Hematology and Blood Cell Production

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Questions and Answers

What is the genetic basis of sickle-cell anemia?

  • Point mutation of the hemoglobin gene on chromosome 11 (correct)
  • Missense mutation of the hemoglobin gene on chromosome 8
  • Point mutation of the hemoglobin gene on chromosome 12
  • Frameshift mutation of the hemoglobin gene on chromosome 14

What is the result of the point mutation in sickle-cell anemia?

  • GAG (Glu) to GTG (Val) on chromosome 11 (correct)
  • GAG (Glu) to GTG (Val) on chromosome 14
  • GTG (Val) to GAG (Glu) on chromosome 11
  • GAG (Glu) to GTG (Val) on chromosome 12

What is the advantage of being heterozygous for sickle-cell anemia?

  • Resistance to malaria (correct)
  • Increased risk of infections
  • Increased risk of stroke
  • Organ damage

What is the characteristic of RBCs in sickle-cell anemia?

<p>Stiff and sticky (B)</p> Signup and view all the answers

What is the shape of RBCs in hereditary elliptocytosis?

<p>Oval (C)</p> Signup and view all the answers

What is the term for the remnants of mitotic spindles seen in megaloblastic anemia?

<p>Cabot's ring (C)</p> Signup and view all the answers

What is the cause of RBCs sticking together in Rouleaux formation?

<p>High fibrinogen reacts with sialic acid on RBC surface (C)</p> Signup and view all the answers

What is the term for the nuclear remnants in circulating RBCs seen in damaged or absent spleen?

<p>Howell-Jolly bodies (D)</p> Signup and view all the answers

What is the shape of RBCs in stomatocytosis?

<p>Bowl-shaped (B)</p> Signup and view all the answers

What is the term for the fragmented RBCs from mechanical destruction?

<p>Schistocytes (D)</p> Signup and view all the answers

What is the primary function of the most abundant formed element in blood?

<p>Carrying oxygen and carbon dioxide (D)</p> Signup and view all the answers

What is the effect of high osmolarity in blood?

<p>Water is drawn from tissues into blood, increasing blood pressure (B)</p> Signup and view all the answers

Which type of leukocyte is involved in allergic reactions and attacks parasites?

<p>Eosinophil (B)</p> Signup and view all the answers

What is the percentage of circulating leukocytes accounted for by PMN leukocytes?

<p>20-30% (B)</p> Signup and view all the answers

What is the ratio of the viscosity of whole blood to that of water?

<p>5:1 (C)</p> Signup and view all the answers

What is the primary function of Ceruloplasmin?

<p>Binding of copper ions (B)</p> Signup and view all the answers

What is the percentage of plasma total weight comprised of other solutes?

<p>2% (D)</p> Signup and view all the answers

Which of the following is NOT a hormone?

<p>Urea (B)</p> Signup and view all the answers

What is the normal range of sodium ions in the blood?

<p>135-145 mEq/L (A)</p> Signup and view all the answers

What is the name of the protein that binds to hemoglobin?

<p>Haptoglobin (C)</p> Signup and view all the answers

What is the primary function of the increased surface area to volume ratio in erythrocytes?

<p>To facilitate the diffusion of substances (C)</p> Signup and view all the answers

What percentage of cytoplasmic protein content is composed of hemoglobin in erythrocytes?

<p>95% (B)</p> Signup and view all the answers

What is the role of carbonic anhydrase in erythrocytes?

<p>To regulate pH balance by producing carbonic acid (D)</p> Signup and view all the answers

What is the approximate percentage of blood volume composed of erythrocytes in women?

<p>42% (A)</p> Signup and view all the answers

What is the average life cycle of erythrocytes?

<p>120 days (B)</p> Signup and view all the answers

What is the maximum number of oxygen molecules that can bind to a hemoglobin molecule?

<p>4 (C)</p> Signup and view all the answers

What is the site of myeloid hemopoiesis?

<p>Red Bone Marrow (B)</p> Signup and view all the answers

What is the difference between granulocytes and lymphocytes in terms of circulation?

<p>Granulocytes migrate one-way into target tissues, while lymphocytes continually circulate between blood, tissues, and lymphatics. (B)</p> Signup and view all the answers

What is the change in hemoglobin's shape when it binds to oxygen?

