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Questions and Answers
What hormone primarily stimulates the production of red blood cells?
Which dietary factors are known to affect red blood cell production?
Which type of hemoglobin is predominantly found in an adult?
What is the primary function of hemoglobin in red blood cells?
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Which stage of red blood cell maturation is the last to undergo mitosis?
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What do macrophages break down hemoglobin into?
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What is a characteristic of fetal hemoglobin (Hb F)?
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What is the reference value for hemoglobin in adult females?
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What is the primary function of hemoglobin in red blood cells?
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Which type of red blood cell precursor is the last capable of mitosis?
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What is the diameter of a mature erythrocyte?
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What is the role of integral proteins in the red blood cell membrane?
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How long does it take for red blood cells to develop from stem cells?
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Which component makes up 52% of the red blood cell membrane?
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What feature distinguishes the orthchromatic normoblast from earlier precursors?
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What allows red blood cells to deform as they pass through capillaries?
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What percentage of carbohydrates is found in the red blood cell membrane?
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Which red blood cell stage contains a fine reticulum of RNA visible with supravital stain?
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What is the primary characteristic of hematopoietic stem cells?
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What is the primary site for medullary hematopoiesis?
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Which of the following cell types is included in precursor cells?
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What percentage of tissue in the bone marrow cavities of adults is composed of fat?
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Which of the following is NOT true about pluripotent hematopoietic stem cells?
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Which organ is considered an extramedullary site of blood production?
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What effect does a short draw in evacuated tubes have on hematocrit readings?
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What is the process of retrogression in bone marrow?
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What is the primary role of B lymphocytes in the immune system?
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Which statement is true about natural killer cells?
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How do platelets contribute to hemostasis?
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What process do megakaryocyte cells undergo to form platelets?
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Which type of lymphocyte matures in the thymus?
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What is the normal range for platelet counts in microliters of blood?
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Which blood anticoagulant is commonly used for platelet studies?
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Which of the following cells represents the largest proportion of lymphocytes in the circulation?
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What is the primary function of iron in the body?
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Which demographic groups are at higher risk for iron deficiency anemia?
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What condition is characterized by a decrease in red blood cells, hemoglobin, and hematocrit?
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What is the storage form of iron in the body?
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Which of the following is a common clinical symptom of iron deficiency anemia?
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Which of the following tests is NOT typically used in the initial laboratory diagnosis of anemia?
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What is pica, commonly experienced by those with long-standing iron deficiency?
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What are bilirubin derivatives responsible for?
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Study Notes
Hematopoietic Stem Cells
- Retain the ability to differentiate into any cell lines
- Referred to as colony-forming units
- Capable of self-renewal and directed differentiation into all required cell lineages
Progenitor Cells
- Differentiate into only one cell line
Precursor Cells
- Blast forms
- Include myeloblast, megakaryoblast, erythroblast
Hematopoiesis
- Occurs in the bone marrow, liver, and spleen
- Medullary hematopoiesis is the primary site of blood cell production in adults.
- Extramedullary hematopoiesis is the production of blood cells outside of the bone marrow.
Bone Marrow
- Red marrow is active and contains developing blood cells and their progenitors.
- Yellow marrow is inactive and composed primarily of adipocytes.
- Retrogression is the process of replacing active marrow with adipocytes during development.
Hematopoietically Active Marrow
- Red marrow is the only active marrow.
Adult Bone Marrow Fat Content
- Approximately 50% of the tissue located in the bone marrow cavities of adults is fat.
Extramedullary Site of Blood Production
- The liver is an extramedullary site of blood production.
Ideal Environment for Hematopoietic Stem Cells
- Necrosis is not a process allowed in an ideal environment for hematopoietic stem cells.
Pluripotent Hematopoietic Stem Cells Characteristics
- Pluripotent hematopoietic stem cells possess self-renewal ability.
- They don't produce progenitor cells committed to a single cell lineage.
- They express the stem cell marker CD13.
- Pluripotent hematopoietic stem cells are morphologically unrecognizable.
Short Draw in Evacuated Tube Hematocrit Reading
- A short draw in an evacuated tube causes the hematocrit reading to be decreased.
