Term
| What stimulates leukopoeisis? |
|
Definition
| hormonally stimulated by 2 families of cytokines: interleukins and colony-stimulating factors |
|
|
Term
| What cells are the most important sources of cytokines? |
|
Definition
|
|
Term
| All leukocytes originate from ______. |
|
Definition
|
|
Term
| Common myeloid stem cell gives rise to what mature cells? |
|
Definition
| eosinophils, neutrophils, basophils, monocytes, erythrocytes, megakaryocytes/platelets |
|
|
Term
| What are the various sites of hematopoiesis throughout development? |
|
Definition
| 3rd week= yolk sac; 3 months = liver (happens here until shortly after birth); 4 months = bone marrow |
|
|
Term
| What germ cell line are WBCs derived from? |
|
Definition
|
|
Term
| Where does hematopoiesis in adults occur? |
|
Definition
| bone marrow of central bones and peripheral joints |
|
|
Term
| Granulopoesis produces what mature cells? |
|
Definition
|
|
Term
| Name the intermediates between myeloid stem cell and mature neutrophil. |
|
Definition
| myeloblast > promyelocyte > myelocyte > metamyelocyte > band |
|
|
Term
| What cell can give rise to any of the granulocytes? |
|
Definition
|
|
Term
| What are the intermediates between myeloid stem cell and mature RBC? |
|
Definition
| pronormoblast, basophilic normoblast, polychromatic normoblast, orthochromatic normoblast, polychromatic erythrocyte |
|
|
Term
| How long does it take for granulocytopoesis to create mature granulocytes? |
|
Definition
|
|
Term
| How long do granulocytes live? |
|
Definition
| 1 day in circulation then 1-2 days in tissue |
|
|
Term
| How many granulocytes are produced by the bone marrow in a resting state? |
|
Definition
| 1-2 X 10^9 granulocytes/kg/day |
|
|
Term
| How long does it take to produce RBCs? |
|
Definition
|
|
Term
| How long do red blood cells live? |
|
Definition
|
|
Term
| How many RBCs are produced by the resting bone marrow? |
|
Definition
|
|
Term
| By how much can the bone marrow increase it's production of RBCs from its resting rate? |
|
Definition
|
|
Term
| How long does it take for megakaryocytopoiesis? |
|
Definition
|
|
Term
| What happens during megakaryocytopoiesis? |
|
Definition
| endomitotic division 3-5 x |
|
|
Term
| How long do platelets live? |
|
Definition
|
|
Term
| What is the most reliable criterion of maturity? |
|
Definition
| nuclear chromatin coarsens and clumps |
|
|
Term
| What happens to the N/C ratio as maturation occurs? |
|
Definition
|
|
Term
| Name the three leukoblasts. |
|
Definition
| monoblast, myeloblast, and lymphoblast |
|
|
Term
| What are the characteristics of leukoblasts? |
|
Definition
| large cells, large nuclei, high N:C, fine chromatin, basophilic cytoplasm, no granules, and prominent nucleoli |
|
|
Term
| What diseases are associated with increased numbers of myeloblasts? |
|
Definition
| acute myelogenous leukemia, myeloproliferative states, erythroleukemia, rarely leukemoid reaction |
|
|
Term
| What's the difference between myeloblast and promyelocyte? |
|
Definition
| presence of dark azurophilic granules |
|
|
Term
| What are the conditions associated with increased numbers of promyelocytes? |
|
Definition
| acute myelogenous leukemia with maturation, acute promyelocytic leukemia, myeloproliferative disroders, rarely leukemoid reactions |
|
|
Term
| What're the morphological differences between a promyelocyte and a myelocyte? |
|
Definition
| slightly indented or flattened nucleus, no nucleoli, clumped chromatin, specific pink granules |
|
|
Term
| What conditions are associated with increased numbers of myelocytes? |
|
Definition
| myeloproliferative d/os, leukemoid reactions, AML with maturation, neutrophilic left shift, leukemoid reaction |
|
|
Term
| What is the last stage of granulopoesis where mitosis can occur? |
|
Definition
|
|
Term
| What're the morphological changes from a myelocyte to a metamyelocyte? |
|
Definition
| indented kidney shaped nucleus, numerous pink/specific granules |
|
|
Term
| What conditions are associated with increased numbers of metamyelocytes? |
|
Definition
| AML with maturation, myeloproliferative d/os, leukemoid reactions |
|
|
Term
| How can you differentiate leukoblasts? |
|
Definition
| ancillary studies; also, monoblasts generally have more cytoplasm |
|
|
Term
| What're the morphological changes as a cell goes from a metamyelocyte to a band cell? |
|
Definition
| indention becomes more than 1/2 the diameter of the theoretical round nucleus |
|
|
Term
| What conditions are associated with an increased number of band cells? |
|
Definition
