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37 Cards in this Set
- Front
- Back
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What are the components of blood?
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It is composed of liquid and cells. The liquid is plasma, and the cellular components include WBC, RBCs, and platelets
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Differentiate plasma from serum
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Plasma is the liquid portion of blood with clotting factors, and serum is when the clotting factors have been used up
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What does blood in tube look like once centrifuged?
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It has three layers, an RBC layer on the bottom, a buffy coat, including white blood cells, and plasma. The plasma is slightly yellow, because of bilirubin, which is a porphyrin breakdown product.
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What is hematocrit?
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The percentage of whole blood that is made up of RBCs
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What are the functions of blood? What is albumin? Why is blood analysis useful?
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Transport nutrients to tissues, remove waste, carry clotting proteins. Albumin is the most important osmotic protein in blood. Blood analysis is a good way to check a patients status - RBCs, WBCs, liver and kidney function, and clotting ability can be determiend
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What is the structure of an RBC?
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It is a biconcave disk.
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What is the ratio of RBCs to WBCs?
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It's 1000:1
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Describe RBCs. Are they nucleated? What is their function? Are they rigid?
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They are bags of hemoglobin. They lack nuclei, mitochondria, and do no protein synthesis. Their main function is to transport O2 and CO2. They are deformable, enabling them to squeeze through capillaries
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What do normal blood cells look like histologically? How does their size compare to WBCs?
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They are red with a white dot in the middle. The red is one third across, the white is one third in the middle, and the red is one third on the other side. Their diameter is about one half that of WBCs
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Describe the structure of hemoglobin. Is oxygen binding to Heme very strong?
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Hemoglobin is made up of globin, which a protein, and heme, a porphyrin ring and iron. Globin has 4 protein chains, 2 alpha and 2 beta.
Oxygen binding to Heme is strong, but only in high O2 areas. Binding is weak in low O2 areas. This enables it to be an O2 transport molecule |
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What are normal hemaocrit ranges? Why the gender difference? What are normal RBC counts?
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Hematocrit - 40-54% in men, 37-47% in women. Women have lower hematocrit due to menstruation.
Normal RBC count in is roughly 5, but slightly higher in men |
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How are RBCs disposed of? What becomes of the RBC components?
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Old RBCs are eaten by macrophages. The macrophages store the Heme, and incorporate it into new RBCs in the bone marrow. Porphyrn is broken down into bilirubin, passes through the liver and is excreted in the stool.
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Why do high bilirubin levels in the serum indicate?
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They might indicate there are liver problems, as the liver is unable to process the excretion of bilirubin.
OR It might indicate RBCs are broken down too quickly IMPORTANT: This indicates a breakdown process is occurring too quickly, not a production problem |
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What is the normal lifespan of an RBC?
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120 days
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What type of cell does a pluripotent stem cell differentiate to in order to make an RBC? A lymphocyte?
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Stem cells turn into myeloid stem cells before becoming RBCs.
They also become lymphoid stem cells before becoming WBCs |
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What are five main types of WBCs?
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Neutrophils - kill bacteria. they have a 5-7 hour halflife
Lymphocytes - kill virally infected cells. Monocytes - phagocytose, can also turn into macrophages or dendritic cells Eosinophils - fight parasites when present, but also release histamine to create allergic response Basophil - also involved in allergic response |
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What are granulocytes?
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Granulocytes are the basophils, neutrophils, and eosinophils.
Eosinophils stain pink (eosin), and basophils stain purple (hemotoxin) |
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Describe histology of the neutrophil, eosinophil, basophil, and monocyte.
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Neutrophil - lobed nuclei, has pink and purple staining
Eosinophil - deep pink staining Basophil - deep purple staining Monocyte - has lobed nuclei like neutrophils, but they overlap and never break into pieces |
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What is a differential white cell count?
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A breakdown of WBCs by type
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What are the normal ranges for the different types of WBCs?
Are the absolute numbers important too? |
Neutrophils - 50-70% (2000-7000)
Lymphocytes 20-40% (1000-4000) Monocytes - 1-6% Eosinophils - 1-5% Basophils - 0-2% Yes, absolute numbers are important |
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What may high neutrophils indicate?
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Bacterial infection
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What might high eosinophils indicate?