<p>It changes shape and oxygen binds more easily (B)</p> Signup and view all the answers

What is the daily production of platelets in an average adult?

<p>400 billion (A)</p> Signup and view all the answers

What is the primary function of colony-stimulating factors (CSFs)?

<p>To stimulate the maturation of progenitor cells (C)</p> Signup and view all the answers

What is the term for the process by which the body produces white blood cells?

<p>Leukopoiesis (D)</p> Signup and view all the answers

What is the relationship between bilirubin and glucoronic acid in the RBC life cycle?

<p>Bilirubin combines with glucoronic acid to form conjugated bilirubin (B)</p> Signup and view all the answers

What is the role of iron in the RBC life cycle?

<p>Iron is involved in the synthesis of hemoglobin (D)</p> Signup and view all the answers

What is the term for the process by which the body recycles hemoglobin from senescent RBCs?

<p>Hemoglobin recycling (A)</p> Signup and view all the answers

Match the following stages of hematopoiesis with their descriptions:

<p>Mitosis = Proliferation Maturation = Differentiation Erythropoiesis = RBC Development Hematopoiesis = Blood cell production in adult bone marrow</p> Signup and view all the answers

Match the following types of stem cells with their characteristics:

<p>Totipotent = Can become any cell of the body Pluripotent = Can grow into different kinds of tissue Multipotent = Can differentiate into many different types of cells Hematopoietic = Primary site in adult bone marrow</p> Signup and view all the answers

Match the following terms related to erythrocyte development with their descriptions:

<p>Erythropoiesis = RBC Development Reticulocyte count = Index of erythropoietic activity Hemoglobin = Increases in each step of erythropoiesis Nucleus = Size decreases in each step of erythropoiesis</p> Signup and view all the answers

Match the following types of bone marrow with their characteristics:

<p>Red bone marrow = Active site of hematopoiesis in adults Yellow bone marrow = _inactive site of hematopoiesis in adults Myeloid tissue = Primary site of hematopoietic stem cells Pelvic bone marrow = One of the primary sites of hematopoiesis in adults</p> Signup and view all the answers

Match the following terms related to hematopoiesis with their descriptions:

<p>Bone marrow = Site of hematopoiesis in adults Hematopoiesis = Blood cell production in adult bone marrow Erythrocyte differentiation = Involves increase in hemoglobin and decrease in nucleus size Hematopoietic stem cells = Primary site in adult bone marrow</p> Signup and view all the answers

Colony-stimulating factors (CSFs) or ______ growth factors:

<p>hematopoietic</p> Signup and view all the answers

Leukopoiesis is the process of producing ______ blood cells.

<p>white</p> Signup and view all the answers

RBCs are an important part of the ______ cycle.

<p>iron</p> Signup and view all the answers

Heme ______ is an important process in RBCs.

<p>metabolism</p> Signup and view all the answers

Hgb ______ is an important process in RBCs.

<p>recycling</p> Signup and view all the answers

RBC ______ is the process by which RBCs mature and die.

<p>life-cycle</p> Signup and view all the answers

In the RBC life-cycle, bilirubin and ______ combine to form conjugated bilirubin.

<p>glucoronic acid</p> Signup and view all the answers

Bilirubin and ______ combine in the blood to form unconjugated bilirubin.

<p>albumin</p> Signup and view all the answers

Hematopoietic growth factors can be used to increase ______.

<p>neutrophils</p> Signup and view all the answers

Colony-stimulating factors (CSFs) stimulate ______ cells to mature.

<p>progenitor</p> Signup and view all the answers

Sickle-cell anemia is an autosomal ______________ inherited disorder.

<p>recessive</p> Signup and view all the answers

Point mutation of the hemoglobin gene occurs from GAG (Glu) to GTG (_____________) on chromosome 11.

<p>Val</p> Signup and view all the answers

RBCs in sickle-cell anemia are ______________ and sticky, tend to clump and get stuck.

<p>stiff</p> Signup and view all the answers

Heterozygote advantage of sickle-cell anemia leads to an increase in incidence in certain populations due to resistance to ______________.

<p>malaria</p> Signup and view all the answers

Target cell is formed due to precipitated ______________.

<p>Hgb</p> Signup and view all the answers

Acanthocyte is a type of RBC with a ______________ shape due to alteration in membrane lipids.

