Intro to Hematology pt. 2

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Intro to Hematology pt. 2
2012-02-23 15:37:08

Intro to Hematology pt.2
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  1. Was is another name for myelopoiesis?
  2. The production of neutrophils, eosinophils, and basophils.
    Myelopoiesis (Granulocytopoiesis)
  3. What is the generation time for myelopoiesis? (the time it takes for cells to mature from blast to mature cell)
    7-11 days
  4. What stimulates the activation of myelopoiesis?
    • Need - sensed by the body
    • regulatory proteins
    • leukopoietin
    • CSF's
    • interleukins

  5. Fill in the Blank:
    • 1. Promyleocyte
    • 2. Mitosis Ends
    • 3. Metamyelocyte
  6. Granulocyte Production:
    What occurs in the proliferative/mitotic pool?
    Cells are growing and dividing
  7. Granulocyte Production:
    What occurs in the maturation pool?
    Represents the end of the DNA synthesis and division
  8. Granulocyte Production:
    What occurs in the storage pool?
    Retain mature cells for release into peripheral circulation
  9. State 4 of the 7 morphological changes that occur during granulopoiesis.
    • Reduction in nuclear volume
    • Condensation (densening) of chromatin
    • Change in nuclear shape
    • Appearance and disappearance of primary granules
    • Appearance of secondary granules
    • Color changes in cytoplasm from blue to pinkish- red
    • Change in size of cells
  10. The earliest recognizable cell in the granulocytic series.
  11. Name that cell:
    Round nucleus that stains predominantly reddish-blue
    Smooth nuclear membrane
    May see more in normal peripheral blood

  12. Identify the cell:
  13. Name that cell:
    Contain granules that stain dark blue or reddish blue
    May be round or irregular in shape
    Granules appear scattered throughout the cytoplasm and may overlay the nucleus
    Nucleus is usually round and large in relation to the cytoplasm
    Not present in normal peripheral blood

  14. Identify the cell:
  15. Name that cell:
    Nuclei may be round, oval, or flattened on one side and eccentrally located.
    Last myeloid precursor capable of division
    Have relatively large amounts of cytoplasm that gradullay become more pinkish

  16. Identify the cell:
  17. Name that cell:
    The nucleus becomes slightly indented (kidney bean shaped)
    Do not divide
    Do not have nucleoli
    Absent in normal peripheral blood

  18. Identify the cell:
  19. Name that cell:
    Nuclear identation is greater than half the width of the nucleus
    Gives the appearance of a horeshoe
    Nuclear chromatin is pyknotic
    Band Neutrophils
  20. Name that cell:
    Nucleus is divided into two to five lobes that are connected by a thin filament or strand
    Segmented Neutrophil

  21. Identify the cell:
    Band Neutrophil

  22. Identify the cell:
    Segmented Neutrophil
  23. Signals sent by bacterial and inflammatory tissue.
  24. Stages of Phagocytosis:
    Neutrophil migrate toward __________
    Neutrophil transforms - _______________
    Penatrates into _____________
    • site of signal
    • pseudopods and a tail
    • tissue (diapedsis)
  25. Moving to penetrate tissue
  26. (surface coated) directional migration under the guidance of chemoattractancts.
  27. Facilitates recognition and attachment by marking the organism for ingestion.
  28. Means to prepare for dining (greek term)
  29. Identify the stage of phagocytosis:
    Membrane surface receptor & microbe bind together
  30. Identify the stage of phagocytosis:
    Ingested organism exposed to lytic activity of granular enzymes
  31. Identify the stage of phagocytosis:
    Leads to killing and digestion
  32. Determine if O2 dependent or O2 independent killing system

    MPO +H2O2+CL-
    O2 dependent
  33. Determine if O2 dependent or O2

    independent killing system
    Lysozyme and proteolytic enzymes
    O2 independent
  34. What is the granule content for 10 granules? (primary)
    Lysozyme, Myeloperoxidase, Acid Phosphatase, Elastase
  35. What is the granule content for 20 granules? (secondary)
    Lysozyme, NADPH oxidase, Lactoferrin, Cytochrome B
  36. What is the granule content for 30 granules?
    Plaminogen Activators, Alkaline Phosphotase, Gelatinase
  37. Identify cell by the following functions:

    Active in allergic and parasitic infections
    Detoxify foreign protein matter
    Ingest antigen-antibody complexes before they damage the body
  38. Identify cell by the followin functions:

    In the tissue known as "mast cell"
    Granular Content
    Degranulate in allergic reations
    Help to resist allergic reactions and anaphylactoid states
  39. What is the normal range for total WBC count?
    4,800 - 10,800/ul
  40. What is the normal range for Neutophils (Segs)?
    • 1.4 - 6.5 X 103/ul
    • 50-70% of the total white count
  41. What is the normal range for Eosinophils?
    • 0 - 0.5 X 103/ul
    • 0-4% of the total white count
  42. What is the normal range for Basophils?
    • 0 - 0.2 X 103/ul
    • 0-2% of the total white count
  43. Identify the cell:
    Contain a large, round nucleus with a small or moderate amount of basophilic cytoplasm
    Nuclear chromatin are thin, lose, evenly stained, not clumped
    One to several nuclei are usually visible
  44. Identify the cell:
    Intermediate chromatin pattern that has clumps in some areas
    Parachromatin may be present in the nucleus(appears reddish-purple)
    Necleus is round or indented
    Nucleoli are less distinct than in lymphoblasts
  45. Identify the cell:
    Second most numerous cell in the blood
    is blue, varying intensity from to light to dark in different cells
    Appears clear
    Round or slightly indentend
    Diameter slightly larger or same size as normal erythrocyte
  46. Identify cell by the following function:

    Participate in cell mediate immunity
    T Cells
  47. Identify cell by the following functions:
    Cause "cell Death"
    Cause cell growth and regulation
  48. Identify the cells by the following functions:
    Participate in body immune response that is humoral immunity
    Participate in antibody production
    B Cells
  49. Identify the cell:
    Represent the end stage of B-lymphocytic lineage
    Not observed in PB smears of normal individuals
  50. Identify the cell:

    Larger than a mature neutrophil
    Abundant cytoplasm in relation to the nucleus
    Dull gray-blue cytoplasm
    Ground glass, cloudy appearance due to fine granules
    Digestive vacuoles may be observed
    Kidney bean shaped, deeply folded or indented
    Appearance of convolutions
    Lacy, delicate chromatin
  51. Monocytes:
    Peripheral Blood Span
    14 hours
  52. Identify cell by the following functions:
    Ingest and kill bacteria
    Remove dead and dying cells
    Dematures metabolites
    Antigen processing and Presentation
    Stimulate T Cell response
  53. What is the first cell in the cell lineage of Megakaryopoiesis?
  54. Identify the cell:
    Largest bone marrow cell
    Give rise to thromocytes
    Proliferate through endomitosis
  55. Identify the cell:
    Anucleated cell
    formed from megakaryocytes
  56. How many days does it take to generate new platelets?
    7 days
  57. What is the life span of platelets?
    9 days
  58. Identify the cell by the following functions:
    Maintenance of capillary integrity
    Primary hemostasis
  59. What is the normal range for platelets?
    150,000 - 450,000uL
  60. What is a pathological cause of neutrophilia?
    Drugs(i.e. epinepherine) - cause white cells to move from the marginating pool to the circulating pool
  61. What are some physiological causes for neutrophilia?
    • Stress
    • Exercise
    • Excessive heat or cold
  62. What are some side effects of neutrophilia?
    • Infection-fungal, bacterial, viral, parasitic, and rickettsial
    • Inflammatory disorders
    • tissue necorsis
    • neoplasms
  63. Reactive response to a stimulus that causes a high rise in neutrophils
    Leukemoid Reaction
  64. Absolute decrease in circulating neutrophils
  65. What are some causes of neutropenia?
    • Overwhelming infections
    • Idiosyncratic drug reactions
    • Autoimmune Disorders
    • Aplastic anemia
    • Malignant disorders replacing BM
    • Megloblastic Anemia
  66. Identify disease:
    Recurrent bacterial infections
    giant lysosomal granules
    mild bleeding tendencies
    death as a result of infection
    Chediak-Higashi Syndrome
  67. Identify disease or defect:
    5 or more segments in 1 - 2% of PMN's
    Seen in megaloblasic Anemia

  68. Identify this cell:

  69. Identify this cell:
  70. Deeply stained, coarse azurophilic (10) granules, rich in myeloperoxidase, changes are transient.
    Toxic Granulation
  71. Grey-blue inclusions in the cytoplasm within the periphery.
    Dohle Bodies
  72. FIll in the blanks
    Leukocyte Alkaline Phosphatase (LAP) stain
    * Reflects ____________________ activity.
    * ________________ in infections (__________response)
    * Differentiates leukemoid reaction from ___________ (CML)
    * Ranges:
    Males: __________ and Females: ___________
    • Intracellular Metabolic
    • Increased; Reactive
    • leukemia
    • Males: 22-124; Females 22-149
  73. What are two types of Neutropenia?
    Aquired and Congenital
  74. Morphological changes in neutrophil cytoplasm
    Dark-staining coarse cytoplasmic granules
    Seen in association with inherited disorders of mucopolysaccharidosis
    Alder Reilly Bodies
  75. Causes hyposegmentation
    Associated with no physiological disease
    Pelger Huet Anomaly
  76. Causes hyposegmentation due to drug ingestion
    Pseudo Pelger Huet
  77. Giant Platelets (Thrombocytopenia)
    Dohle-like inclusions in neutrophils.
    May Hegglin Anomaly
  78. Name 3 causes for Eosinophilia.
    • Skin disorders
    • Pulmonary Disorders
    • Other inflammatory disorders
    • Metazoic Parasites
    • Allergic conditions/Hypersensitvity Reactions
  79. Name 3 causes for Basophilia.
    • Infections(chicken pox, small pox, influenza)
    • Immediate hypersensitivity reactions
    • Myeloproliferative diseases
    • Associated with inflammatory bowel disease
    • Endocrine disorders
    • exposure to radiation

