Hematopoiesis: Blood Cell Formation

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Questions and Answers

Which term refers to the formation and development of red blood cells?

  • Thrombopoiesis
  • Erythropoiesis (correct)
  • Leukopoiesis
  • Hematopoiesis

What is the function of erythrocytes?

  • Oxygen transport (correct)
  • Antibody production
  • Primary hemostasis
  • Defense against microorganisms

Which of the following best describes the role of leukocytes in the body?

  • Facilitating oxygen transport
  • Defending against disease (correct)
  • Transporting nutrients
  • Promoting primary hemostasis

What is the main function of thrombocytes?

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

Which of the following is a primary site of hematopoiesis in adults?

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

In a developing embryo, where does erythropoiesis primarily occur?

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

During fetal development, which organs are involved in hematopoiesis?

<p>Liver, spleen, and thymus (A)</p> Signup and view all the answers

What characterizes active bone marrow?

<p>Major site of hematopoiesis (C)</p> Signup and view all the answers

What is the composition of inactive bone marrow?

<p>Adipocytes, endothelial cells, and reticular cells (A)</p> Signup and view all the answers

What is the primary function of the thymus?

<p>Differentiation of T lymphocytes (A)</p> Signup and view all the answers

What characterizes extramedullary hematopoiesis (EMH)?

<p>Hematopoiesis occurring outside the bone marrow (A)</p> Signup and view all the answers

What role does the mononuclear phagocyte system play in hematopoiesis?

<p>Removal and destruction of blood cells (B)</p> Signup and view all the answers

What role do reticular cells play in the bone marrow's structural elements?

<p>Providing scaffolding for hematopoietic cells (C)</p> Signup and view all the answers

Which statement accurately describes the role of cytokines in hematopoiesis?

<p>Cytokines regulate differentiation and production of blood cells. (A)</p> Signup and view all the answers

Which process is characterized by the commitment of progenitor cells to specific cell lines?

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

Which process is associated with morphologic changes in cells?

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

What is the term used to describe hematopoietic activity that occurs outside the bone marrow?

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

What stimulates the production of erythropoietin?

<p>Low tissue oxygen levels (B)</p> Signup and view all the answers

What is the main function of thrombopoietin (TPO)?

<p>Promotes megakaryocyte and platelet production (D)</p> Signup and view all the answers

Which of the following is the first identifiable erythroid cell in the maturation sequence?

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

What happens to the nucleus during erythrocyte maturation?

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

Which of the following features characterizes a prorubricyte?

<p>Clumped chromatin and no nucleolus (C)</p> Signup and view all the answers

What is a key characteristic of the cytoplasm in a mature erythrocyte?

<p>Red-staining (A)</p> Signup and view all the answers

Which hormone increases EPO production?

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

Cytokines influence hematopoiesis. What are cytokines?

<p>Proteins that modulate the function of other cell types (B)</p> Signup and view all the answers

What is the term for platelets produced from thromboblasts?

<p>Other species (avian, reptile, amphibian, fish) (C)</p> Signup and view all the answers

What is endomitosis?

<p>A process where the nucleus replicates, but the nucleus and the cell do not divide, resulting in a very large cell with a multilobulated nucleus. (C)</p> Signup and view all the answers

What is the outcome when high levels of EPO are present?

<p>Platelets may decrease as stem cells differentiate into the erythroid pathway (A)</p> Signup and view all the answers

During granulocyte maturation, what is the first recognizable cell in the granulocytic lineage?

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

Which characteristic distinguishes a promyelocyte from a myeloblast?

<p>Smaller cell size and reddish-purple cytoplasmic granules (D)</p> Signup and view all the answers

What feature defines a band cell (stab cell) during granulocyte maturation?

<p>A nucleus with parallel sides (C)</p> Signup and view all the answers

Which condition may lead to the release of immature cells into circulation?

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

How does estrogen influence erythropoiesis?

<p>Decreases response to EPO (C)</p> Signup and view all the answers

What is the significance of the bone marrow's structural microenvironment in hematopoiesis?

<p>It ensures proper structural and chemical support, influencing blood cell production. (B)</p> Signup and view all the answers

In non-mammalian species like fish and amphibians, which organs are involved in hematopoiesis?

<p>Kidney, liver, and spleen. (C)</p> Signup and view all the answers

Given that horses do not release reticulocytes in response to anemia, what compensatory mechanism might be expected in equine erythropoiesis compared to other species?

