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50 Cards in this Set

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Bones in which active hematopoiesis occurs
VERTEBRA, STERNUM, PELVIS
Ribs, skull, scapula
Proximal long bones
EPO
(Erythropoietin)
Source -- kidney
INCREASES RBC production
Used in anemia of RF, chronic disease, malignancy
G-CSF and GM-CSF
Sources -- monocytes, fibroblasts, endothelial cells
Note: Production is increased by inflammation (IL-1 [from monocytes])
INCREASE granulocyte release from BM
INCREASE BM production of all cell lineages
Used in neutropenias, BM transplantation
IL-3
Source -- activated T lymphocytes
Causes proliferation of ALL hematopoietic precursors
SYNERGISTIC with G-CSF, GM-CSF, SCF
SCF
(Stem Cell Factor)
Sources -- fibroblasts, BM stomral cells
Enhances stem cell survival
Mitogenic
SYNERGISTIC with IL-6, IL-3, G(M)-CSF
Used in BM failure
IL-5
Source -- marrow stromal cells
Eosinophil growth factor
IL-1
Source -- stimulated monocytes
Stimulates production of IL-2 and other cytokines (G-CSF)
Tumor Necrosis Factor
Stimulates production of GM-CSF, M-CSF, and IL-1
Retinoic acid
Promotes granulocyte differentiation
Cytokines induced by inflammation and infection
GM-CSF, IL-3, IL-6
Growth factors produced by Acute Myelogenous Leukemias
GM-CSF, G-CSF, M-CSF
Produced in an AUTOCRINE fashion
Erythroblast
(Pronormoblast)
Earliest identifiable erythroid cell
Fine chromatin, nucleoli
Basophilic cytoplasm
Found in the BM
Orthocromic Normoblast
Pink cytoplasm
Nucleus is extruded following this stage
Found in the BM
Reticulocyte
Larger than mature RBCs
Slightly bluish-grey color (persistent RNA)
Polychromasia -- the reaction to stain (methylene blue)
Erythropoietin
Regulator of erythrocyte production
Production of this is mediated by TISSUE O2 LEVELS
2,3 DPG
Modulates the oxygen affinity of Hgb
Inc. 2,3 DPG results in Inc. O2 release
Anisocytosis
Variation in RBC size (RDW)
Poikilocytosis
Variation in RBC shape
Schistocytes
Fragmented RBCs
Split or broken by physical means
3 main causes: DIC, TTP, HUS
Target Cells
Concentrated Hgb in the center
Seen in thalassemia, liver disease, and post-splenectomy
Spherocytes
Spherical RBCs, WITHOUT central pallor
Ovalocyte
Egg-shaped RBCs
Elliptocytes
Oblong RBCs, with nearly parallel sides
Acanthocyte
SPIKY RBC WITHOUT central pallor
Commonly seen in liver disease
Burr Cell
RBC with knobby surface bumps
Usually, these are artifact
Can be seen in Anemia of Renal Failure
Acute Intermittent Porphyria
Defect in PORPHOBILINOGEN DEAMINASE
Signs -- ab pain, NEUROLOGIC defects
Variegate Porphyria
Defect in protoporphyrinogen oxidase
Same symptoms as AIP, plus light sensitivity
Porphyria Cutanea Tarda
PARTIAL defect in URO-DECARBOXYLASE
Signs -- dermal photosensitivity
Can be triggered by estrogen and alcohol
Protoporphyria
Due to decreased Heme Synthetase (ferrochelatase)
Dermal photosensitivity is increased
Thalassemia
Hgb synthesis disorder
Decr. globin chain synthesis
Often entails chronic hemolytic anemia
Spectrins
Proteins that link to form "scaffolding" for RBCs
Ankyrins
Proteins that bind RBC membrane to "scaffolding"
Normal HCT values
Women -- .35 - .47
Men -- .40 - .52
Normal Hgb values
Women -- 120 - 160
Men -- 130 - 180
Normal MCV values
80 - 100 fl for both men and women
3 major patterns of anemia
Hemolytic (Inc. R-cytes, Decr. M:E)
Hypoproliferative (Decr. R-cytes, Incr. M:E)
Ineff. Erythropoiesis (Decr. R-cytes, Decr. M:E)
Hemosiderin
Storage form of iron
Commonly seen in MACROPHAGES
Heme Oxygenase
Separates iron from heme @ enterocyte membrane
Ferroportin
Hephaestin
Transport iron across BASOLATERAL membrane
Hand iron off to transferrin
Divalent Metal Transporter 1
Protein that transports ferric iron across apical membrane
Hepcidin
Primary regulator for the absorption and release of iron
Manufactured in the liver
High plasma iron --> Incr. hepcidin --> Decr. release of iron
Low plasma iron --> Decr. hepcidin --> Incr. release of iron
Ceruloplasmin
Important in mobilizing iron from macrophages
Iron oxidized and incorporated into ferric transferrin
Sequence of iron depletion in anemia
BM --> RBCs --> other tissues
Type of anemia that Iron Def. Anemia is
Microcytic
Hypochromic
Serum Iron (SI)
All iron bound to transferrin
Total Iron Binding Capacity
Approximates amount of transferrin
% Saturation = SI divided by TIBC
Soluble transferrin receptor
Reflects the total body mass of cellular transferrin receptor
Type of Anemia that anemia of inflammation is
Normocytic
Normochromic
Type of anemia that Anemia of RF is
Normocytic
Normochromic
Type of anemia that Sideroblastic Anemia ia
Microcytic
Hypochromic
Note: has "ringed sideroblasts"