<p>thorny</p> Signup and view all the answers

Pappenheimer bodies are formed due to excessive ______________ granules.

<p>iron</p> Signup and view all the answers

Basophilic stippling is caused by ______________ from myelodysplastic syndrome or heavy metal poisoning.

<p>ribosomes</p> Signup and view all the answers

Rouleaux formation is caused by high ______________ reacting with sialic acid on RBC surface.

<p>fibrinogen</p> Signup and view all the answers

Cabot's ring is a remnant of ______________ spindles seen in megaloblastic anemia.

<p>mitotic</p> Signup and view all the answers

A person with sickle-cell trait is resistant to malaria.

<p>True (A)</p> Signup and view all the answers

Sickle-cell anemia is an autosomal dominant inherited disorder.

<p>False (B)</p> Signup and view all the answers

Target cell is formed due to precipitated hemoglobin.

<p>True (A)</p> Signup and view all the answers

Ovalocyte is a type of RBC seen in hereditary elliptocytosis with a circular shape.

<p>False (B)</p> Signup and view all the answers

Stomatocyte is a type of RBC with a bowl-shaped morphology due to membrane defect.

<p>True (A)</p> Signup and view all the answers

Acanthocyte is a type of RBC with a spherical shape due to alteration in membrane lipids.

<p>False (B)</p> Signup and view all the answers

Pappenheimer bodies are formed due to excessive iron granules in sideroblasts.

<p>True (A)</p> Signup and view all the answers

Basophilic stippling is caused by ribosomes in myelodysplastic syndrome or heavy metal poisoning.

<p>True (A)</p> Signup and view all the answers

Rouleaux formation is caused by high fibrinogen reacting with sialic acid on RBC surface.

<p>True (A)</p> Signup and view all the answers

Cabot's ring is a remnant of mitotic spindles seen in sickle-cell anemia.

<p>False (B)</p> Signup and view all the answers

What is the result of the point mutation in the hemoglobin gene in sickle-cell anemia?

<p>Stiff and sticky RBCs (B)</p> Signup and view all the answers

Which type of RBC has a morphology characterized by a bowl-shaped appearance?

<p>Stomatocyte (A)</p> Signup and view all the answers

What is the advantage of being heterozygous for sickle-cell anemia?

<p>Resistance to malaria (A)</p> Signup and view all the answers

What is the characteristic of Pappenheimer bodies?

<p>Excessive iron granules (D)</p> Signup and view all the answers

Which type of RBC is characterized by a thorny appearance?

<p>Acanthocyte (C)</p> Signup and view all the answers

What is the condition in which the malaria parasite is unable to reproduce in the RBCs?

<p>Sickle-cell anemia (B)</p> Signup and view all the answers

What is the shape of RBCs in sickle-cell anemia?

<p>Stiff and sickle-shaped (B)</p> Signup and view all the answers

What is the effect of the point mutation in the hemoglobin gene on the RBCs in sickle-cell anemia?

<p>RBCs become more sticky (D)</p> Signup and view all the answers

What is the cause of the RBCs sticking together in Rouleaux formation?

<p>High fibrinogen reacting with sialic acid on the RBC surface (B)</p> Signup and view all the answers

What is the term for the remnants of mitotic spindles seen in megaloblastic anemia?

<p>Cabot's ring (B)</p> Signup and view all the answers

What is the primary site of hematopoietic stem cells in adults?

<p>Bone marrow (C)</p> Signup and view all the answers

What is the term for the process of blood cell production in adults?

<p>Hematopoiesis (D)</p> Signup and view all the answers

What is the characteristic of totipotent cells?

<p>Can become any cell of the body (D)</p> Signup and view all the answers

What is the duration of erythrocyte development in the process of erythropoiesis?

<p>3-5 days (C)</p> Signup and view all the answers

What is the index of erythropoietic activity?

<p>Reticulocyte count (A)</p> Signup and view all the answers

What is the type of stem cell that has unlimited differentiation potential and can grow into different kinds of tissue?

<p>Pluripotent (C)</p> Signup and view all the answers

How many red blood cells are produced every second?

<p>2.5 million (A)</p> Signup and view all the answers

What is the main function of Haptoglobin?