<p>Increased EPO production to stimulate quicker erythrocyte maturation. (D)</p> Signup and view all the answers

What is the functional implication of mature megakaryocytes being polyploid, possessing a multilobulated nucleus with 8-128N?

<p>Increased capacity for protein synthesis to produce platelets. (A)</p> Signup and view all the answers

Unlike mammals, avian species possess nucleated thrombocytes. How does this difference likely affect the avian clotting process compared to mammals?

<p>Avian thrombocytes may contribute to immune responses and wound repair via cytokine production. (C)</p> Signup and view all the answers

A researcher discovers a novel cytokine that selectively inhibits the differentiation of common myeloid progenitors (CMP) into granulocyte-monocyte progenitors (GMP) while sparing megakaryocyte-erythroid progenitors (MEP). What is the hematological consequence?

<p>Granulocytopenia and monocytopenia, with unaffected erythropoiesis and thrombopoiesis. (C)</p> Signup and view all the answers

Which of the following organs is NOT directly involved in hematopoiesis?

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

Where does erythropoiesis primarily occur in the mammalian embryo?

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

Which of the following is the primary site of hematopoiesis in adult mammals?

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

What cellular process directly leads to the formation of platelets?

<p>Fragmentation of megakaryocyte cytoplasm (C)</p> Signup and view all the answers

What characterizes the role of the spleen in hematopoiesis?

<p>Reservoir for erythrocytes and platelets (B)</p> Signup and view all the answers

What is the function of reticular cells in the bone marrow?

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

What is the clinical implication of damage to the endothelial cells within the bone marrow?

<p>Premature release of immature cells (D)</p> Signup and view all the answers

What is the primary role of the mononuclear phagocyte system in the context of hematopoiesis?

<p>Removal and destruction of blood cells (A)</p> Signup and view all the answers

Why is the study of hematopoiesis important in veterinary medicine?

<p>It is essential for diagnosing and treating blood disorders across species. (C)</p> Signup and view all the answers

What characterizes 'differentiation' in the context of hematopoiesis?

<p>The commitment of progenitor cells to a specific cell line. (B)</p> Signup and view all the answers

What is the significance of the bone marrow microenvironment in hematopoiesis?

<p>It provides structural support, nutrients, and growth factors. (D)</p> Signup and view all the answers

Which characteristic is associated with active bone marrow?

<p>Major site of hematopoiesis in adults (B)</p> Signup and view all the answers

During erythrocyte maturation, what change occurs in the cytoplasm?

<p>Becomes less basophilic (C)</p> Signup and view all the answers

Which of the following best describes the role of colony-stimulating factors (CSFs) in hematopoiesis?

<p>Influencing cell proliferation and differentiation (D)</p> Signup and view all the answers

What is the underlying principle of how thrombopoietin (TPO) levels are regulated in the body?

<p>Free TPO levels are directly influenced by total platelet mass (B)</p> Signup and view all the answers

What stimulates the production and release of erythropoietin (EPO)?

<p>Low tissue oxygen levels (A)</p> Signup and view all the answers

How does the liver contribute to hematopoiesis?

<p>It produces coagulation factors and sometimes erythropoietin. (D)</p> Signup and view all the answers

How do the effects of estrogen influence erythropoiesis?

<p>Decreases the response to erythropoietin (EPO). (A)</p> Signup and view all the answers

In the context of granulocyte maturation, which feature distinguishes a myelocyte from a metamyelocyte?

<p>Indented or kidney-shaped nucleus (B)</p> Signup and view all the answers

During granulocyte maturation, what event characterizes the transition from myelocyte to metamyelocyte?

<p>Indentation of the nucleus (C)</p> Signup and view all the answers

What is the cellular origin of platelets?

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

What effect do testosterone and anabolic steroids have on erythropoiesis?

<p>Increase erythropoietin production (B)</p> Signup and view all the answers

What is the role of the thymus in hematopoiesis?

<p>T lymphocyte differentiation (D)</p> Signup and view all the answers

Which cell type is characterized by dark blue-staining cytoplasm, a pale-staining nucleus, and a visible nucleolus?

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

What is the correct maturation sequence of granulocytes?

<p>Myeloblast → Promyelocyte → Myelocyte → Metamyelocyte → Band → Segmented (C)</p> Signup and view all the answers

Which erythroid precursor is characterized by a completely condensed nucleus and the presence of a polychromatophilic cytoplasm?

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

In avian species, nucleated thrombocytes are produced from thromboblasts. Assuming similar hemostatic mechanisms, what is a plausible functional consequence of this structural difference compared to mammalian platelets?