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An allergy (possibly a parasite)
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What might high lymphocytes indicate?
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A viral infection!
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What are the three steps required in hematopoiesis? Are they regulate independently? What cell type does the most proliferation?
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The three steps are proliferation, differentiation, and maturation.
They are all regulated independently. Pluripotent stem cells do most of the proliferation |
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What is the most primitive blood cell? What types of divisions may it cells undergo?
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The pluripotent hematopoietic stem cell. It may under self-replication or differentiate.
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Describe RBC matuation
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The most immature RBC is an erythroblast. Its stained blue in its cytosol, which is RNA. Over its progression, the nucleus shrinks (becomes pyknotic), and the blueness disappears (less RNA is made)
The differentiation right before the mature RBC is the reticulocyte. It is mostly found in bone marrow, but less than 1% of RBCs in circulation are reticulocytes |
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What does a high reticulocyte count indicate?
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This indicates there is an increased need for RBCs (when there is a greater demand for RBCs, more reticulocytes end up in circulation). RBC production is competent, but they are being lost or not being broken down quickly enough. CHECK THIS
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Describe the progression of WBC development? What is the name of the most immature WBC? What do the become? What is a left shift?
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The most immature WBC is called a myeloblast. As it develops, the nucleus does not get pyknotic, but horse shoe shaped instead. This intermediate is called a band. A left shift is a higher presence of bands in the blood (the progression is drawn left to right). A left shift may indicate an infection
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What are megakaryocytes? What is their relationship to platelets? What are platelets? Describe their half life. What do they do?
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These are large cells that has granules, which contains clotting factors. Platelets are fragments of this cell. Platelets have no nucleus and have a short half life - they only last about 10-12 days in the circulation. Platelets plug small holes
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Describe three hematopoietic growth factors
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Erythropoietin - detects O2 levels, and promotes RBC production
G-CSF/GM-CSF - produced in bone marrow stroma, and promotes granulocyte maturation Thrombopoietin - promotes megakaryocyte development |
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Whre does hematopoiesis occur? What is it called when an adult conducts hematopoiesis in the spleen (sometimes liver)? Why does this occur?
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In a 19 day embryo, it occurs in the yolk sac
In 6-24 weeks, it occurs in the liver and spleen In adults, its carried out in the bone marrow. Adult hematopoiesis in the liver is called extramedullary hematopoiesis, and it is usually indicative of a bone marrow problem |
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Where is bone marrow typically taken from? How do the percentages of cells and fat in bone marrow indicate. What may too few cells indicate? Too many cells?
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It is usually taken from the iliac crest. The percentage of fat versus cells indicates the age of the individual. More fat indicates older age – a 50 year old may have 50% fat, 80 year old may have 80% fat, 20% cells
Too few cells may indicate an exposure to toxin, such as chemotherapy. Too many cells may indicate cancer |
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What is cytopenia? Name the cytopenias for RBCs, neutrophils, lymphocytes, and platelets.
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Cytopenia is the condition of having too few cells
Anemia = too few RBCs Neutropenia = too few neutrophils Lymphopenia = too few lymphocytes Thrombocytopenia = too few platelets |
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What is cytosis / cytophilia? Name this process for RBCs, neutrophils, lymphocytes, and platelets.
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Erythrocytosis, neuotrophilia, lymphocytosis, and thrombocytosis
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What two general mechanisms may cytopenias caused by?
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They may be caused by problems of production (stem cell problem, committed precursor problem, or bone marrow environment problem), or they may be due to peripheral loss of destruction (bleeding, prolonged infection, or multiple clotting sites)
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What two general mechanisms may having too many cells be caused by?
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Secondary - a physiologic response such as altitude or infection
Primary - uncontrolled production, such as a neoplastic process |
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What parameters may be evaluated by looking at a sample of centrifuged?
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You may observe the hematocrit, which is the height of the red RBCs on the bottom. This should be a little under 50. A low red line indicates anemia, whereas a high red line indicates erythrocytosis, Erythrocytosis patients also complain of fatigue, since their blood is sludgy. You may observe the thickness of the buffy coat - when this is very thick, it may indicate leukemia.
The degree to which the serum is yellow indicates the level of bilirubin. Very yellow serum indicates high bilirubin, which when combined with anemia, suggests an anemia of destruction, not production |
