Hematology Course Introduction 2024 Prof. Waseem AlTameemi
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Questions and Answers

What is the percentage of haemopoietic stem cells (HSC) in total bone marrow cells?

  • 0.001% (correct)
  • 0.1%
  • 1%
  • 10%

    • What is the main function of hematopoiesis?

  • To form bone cells
  • To produce brain cells
  • To develop muscle cells
  • To replenish dying cells with new blood cells (correct)

    • What kind of cell is a pluripotential stem cell (HSC)?

  • CD34- CD38- and negative for lineage markers (Lin-)
  • CD34- CD38+ and positive for lineage markers (Lin+)
  • CD34+ CD38- and negative for lineage markers (Lin-) (correct)
  • CD34+ CD38+ and positive for lineage markers (Lin+)

    • How many mature blood cells can one stem cell produce after 20 cell divisions?

    <p>$10^6$</p> Signup and view all the answers

    What happens to bone marrow cells as they mature?

    <p>They increasingly differentiate and lose the capacity for self-renewal</p> Signup and view all the answers

    Which growth factor stimulates the production of granulocytes?

    <p>Interleukin-3 (IL-3)</p> Signup and view all the answers

    What can induce hematopoietic stem cells to circulate?

    <p>Granulocyte colony stimulating factor (G-CSF)</p> Signup and view all the answers

    What is the normal range of reticulocytes in adults in peripheral blood?

    <p>0.5% - 2.0%</p> Signup and view all the answers

    What stimulates erythropoietin (Epo) production in response to tissue hypoxia?

    <p>New vessel formation</p> Signup and view all the answers

    Which of the following is an indication for erythropoietin therapy?

    <p>Anemia associated with malignancy and chemotherapy</p> Signup and view all the answers

    What is the first recognizable granulocyte in the bone marrow?

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

    What is a clinical application of Granulocyte colony stimulating factor (G-CSF)?

    <p>Peripheral blood stem cell mobilization</p> Signup and view all the answers

    How long does it take for neutrophils to mature within the bone marrow?

    <p>~5 days</p> Signup and view all the answers

    Which cells are mostly concentrated in the bone marrow?

    <p>Hematopoietic stem cells</p> Signup and view all the answers

    What is a potential consequence of hematopoiesis when the bone marrow becomes infiltrated by malignant cells?

    <p>Ineffective production of healthy blood cells</p> Signup and view all the answers

    What is the main manifestation of structural heart disease or abnormal conduction in an otherwise healthy heart?

    <p>Disturbance of the electrical rhythm of the heart</p> Signup and view all the answers

    Which age group may experience arrhythmias according to the text?

    <p>Any age group</p> Signup and view all the answers

    What are the three main mechanisms of tachycardia mentioned in the text?

    <p>Increased automaticity, reentry, triggered activity</p> Signup and view all the answers

    How is a heart rate > 100/min classified according to the text?

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

    Which chambers of the heart are involved in wide bizzare QRS arrhythmias?

    <p>Lower chambers (ventricles)</p> Signup and view all the answers

    What are the classifications of arrhythmias mentioned in the text?

    <p>Mechanism and site of origin</p> Signup and view all the answers

    Which type of tachycardia is initiated by an ectopic beat and sustained by a re-entry circuit?

    <p>Ectopic atrial tachycardia</p> Signup and view all the answers

    Which type of after-depolarizations can occur in the late phase 3 of the action potential?

    <p>Delayed after-depolarizations</p> Signup and view all the answers

    What can cause ventricular arrhythmias in patients with coronary heart disease, arising from an incompletely repolarized cell membrane?

    <p>Triggered automaticity</p> Signup and view all the answers

    Which type of rhythm exhibits phasic alteration of the heart rate during respiration?

    <p>Sinus nodal rhythm disturbances</p> Signup and view all the answers

    Which type of arrhythmia is characterized by 'palpitation', 'dizziness', and 'chest discomfort or breathlessness'?

    <p>Atrial fibrillation</p> Signup and view all the answers

    Which drug classification includes drugs acting on the atria, ventricles, and accessory pathways?

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

    What is the main cause of bradycardia due to reduced automaticity?