<p>Thrombocytes are capable of protein synthesis and may have a role in immune responses. (C)</p> Signup and view all the answers

A researcher is studying a novel cytokine. Which characteristic would classify it as an interleukin?

<p>It primarily modulates immune and inflammatory responses. (D)</p> Signup and view all the answers

If a patient has a condition leading to increased levels of erythropoietin (EPO), what effect would this have on platelet production?

<p>Platelet numbers may decrease as stem cells are directed towards erythroid differentiation (D)</p> Signup and view all the answers

A researcher discovers that a particular disease causes a significant decrease in the number of reticular cells in the bone marrow. How would this likely impact hematopoiesis?

<p>Reduced structural support for hematopoietic cells (C)</p> Signup and view all the answers

A patient with chronic kidney disease is likely to experience anemia because of what primary mechanism?

<p>Decreased erythropoietin (EPO) production (D)</p> Signup and view all the answers

A researcher introduces a pharmaceutical agent that selectively enhances the production of granulocyte-monocyte progenitors (GMP) from common myeloid progenitors (CMP) while simultaneously inhibiting erythropoiesis. What hematological changes are most likely to be observed in the short-term?

<p>Increased granulocytes and monocytes, decreased erythrocytes (C)</p> Signup and view all the answers

Consider a scenario where a genetic mutation results in megakaryocytes that are incapable of endomitosis. What would be the most likely consequence of this mutation?

<p>Decreased platelet production due to smaller, less polyploid megakaryocytes (C)</p> Signup and view all the answers

In the context of this course, what is the primary focus of clinical pathology?

<p>Diagnosing diseases in live animals through laboratory tests. (A)</p> Signup and view all the answers

Which of the following represents the three primary divisions within clinical pathology covered in this course?

<p>Hematology, cytology, and clinical chemistry. (C)</p> Signup and view all the answers

Which statement accurately describes the instructor's approach to exam questions regarding reference intervals?

<p>Reference intervals will be provided for all cases, so memorization is not required. (B)</p> Signup and view all the answers

What is the primary role of thrombocytes in hemostasis?

<p>Participating in primary hemostasis by plugging small blood vessel leaks. (C)</p> Signup and view all the answers

How does the instructor plan to assess student participation in the discussion sessions?

<p>Tracking attendance and participation using Poll Everywhere. (A)</p> Signup and view all the answers

What is the significance of the bone marrow microenvironment's structural elements in hematopoiesis?

<p>They provide structural support and a suitable chemical surrounding for blood cell production. (C)</p> Signup and view all the answers

During erythropoiesis, what morphological changes occur to the nucleus as the cell matures from a rubriblast to a metarubricyte?

<p>The nucleus decreases in size, the chromatin condenses, and it eventually becomes pyknotic. (C)</p> Signup and view all the answers

What is the role of the endothelial cells lining the sinuses within the bone marrow?

<p>They act as a selective barrier, preventing immature cells from entering the circulation. (D)</p> Signup and view all the answers

Which of the following best describes the function of erythropoietin (EPO)?

<p>Inhibits apoptosis and stimulates proliferation of erythroid precursor cells. (C)</p> Signup and view all the answers

Based on the lecture, which of the following scenarios would most likely lead to extramedullary hematopoiesis (EMH)?

<p>Severe bone marrow damage or disease preventing normal blood cell production. (C)</p> Signup and view all the answers

According to the instructor, what is a key distinction between differentiation and maturation in the context of hematopoiesis?

<p>Differentiation is commitment to a cell lineage, while maturation is development into a functional cell. (B)</p> Signup and view all the answers

What is the primary significance of the spleen in the context of hematopoiesis and blood cell function?

<p>It acts as a reservoir for erythrocytes and platelets and removes damaged blood cells. (D)</p> Signup and view all the answers

If a patient presents with a mid-shaft fracture of the humerus, what is the likelihood of observing a release of immature hematopoietic cells into circulation, and why?

<p>Low likelihood, as the mid-shaft of the humerus typically contains inactive marrow in adult animals. (D)</p> Signup and view all the answers

What is the role of macrophages, sometimes referred to as 'nurse cells', in erythropoiesis?

<p>They provide iron, phagocytize defective cells, and remove extruded nuclei. (C)</p> Signup and view all the answers

How is the term 'myeloid' used in the context of bone marrow composition and myeloid:erythroid (M:E) ratio?

