Hematology Exam 1

Front 1

the branch of medicine that deals with the study of the blood and its components

Back 1

hematology

Front 2

the chief means of transport within the body provides the means of moving nutrients and other necessary substances to the fixed tissue cells of the body

Back 2

blood

Front 3

FUNCTIONS OF THE BLOOD:

Back 3

1. Transport oxygen from the lungs to all cells of the body, via the red blood cells.
2. Transports carbon dioxide, a major waste product of metabolism, from the cells of the body to the lungs, via the red blood cells.
3. Transports nutrients from the digestive organs to the cells.
4. Transports waste products from the cells to the kidneys, lungs and sweat glands for excretion.
5. Transports hormones from the endocrine glands to the cells.
6. Transports enzymes to the various cells.
7. Assists in regulation of body pH through buffers and amino acids. (NOTE: hemoglobin, found in the red blood cells, is a major buffering system of the blood.)
8. Plays a role in the regulation of normal body temperature because it contains a large volume of water (an excellent heat absorber and coolant).
9. Regulates the water content of the cells, principally through dissolved sodium ions.
10. It regulates body fluid loss through the clotting mechanism.
11. Protects against toxins and foreign microbes through special cellular func- tions (i.e., granulocytes, etc.).

Front 4

The blood is moved throughout the body via the ___________

Back 4

circulatory system

Front 5

composed of a propelling organ, the heart, and a closed system of vessels - arteries, veins, capillaries, arterioles, and venules.

Back 5

the circulatory system

Front 6

Blood is pumped from the ____ side of the heart through the _______, which are large, elastic vessels

Back 6

left; arteries

Front 7

It is at the _______ level that the exchange of nutrients and wastes takes place

Back 7

capillary

Front 8

______ carry blood back to the right side of the heart from the capillaries

Back 8

veins

Front 9

The viscosity of blood ranges from:

Back 9

4.5 - 5.5.

Front 10

. The specific gravity of whole blood varies from:

Back 10

1.052 - 1.061.

Front 11

______ is the liquid portion of the blood

Back 11

plasma

Front 12

Plasma has a specific gravity of:

Back 12

1.022 - 1.031

Front 13

Temperature of blood:

Back 13

38 C

Front 14

pH of blood:

Back 14

7.35 - 7.45 (slightly alkaline) NOTE: Red blood cells cannot live in a pH <6.8 or >7.8

Front 15

salt concentration of blood:

Back 15

0.85 % - 0.9% NaCl (referred to as normal saline, physiologic saline or isotonic saline)

Front 16

Blood constitutes approximately _____ of the total body weight

Back 16

8%

Front 17

Blood's average volume:
male
Female

Back 17

Males typically have 5 - 6L (5-6 quarts); an average size female has 4 - 5L; a 75 kg individual will have approximately 5200 ml of blood

Front 18

what are the two portions of blood?

Back 18

1) serum / plasma
2) formed elements

Front 19

what is the difference between plasma and serum?

Back 19

the difference between plasma and serum is that plasma has fibrinogen and serum does not

Front 20

The plasma or serum portion of the blood comprises _______ of the total blood volume and is made up of ______ water

Back 20

55 - 60%;90%

Front 21

what are the formed elements of blood?

Back 21

erythrocytes, leukocytes, and thrombocytes

Front 22

The combination of platelets and white blood cells is referred to as the _______, it is apparent as a white layer atop the red blood cells in blood that has been separated into its component parts

Back 22

"buffy coat"

Front 23

The usual source of supply of the cellular elements in the normal adult is the _______
ex: _______

Back 23

bone marrow in the flat bones of the body - the sternum, ribs, vertebrae, and pelvis.

Front 24

________ supplies the body with lymphocytes

Back 24

lymphoid organs

Front 25

# of platelets:
# of WBCs:
# of RBCs:

Back 25

# of platelets: 150,000 - 450,000/cubic millimeter

# of WBCs: 4,500 - 11,000/cubic millimeter

# of RBCs: 4.5 - 6.0 million/cubic millimeter

Front 26

for every ___ red blood cells there are approximately ___ platelets and __ white cell.

Back 26

500; 30; 1

Front 27

the color of blood is due to what pigment?