<p>To bind free hemoglobin (C)</p> Signup and view all the answers

Which of the following electrolytes is responsible for maintaining proper muscle and nerve function?

<p>Potassium (D)</p> Signup and view all the answers

What is the primary function of colony-stimulating factors (CSFs)?

<p>To stimulate the production of white blood cells (C)</p> Signup and view all the answers

What is the term for the process by which the body produces white blood cells?

<p>Leukopoiesis (D)</p> Signup and view all the answers

What is the primary function of Transferrin?

<p>To transport iron (D)</p> Signup and view all the answers

What is the primary function of hemoglobin?

<p>To transport oxygen from the lungs to the tissues (D)</p> Signup and view all the answers

Which of the following is NOT a regulatory substance found in the blood?

<p>Electrolytes (C)</p> Signup and view all the answers

What is the primary function of Ceruloplasmin?

<p>To transport copper (A)</p> Signup and view all the answers

What is the term for the process by which red blood cells mature and die?

<p>RBC Life-Cycle (A)</p> Signup and view all the answers

What is the term for the remnants of mitotic spindles seen in megaloblastic anemia?

<p>Cabot's ring (B)</p> Signup and view all the answers

Which of the following is a waste product found in the blood?

<p>All of the above (D)</p> Signup and view all the answers

What is the term for the fragmented red blood cells from mechanical destruction?

<p>Schistocyte (D)</p> Signup and view all the answers

What is the normal range of calcium ions in the blood?

<p>8.4-10.6 mg/dL (A)</p> Signup and view all the answers

What is the primary function of heme metabolism?

<p>To synthesize hemoglobin (C)</p> Signup and view all the answers

What is the maximum number of oxygen molecules that can bind to a hemoglobin molecule?

<p>4 (C)</p> Signup and view all the answers

What is the shape of the protein chains in hemoglobin that conjugate with the heme groups?

<p>Alpha-helical (C)</p> Signup and view all the answers

What is the process by which the body produces red blood cells, white blood cells, and platelets?

<p>Hemopoiesis (B)</p> Signup and view all the answers

What is the difference between the circulation of granulocytes and lymphocytes?

<p>Granulocytes circulate in the blood vessels and migrate one-way into target tissues, while lymphocytes travel in both blood and lymphatic vessels. (D)</p> Signup and view all the answers

What is the site of myeloid hemopoiesis?

<p>Red bone marrow (B)</p> Signup and view all the answers

What is the role of the heme groups in hemoglobin?

<p>To bind to oxygen molecules (D)</p> Signup and view all the answers

What is the average daily production of red blood cells in an adult?

<p>200 billion (C)</p> Signup and view all the answers

What is the primary function of vitamin B12 in erythropoiesis?

<p>Synthesis of DNA and maturation of erythrocytes (D)</p> Signup and view all the answers

What is the consequence of a high hematocrit (>65%)?

<p>Increased viscosity and resistance, high blood pressure, and risk of stroke (B)</p> Signup and view all the answers

What is the role of copper in erythropoiesis?

<p>Required for mobilization of iron from tissues to plasma (C)</p> Signup and view all the answers

What is the primary function of vitamin C in erythropoiesis?

<p>Iron metabolism (C)</p> Signup and view all the answers

What is the characteristic of anemia?

<p>Low oxygen-carrying capacity of blood (B)</p> Signup and view all the answers

What is the role of vitamin B6 in erythropoiesis?

<p>Heme synthesis (D)</p> Signup and view all the answers

What is the normal range of hematocrit for adult males?

<p>40-54% (A)</p> Signup and view all the answers

What is the role of iron in erythropoiesis?

<p>Heme synthesis and oxygen transport (A)</p> Signup and view all the answers

What is the characteristic of polycythemia?

<p>High hematocrit (&gt;65%) (A)</p> Signup and view all the answers

What is the role of vitamin E in erythropoiesis?

<p>Oxidative reactions (C)</p> Signup and view all the answers

What is the primary function of colony-stimulating factors (CSFs)?

<p>To stimulate progenitor cells to mature (A)</p> Signup and view all the answers

What is the process of producing white blood cells?

<p>Leukopoiesis (A)</p> Signup and view all the answers

What is the term for the process by which the body recycles hemoglobin from senescent RBCs?

<p>Heme metabolism (C)</p> Signup and view all the answers

What is the life cycle of RBCs characterized by?

