Term
|
Definition
Plasma (about 55% vol.)
Blood cells
White blood cells (about 1%)
Red blood cells (40-45% vol.)
Hematocrit (Hct) = RBC vol. /total volume
Normal Hct 40-45% |
|
|
Term
|
Definition
Plasma
- Fluid and metabolite circulation
- Maintains oncotic pressure
- Coagulation proteins, immunoglobulins
Red blood cells: carry oxygen, carbon dioxide
White blood cells
- fight infection
- regulate the immune system
Platelets: primary hemostatic plug |
|
|
Term
|
Definition
Water (90%)
Proteins
- Albumin: maintains oncotic pressure, prevents water from escaping into the interstitium
- Globulins: g - antibodies, b - transport proteins
- Coagulation factors
Lipids
- Free fatty acids, cholesterol, chylomicrons
Metabolites, toxic by-products |
|
|
Term
| What are the Blood Cells? |
|
Definition
Red blood cells (RBCs, erythrocytes)
White blood cells (WBCs, leukocytes)
- Granulocytes
Neutrophils, eosinophils, basophils
- Mononuclear cells (a.k.a. agranulocytes)
Lymphocytes, monocytes/macrophages
Platelets (thrombocytes) |
|
|
Term
| What is the composition of Red Blood Cells? |
|
Definition
How many? Lots! 5 x 106/ml
How big? 7- 8 mm wide x 2 mm tall
Shape? Bi-concave disk
Why is it red? Hemoglobin
Nucleus? NONE
What keeps it going? Cytoplasmic enzymes, glucose
Functions
Carry oxygen and carbon dioxide between lungs and other tissues
Normal lifespan: 120 days
Regulators of erythropoiesis
- Hypoxia (low oxygen)
- Erythropoietin (made by kidney)
- Increased destruction of red cells |
|
|
Term
| What are Red Blood cells abnormalities? |
|
Definition
RBC abnormalities
Inherited: abnormal hemoglobin, membrane proteins, or enzyme deficiencies can all lead to shortened lifespan, increased hemolysis
Acquired: abnormal production due to iron deficiency, lead poisoning, kidney failure (low erythropoietin), other toxic metabolites
Anemia: reduced numbers of RBCs |
|
|
Term
| What is the normal RBC size? |
|
Definition
| The same as the nucleus of small lymphocyte |
|
|
Term
| What are the abnormal RBC sizes? |
|
Definition
Too small = microcytosis: Iron deficiency, thalassemia
Too big = macrocytosis. Vitamin B12 or folic acid deficiency, bone marrow failure syndromes, young red cells |
|
|
Term
|
Definition
Young RBCs which have recently lost their nuclei and still have lots of RNA
- larger than average RBCs
- More blue-gray in color
- sometimes folded shape |
|
|
Term
| Official count of what RBC in the blood requires special stain which shows residual RNA? |
|
Definition
|
|
Term
Abnormal RBC Color
Normal central pallor = 1/3 of diameter of RBC
Too pale = not enough hemoglobin, high central pallor
Too pale = ???
ex: Iron deficiency, deficient hemoglobin production
Abnormal RBC Color
Too dark = high hemoglobin concentration due to decreased cell size or loss of H20
Too dark = ???
Loss of central pollar = ??? |
|
Definition
Hypochromia
Hyperchromia
Spherocytes |
|
|
Term
| Components of White blood cell |
|
Definition
Granulocytes --> have granules!
Mononuclear cells (a.k.a. Agranulocytes)
- Lymphocytes
- Monocytes/macrophages |
|
|
Term
|
Definition
Granules:
- specific granules
Neutrophils: neutral granules
Eosinophils: red granules
Basophils: large, dark blue granules
- non-specific azurophilic granules.
Contents of specific granules vary between cell types. |
|
|
Term
|
Definition
Granules stain “neutrally,” which is purplish on H&E stain
How big? 10-12 mm
Nuclei: multiple segments (3-5)
Cytoplasm: pinkish/salmon-colored
a.k.a. “polymorphonuclear leukocyte” (PMN) or “seg” |
|
|
Term
|
Definition
| Things in RBCs that are not supposed to be there |
|
|
Term
younger neutrophil
single, U-shaped nucleus |
|
Definition
|
|
Term
|
Definition
How many? 2000-5000uL/, 35-62% of all WBCs
Increased numbers: (granulocytosis) of neutrophils and band forms are seen in severe infections
Reduced numbers (neutropenia) may result from immunologically mediated destruction or reduced production in the bone marrow
-Severe neutropenia ( < 500/ml) can lead to severe bacterial or fungal infections |
|
|
Term
|
Definition
Functions of neutrophils: KILL Bacteria!