Back 27

hemoglobin

Front 28

_______ is the chemical compound that carries oxygen from the lungs to the tissues where it is needed

Back 28

Hb or Hgb

Front 29

have an intracellular concentration that is 1:12 with extracellular plasma levels

Back 29

Sodium (Na+) levels in a normal Red Blood Cell:

Front 30

will cause thrombocytopenia due to increased consumption of platelets

Back 30

Disseminated Intravascular Coagulation (DIC)

Front 31

The Hematopoietic Growth Factor that stimulates the production of RBC’s in the bone marrow is called:

Back 31

Erythropoietin

Front 32

Transmembrane proteins exposed on the outer membrane surface of the lipid bilayer

Back 32

Are known as integral proteins

Front 33

A mature red blood cell Is viable without a nucleus for approximately how long?

Back 33

120 days

Front 34

Ineffective erythropoiesis relates primarily to

Back 34

Maturation defects of RBC’s in the bone marrow

Front 35

A platelet count of 50,000/μL is considered?

Back 35

panic value

Front 36

As the contents of the cytoplasm are released from a megakaryocyte what are formed?

Back 36

platelets

Front 37

An orthochromic normoblast is a fancy word for

Back 37

A nucleated red blood cell (NRBC)

Front 38

What cell does not have a nucleus?

Back 38

reticulocyte

Front 39

what are the criteria for differentiating cells?

Back 39

size of the cell

N:C ratio

Nuclear chromatin

Color of cytoplasm and granular contents

Front 40

cell size ____ with maturation

Back 40

decreases

Front 41

Intended to relay information about the amount of nuclear material compared to amount of cytoplasm apparent in the cell

Back 41

N:C ration (nucleus to cytoplasm ratio)

Front 42

as the cell matures, the _____ becomes smaller (there is more cytoplasm compared to the amount of nuclear material)

Back 42

N:C ratio

Front 43

a ____ will have a typically high N:C ratio

Back 43

"blast"

Front 44

important things to consider in viewing the nucleus to determine maturity are:

Back 44

chromatin pattern

nucleoli

size

color

Front 45

the fundamental structural unit of chromatin

Back 45

nucleosome

Front 46

what is a nucleosome composed of?

Back 46

histones and DNA

Front 47

appears to be composed of relatively smooth fibers

Back 47

chromatin

Front 48

the condensed regions of chromatin; genes here are generally inactive highly compct; this chromatin is usually transcriptionally inert

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heterochromatin

Front 49

unfolded regions of chromatin; genes are loosely packed and very active; transcriptionally active DNA has this structure

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euchromatin

Front 50

During the period between cell divisions, when the chromosomes are in their extended state, 1 or more of them (10 in human cells) have loops extending into a spherical mass called the

Back 50

nucleolus (nucleoli)

Front 51

bluish color

Back 51

basophilic

Front 52

where does synthesis of RNA take place

Back 52

nucleolus

Front 53

In general, as the cell matures, the chromatin tends to _______________ and has less DNA activity.

Back 53

clump or condense (become heterochromatin)

Front 54

all material between the cell wall and nuclear membrane

Back 54

cytoplasm

Front 55

processes proteins synthesized in endoplasmic reticulum

Back 55

Golgi apparatus

Front 56

membrane organelle that provides the energy for cellular metabolism

Back 56

Mitochondria

Front 57

synthesize proteins, steroids, storage and production of glycogen

Back 57

Endoplasmic reticulum

Front 58

filled with enzymes produced by the rough endoplasmic reticulum; the enzymes play a major role in destruction of foreign invaders, whether they be bacteria, food, or old organelles

Back 58

Lysosomes

Front 59

Basophilia is due to the amount of ____ present in the cytoplasm of the cell.

Back 59

RNA

Front 60

in this process:
the cytoplasm goes from blue to orange (RNA decreases and hbg increases)

the nucleus becomes smaller and chromatin pattern becomes more aggregated

Back 60

erythropoiesis

Front 61

the earliest erythroid element

Back 61

proerythroblast

Front 62

another name for a basophilic erythroblast

Back 62

normoblast

Front 63

another name for a polychromatophilic erythroblast

Back 63

polychromatic normoblast

Front 64

the last erythroid precursor with a nucleus

Back 64

Orthochromatic (acidophilic) erythroblast (normoblast)

Front 65

young erythrocytes with granular or reticular filamentous structures consisting of 0.5-2.0% of all erythrocytes

