs, RBCs or platelets |
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Identify the clotting factor which is stored in endothelial cell, whose deficiency can lead to a bleeding disorder call hemophilia.
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Clotting factor VIII or Clotting factor IX
Inhibits the production of Fibrin |
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State the consequence of mismatched transfusion in a person.
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Clumping as antibodies latch on to erythrocytes
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Explain how malaria is transmitted and describe the appearance of red blood cells infected by malarial paracites
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<img src="paste53ttbw.jpg" />
Within minutes of being introduced into the human host, the sporozoites infect hepatocytes, multiplying asexually and asymptomatically for a period of 8–30 days. Once in the liver, these organisms differentiate to yield thousands of merozoites, which, following rupture of their host cells, escape into the blood and infect red blood cells, thus beginning the erythrocytic stage of the life cycle. The parasite escapes from the liver undetected by wrapping itself in the cell membrane of the infected host liver cell. Within the red blood cells, the parasites multiply further, again asexually, periodically breaking out of their hosts to invade fresh red blood cells. Several such amplification cycles occur. Thus, classical descriptions of waves of fever arise from simultaneous waves of merozoites escaping and infecting red blood cells |
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Define the term "polycythemia vera"
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erythremia - a blood disorder in which the bone marrow makes too many red blood cells and may also result in the overproduction of white blood cells and platelets. Most of the health concerns associated with polycythemia vera are caused by a blood-thickening effect that results from an overproduction of red blood cells.
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Define the term "essential thrombocytemia"
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A rare chronic blood disorder characterized by the overproduction of platelets by megakaryocytes in the bone marrow in the absence of an alternative cause.
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