| myeloproliferative d/os, neutrophilic left shift, and leukemoid reactions, also are normal constituents of peripheral blood |
|
|
Term
| How many lobes does a PMN have? |
|
Definition
|
|
Term
| Increased numbers of PMNs are associated with what conditions? |
|
Definition
| infections, stress, leukemoid reactions |
|
|
Term
| Where on a peripheral blood smear is the best place to look? |
|
Definition
| at the margin of the feathered edge where very few RBCs are overlapping |
|
|
Term
| What percent of total blood volume is made up of complete cells? |
|
Definition
|
|
Term
| What is the deffinition of leukocytosis? |
|
Definition
|
|
Term
| What percent of WBCs are PMNS? |
|
Definition
|
|
Term
| What percent of WBCs are lymphocytes? |
|
Definition
|
|
Term
| What percent of WBCs are bands? |
|
Definition
|
|
Term
| What percent of white blood cells are eo's? |
|
Definition
|
|
Term
| What percent of WBCs are monocytes? |
|
Definition
|
|
Term
| What percent of WBCs are basophils? |
|
Definition
|
|
Term
| What percent of lymphocytes are atypical? |
|
Definition
|
|
Term
| Granulocytes have cytoplasmic granules that stain specifically with ________ stain. |
|
Definition
|
|
Term
| T/F Granulocytes are all phagocytic cells. |
|
Definition
|
|
Term
| What are the the neutrophilic granules? |
|
Definition
| perixodiases, hydrolytic enzymes, and defensins |
|
|
Term
| How big are PMNs vs bands? |
|
Definition
10-15 um PMNs
10-18 um bands |
|
|
Term
| What role do eo's play in allergies? |
|
Definition
| lessen the severity by phagocytizing immune complexes |
|
|
Term
| What is the significance of a few dark purple granules in eosinophils? |
|
Definition
|
|
Term
| Eosinophils are increased in what conditions? |
|
Definition
| invasive parasites, drug reactions, allergic and skin d/os |
|
|
Term
| What cell can be confused with basophils? |
|
Definition
| neutrophils with toxic granules |
|
|
Term
| Increased numbers of basophils are seen in what conditions? |
|
Definition
| myeloproliferative states, hypersensitivity reactions, myxedema |
|
|
Term
| Describe the shape of the monocyte nucleus? |
|
Definition
| round to oval, often indented |
|
|
Term
| What conditions cause an increase in monocytes? |
|
Definition
| chronic infections, malignancy, inflammatory bowel disease, collagen vascular diseases |
|
|
Term
| How big is a lymphocyte versus a reactive lymphocyte? |
|
Definition
lymphocyte= 8-10 um
reactive lymphocyte= 10-25 um |
|
|
Term
| Do lymphocytes have granules? |
|
Definition
| they have occasional azurophilic granules |
|
|
Term
| Lymphocytes are increased in what conditions? |
|
Definition
| chronic infections or inflamation; viral illness; drug reaction; acute infections (pertussis, mycoplasma, pneumonia, typhoid fever) |
|
|
Term
|
Definition
|
|
Term
| What is the morphology of a reactive lymphocyte? |
|
Definition
| variable round, oval, notched folded lobulated, indented or cleaved, may contain nucleoli, gray blue cytoplasm that may be darker peripherally, cytoplasm may contain fine azurophilic granules or vacuoles and be indented by adjacent red blood cells |
|
|
Term
| What conditions are associated with increased numbers of reactive lymphocytes? |
|
Definition
| can be normal, EBV, CMV, other viral, drug rxns, chronic inflammatory disorders (SLE or rheumatoid arthritis) |
|
|
Term
|
Definition
|
|
Term
| What are potential look alides of platelets? |
|
Definition
| extracellular babesia and stain precipitate |
|
|
Term
| Increased numbers of platelets occur in what conditions? |
|
Definition
| MPD, inflammation, exercise |
|
|
Term
| What size is normocytic for a RBC? |
|
Definition
|
|
Term
| What is a normochromic RBC? |
|
Definition
| RBC with central pallor approximately 1/3 the diameter of the cell |
|
|
Term
| What causes target cells? |
|
Definition
| excessive membrane (d/t excess lipid of liver disease) or less interior content (thalassemia or other hemoglobinopathies) |
|
|
Term
| What causes ovalocytes/elliptocytes? |
|
Definition
| hereditary elliptocytosis, megaloblastic anemia, thalessemia, severe iron deficiency anemia, sickle cell anemia, congenital dyserythrompoietic anemia |
|
|
Term
|
Definition
| spherical RBC, absent central pallor and usually decreased in diameter |
|
|
Term
|
Definition
| decreased membrane redundancy in conditions such as hereditary spherocytosis and immunohemolytic anemia |
|
|
Term
|
Definition
| mouth or cup=like deformity of RBCs |
|
|
Term
| What causes stomatocytes? |
|
Definition
| membrane defect d/t hereditary stomatocytosis and may see a few in immunohemolytic anemias |
|
|
Term
| What causes > 10% acanthocytes? |
|
Definition