<p>Unconjugated and conjugated bilirubin in blood (D)</p> Signup and view all the answers

What is the primary function of hematopoietic growth factors?

<p>To stimulate progenitor cells to mature (C)</p> Signup and view all the answers

What is the result of the point mutation in the hemoglobin gene in sickle-cell anemia?

<p>Glu to Val (D)</p> Signup and view all the answers

What is the shape of RBCs in hereditary elliptocytosis?

<p>Oval (B)</p> Signup and view all the answers

What is the characteristic of RBCs in sickle-cell anemia?

<p>Stiff and sticky (D)</p> Signup and view all the answers

What is the advantage of being heterozygous for sickle-cell anemia?

<p>Resistance to malaria (B)</p> Signup and view all the answers

What is the term for the process by which the body recycles hemoglobin from senescent RBCs?

<p>Hemolysis (C)</p> Signup and view all the answers

What is the cause of RBCs sticking together in Rouleaux formation?

<p>High fibrinogen levels (B)</p> Signup and view all the answers

What is the term for the remnants of mitotic spindles seen in megaloblastic anemia?

<p>Cabot's ring (B)</p> Signup and view all the answers

What is the shape of RBCs in thalassemia?

<p>Tear drop (A)</p> Signup and view all the answers

What is the term for the fragments of RBCs from mechanical destruction?

<p>Schistocytes (C)</p> Signup and view all the answers

What is the cause of Basophilic stippling in RBCs?

<p>All of the above (D)</p> Signup and view all the answers

What is the result of the mutation in the hemoglobin gene in sickle-cell anemia?

<p>GAG (Glu) to GTG (Val) (C)</p> Signup and view all the answers

What is the shape of red blood cells in hereditary elliptocytosis?

<p>Oval (D)</p> Signup and view all the answers

What is the term for the fragments of red blood cells from mechanical destruction?

<p>Schistocytes (C)</p> Signup and view all the answers

What is the advantage of being heterozygous for sickle-cell anemia?

<p>Resistance to malaria (D)</p> Signup and view all the answers

What is the characteristic of red blood cells in sickle-cell anemia?

<p>Stiff and sticky (A)</p> Signup and view all the answers

What is the term for the remnants of mitotic spindles seen in megaloblastic anemia?

<p>Cabot's rings (B)</p> Signup and view all the answers

What is the cause of Rouleaux formation?

<p>High fibrinogen (A)</p> Signup and view all the answers

What is the term for the nuclear remnants in circulating red blood cells?

<p>Howell-Jolly bodies (C)</p> Signup and view all the answers

What is the characteristic of target cells?

<p>Precipitated hemoglobin (D)</p> Signup and view all the answers

What is the shape of red blood cells in sickle-cell anemia?

<p>Sickle (B)</p> Signup and view all the answers

What is the primary site of hematopoietic stem cells?

<p>Bone marrow (D)</p> Signup and view all the answers

What is the term for the index of erythropoietic activity?

<p>Reticulocyte count (D)</p> Signup and view all the answers

What is the duration of erythrocyte development?

<p>3-5 days (A)</p> Signup and view all the answers

What type of stem cells can become any cell of the body?

<p>Totipotent (C)</p> Signup and view all the answers

In which stage of hematopoiesis does differentiation occur?

<p>Maturation (A)</p> Signup and view all the answers

What is the name of the primary site of active bone marrow in adults?

<p>Red bone marrow (C)</p> Signup and view all the answers

What is the result of the process of hematopoiesis?

<p>Production of red blood cells, white blood cells, and platelets (B)</p> Signup and view all the answers

What is the purpose of hematopoiesis in the body?

<p>To replace blood cells that grow old and die, are killed by disease, or are lost through bleeding (D)</p> Signup and view all the answers

What is the normal range of reticulocyte count?