Back 65

reticulocytes

Front 66

frequently occurs after hemolysis or acute blood loss

Back 66

reticulocytosis

Front 67

are circular, reddish, biconcave cells

Back 67

erythrocytes

Front 68

cells are the same size as the nucleus of a small lymphocyte

Back 68

erythrocyte

Front 69

this cells cytoplasm contains striking azurophilic granules or primary granules

Back 69

promyelocyte

Front 70

at the point in development when secondary granules can be recognized, the cell becomes a

Back 70

myelocyte

Front 71

have kidney shaped indented nuclei and relatively dense chromatin as well are numerous secondary granules

Back 71

metamyelocytes

Front 72

slightly smaller than juveniles, are marked by a U-shaped or deeply indented nucleus

Back 72

bands

Front 73

encompasses the formation, development, and specialization of all functional blood cells

Back 73

Hematopoiesis

Front 74

functional blood cells (3):

Back 74

RBCs
WBCs
platelets

Front 75

the sole site of effective hematopoiesis

Back 75

The marrow, located in the medullary cavity of bones

Front 76

175 billion produced a day (hematopoiesis)

Back 76

RBCs and platelets

Front 77

70 billion produced per day (hematopoiesis)

Back 77

granulocytes

Front 78

where does hematopoiesis take place in the 1st trimester?

Back 78

yolk sac

Front 79

where does hematopoiesis take place during the 2nd trimester?

Back 79

liver and spleen (mainly liver)

Front 80

where does hematopoiesis take place in the 3rd trimester?

Back 80

central and peripheral skeleton

Front 81

where does hematopoiesis take place in the adult?

Back 81

vertebral bodies, sternum, ribs, pelvis (mainly pelvis then vertebra)

Front 82

Hematopoiesis may expand into fetal sites in times of severe demand

Back 82

extramedullary hematopoiesis, or hematopoiesis outside of the bone marrow cavity

Front 83

The total marrow space in the adult is about

Back 83

4 liters

Front 84

The total marrow in the child is

Back 84

1.6 liters

Front 85

inactive – composed primarily of fat

Back 85

yellow marrow

Front 86

active site for Hematopoiesis

Back 86

red marrow

Front 87

(key role in marrow)
Specialized Fibroblasts

Physical support for Hematopoietic Cells

Express adhesion molecules

Secrete Growth Factors

Back 87

Stromal cells

Front 88

fat islands

Back 88

adipocytes

Front 89

where does hematopoiesis take place during the 2nd trimester?

Back 89

liver and spleen (mainly liver)

Front 90

where does hematopoiesis take place in the 3rd trimester?

Back 90

central and peripheral skeleton

Front 91

where does hematopoiesis take place in the adult?

Back 91

vertebral bodies, sternum, ribs, pelvis (mainly pelvis then vertebra)

Front 92

Hematopoiesis may expand into fetal sites in times of severe demand

Back 92

extramedullary hematopoiesis, or hematopoiesis outside of the bone marrow cavity

Front 93

The total marrow space in the adult is about

Back 93

4 liters

Front 94

The total marrow in the child is

Back 94

1.6 liters

Front 95

inactive – composed primarily of fat

Back 95

yellow marrow

Front 96

active site for Hematopoiesis

Back 96

red marrow

Front 97

(key role in marrow)
Specialized Fibroblasts

Physical support for Hematopoietic Cells

Express adhesion molecules

Secrete Growth Factors

Back 97

Stromal cells

Front 98

fat islands

Back 98

adipocytes

Front 99

normal ranges? -
Myeloid Cells
Erythroid Cells
Lymphocytes
Plasma Cells
Fibroblasts, etc.

Back 99

Myeloid Cells 60-70%
Erythroid Cells 20%
Lymphocytes 10-15%
Plasma Cells 2%
Fibroblasts, etc. 1%

Front 100

Myeloid : Erythroid ratios -

normal
infection
anemia

Back 100

Normal 2.5-4:1

Infection 5-6:1

Anemia 2:1

Front 101

Capable of unlimited self-renewal;
Capable of unlimited differentiation-can give rise to any cellular element;
Self Renewal Pathway – division without diffentiation;
Differentiation pathway gives rise to progenitors;Low mitotic rate;
Highly resistant to chemotherapy;

Back 101

totipotential stem cells - "the godfather cells"

Front 102

Derived from totipotential stem cells;
Capable of extended self-renewal;
Capable of extended differentiation

Back 102

multipotential stem cells (i.e. lymphoid, myeloid stem cells)