Locations of Adult Hematopoiesis Tissue
- The spleen, liver, and lymph nodes are all locations of adult hematopoiesis tissue.
Red Blood Cells
- Biconcave discs
- One-third hemoglobin
- Able to readily squeeze through capillaries
- Lack nuclei and cytoplasmic organelles
- Human Erythrocytes are 7.5 um in diameter, 2.6 um thick at the rim, and 0.8 um thick in the center
- The normal concentration of erythrocytes in blood is approximately 3.9- 5.5 million/uL in women and 4.1-6 million/uL in men.
Erythropoiesis
- The process of RBC development from stem cells
- Takes about 7 days.
Red Blood Cell Maturation Series (The Precursors)
- Pronormoblast: The earliest morphologically recognizable precursor.
- Basophilic Normoblast: Intense basophilic cytoplasm; chromatin may be partially clumped.
- Polychromatophilic Normoblast: Blue-gray to pink-gray cytoplasm; last stage capable of mitosis; first stage of hemoglobin synthesis.
- Orthochromic Normoblast: Small pyknotic nucleus; enucleation; last nucleated stage; first stage incapable of mitosis.
- Reticulocyte: Pink to slightly pinkish gray cytoplasm; contains fine basophilic reticulum of RNA which is only visible with supravital stain; last stage capable of producing hemoglobin.
- Mature Erythrocyte: 6-8 um diameter; salmon pink in color; non-nucleated, round, biconcave disc with a central pallor that occupies the middle 1/3 of the cell; no mitochondria.
Erythrocyte Membrane Physiology
- Three components: protein (52%), lipid (40%), carbohydrates (8%)
- Proteins serve as transport and adhesion sites and signaling receptors.
- Peripheral proteins provide the shape and flexibility of the RBC.
- Lipids maintain cell deformability, osmotic balance, and support surface antigens and receptors. Lipids also aid in transporting essential cellular ions and gases.
Erythropoietin
- A hormone glycoprotein produced in the kidney and liver.
- Stimulates the production of globin and enhances the release of reticulocytes into circulation.
- Enhances reticulocyte maturation to mature RBCs.
- Major stimulant is hypoxia.
- Other stimuli include testosterone, estrogen, pituitary and thyroid hormones.
Dietary Factors Affecting Red Blood Cell Production
- Iron
- Vitamin B12
- Folic acid
- Copper
- Pyridoxine (Vitamin B6)
- Riboflavin (Vitamin B2)
- Niacin
Primary Target Cells of EPO
- Bone marrow erythroid progenitors are the primary target cells of EPO.
Cytoplasmic Color in Younger Cells
- Younger cells have a lighter blue cytoplasmic color.
Precursor of Orthochromic Normoblast
- The polychromatophilic normoblast is the precursor of the orthochromic normoblast.
Last RBC Maturation Stage to Undergo Mitosis
- The polychromatophilic normoblast is the last RBC maturation stage that undergoes mitosis.
Hemoglobin
- The main component of a red blood cell; accounts for about a third of the cell's volume.
- Responsible for transporting O2 from lungs to tissues and CO2 from tissues to lungs.
- Composed of four subunits; each subunit has heme and globin.
- 4 Heme - Consists of protoporphyrin IX and ferrous iron.
- 4 Globin - Consists of 2 identical pairs of unlike polypeptide chains.
Hemoglobin Reference Values
- Children: 12 to 15 g/dl
- Adult Male: 14 to 18 g/dl
- Adult Female: 12 to 15 g/dl
Types of Hemoglobin
- Fetal Hemoglobin (Hb F): Present in the fetus during the last seven months of development in the uterus and is replaced by adult hemoglobin within 6 months after birth.
- Adult Hemoglobin (Hb A): Predominate hemoglobin in an adult; subdivided into glycosylated fractions A1c which reflects glucose level in the blood.
Destruction of Hemoglobin
- Macrophages break down hemoglobin into heme and globin.
- The globin chains of hemoglobin are broken down into individual amino acids and are metabolized or used to build new proteins.
- Iron is released from the heme of hemoglobin.
- Heme is converted into bilirubin.
- Iron is transported in the blood to the red bone marrow and used in the production of new hemoglobin.