<p>&lt; 1.5% (D)</p> Signup and view all the answers

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Study Notes

Hematologic System Components

  • Formed elements (45% by volume):
    • Red Blood Cells (RBCs)
    • White Blood Cells (WBCs)
    • Platelets
  • Plasma proteins (7% by volume):
    • Albumin (57%): carrier function, controls plasma osmotic pressure
    • Globulins (38%): α, β, γ, including antibodies (Ig), clotting factors, and transport proteins
    • Clotting factors (5%): synthesized in the liver
  • Other solutes (2% by volume):
    • Electrolytes (ions): sodium, potassium, calcium, magnesium, chloride, bicarbonate, phosphate, sulfate
    • Gases: oxygen, carbon dioxide, nitrogen
    • Nutrients: glucose, amino acids, fatty acids
    • Waste products: urea, uric acid, creatinine, bilirubin

Red Blood Cells (RBCs)

  • Function: gas transport and exchange
  • Characteristics:
    • Biconcavity: high surface-to-volume ratio for optimal gas diffusion
    • Reversible deformity: enables RBCs to squeeze through microcirculation
    • No nucleus or mitochondria: cannot divide, constantly replenished
    • 120-day life cycle
  • Hemoglobin (Hb):
    • Oxygen-carrying protein
    • Composed of 4 heme groups conjugated with 4 protein chains (2 α and 2 β)
    • Each Hb molecule can carry 4 oxygen molecules
    • Can also transport some carbon dioxide
  • RBC development:
    • Erythropoiesis: production of RBCs in bone marrow
    • Erythropoietin (EPO): hormone produced by kidneys, stimulates RBC production
    • Development takes 3-5 days

White Blood Cells (WBCs)

  • Types:
    • Neutrophils (45-75%): phagocytosis, involved in allergic reactions
    • Lymphocytes (20-40%): involved in immune response, produce antibodies
    • Monocytes (2-8%): mature into macrophages, involved in immune response
    • Eosinophils (1-4%): involved in parasitic infections and allergic reactions
    • Basophils (0.5-1%): involved in allergic reactions
  • Functions:
    • Phagocytosis
    • Antibody production
    • Immune response
    • Inflammation

Platelets (Thrombocytes)

  • Function: blood clotting
  • Characteristics:
    • Small, irregular shapes
    • Produced in bone marrow
    • 7-10 day life cycle
  • Development:
    • Thrombopoiesis: production of platelets in bone marrow
    • Thrombopoietin: hormone produced by liver, stimulates platelet production

Hematopoiesis

  • Definition: production of blood cells
  • Locations:
    • Bone marrow (adult)
    • Liver and/or spleen (fetus)
  • Process:
    • Two stages: mitosis (proliferation) and maturation (differentiation)
    • Continues throughout life to replace blood cells
  • Types of stem cells:
    • Totipotent: can become any cell of the body
    • Pluripotent: can differentiate into multiple types of cells
    • Multipotent: can differentiate into several types of cells

Sickle-cell Anemia

  • Definition: autosomal recessive inherited disorder
  • Characteristics:
    • Point mutation of hemoglobin gene
    • Stiff and sticky RBCs, leading to blocked blood flow and tissue damage
    • Pain, infections, stroke, and organ damage
    • Heterozygotes (carriers) have sickle-cell trait, resistant to malaria### Hematologic System
  • The hematologic system consists of formed elements (45% by volume) and plasma proteins.
  • Formed elements include:
    • Red Blood Cells (RBCs): carry oxygen and carbon dioxide
    • Leukocytes (WBCs): involved in allergic reactions and parasite attacks
    • Platelets: form platelet plug in hemostasis, contain histamine and heparin

Erythropoiesis

  • Erythropoietin (EPO) stimulates the production and release of RBCs from the bone marrow.
  • Produced by interstitial cells in the kidneys.
  • Hypoxia stimulates the production and release of EPO.

Plasma Proteins

  • Albumin (57%): functions as carriers and controls plasma osmotic pressure
  • Globulins (38%): includes alpha, beta, and gamma globulins
  • Clotting factors (5%): includes factors involved in blood clotting

Hemostatic Mechanism

  • Platelets play a key role in hemostasis.
  • The coagulation cascade involves intrinsic and extrinsic pathways.
  • Tissue plasminogen activator (t-PA) and plasminogen activator (PA) are involved in fibrinolysis.

Blood Typing

  • Blood typing is based on the presence or absence of specific antigens on RBC surfaces.
  • ABO blood group system: defines four main blood types (A, B, AB, and O)

Hemopoiesis

  • Hemopoiesis is the process of blood cell production in the bone marrow.
  • Totipotent stem cells differentiate into myeloid and lymphoid stem cells.
  • Colony-stimulating factors (CSFs) stimulate the production of RBCs, WBCs, and platelets.