<p>'Myeloid' includes granulocytes and monocytes, but not erythroid cells or lymphocytes. (D)</p> Signup and view all the answers

In the context of veterinary medicine, why is understanding the process of hematopoiesis vital for clinical practice?

<p>It’s essential for interpreting complete blood counts and diagnosing various diseases. (D)</p> Signup and view all the answers

What is the primary mechanism by which low tissue oxygen levels stimulate erythropoiesis?

<p>Causing peritubular interstitial fibroblasts in the kidney to produce erythropoietin. (D)</p> Signup and view all the answers

Which characteristic distinguishes granulocytes from mononuclear cells?

<p>Granulocytes contain segmented nuclei, while mononuclear cells have a single, unsegmented nucleus. (D)</p> Signup and view all the answers

Which of the following cell types is most likely to exhibit the deepest blue cytoplasm when observed in a bone marrow aspirate stained with Romanowski stain?

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

A researcher is examining a bone marrow sample and identifies a cell undergoing endomitosis. Which type of cell is the researcher most likely observing?

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

In a clinical scenario involving chronic renal failure, why does the erythropoietin response often result in severe anemia?

<p>Because damaged kidneys fail to produce adequate erythropoietin, impairing erythropoiesis. (C)</p> Signup and view all the answers

Which description accurately portrays the role of hematopoietic growth factors such as interleukins (IL) and colony-stimulating factors (CSFs)?

<p>They promote the proliferation and differentiation of hematopoietic precursor cells. (D)</p> Signup and view all the answers

In avian hematopoiesis, assuming similar erythropoietic mechanisms to mammals, how might the absence of a discrete reticulocyte stage (due to continuous maturation) affect diagnostic interpretation of anemia in birds?

<p>Polychromasia would serve as the primary indicator of regenerative anemia, necessitating more emphasis on cytoplasmic staining. (C)</p> Signup and view all the answers

Unlike mammals which enucleate during erythropoiesis, non-mammalian vertebrates retain a nucleus. How does this one difference impact blood parameters?

<p>MCV and MCHC will appear increased; impedance counters cannot be used to accurately enumerate RBCs. (A)</p> Signup and view all the answers

Which of the following scenarios would you expect to see increased levels of erythropoietin (EPO)?

<p>An animal living at high altitude. (C)</p> Signup and view all the answers

You observe a patient with increased numbers of metarubricytes in the blood. What does the presence of metarubricytes say about the anemia?

<p>The presence of metarubricytes suggests that the anemia is regenerative. (A)</p> Signup and view all the answers

Which of the following is NOT a cellular component of bone marrow?

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

Within the bone marrow, you see dark structures forming that inhibit the surrounding hematopoietic cells. What are these dark structures most likely to be?

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

What is a 'nurse cell'?

<p>A macrophage supporting erythropoiesis with iron supply. (A)</p> Signup and view all the answers

How would acute blood loss impact EPO levels?

<p>Acute blood loss would increase EPO levels. (A)</p> Signup and view all the answers

Fish and amphibians do not have bone marrow. Where do they perform hematopoiesis instead?

<p>Kidney, liver and spleen. (B)</p> Signup and view all the answers

A patient has a tumor secreting EPO despite normal oxygen levels. What would you expect to see on the patient's CBC?

<p>Increased red blood cell count. (B)</p> Signup and view all the answers

An endothelial cell of a patient's bone marrow is dysfunctional such that it cannot prevent progenitor cells from being released into the blood. What would you expect to see on a CBC?

<p>Precursor and progenitor blood cells. (B)</p> Signup and view all the answers

What is the primary focus of clinical pathology, as distinguished from anatomic pathology?

<p>The laboratory diagnosis of disease in living animals. (B)</p> Signup and view all the answers

Which of the following best represents the core disciplines within clinical pathology that will be covered in this course?

<p>Hematology, cytology, and clinical chemistry. (A)</p> Signup and view all the answers

According to the instructor, what is the primary reason for including discussion sessions in the ClinPath course?

<p>To provide practical experience in interpreting laboratory data and answering clinical questions collaboratively. (A)</p> Signup and view all the answers

Which statement reflects the instructor's policy regarding the memorization of reference intervals for examinations?

<p>Reference intervals will be provided during exams; memorization is not required. (C)</p> Signup and view all the answers

What is the primary function of platelets (thrombocytes) in the context of hemostasis?

<p>To participate in primary hemostasis by forming a plug at the site of vascular injury. (A)</p> Signup and view all the answers

What is the rationale behind the instructor's decision to deliver the lecture on hematopoiesis relatively early in the ClinPath course?