| abetalipoproteinemia or advanced liver disease (alcoholism) |
|
|
Term
| What causes < 10% acathocytes? |
|
Definition
| post splenectomy, myeloproliferative disorders, autoimmune hemolytic anemia, sideroblastic anemia, thalassemia major, vitamin E deficiency |
|
|
Term
| What's the difference between an acanthocyte and an echinocyte? |
|
Definition
acanthocyte has no central pallor and few big spurs
echinocyte has central pallor with numerous short blunt spicules |
|
|
Term
| What is the most common cause of echinocytes? |
|
Definition
| artifact of improper slide prep (slow drying, too thick, aged blood) |
|
|
Term
| What are diseases that cause echinocytes? |
|
Definition
| uremia or chronic renal disease, liver disease, myeloproliferative d/os, heparin therapy, post transfusion of aged blood |
|
|
Term
| Give synonyms for a fragmented cell. |
|
Definition
| schistocytes, helmet cell, keratocyte |
|
|
Term
| What conditions cause fragmented cells? |
|
Definition
| microangiopathic anemia, severe burns, DIC, thrombotic thrombocytopenic purpura, hemolytic uremia syndrome, malignant hypertension |
|
|
Term
| Do sickle cells have central pallor? |
|
Definition
|
|
Term
| Besides sickle cells, PBS of sickle cell patients also show.. |
|
Definition
| ovalocytes, target cells, polychromias, basophilic stippling, NRBCs, H-J and pappenheimer bodies |
|
|
Term
| What causes hemoglobin C crystals? |
|
Definition
| hemoglobin C disease (HbCC) or Hemoglobin SC disease |
|
|
Term
| What is a howell-jolly body? |
|
Definition
| eccentrically placed fragment of DNA |
|
|
Term
| What are the conditions are associated with Howell-Jolly bodies? |
|
Definition
| hypo and asplenism, severe hemolytic anemia, megaloblastic anemia, congenital dyserythropoietic anemias |
|
|
Term
| What is basophilic stippling? |
|
Definition
| aggregated ribosomes and polyribosomes |
|
|
Term
| What conditions lead to basophilic stippling? |
|
Definition
| lead poisoning, thalessemia, refractory anemia, sideroblastic anemia, megaloblastic anemia, sickle cell anemia |
|
|
Term
| What are pappenheimer bodies composed of? |
|
Definition
| secondary lysosomes containing iron (non-heme) plus protein or iron-containing mitochondria |
|
|
Term
| What stain should you use to specifically see a pappenheimer body? |
|
Definition
| prussian blue (iron) stain |
|
|
Term
| What conditions are associated with pappenheimer bodies? |
|
Definition
| sideroblastic anemia, thalassemia, post-splenectomy states, congenital dyserythropoeitic anemias, hemolytic aenmieas, megaloblastic anemias |
|
|
Term
| Bite cells are characteristically due to a defect in ________. |
|
Definition
| a red blood cell enzyme. Precipitated hemoglobin is removed by spleen |
|
|
Term
| What do you call precipitated hemoglobin in a RBC? |
|
Definition
|
|
Term
| What conditions are associated with bite cells? |
|
Definition
| disorders associated with Heinz body formation, unstable hemoglobins, chemical poisonings, oxidant drugs, G-6-PD deficiency and other enzymopathies |
|
|
Term
| What conditions are associated with NRBCs? |
|
Definition
| severe stress rxn, myelofibrosis (myelophthisic processes), thalessemias, hemolytic anemias, acute leukemia, myeloproliferative disorders, other severe anemias |
|
|
Term
| What are the morphological differences between a normal RBC and a polychromatophilic erythrocyte? |
|
Definition
| slightly larger, round to slightly oval, little or no central pallor, more basophilic (blue-gray cytoplasm) |
|
|
Term
| What special stain do you use for polychromatophilic erythrocytes? |
|
Definition
| supravital stain (new methylene blue, crystal violet) shows retained RNA (reticulocyte) |
|
|
Term
| What conditions are associtaed with polychromatiophilic erythrocytes? |
|
Definition
| newborns, after acute blood loss and recovery of marrow after cytoreduction (e.g. chemotherapy) |
|
|
Term
| What are associated conditions of rouleaux? |
|
Definition
| chronic liver disease with hypergammagloblulinemia, multiple myeloma, chronic infections and inflammatory processes, malignant lymphoma |
|
|
Term
| What is red cell agglutination? |
|
Definition
| irregular overlapping of red blood cells in a clump or cluster. |
|
|
Term
| What are associated conditions of red cell agglutination? |
|
Definition
| cold autoimmune hemolytic anemia, paroxysmal cold hemoglobinuria, cold agglutinins without anemia, malignant lymphomas associated with monoclonal IgM spikes (e.g. Waldenstrom's macroglobulinemia), plasma cell dyscrasia with monoclonal IgM paraprotein spikes |
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