Hema Hematopoiesis Ajfb

Front 1

Production of Blood Cells

Cellular Formation, Proliferation, Differentiation and Maturation of Blood Cells

Back 1

Hematopoiesis

Hint 1

Yolk Sac=>

Liver=>

Spleen=>

Thymus=>

Lymph Node=>

BM

Front 2

As early as 19th day gestation in the blood islands of the yolk sac of the human embryo blood pxn starts

Back 2

Mesoblastic Stage

Hint 2

Blood Islands remain active for

8-12 Weeks

Hematopoietic activity confined to erythropoiesis

Front 3

First Blood Cell produced by developing embryo

Back 3

Erythrocytes/RBCs

Front 4

Embryonic Hemoglobins:

Back 4

1. GOWER 1

-2 Zeta, 2 Epsilon

2. GOWER 2

-2 Alpha, 2Epsilon

3. PORTLAND

-2 Zeta, 2 Gamma

Hint 4

ZAZ

EEG

Front 5

3rd month Yolk Sac discontinues its role, Fetal Liver becomes active

Also active Spleen, thymus, lymph nodes

Erythrocytes & Granulocytes in pxn

Back 5

Hepatic Stage

Hint 5

End of 4th month primitive cells disappearing, Inc in more definitive erythroblasts, granulo, & megakaryo

Front 6

Between 5th and 6th month gestation the BM become the primary site of hematopoiesis

At Birth, BM primary source of cell pxn

Back 6

Myeloid Stage

Hint 6

Sternum (Flat Bones) - BM Primary Site for Hematopoiesis

Iliac Crest - Safest most accessible site for BM Biopsy

Front 7

Normal Myeloid to Erythroid Ratio (M:E)

Back 7

2:1 - 4:1

Hint 7

Inc in:

1. Infection (6:1)

2. Leukemia

Front 8

Normocellular Marrow for Adult:

Back 8

Fat/Yellow Marrow:

10 - 50%

Hematopoietic Elements/Red Marrow:

40-60% Av: 50%

Hint 8

Child Under 2 yrs has

100% Red Marrow

Retrogression

-Replacement of active BM by adipose cells

Front 9

Marrow Differential

Recommended Count _______

Preffered Count ________

Back 9

500

1000

Hint 9

Predominant Cell in the adult BM: Metamyelocytes/Juvenile

Front 10

Marker for Lymphoid, Pan T Cells

Back 10

CD2, CD3

Hint 10

CD4

- Helper/Inducer T Cells

CD8

- Suppressor/Cytotoxic T Cells

Front 11

Marker for

Pan Myeloid

Back 11

CD13

Hint 11

CD33

-Pan Myeloid Cells

Front 12

Marker for Monocytes

Back 12

CD11c, CD14

Front 13

Marker for Lymphoid, Pan B Cells

Back 13

CD19

CD20

Front 14

Stem Cell Marker

(Lymphoid & Myeloid Precursor)

Back 14

CD34

Hint 14

Stem Cells <1% of cells in BM

Front 15

Marker for

NK Cells

Back 15

CD16, CD56

Front 16

Common ALL Antigen

Back 16

CD10

Hint 16

CALLA

Front 17

Primary regulator of Erythropoiesis

Back 17

Erythropoietin (EPO)

Hint 17

Pronormoblasts to Retics:

3-5 Days

Retics remian in the BM for:

1-2 Days before being released to the circulation

In Peripheral Circulation Retics continue to Mature for:

1 Day

Front 18

Erythropoiesis:

Back 18

1. Pronormoblast/

Rubriblast

2. Basophilic Normoblast/

Prorubricyte

3. Polychromatophilic Normoblast/

Rubricyte

4. Orthochromatophilic Normoblast/

Metarubricyte

5. Polychromatophilic Erythrocyte/

Reticulocyte

6. Mature Erythrocyte

Front 19

Deeply Basophilic Cytoplasm

Perinuclear Halo lighter area around nucleus

N/C Ratio: 8:1

Fine Chromatin

Back 19

Pronormoblast/

Rubriblast

Front 20

Intensely Basophilic Cytoplasm

Chromatin Pattern Slighlty Coarser

N/C Ratio: 6:1

Back 20

Basophilic Normoblast/

Prorubricyte

Front 21

Last stage capable of Cell Division

Start of Hgb Pxn (Blue-gray/Pink-gray cytoplasm)

More condensed;

chromatin pattern is coarse & clumped

Distinct Parachromatin

N/C Ratio: 4:1

Back 21

Polychromatophilic Normoblast/

Rubricyte

Front 22

Last nucleated stage

Pyknotic Nucleus, Partially extruded from the cell

Pinker Cytoplasm (Inc Hgb Pxn)