<p>To provide foundational knowledge of blood cell development necessary for understanding hematologic abnormalities. (C)</p> Signup and view all the answers

Which of the following is NOT considered a primary hematopoietic organ in adult mammals under normal conditions?

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

During embryonic development, what is the correct chronological sequence of primary hematopoietic sites?

<p>Yolk sac → Liver &amp; Spleen → Bone marrow (A)</p> Signup and view all the answers

What characterizes 'active' bone marrow, also known as red marrow, in contrast to 'inactive' or yellow marrow?

<p>High concentration of hematopoietic cells actively producing blood cells and lower adipocyte content. (B)</p> Signup and view all the answers

What is the role of reticular cells within the bone marrow microenvironment?

<p>To provide structural support and secrete extracellular matrix components for hematopoietic cells. (A)</p> Signup and view all the answers

How do endothelial cells lining the sinuses in bone marrow regulate the release of blood cells into circulation?

<p>They form a selective barrier that prevents immature hematopoietic cells from entering the bloodstream until they are mature. (C)</p> Signup and view all the answers

What is the functional consequence of damage to the endothelial cells lining bone marrow sinuses?

<p>Premature release of immature hematopoietic cells into the peripheral blood. (B)</p> Signup and view all the answers

Which of the following best describes cytokines in the context of hematopoiesis?

<p>Soluble proteins that act as growth factors and signaling molecules to modulate hematopoiesis. (B)</p> Signup and view all the answers

What distinguishes 'differentiation' from 'maturation' in the process of hematopoiesis?

<p>Differentiation is the commitment of progenitor cells to specific cell lines, while maturation is the development of those committed cells into functional blood cells. (D)</p> Signup and view all the answers

What is the significance of the term 'myeloid' in 'myeloid:erythroid (M:E) ratio' within bone marrow evaluation?

<p>It encompasses all non-lymphoid hematopoietic cell lines, typically granulocytes and monocytes, but not erythroid cells. (C)</p> Signup and view all the answers

During erythropoiesis, what is the sequence of nuclear changes as a rubriblast matures into a metarubricyte?

<p>Nucleus becomes smaller and more condensed (pyknotic). (C)</p> Signup and view all the answers

Which cellular feature is characteristic of a rubriblast, the earliest recognizable erythroid precursor?

<p>Large cell size with a round nucleus, open chromatin, and intensely basophilic (dark blue) cytoplasm. (D)</p> Signup and view all the answers

What is the primary role of erythropoietin (EPO) in regulating erythropoiesis?

<p>To inhibit apoptosis of erythroid precursors and stimulate their proliferation and maturation. (D)</p> Signup and view all the answers

What is the main stimulus for erythropoietin (EPO) production and release in mammals?

<p>Low tissue oxygen levels (hypoxia) in the kidney. (B)</p> Signup and view all the answers

In the context of red blood cell maturation, what is the significance of a 'polychromatophilic erythrocyte' (or reticulocyte)?

<p>It is an immature, non-nucleated erythrocyte that still contains some RNA and is actively synthesizing hemoglobin. (B)</p> Signup and view all the answers

How does the spleen contribute to hematopoiesis and blood cell maintenance?

<p>It serves as a reservoir for erythrocytes and platelets, removes aged or damaged blood cells, and can be a site for extramedullary hematopoiesis. (D)</p> Signup and view all the answers

What is 'extramedullary hematopoiesis' (EMH), and under what conditions is it most likely to occur?

<p>Hematopoiesis occurring outside the bone marrow, typically in organs like the spleen and liver, often in response to bone marrow stress or disease. (B)</p> Signup and view all the answers

What is the function of 'nurse cells' (macrophages) in erythropoiesis?

<p>They provide iron to developing erythroid precursors, phagocytose defective cells, and remove extruded nuclei. (C)</p> Signup and view all the answers

Which of the following is a characteristic feature of granulocytes but not mononuclear cells (lymphocytes and monocytes)?

<p>Presence of cytoplasmic granules. (D)</p> Signup and view all the answers

In fish and amphibians, which organs primarily undertake hematopoiesis instead of bone marrow?

<p>Kidney, liver, and spleen. (A)</p> Signup and view all the answers

What is the likely hematological consequence of myelofibrosis, a condition characterized by the proliferation of fibroblasts and collagen in the bone marrow?

<p>Disruption of the bone marrow microenvironment, impairing hematopoiesis and potentially leading to cytopenias. (C)</p> Signup and view all the answers

A patient presents with chronic renal failure. Which of the following mechanisms is the most direct cause of anemia commonly associated with this condition?