- Chemotaxis: crawl and move towards bacteria Cells need to stick to tissues via cell adhesion molecules
- Phagocytosis: eat bacteria
- Digest: granules contain proteolytic enzymes needed to kill bacteria, oxygen radicals are produced by cytoplasmic enzymes |
|
|
Term
| Abnormal neutrophil function |
|
Definition
Abnormal function of enzymes, movement, or adhesion molecules can lead to impaired defense against bacterial infections
Examples:
- Abnormal oxidative burst (killing): Chronic granulomatous disease
- Inability to stick to blood vessels due to mutations in adhesion molecules: Leukocyte adhesion deficiency |
|
|
Term
|
Definition
Eosin-staining or orange-red granules
Bi-lobed nucleus
Granules contain
- lysosomal enzymes
- peroxidase
- histamine
- crystals
1-4% of total WBCs
Functions
Phagocytose antigen-antibody complexes
Increased numbers are seen in
- allergic conditions
- parasitic infections
- Cancers |
|
|
Term
| Electron microscopy (EM): granules contain crystalloid major basic protein (MBP) |
|
Definition
|
|
Term
|
Definition
Basophilic or blue granules, very large 0.5-1% of total WBCs
Granules contain heparin, histamine
Granule contents are released after binding of
specific IgE in allergic reactions |
|
|
Term
A.k.a. “agranulocytes”
- Monocytes
- Lymphocytes: B- and T-cells
Have single, non-segmented nucleus
Contain non-specific, azurophilic granules |
|
Definition
|
|
Term
Derived from granulocyte-macrophage precursors
3-8% of total WBC
Size: 9-15 mm
Called macrophages when in found in tissues
Functions
- Motile and phagocytic
- Granules contain proteolytic enzymes
- Produce cytokines |
|
Definition
|
|
Term
Non-phagocytic cells
Size: 5-15 mm
20-45% of total WBC
Functions: B-cells
- Make antibodies (immunoglobulins)
- Memory cells
- Plasma cells
Functions (cont’d)
T-cells: cellular immunity, produce lymphokines which may influence the activities of other cells
- Helper (CD4) cells: enhance activity of other lymphocytes
- Suppressor (CD8) cells: inhibit activity of other cells
- Cytotoxic (“killer”) cells: can kill other cells on direct contact |
|
Definition
|
|
Term
Abnormal B-cell function
Impaired immunoglobulin production and increased bacterial infections
Abnormal T-cell function (e.g. HIV-infection)
Impaired defenses against viruses, parasites, and tumor surveillance
describes what cell's abnormalities? |
|
Definition
Abnormalities of lymphocytes
Abnormalities of lymphocytes (extra_
Increased numbers of lymphocytes may be seen with certain viral infections, e.g. varicella (chicken pox), EBV mononucleosis
“Atypical” lymphocytes may be seen in viral infections |
|
|
Term
Cytoplasmic buds from megakaryocytes in the bone marrow
How many: 150K-400K/ml
Size: 2-4 mm
Lifespan: 8-10 days
Function: Activates clotting |
|
Definition
|
|
Term
Nucleus: NONE.
Do contain mitochondria and glycogen
Granules:
- Alpha: contain fibrinogen, PDGF, VWF, thrombospondin, fibronectin
- Delta (dense): ADP, ATP, Ca2+, serotonin
Membrane adhesion molecules allow sticking to exposed basement membrane proteins and to each other |
|
Definition
|
|
Term
Injury to blood vessel exposes basement membrane proteins, such as collagen
Platelet activation: change shape and adhesion molecules become activated (sticky)
Granule contents are released to activate more platelets
all describe? |
|
Definition
|
|
Term
Increased platelets can cause to clotting
Inflammation
Splenectomy
myeloproliferative disorders.
Reduced platelets can cause bleeding
Increased destruction, ex. immunologically mediated
Reduced production
bone marrow malignancy
infections
are all abnormalities of platelets |
|
Definition
|
|
Term
Can cause excessive bleeding
Abnormal granule contents or release of contents
Abnormal membrane adhesion molecules impair adherence to bleeding sites
Large platelets are seen in conditions which stimulate increased production |
|
Definition
| Abnormal Platelet Function |
|
|
Term
Circulate in plasma in inactive proenzyme form
Active forms are proteolytic except for fibrin
Most are made in liver, except
- Factor VIII, vonWillebrand factor: produced by endothelial cells and megakaryocytes |
|
Definition
|
|
Term
There are inherited deficiencies of all of the proteins in the coagulation cascade
Cause increased bleeding
Ex: Hemophilia A = Factor VIII deficiency
Hemophilia B = Factor IX deficiency |
|
Definition
|
|
Term
| LOOK OVER ABNORMAL BLOOD CHART IN ONE NOTE OR SLIDE # 52 |
|
Definition
|
|
Term
There are also proteins which break down clots
Deficiencies of these cause increased clotting (thrombosis)
“Clot busting” drugs activate breakdown of fibrin clots through ??? |
|
Definition
|
|
Term
Objectives of reviewing blood smears
- Is there a normal number of blood cells?
- Are the cells normal?
- Describe the appearance of blood in words
Low power
Are all cell varieties present? Any clumps of abnormal cells present?
Higher power
Analyze each “cell line” individually: RBCs, WBCs, platelets
Normal number, size, color, shapes?
Abnormal cells? (e.g. leukemia)
Red cells
Size
Color
Shapes
White blood cells
Correct % of each type
Neutrophils: too many nuclear segments? Unusually large granules? Inclusions?
Lymphocytes: atypical?
What type of smearing tells us this info?
Platelets
Estimate the number
Size?
Unusual appearance of granules? (rare) |
|
Definition
|
|
Term
|
Definition
Spur cells (renal failure - shrinkage of cell; kinda spiky)
Elliptocytes (spectrin mutation - elongated cell)
Fragments (schistocytes - different fragments including reticulocyte)
Sickle cells - stretchy RBC |
|
|
Term
|
Definition
Nucleated red blood cell (has nucleus; not supposed to)
Nuclear remnant (Howell Jolly body) seen after splenectomy
Basophilic stippling - lead poisoning
Malaria parasites |
|
|