Front 103

give rise to all categories of mature lymphocytes

Back 103

Lymphoid stem cells

Front 104

give rise to red cells, granulocytes, monocytes, and platelets

Back 104

Myeloid stem cells

Front 105

Derived from multipotential stem cells
Capable of limited self-renewal
Capable of limited differentiation

Back 105

pregenitor cells - CFU;s (colony forming units)

Front 106

CFU-GEMM

Back 106

colony forming unit - granulocyte, erythrocyte, macrophage, megakaryocyte

Front 107

CFU-E

Back 107

colony forming unit - erythroid

Front 108

CFU-GM

Back 108

colony forming unit - granulocyte monocyte

Front 109

CFU-G

Back 109

colony forming unit - granulocyte

Front 110

Responsive to Hematopoietic Growth factors

Back 110

Pregenitor cells

Front 111

carry oxygen, carbon dioxide, life-span 120 days

Back 111

RBC

Front 112

phagocytosis, killing

Back 112

neutrophils

Front 113

phagocytosis, killing, antigen presentation

Back 113

monocytes

Front 114

identify cells as self or non-self

Back 114

lymphocytes

Front 115

hemostasis involved effector cells

Back 115

platelets

Front 116

initial ___poiesis takes place in marrow, maturation takes place in lymph nodes, thymus

Back 116

lymphocytes

Front 117

Synthesized in the kidney;
Induces proliferation of CFU-E;
Synthesis rises when RBC level falls

Back 117

erythropoietin

Front 118

Secreted by lymphocytes, endothelial cells, stromal cells in marrow;
Stimulates the production of granulocytes, monocytes;
Commercially available;
Synthesis rises when rbc levels fall

Back 118

Granulocyte-Monocyte Colony Stimulating Factor (GM-CSF)

Front 119

Secreted mainly by marrow stromal cells;
Primarily, but not exclusively, stimulates production and function of granulocytes;
Synthesis rises in response to infections

Back 119

Granulocyte Colony Stimulating Factor (G-CSF)

Front 120

Stimulates totipotent, pluripotent stem cells to enter differentiation pathway

Back 120

stem cell factor (SCF)

Front 121

Mediate multiple, highly complex communications between various classes of white blood cells;
Levels rise in response to infections;
Mediate WBC effects on Hematopoiesis

Back 121

inerleukins (IL1, IL2, IL3...IL14)

Front 122

constant state within the body, naturally maintained such as blood production.

Back 122

homeostasis

Front 123

Includes tissues and organs involved in the proliferation, maturation and destruction of blood cells. These include mononuclear phagocyte system, spleen, bone marrow, and liver.

Back 123

hematopoietic system

Front 124

the ability to remove old, defective red blood cells.

Back 124

culling

Front 125

the ability to remove particulate inclusions form RBC’s without destroying them.

Back 125

pitting

Front 126

the ability to accumulate RBC’s, WBC’s and Platelets.

Back 126

sequestration

Front 127

carries oxygen to tissues and eliminates CO2

Back 127

RBC's

Front 128

Anatomical unit of erythropoiesis in the bone marrow

Back 128

erythroblastic island

Front 129

Replenishment of RBC’s is based upon availability of ?

Back 129

undifferentiated stem cells

Front 130

Glycoproteins that are responsible for cell to cell communication

Back 130

cytokines

Front 131

Consist of stem cell factors (SCF),l colony-stimulating factors (CSF, aka growth factors), interleukins (IL) and erythropoetin (EPO)

Back 131

cytokines

Front 132

Different forms of each of these regulate blood cell development by mediating proliferation, differentiation and maturation of the progenitor cells

Back 132

cytokines

Front 133

____ is the primary cytokine responisble for the maturation of CFU-E cell into mature RBC's/

Back 133

Erythropoetin

Front 134

the first erythrocyte precursor that can be identified by light microscopy

Back 134

rubriblast

Front 135

___-___ mature erythrocytes are produced from a single rubriblast

Back 135

14-16

Front 136

in a reticulocyte, expulsion of the nucleus is done by what?

Back 136

microtubules

Front 137

the cellular process of proliferation and differentiation of megakaryocytes leading to the formation of blood platelets.

Back 137

megakaryocytopoiesis

Front 138

One of the earliest identifiable megakaryocyte progenitor

Back 138

the high proliferative potential colony forming unit - megakaryocyte (HPP CFU-MK)

Front 139

the most potent cytokine that physiologically regulates platelet production.