<p>Suppressed erythropoietin production by the diseased kidneys. (C)</p> Signup and view all the answers

If a researcher were to discover a substance that specifically inhibits the function of reticular cells in the bone marrow, what would be the most direct anticipated hematological consequence?

<p>Disrupted structural support and altered microenvironment for hematopoiesis. (D)</p> Signup and view all the answers

Consider a scenario where a genetic mutation impairs the ability of macrophages to function as 'nurse cells' in erythropoiesis. Which aspect of red blood cell development would be most directly affected?

<p>Iron delivery to developing erythroid precursors and removal of extruded nuclei. (C)</p> Signup and view all the answers

A bone marrow aspirate from an adult animal is taken from the mid-shaft of the humerus. What is the most likely composition of the sample obtained, and why?

<p>Predominantly yellow marrow (adipose tissue), because active marrow recedes from long bone shafts with age. (B)</p> Signup and view all the answers

If a patient experiences a transient hypoxic event, such as during a seizure, and subsequently shows a mild increase in circulating immature erythroid cells, what is the most plausible mechanism for this observation?

<p>Damage to bone marrow endothelial cells causing premature release of immature cells. (C)</p> Signup and view all the answers

Given that horses do not typically release reticulocytes into circulation in response to anemia to the same extent as other species, what compensatory mechanism might be expected in equine erythropoiesis?

<p>Increased erythropoietin production to stimulate faster maturation of erythrocytes within the bone marrow. (B)</p> Signup and view all the answers

Unlike mammals, avian species possess nucleated thrombocytes. Assuming similar hemostatic mechanisms, how might this structural difference affect the avian clotting process compared to mammals?

<p>The presence of a nucleus in avian thrombocytes may provide additional functions, such as protein synthesis or DNA repair, within the clotting process without fundamentally altering the basic mechanism. (B)</p> Signup and view all the answers

A researcher discovers a novel cytokine that selectively inhibits the differentiation of common myeloid progenitors (CMP) into granulocyte-monocyte progenitors (GMP) while sparing megakaryocyte-erythroid progenitors (MEP). What hematological change would be most anticipated?

<p>Selective decrease in granulocytes and monocytes with relatively preserved erythroid and megakaryocytic lineages. (A)</p> Signup and view all the answers

What is the expected outcome if erythropoietin (EPO) levels are chronically elevated due to a pathological condition, assuming bone marrow responsiveness remains normal?

<p>Polycythemia (increased red blood cell mass). (B)</p> Signup and view all the answers

During granulocyte maturation, which cell type is the first recognizable, committed precursor in the granulocytic lineage?

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

Which feature distinguishes a promyelocyte from a myeloblast during granulocyte maturation?

<p>Appearance of primary (azurophilic) granules in the cytoplasm of promyelocytes. (D)</p> Signup and view all the answers

What morphological characteristic defines a band cell (stab cell) during granulocyte maturation?

<p>A horseshoe-shaped or band-shaped nucleus. (D)</p> Signup and view all the answers

Under what clinical condition might you expect to observe an increased number of band cells and other immature granulocytes in peripheral blood?

<p>Acute, overwhelming infection or inflammation. (A)</p> Signup and view all the answers

What is the primary focus of clinical pathology, as opposed to anatomic pathology?

<p>The study of disease in live animals through laboratory diagnosis. (B)</p> Signup and view all the answers

Which of the following best represents the three main divisions of clinical pathology discussed in the lecture?

<p>Hematology, cytology, and clinical chemistry. (A)</p> Signup and view all the answers

According to the instructor, what is the role of discussion sessions?

<p>To review and reinforce material covered in lecture through required participation. (B)</p> Signup and view all the answers

What is the significance of the instructor's assertion that students do not need to memorize reference intervals?

<p>Reference intervals vary between laboratories and will be provided during assessments. (C)</p> Signup and view all the answers

In the context of hematopoiesis, what is the collective term for platelets or thrombocytes?

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

What is the primary role of platelets (thrombocytes) in the process of hemostasis?

<p>Plugging small breaks in blood vessels during primary hemostasis. (A)</p> Signup and view all the answers

The lecturer mentions a potential source of confusion regarding terminology used to describe granulocytes and mononuclear cells. Which statement accurately describes the difference between the two?

<p>Granulocytes are named based on the staining characteristics of their cytoplasmic granules, whereas mononuclear cells have relatively agranular cytoplasm. (C)</p> Signup and view all the answers

In a scenario where an adult animal requires increased red cell production due to hemolytic disease affecting the animal, where can active bone marrow expand back into?