Iron Cycle

  • Iron is essential for hemoglobin production.
  • Iron is stored in the liver and released as needed.
  • Iron deficiency can lead to anemia.

Blood Cell Development

  • Granulocytes (WBCs) and monocytes develop from myeloid stem cells.
  • Lymphocytes develop from lymphoid stem cells.
  • Platelets develop from megakaryocytes.

RBC Morphology

  • RBCs have a biconcave disk shape.
  • Abnormal shapes include target cells, spherocytes, ovalocytes, stomatocytes, and acanthocytes.

Sickle-Cell Anemia

  • Autosomal recessive inherited disorder.
  • Point mutation of the hemoglobin gene.
  • Stiff and sticky RBCs tend to clump and get stuck, blocking blood flow.

Blood Cell Production and Destruction

  • Average adult production per day: 10 billion WBCs, 200 billion RBCs, and 400 billion platelets.
  • RBCs have a lifespan of 120 days, WBCs have a variable lifespan, and platelets have a lifespan of 8-12 days.Here are the study notes for the text:

Hematopoiesis

  • Blood cell production in adult bone marrow or in the liver and/or spleen in the fetus
  • Two stages: Mitosis (proliferation) and Maturation (differentiation)
  • Continues throughout life to replace blood cells that grow old and die, are killed by disease, or are lost through bleeding

Bone Marrow

  • Primary site of hematopoietic stem cells
  • Also called myeloid tissue
  • Red versus yellow bone marrow
  • Adult active bone marrow: pelvic bones, vertebrae, cranium & mandible, sternum & ribs, humerus, and femur

Erythropoiesis (RBC Development)

  • Erythrocyte differentiation
  • In each step, hemoglobin increases and nucleus size decreases
  • Development takes 3 – 5 days
  • Reticulocyte count: Index of erythropoietic activity
  • Indicates whether new RBCs are being produced
  • Normal range < 1.5%

Hematopoiesis

  • Totipotent: cells that can become any cell of the body
  • Pluripotent: cells continue to have unlimited differentiation potential and can grow into different kinds of tissue
  • Multipotent: cells are more limited but have abilities to differentiate into many different types of cells
  • Colony-stimulating factors (CSFs) or hematopoietic growth factors: Stimulate progenitor cells to mature; can be used to increase neutrophils

RBC Morphology

  • Target cell - precipitated Hgb (Causes: Sickle-cell, Thalassemias, low Fe)
  • Spherocyte - a form of autoimmune hemolytic anemia
  • Ovalocyte - hereditary elliptocytosis (destabilization of cytoskeletal scaffold)
  • Stomatocyte - bowl shaped, loses biconcavity due to membrane defect
  • Acanthocyte - thorny cells - alteration in membrane lipids (abetalipoproteinemia)
  • Helmet cell/Schistocytes - fragmented rbcs from mechanical destruction
  • Tear drop "dacrocyte" - from Hgb defect in Beta Thalassemia
  • Burr cell - many causes - from mix with anticoag (EDTA - ethylene diamine tetra acetic acid) also seen in uremia, PKd (pyruvate kinase deficiency), low Mg, low Phos
  • Pappenheimer bodies/found in sideroblasts - excessive iron granules
  • Cabot's ring - remnants of mitotic spindles seen in megaloblastic anemia
  • Basophilic stippling - ribosomes from myelodysplastic syndrome, heavy metal poisoning
  • Howell-Jolly bodies - nuclear remnants in circulating RBCs - seen in damaged or absent spleen
  • Rouleaux - high fibrinogen reacts with sialic acid on RBC surface, causes them to stick together surface-to-surface

Anemia and Polycythemia

  • Anemia: Low oxygen-carrying capacity of blood
    • Low RBC count/volume
    • Hematocrit - percentage of total blood volume occupied by RBCs
    • Normal female range = 38 - 46% (average 42%)
    • Normal male range = 40 - 54% (average 46%)
    • Low hematocrit indicates anemia (< 38%)
  • Polycythemia: high hematocrit (>65%)
    • Will cause: increased viscosity/resistance, high BP, risk of stroke
    • Signs: Erythroid hyperplasia (high reticulocytes), tissue hypoxia, high EPO

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