N/C Ratio: 1:2

NUCLEUS EJECTED

Back 22

Orthochromatophilic Normoblast/ Metarubricyte

Front 23

Pink to slight pinkish gray

Contains a fine basophilic reticulum of RNA

Diffusely Basophilic

Back 23

Polychromatophilic Erythrocyte/Reticulocyte

Front 24

Pink Color

Non-nucleated, round, biconcave cell

Back 24

Mature Erythrocyte

Front 25

How many erythrocytes are produced from each pronormoblast

Back 25

16 Erythrocytes

Hint 25

Life Span:

120 Days +/- 20 Days

Front 26

Granulocytic Series:

Back 26

1. Myeloblast

2. Promyelocyte

3. Myelocyte

4. Metamyelocyte

5. Band

6. Mature Granulocyte

-Segmented Neutro

-Eos

-Baso

Front 27

Cytoplasm Moderate Blue in Color

Smooth, Non-granular

Extremely Fine Chromatin

N/C Ratio: 4:1

Back 27

Myeloblast

Front 28

Pale Blue to Basophilic Cytoplasm

Appearance of Primary/Non-specific Granules

N/C Ratio: 2:1

Back 28

Promyelocyte

Front 29

Last stage capable of cell division

Appearance of Secondary/Specific Granules

N/C Rtaio: 1:1

Back 29

Myelocyte

Hint 29

Neutro Myelocyte:

PINK SPECIFIC GRANULES

Eosinophil Metamyelocyte:

ORANGE SPECIFIC GRANULES

Basophil Myelocyte:

DARK BLUE-PURPLE GRANULES

Front 30

Indented/Kidney-shaped Nucleus

Chromatin is coarse and clumped and stains dark purple

Full Complement of Specific Granules

Not anymore Capable of Mitosis

Predominant Cell in Adult BM

Back 30

Metamyelocyte (Juvenile)

Hint 30

Neutrophil Metamyelocyte:

PINKER & more numerous granules

Eosinophil Metamyelocyte:

BRIGHTER ORANGE

Basophil Metamyelocyte:

DARK PURPLE TO BLACK

Front 31

Youngest stage to normally appear in peripheral blood

Elongated/Sausage/Curved Nucleus

Back 31

BAND

Front 32

Pink to rose-violet specific granules

2-5 Lobes

Coarse, clumped chromatin pattern

Back 32

Segmented Neutrophil

Hint 32

Ferrata Cell

Front 33

Large, reddish orange granules

Usually has 2 Lobes

Coarse, clumped chromatin Pattern

Back 33

Eosinophil

Hint 33

Inc in the Afternoon

Primary Suppression of Immune Response

Front 34

Dark purple to blue-black granules

Water Soluble Granules

Unsegmented or Bilobed, rarely has 3-4 lobes

Back 34

Basophil

Hint 34

Rare: 0-1%

Effector Cell of Type 1 Hypersensitivity

Front 35

Monopoiesis:

Back 35

1. Monoblast

2. Promonocyte

(Resemble Neutrophil Band)

3. Monocyte

Hint 35

Monocyte

- Largest cell in Peripheral Bld

- Abundant blue-gray cytoplasm, Many Fine azurophilic granules, ground glass appearance

- Round, kidney, Horse-shoe shaped

- Brain-like convolutions

- Skein-like strands of Chromatin

- Differentiate to become macrophages

Front 36

Lymphopoiesis:

Back 36

1. Lymphoblast

2. Prolymphocyte

3. Mature Lymphocyte

-Small Lymphocyte

-Medium Lymphocyte

-Large Lymphocyte

Hint 36

Small Lymphocyte

- Thin rim around nucleus

- Moderate - Dark Blue Cytoplasm

Medium Lymphocyte

- More abundant cytoplasm

- Pale to moderately blue

Large Lymphocyte

- Abundant cytoplasm

- Clear, very pale blue

Front 37

Derived from BM

Differentiates into plasma cells secretes Igs

Humoral Immunity

Back 37

B Lymphocytes

Front 38

Mature in Thymus

Interact w/ antigens to form specific effector cells

Cellular Immunity

Back 38

T Lymphocytes

Front 39

Morphologically resemble Large Granular Lymphocytes (LGL)

Destruction of Tumor and virus infected cells without Ag specificity or prior sensitization

Back 39

Null Lymphocytes/

NK Cells

Hint 39

Lack characteristic of Mature T & B lymphocytes

Front 40

NK Cells exposed to IL2 which acts against cancer

Back 40

Lymphokine-Activated Killer (LAK) Cells

Front 41

Cells mistaken as Lymphocytes:

Back 41

1. Monocytes

2. Blasts

3. Rubricytes

Front 42

Plasma Cells:

Back 42

1. Plasmablast

2. Proplasmacyte

3. Plasmacyte/Plasma Cell

Hint 42

Plasmablast

- Basophilic Cytoplasm

- Red/Pink Cyst, Flame

Proplasmacyte

- Intensely Basophilic

- HOF/Perinuclear Halo

Plasmacyte/Plasma Cell

- Deeply Basophilic

- Cart-wheel-like pattern Nucleus

Front 43

Each megakaryocyte generally produces _____________ Platelets

Back 43

2,000 - 4,000 Platelets

Hint 43

Megakaryocyte

- Cell w/c gives rise to blood platelets

Front 44

It takes how many days for megakaryocyte to mature in the BM

Back 44

4-5 Days

Front 45

Hormone produced by the liver & kidney which influences maturation of platelets

Back 45

Thrombopoietin (TPO)

Front 46

Megakaryopoiesis/

Thrombopoiesis

Back 46

1. Megakaryoblast

2. Promegakaryocyte

3. Granular Megakaryocyte

4. Mature Megakaryocyte (Metamegakaryocyte)

5. Platelet (Thrombocyte)

Hint 46

Megakaryoblast

- Where endomitosis Starts

Promegakaryocyte

- Where Endomitosis (nuclear division w/out cytodivision) ends

Front 47

Invagination of the plasma membrane that becomes the future site of platelet fragmentation

Back 47

Demarcating System (DMS)

Front 48

Platelets life span once released to the peripheral blood

Back 48

9-12 Days

Front 49

2/3 of Plts are in the

1/3 of Plts are in the

Back 49

BLOOD

SPLEEN

Hint 49

Platelet Factors:

PF3

- Platelet phospholipid needed for proper platelet function

PF4

- Neutralizes Heparin

Front 50

Contains coarse clumps of granules aggregating into little bundles, bud off from the periphery to become platelets

Multiple Nuclei

Back 50

Mature Megakaryocyte/Metamegakaryocytes

Hint 50

40-120 um

Front 51

Programmed Cell Death

Cell Shrinkage

Condensation of Nucleus

Back 51

Apoptosis

Front 52

Cell Swelling

Karyolysis

Pathologic

Back 52

Necrosis

Front 53

Light Blue to purple cytoplasm

Very Granular

Back 53

Platelet/ Thrombocyte

Hint 53

Consists of 2 Parts:

Chromomere

- Granular, located centrally

Hyalomere

- Surrounds the chromomere and is non-granular and clear to light blue

Front 54

Start of Endomitosis:

Back 54

LD-Meg (New Rodak)

MK-1 (Old Rodak)

Front 55

Four Areas of Platelet Structure:

Back 55

1. Peripheral Zone

2. Sol-gel Zone

3. Organelle Zone

4. Membranous System

Front 56

Responsible for Platelet Adhesion and Aggregation

Back 56

Peripheral Zone

Hint 56

Adhesion - Plt to Blood vessel surface

Aggregation - Platelet to Platelet

Consists of:

1. Glycocalyx

2. Plasma Membrane

3. Sub-membranous Area

Front 57

External Surface of the platelet

Composed of glycoproteins including coag factors 5, 8 & Fibrinogen

Back 57

Glycocalyx

Hint 57

Important in plt reactions w/ thrombin, vWF, & Fibrinogen

Front 58

Lies beneath glycocalyx

Composed of a bilayer of asymmetrically distributed phospholipids embedded w/ integral proteins, arachidonic acid is a major component

Back 58

Plasma Membrane

Hint 58

GpIb - receptor for vWF

GP IIb & IIIa - Receptors for fibrinogen

Front 59

Provide a cytoskeleton to maintain platelet shape, a contractile system

Back 59

Sol-Gel Zone

Hint 59

Consists of:

1. Microfilaments

2. Microtubules

Front 60

Contain the proteins actin & myosin

Upon stimulation of platelet, will interact to form Actomyosin (Thrombosthenin)

Back 60

Microfilaments

Hint 60

Actomyosin (Thrombosthenin)

- A contractile protein, important in clot retraction

Front 61

Composed of protein tubulin, which maintains the platelet's disc shape

Back 61

Microtubules

Front 62

Responsible for platelet aggregation and Generation of ATP

Back 62

Organelle Zone

Hint 62

Consists of:

1. Alpha Granules

2. Dense Bodies

3. Mitochondria

4. Lysosomal Granules

Front 63

Important for ATP Synthesis for platelet metabolism

Back 63

Mitochondria

Front 64

Contain ACP & Hydrolytic Enzymes

Back 64

Lysosomal Granules

Front 65

Membranous System:

Back 65

1. Dense Tubular System

2. Surface Connecting System (Open Canlicular System)

Front 66

Derived from the smooth reticulum and sequesters (holds) calcium for platelet activation processes

Also synthesizes prostaglandins

Back 66

Dense Tubular System

Hint 66

Control System

Site of Arachidonic Acid Metabolism to form TXA2

Front 67

Invagination of the plasma membrane, acts as canal for the release of the granule constituents and cytoplasm to the exterior of the platelet

Back 67

Surface Connecting System (Open Canalicular System)

Hint 67

Also involved in Platelet Phagocytosis

Front 68

The hemoglobin molecule is composed of four subunits, each containing

Back 68

Heme (4)

Globin (4)

Hint 68

*1 Heme Carries 1 Mole of Oxygen

Front 69

Synthesis of Heme begins in the

Back 69

Mitochondria

Hint 69

With the formation of

D-ALA from

Glycine &

Succinyl Coenzyme A

Front 70

Chromosome 16

codes for

Back 70

Alpha

Zeta

Front 71

Chromosome 11

codes for

Back 71

1. Gamma

2. Beta

3. Epsilon

4. Delta

Hint 71

GBED

Front 72

Newborn & Adult Hemoglobins

Back 72

1. HbA1

2 Alpha, 2 Beta

2. HbA2

2 Alpha, 2 Delta

3. HbF (Fetal)

2 Alpha, 2 Gamma

Hint 72

ABADAG

Front 73

Influence of pH on the release of oxygen from Hgb

Back 73

Bohr Effect

Front 74

Oxyhemoglobin Dissociation Curve

Back 74

Sigmoidal

Hint 74

Indicates Low Hgb Affinity for oxygen @ low oxygen tension & high affinity for oxygen at high oxygen tension

Front 75

Shift to the Right

Back 75

Inc Blood Temp, 2,3 DPG, CO2

Dec pH

Hint 75

Decreased Affinity for O2

Front 76

Shift to the Left

Back 76

Inc pH, HbF admixture

Dec Blood Temp, 2,3 DPG, CO2

Hint 76

Increased Affinity for O2

Front 77

Gives Blood a Cherry Red Color

Light Sensitive

Increase Conc shifts the Hgb-O2 Dissociation Curve to the LEFT

Cannot bind & Carry Oxygen

Hgb bound to Carbon Monoxide

Back 77

Carboxyhemoglobin

Hint 77

Pink CSF

Quantitated by:

1. Differential Spectrophotometry

2. Gas Chromatography

Front 78

Oxygen derivative in which the Ferrous iron is not oxidized to Ferric state resulting to inability to combine reversibly w/ oxygen

Gives Blood a Chocolate Brown discoloration

Back 78

Methemobglobin/Hemiglobin (Hi)

Hint 78

Other Causes:

1. Methgb Reductase Def

2. Chem/Drugs (Chlorate, Nitrate, Nitrite)

3. Hgb M

*Quantitated using Spectrophotometry

Front 79

An abnormal Hgb that may also be responsible for Methgbinemia noted at birth or in the first few months of life

Px is Cyanotic

Back 79

Hgb M

Hint 79

Treated w/ Methylene Blue

Front 80

Mixture of oxidized, partially denatured forms of Hgb that form during oxidative lysis

Blood is Mauve-Lavander color

Irreversible

Back 80

Sulfhemoglobin

Hint 80

Quantitated by Spectro

Front 81

Reported in Pxs:

1. Treatment w/ sulfonamides or aromatic amine drugs (Phenacitin, Acetanilid)

2. Severe Constipation

3. C. perfringens Infection

4. Enterogenous Cyanosis

Back 81

Sulfhemoglobin

Front 82

Maintains the iron in its ferrous state for it to be functional

Back 82

Methgb Reductase

Front 83

Cyanmethgb Method can measure all forms of oxygen exc:

Back 83

Sulfhemoglobin

Front 84

Adult Hgb Normal Distribution

Back 84

HbA1 >/= 95%

HbA2 1.5-3%

HbF <1-2%

Front 85

Neonatal Hgb Normal Distribution

Back 85

HbF 60-80%

HbA 20-40%

Front 86

Multi-CSF

Multi-Lineage

Colony Stimulating Factor

Stimulates Hematopoietic Cells

Back 86

IL-3

Front 87

Most potent phagocytic Cell

Most efficient APC

From:

Common Lymphoid Progenitor

Back 87

Dendritic Cells

Front 88

Not an End Cell

Back 88

Monocytes

B Cells

Hint 88

Rodak: B Cells