  80. Name the disorder:
    Alder Reilly Bodies

  81. Name the anomaly:
    May Hegglin Anomaly

  82. Name the disorder:
    Toxic Granulation
  83. Indicates the red cell is normal in color.
  84. "low color" cells have less than the normal amount of hemoglobin.
  85. How is color for RBC's measured?
    Mean Corpuscular Hemoglobin Concentration. (MCHC)
  86. What is the formula for mean corpuscular volume (MCV) and what does it measure?
    • HCT(%) x 10 / RBC count
    • Gives us size
  87. What is the formula for mean corpuscular Hgb concentration (MCHC) and what does it measure?
    • Hgb(g/L) x 100 / Hct(%)
    • Gives us color
  88. What is the formula for mean corpuscular Hgb and what does it measure?
    • Hgb(g/L) x 10 / RBC count
    • Give weight of Hgb in the mean cell population
  89. Variation in cell size
  90. An index of the variation in cell volume within the red cell population
    Red Blood Cell Distribution Width (RDW)
  91. Variation in cell shape

  92. Identify the cell:
    Pieces (fragments) of RBC's
    Result of some trauma to the cell membrane

  93. Identify the cell:
    10-30 rounded spicules evenly placed over the surface of the red cell
    Associated with Uremia
    Burr Cell

  94. Identify the cell:
    Not biconcave
    Increased permeability to sodium; leads to increased osmotic fragility

  95. Identify the cell:
    3 to 12 spicules of uneven length distributed along the periphery of the cell membrane

  96. Identify the cell:
    Result of an increase in RBC surface membrane
    Target cells

  97. Identify the cell:
    Pear shaped or tear shaped
    Teardrop cell

  98. Identify the cell:
    Crescent or sickle shaped
    Hgb is rigid, inflexible cells with pointed projection
    Sickle cell

  99. Identify cells:

  100. Identify cells:

  101. Identify cells:
    Membrane of the cell is altered
    Missing pieces represents macrophages trying to clear things out
    Helmet Cells

  102. Identify cells:
    Smaller than normal RBC
    Concentrated hemoglobin content

  103. Identify cells:
    Gray-blue in color, larger in size than normal RBC

  104. Identify cells:
    DNA remnants
    Howell-Jolly bodies

  105. Identify cells:
    Ribolnucleoprotein, mitochondrial remnants
    Fine/coarse blue dusting
    Basophilic stippling

  106. Identify cells:
    Denatured hemaoglobin
    Crystal violet/brilliant cresyl blue stain
    Heinz bodies

  107. Identify the cells:
    Figure 8 beads
    Cabot rings

  108. Identify the cells:
    Small ireggular granules
    Pappenheimer bodies

  109. What is going on in this picture? (Hint: it occurs at room temp)

  110. What is going on in this picture?
  111. Fill in the blank:
    RBC function is dependent on it's ___________ and _________.
    structure; metabolism
  112. What is red blood cells primary function?
    Primary means is to carry oxygen to distal tissue.
  113. What are the functions of the RBC membranes?
    • Controls transport across the membrane and flexibility through small spaces.
    • Highly elastic
    • Responds to fluids changes
  114. What is the red blood cell membrane composed of?
    • 50% proteins
    • 42% lipids
    • 8% COH (carbohydrates)
  115. Name the 3 layers that make up the rbc membrane.
    • Outer Layer
    • Central Layer
    • Inner Layer
  116. What is the outer layer composed of?
    Glycolipids, glycoproteins, and proteins
  117. What is the central layer composed of?
    Proteins, phospholipids and cholesterol
  118. What is the inner layer composed of?
  119. Membrane Proteins:
    Integral Protein
    Span entire thickness of bilayer
    Appears on external surface of membrane
    Location of RBC antigens
    Isolate and regulate cell interior
  120. Membrane Proteins:
    Peripheral Protein
    Most abundant
    Strengthens membrane
    Controls biconcave shape
    Protect from breakage
  121. What is able to freely pass through the rbc membrane?

    • Anions:
    • Chloride (Cl-)
    • Bicarbonate (HCO
  122. What is unable to freely pass through the rbc membrane?
    • Cations:
    • Potassium (K+)
    • Sodium (Na+)
  123. Conjugated globular protein.
  124. What is the makeup of a Hgb molecule?
    • Composed of two like pairs of globin chains (polypeptide chains) Alpha and Beta chain.
    • 4 heme groups, 1 attached to each polypeptide chain