    <p>\text{Sick sinus syndrome}</p> Signup and view all the answers

    Which investigation is used to assess sinus node function, AV conduction, and inducibility of arrhythmias?

    <p>\text{Catheter-based electrophysiologic studies (EPS)}</p> Signup and view all the answers

    Which type of rhythm exhibits anatomic circuit with two pathways joined by a common tissue?

    <p>\text{Re-entry circuit}</p> Signup and view all the answers

    Study Notes

    Hematopoiesis

    • Haemopoietic stem cells (HSC) make up approximately 0.01% of total bone marrow cells.
    • The main function of hematopoiesis is to produce mature blood cells.
    • A pluripotential stem cell (HSC) has the ability to differentiate into multiple cell types.

    Stem Cell Production

    • One stem cell can produce approximately 10^18 (100 trillion) mature blood cells after 20 cell divisions.

    Maturation of Bone Marrow Cells

    • As bone marrow cells mature, they become more differentiated and specialized.

    Granulocyte Production

    • The growth factor granulocyte-colony stimulating factor (G-CSF) stimulates the production of granulocytes.

    Hematopoietic Stem Cell Circulation

    • Inflammation and stress can induce hematopoietic stem cells to circulate.

    Reticulocytes in Peripheral Blood

    • The normal range of reticulocytes in adults in peripheral blood is 0.5-2.5%.

    Erythropoietin (Epo) Production

    • Hypoxia stimulates Epo production, which in turn stimulates red blood cell production.

    Indication for Erythropoietin Therapy

    • Erythropoietin therapy is indicated for patients with chronic kidney disease or anemia.

    Granulocyte Development

    • The first recognizable granulocyte in the bone marrow is the myeloblast.

    Clinical Application of G-CSF

    • Granulocyte colony stimulating factor (G-CSF) is used to stimulate the production of neutrophils in patients with neutropenia.

    Neutrophil Maturation

    • It takes approximately 10-14 days for neutrophils to mature within the bone marrow.

    Bone Marrow Cell Distribution

    • Immature cells are mostly concentrated in the bone marrow.

    Consequences of Malignant Infiltration

    • When the bone marrow becomes infiltrated by malignant cells, hematopoiesis can be disrupted.

    Arrhythmias and Cardiac Conduction

    Age Group and Arrhythmias

    • The elderly may experience arrhythmias.

    Mechanisms of Tachycardia

    • The three main mechanisms of tachycardia are re-entry, automaticity, and triggered activity.

    Heart Rate Classification

    • A heart rate > 100/min is classified as tachycardia.

    Wide Bizarre QRS Arrhythmias

    • Wide bizarre QRS arrhythmias involve the ventricles.

    Arrhythmia Classifications

    • The classifications of arrhythmias include supraventricular and ventricular arrhythmias.

    Type of Tachycardia

    • Re-entrant tachycardia is initiated by an ectopic beat and sustained by a re-entry circuit.

    After-Depolarizations

    • Early after-depolarizations can occur in the early phase 2 of the action potential, while late after-depolarizations can occur in the late phase 3.

    Ventricular Arrhythmias

    • Ventricular arrhythmias can occur in patients with coronary heart disease, arising from an incompletely repolarized cell membrane.

    Respiratory-Dependent Rhythm

    • Sinus arrhythmia exhibits phasic alteration of the heart rate during respiration.

    Symptoms of Arrhythmia

    • Symptoms of arrhythmia include palpitations, dizziness, and chest discomfort or breathlessness.

    Anti-Arrhythmic Drugs

    • Class III anti-arrhythmic drugs act on the atria, ventricles, and accessory pathways.

    Bradycardia

    • Bradycardia is often caused by reduced automaticity, which can be due to sinus node dysfunction.

    Investigation of Arrhythmias

    • Electrophysiological studies are used to assess sinus node function, AV conduction, and inducibility of arrhythmias.

    Anatomic Circuit

    • Atrial flutter exhibits an anatomic circuit with two pathways joined by a common tissue.

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    Description

    Learn about the process of formation of blood cells, the concept of a stem cell, general mechanisms of anemia, and terms like left shift, leukoerythroblastic picture, leukemoid reaction in this introductory lecture. Understand the well-controlled, continuous process of blood cell formation known as hematopoiesis (hemopoiesis).

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