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

Why is it important to select the appropriate bone marrow sampling site?

<p>To ensure a representative sample of active hematopoietic tissue is collected. (D)</p> Signup and view all the answers

Which of the following best describes the function of the endothelial cells lining the sinuses within the bone marrow?

<p>Regulating the release of mature blood cells into circulation and preventing premature release of immature cells. (C)</p> Signup and view all the answers

In the context of extramedullary hematopoiesis (EMH), which organ is most commonly involved?

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

What is the role of macrophages, also known as 'nurse cells', in erythropoiesis?

<p>Providing iron and support to developing erythroid cells. (A)</p> Signup and view all the answers

In the context of bone marrow composition, what does the term 'myeloid' refer to when discussing the myeloid:erythroid (M:E) ratio?

<p>Granulocytes and monocytes, but not lymphocytes or erythroid cells. (D)</p> Signup and view all the answers

How does damage to the endothelial cells lining bone marrow sinuses impact blood cell release?

<p>It can result in the premature release of immature blood cells into circulation. (C)</p> Signup and view all the answers

What is the primary effect of erythropoietin (EPO) on erythropoiesis?

<p>It inhibits apoptosis and stimulates proliferation of erythroid precursor cells. (D)</p> Signup and view all the answers

In avian species, if a diagnostic test is performed for anemia compared to mammals, how might you interpret results?

<p>Avian erythropoiesis lacks a discrete reticulocyte population like mammals. (D)</p> Signup and view all the answers

A patient with chronic renal failure is likely to experience anemia due to decreased...

<p>Production of erythropoietin by the kidneys. (B)</p> Signup and view all the answers

You observe large clusters of developing erythroid cells on a bone marrow slide. Upon closer inspection, you also note that all of these large cells exhibit the same abnormal morphology, which is distinct from a rubriblast. Which cell has become neoplastic?

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

Consider a novel therapeutic strategy aimed at treating canine IMHA which targets nurse cell function. Which of the following best describes how the treatment would function?

<p>Prevent nurse cells from phagocytizing defective cells (D)</p> Signup and view all the answers

In mammals, what is the primary function of platelets?

<p>Providing primary hemostasis by sealing small vascular defects. (B)</p> Signup and view all the answers

What is the key difference between platelets and thrombocytes?

<p>Platelets are non-nucleated cell fragments found in mammals, while thrombocytes are nucleated cells found in non-mammalian vertebrates. (A)</p> Signup and view all the answers

Which hormone primarily stimulates megakaryocyte and platelet production?

<p>Thrombopoietin (TPO). (B)</p> Signup and view all the answers

Where is thrombopoietin (TPO) primarily produced?

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

Which of the following factors increases erythropoietin production?

<p>Thyroxine by increasing tissue oxygen demand. (A)</p> Signup and view all the answers

What effect do testosterone and anabolic steroids generally have on erythropoietin production?

<p>They increase erythropoietin production. (B)</p> Signup and view all the answers

What effect does estrogen have on erythropoiesis?

<p>Decreases the response to erythropoietin. (C)</p> Signup and view all the answers

In a mammal with a small vascular defect, which process is primarily responsible for sealing the defect?

<p>Primary hemostasis involving platelet adhesion and aggregation. (A)</p> Signup and view all the answers

How does the body primarily regulate thrombopoietin (TPO) levels?

<p>By the binding of TPO to circulating platelets and endothelial cells. (A)</p> Signup and view all the answers

What happens to free thrombopoietin levels when there are fewer platelets available in circulation?

<p>Free thrombopoietin levels increase. (A)</p> Signup and view all the answers

What is the significance of the morel receptor in platelet production?

<p>It stimulates platelet production through platelet breakdown. (A)</p> Signup and view all the answers

Why might chronic thrombocytopenia be difficult to resolve even after addressing the underlying cause?

<p>The body decreases thrombopoietin production due to insufficient platelet breakdown. (D)</p> Signup and view all the answers

What is the purpose of giving blood transfusions or platelet-rich plasma to a patient with severe thrombocytopenia?

<p>To provide platelets from an external source to compensate for the deficiency. (C)</p> Signup and view all the answers

How does erythropoietin (EPO) affect red blood cell production?

<p>It speeds up red blood cell production and decreases apoptosis. (D)</p> Signup and view all the answers

What is a common finding in dogs, cats and rodents in response to erythropoietin stimulation?