- Bilirubin is transported in the blood to the liver.
- Bilirubin is excreted as part of the bile into the small intestine.
- Some bilirubin derivatives contribute to the color of feces.
- Other bilirubin derivatives are reabsorbed from the intestine into the blood and excreted from the kidneys in the urine, contributing to the color of urine.
Anemia
- A decrease in RBC, Hb, and hematocrit, resulting in decreased oxygen delivery to the tissues.
- Classified morphologically using RBC indices.
- Classified based on etiology/cause.
Iron Deficiency Anemia / Nutritional Anemia
- The most common form of anemia.
- Prevalent in infants and children, pregnancy, excessive menstrual flow, elderly with poor diets, malabsorption syndromes, and chronic blood loss.
-
Etiology:
- Inadequate intake of iron.
- Increased demand (pregnancy, infancy, and childhood).
- Impaired iron absorption (Celiac disease and decreased stomach acidity).
- Chronic blood loss.
Iron Deficiency Anemia Clinical Signs and Symptoms
- Fatigue, weakness, and shortness of breath, especially with exertion.
- Sore tongue.
- Inflamed cracks at the corners of the mouth.
- Koilonychia may be seen if the deficiency is long-standing.
- Pica may also occur.
Storage Form of Iron in Insoluble Form
- Hemosiderin is the storage form of iron in insoluble form.
Normal Hemoglobin
- Deoxyhemoglobin is considered a normal hemoglobin.
Initial Laboratory Tests for Anemia Diagnosis
- Complete blood count, reticulocyte count, and peripheral blood film examination are the initial laboratory tests performed for the diagnosis of anemia.
White Blood Cells
- Leucocytes are the largest blood cells.
T-Lymphocytes
- Represent 60-80% of circulating lymphocytes in the peripheral blood.
- Mature at the thymus.
- End products of activation are cytokines.
B-Lymphocytes
- Represent 20-35% of the lymphocytes population.
- Mature at the bone marrow.
- Precursor cells in antibody production.
- B cells are the precursor of plasma cells.
Natural Killer Cells
- Represent 10-15% of the total lymphocytes population.
- Are under the natural immunity, which means they are non-specific compared to B and T cells.
- Essential mediators of virus immunity.
- Can destroy virally infected cells or tumor cells.
Platelets
- Non-nucleated disc-like cell fragments 2-4 µm in diameter.
- Not true cells.
- Originate from fragments of megakaryocyte cytoplasm that reside in the red bone marrow.
- Promote blood clotting and help repair gaps in the walls of blood vessels, preventing loss of blood.
- Normal platelet counts range from 200,000- 400000 per microliter of blood.
- Thrombopoietin released by kidneys has the ability to stimulate platelet synthesis.
Megakaryopoiesis
- Maturation time is 5 days.
- Endomitosis is nuclear division without cytoplasmic division, a form of mitosis that lacks telophase and cytokinesis.
Platelet Clumping
- Platelet clumping can occur for various reasons, such as:
- Platelet activation due to inflammation
- Platelet activation due to blood vessel injury
- Platelet activation due to blood transfusions
- Platelet activation due to drug reactions
End Cells
- Neutrophils, monocytes, lymphocytes, and platelets are all considered end cells.
Antibody Producing Lymphocytes
- B cells are the antibody producing lymphocytes.
Blood Anticoagulant Used for Platelet Studies
- EDTA is used as the anticoagulant for platelet studies.
Large Platelet Clump Effect on Automated Hematology Analyzer Count
- Large platelet clumps may increase the nucleated RBC count when using an automated hematology analyzer.
Not an End Cell
- Platelets are not an end cell.
Megakaryocytic Cell Mitotic Process
- Megakaryocytic cells undergo endomitosis.
Megakaryocytic Cell Giant Multinucleated Cell Generation
- Megakaryocytic cells undergo multiple mitotic divisions without cytoplasmic division, generating giant multinucleated cells.
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Description
This quiz covers key concepts related to hematopoietic stem cells, progenitor and precursor cells, and the process of hematopoiesis. It explores the functions of bone marrow and its types, as well as the physiological processes involved in blood cell formation. Test your knowledge on the essential elements of hematology.
