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45 Cards in this Set
- Front
- Back
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Site of blood cell production in:
Embryo Fetus Neonate Child Adult |
Embryo: Yolk sac
Fetus: Liver, spleen Neonate: Bones (entire skeleton) Child: Long bones Adult: Central axial skeleton (pelvis, sternum, |
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Bone marrow occupies spaces between _____ and consists of _____.
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BM occupies spaces between trabculae
Consists of: hematopoietic "cords" Stroma (cells and matrix)--supporting tissue Sinusoids |
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Myeloid stem cell derivatives.
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RBCs, platelets, granulocytes (ephils, bphils, nphils)
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Lymphoid stem cell derivatives.
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B cells, T cells, NKCs (all via lymphoblast)
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What cells are derived from myeloblasts?
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Granulocytes (ephils, bphils, nphils)
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What cells are derived from lymphoblasts?
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B cells, T cells, NKCs
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How are hematopoietic stem cells identified?
What is their morphology? |
Identified by expression of CD34
Heme stem cells are morphologically bland (can't be ID'd by morphology) |
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What is asymmetric mitosis?
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When stem cells divide into both daughter cells and stem cells (self-renewal)
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Stem cells are [pluri-, toti-] potential.
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Pluripotential; can divide into different kinds of heme cells
Totipotential = embryonic stem cells that can dx into anything |
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CFU-E allows for the production of ______.
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erythrocytes
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CFU-GEMM allows for the production of ______.
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granulocytes, erythrocytes, monocytes, megakaryocytes
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CFU-GM allows for the production of ______.
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granulocytes, macs
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Where are most heme GFs produced?
What are the exceptions? |
Most heme GFs produced by stromal cells (endothelial cells, fibroblasts, T cells, macs)
EXCEPT: EPO (kidneys) Thrombopoeitin (liver) |
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G-CSF allows for the production of _________.
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Neutrophils
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Peg-Filgrastim allows for the production of ________.
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Neutrophils
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GM-CSF allows for the production of __________.
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Neutrophils
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IL-11 allows for the production of _________.
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Platelets
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Romiplostim allows for the production of ________.
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Platelets
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These growth factors act through the JAK-STAT pathway.
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G-CSF, GM-CSF
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Effects of G-CSF on neutrophils.
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Proliferation
Differentiation from progenitor cells Speeds maturation Suppresses apoptosis Functionally activates nphils |
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Effects of GM-CSF on neutrophils.
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Stimulates proliferation and dx of early and late progenitors
Increases phagocytic ability of mature nphils Mobilizes heme stem cells (less effectively than G-CSF) |
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G-CSF, GM-CSF:
Indications Toxicity (which poses greater risk of toxicity?) |
Indications:
1) Myelosuppressive Chemotx 2) Pts undergoing peripheral stem cell harvesting (to mobilize peripheral stem cells) 3)Chronic npenia Toxicity: GM-CSF has more side effects bc acts more broadly Effects include bone pain, fever, myalgias, arthralgias, capillary leak syndrome |
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IL-11:
Indications MOA |
Indications: thrombocytopenia
MOA: stimulates megakaryocte progenitors and increases platelet count |
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Romiplostim:
Indications MOA |
Chronic ITP (immune thrombocytopenia) who have failed other treatments
MOA: Thrombopoietin agonist binds MPL receptor |
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List five types of WBCs in decreasing order of abundance.
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NLMEB
Nphils Lymphocytes Mcytes Ephils Bphils |
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Agranulocytes vs Granulocytes:
Nucleus |
Agranulocytes: mononuclear
Granulocytes: polymorphonuclear |
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Primary granules appear in _____.
Function? |
Appear in promyelocytes (aka azorophilic granules)
Contain myeloperoxidase; fn: lysosomes |
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In which cells of granulocytopoiesis does mitosis occur? How could you tell in a microscope?
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Occurs in myeloblast, promyelocyte, myelocytes
Can tell because nucleus is huge |
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What are secondary granules?
In what cells do they become apparent? Examples of granules by cell type. |
Secondary granules are granules that are specific to the fate of the cell's origin.
They become apparent in myelocytes. Nphils: lactoferrin, collagenase Ephil: MBP (to kill parasites) Bphil: Histamine, heparin |
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What is a left shift?
When is it seen? What is it seen with? |
Polys, bands, metamyelocytes seen in peripheral blood (inc in WBCs)
Seen in acute infections Seen with toxic granulations and Dohle bodies |
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Beginning with a myeloblast, list the subsequent cells formed on the way to a seg.
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Myeloblast
Promyelocyte Myelocyte Metamyelocyte Band Seg |
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What are Dohle bodies?
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Remnants of rough ER from earlier maturation stages often seen with left shift (inflammatory processes)
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Pelger-Huet Anomaly:
What is it? |
Anomaly whereby nphils cannot segment properly (pince-nez, i.e., pinch nose anomaly)
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Chediak-Higashi Syndrome:
What is it? Pathophys? Why does it result in albinism? |
AR disorder of childhood resulting in abnl trafficking of intracellular vesicles due to:
Fusion of primary lysosomes in wbcs (chunky grnaules) DEFECTS IN PHAGOLYSOSOME formation (-->inc'd infection) Abnl melanosome granule trafficking-->oculocutaneous albinism |
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Functional vs Quantitative Defects:
General |
Fnal: Chemotaxis, phag + killing
Quant: Npenia, nphilia |
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Absolute Neutrophil Count:
Equation Normal Value Mild, Mod, Severe Neutropenia Values |
= Total WBC x (%seg + %bands)
Normal ANC: 1500-1800 Mild Npenia: 1000-1500 Mod: 500-1000 Severe: <500 Infection risk related to severity and duration of npenia |
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Biggest cause of decreased production of neutrophils.
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Drugs
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Causes of drug-induced neutropenia.
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Chemotx agents (intentional, know this in advance)
Idiosyncractic rxns to drugs namely to chloramphenicol, chlorpromazine, sulfa drugs, phenytoin, carbamazepine |
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Aplastic Anemia:
Definition Effects Pathologic Features Causes |
(worse than neutropenia); results in pancytopenia!
Bone Marrow failure-->anemia, npenia, thrombocytopenia Path: BM is hypocellular with fatty infiltrate Causes: Congenital: Fanconi anemia (rare AR disorder of DNA repair) Acquired: Idiopathic (70%) Secondary: radiation, benzene, ecstacy, drugs, viruses (Non-A, Non-B, Non-C viral hepatitis; PARVOVIRUS) |
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Formula to calculate percent cellularity of a patient.
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100% - Age
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Causes of increased destruction of neutrophils.
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Autoimmune (lupus, drug-induced formation of Abs against nphils)
Splenic enlargement (inc'd destruction of wbc, rbc, and platelets) Inc'd peripheral utilization (as in overwhelming sepsis) |
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Leukemoid reaction:
What is it? |
Moderate to severe leukocytosis with significant inc in early nphil prescursors
This is a response to severe stress or infection Will result in inc'd nphil precursors in peripheral smears BM will be hypercellular |
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Leukoerythroblastic reaction:
What is it? |
Similar to leukemoid rxn but there are also nuc'd RBCs; thicnk myelofibrosis or mets
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What is demargination of neutrophils?
What causes it? |
Inc'd number of nphils in blood stream bc are released from peripheral stores (?); due to exercise, epinephrine
Can also be due to glucocorticoids bc have dec'd entry into tissues |
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Functions of monocytes.
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Enter CT spaces to become macs; fns:
Phag Production of cytokines Ag presentation |