Back 139

thrombopoietin

Front 140

cell fragments formed in the bone marrow that circulate throughout the bloodstream. They are critical to the body's ability to help blood clot,

Back 140

Platelets

Front 141

platelets live for approximately ____ in the bloodstream

Back 141

9-12 days

Front 142

normal platelet count

Back 142

150,000-450,000

Front 143

occurs when platelet count drops below 50,000

Back 143

thrombocytopenia

Front 144

term for a reduced platelet count

Back 144

thrombocytopenia

Front 145

characterised by massively increased fibrous tissue, which impairs platelet production as well as the production of other blood cells.

Back 145

myelofibrosis

Front 146

a complex systemic thrombohemorrhagic disorder involving the generation of intravascular fibrin and the consumption of procoagulants and platelets

Back 146

Disseminated intravascular coagulation (DIC)

Front 147

When a patient is massively transfused with a large volume of red blood cells, which do not contain platelets, the platelet count can fall because of

Back 147

dilution

Front 148

what does asprin do to platelets?

Back 148

inhibits platelet production

Front 149

membrane protein found underneath the membrane & part of the cytoskeleton

Back 149

peripheral protein

Front 150

most abundant peripheral protein

Back 150

spectrin

Front 151

Carry antigens, act as receptors for transplant proteins;
Serve as anchoring sites for cytoskeletal proteins to lipid bilayer

Back 151

integral proteins

Front 152

Is rigid and decreases fluidity of fatty acids in membrane

Back 152

cholesterol

Front 153

Too much cholesterol may be due to:

Back 153

Liver Disease: Target Cells
Lipid Disorders – Acanthocytes
Hemolysis and RBC Fragmentation
Chronic Hemolytic Anemia
Spleen Removes excess cholesterol from RBC

Front 154

Regulates membrane fluidity and membrane permeability;
Responsible for the passive cation permeability of the membrane

Back 154

cholesterol - causes RBC's to become distorted (acanthocytes)

Front 155

___ major and ____ minor proteins on RBC membranes

Back 155

10 major and 200 minor proteins

Front 156

Include:
Spectrin
Band 4.1 and 4.2
Actin (band 5)
Band 6
Ankyrin (band 2.1)
Adducin

Back 156

peripheral proteins

Front 157

Include
Glycophorin A
Glycophorin B
Glycophorin C
Anion-exchange channel protein (band 3)

Back 157

integral membrane proteins

Front 158

major integran membrane proteins

Back 158

Glycophorins

Front 159

mediate the structural changes that provide deformability, shape and stability to RBCs

Back 159

peripheral membrane proteins

Front 160

The most important pathways in the mature RBC require glucose as substrate
These pathways include:

Back 160

Embden-Meyerhof pathway
Hexose Monophosphate shunt
Methemoglobin Reductase pathway
Rapaport-Leubering pathway

Front 161

Anaerobic glycolysis
Glucose-->Pyruvate + 2 ATP+ NADH

Back 161

embden myerhof pathway

Front 162

Approximately 90-95% of the cell’s glucose consumption is utilized by this pathway

Back 162

embden myerhof pathway

Front 163

Results in the production of 2,3-diphosphoglycerate

Back 163

Rappaport-Leubering Pathway

Front 164

regulates affinity of Hgb for oxygen molecule

Back 164

2,3-DPG

Front 165

Maintains Hgb in reduced state
Essential to maintain heme iron in ferrous (2+) state or reduced state

Back 165

methemoglobin reductase pathway

Front 166

This pathway utilizes 5-10% of cellular glucose levels;
Provides reducing power to protect Hgb and the RBC membrane from oxidant injury

Back 166

Hexose-monophosphate shunt

Front 167

if platelet count drops below ____; the patient may have spontaneous bleeding that could result in death

Back 167

20,000

Front 168

platelets stick to each other...called _____

Back 168

aggregation

Front 169

substance secreted when a platelet is active

Back 169

alpha granule

Front 170

RBC maintains it's volume and water homeostasis by regulating

Back 170

Na and K levels

Front 171

Na+ ratio (intracellular:extracellular)

Back 171

1:12 (intracellular:extracellular)

Front 172

K+ ratio (intracellular:extracellular)

Back 172

25:1 (intracellular:extracellular)

Front 173

region and component of the spleen loaded with macrophages that phagocytize old RBC's

Back 173

Reticuloendothelial System (RES)