<p>Release of immature red blood cells into circulation. (C)</p> Signup and view all the answers

In which animal species is the release of reticulocytes less pronounced, making it less useful for assessing regenerative anemia?

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

What is the effect of mildly increased erythropoietin levels on platelet numbers?

<p>Increased platelet numbers. (C)</p> Signup and view all the answers

What condition may lead to anemia due to excessive levels of estrogen?

<p>Estrogen-producing tumor. (D)</p> Signup and view all the answers

In non-mammalian species (birds, reptiles, amphibians, fish), what cells are analogous to mammalian platelets?

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

A veterinarian observes pseudopodia extending from platelets on a blood smear. What is the most accurate interpretation of this finding?

<p>The platelets may have been activated during blood collection and smearing. (B)</p> Signup and view all the answers

What is the primary morphological characteristic of megakaryocytes?

<p>Large size with a multilobulated nucleus. (B)</p> Signup and view all the answers

Which event directly leads to the formation of platelets from megakaryocytes?

<p>Cytoplasmic extensions breaking off and resealing. (C)</p> Signup and view all the answers

Where are megakaryocytes typically found?

<p>Primarily in the bone marrow but can be found in the spleen and lungs. (C)</p> Signup and view all the answers

Given a patient with renal disease exhibiting severe non-regenerative anemia, what is the most likely underlying cause?

<p>Low erythropoietin levels due to impaired kidney function. (C)</p> Signup and view all the answers

A veterinarian is evaluating a blood smear from a bird. Which feature would help differentiate thrombocytes from lymphocytes?

<p>Thrombocytes typically have a denser nucleus and less blue cytoplasm. (C)</p> Signup and view all the answers

In a patient exhibiting elevated erythropoietin levels, what is the expected erythropoietic response in the bone marrow?

<p>Increased erythroid precursors and accelerated erythropoiesis. (C)</p> Signup and view all the answers

A dog presents with iron deficiency anemia and a concurrent increase in platelet count (thrombocytosis). What is the likely relationship between these two findings?

<p>Mildly increased erythropoietin, stimulated by the anemia, is also increasing platelet production. (D)</p> Signup and view all the answers

Cavalier King Charles Spaniels are known to sometimes have a genetic defect resulting in lower-than-normal platelet counts, yet they do not typically exhibit bleeding disorders. Which of the following best explains this phenomenon?

<p>Their platelets are larger in size, compensating for the lower platelet number. (B)</p> Signup and view all the answers

A researcher is investigating a novel drug that enhances the desialization of aged platelets. What is the intended outcome of this drug's action?

<p>Increased platelet production due to enhanced clearance and thrombopoietin stimulation. (D)</p> Signup and view all the answers

You observe a megakaryocyte in a bone marrow aspirate with abundant pinkish granulation in the cytoplasm. What does this observation indicate?

<p>The cell is actively producing platelet granules. (B)</p> Signup and view all the answers

Differentiate primary hemostasis from secondary hemostasis.

<p>Primary hemostasis is platelet involvement in sealing small tears; secondary hemostasis involves fibrin clot formation for larger defects. (D)</p> Signup and view all the answers

What does it indicate if you find a large megakaryocyte in a blood smear?

<p>Finding one megakaryocyte in a blood smear is not typically significant--more cells must be found before drawing conclusions. (B)</p> Signup and view all the answers

Which of these choices does erythropoietin NOT increase?

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

If a researcher discovers a novel drug that selectively impairs the function of the morel receptor, what hematological abnormality would be most anticipated?

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

A patient presents with a condition leading to increased levels of erythropoietin (EPO). However, the patient is also experiencing severely blocked blood flow in the bone marrow. What effect would this impact thrombopoietin?

<p>Platelet production would likely be reduced. (D)</p> Signup and view all the answers

You observe a dog with a platelet count significantly lower than normal but their platelet size is much higher and their blood exhibits abnormal clotting. Which diagnosis is most likely?

<p>The total platelet <em>mass</em> may be normal, indicating that enough platelets exist to maintain functional clotting. (B)</p> Signup and view all the answers

Flashcards

Hematopoiesis

The formation and development of blood cells.

Erythropoiesis

The formation and development of red blood cells.

Leukopoiesis

The formation and development of white blood cells.

Thrombopoiesis

The formation and development of platelets (or thrombocytes).

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Bone Marrow

Major site of hematopoiesis in adults, also stores/reserves mature cells, iron, and lipids.

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Active Bone Marrow

Active marrow is retained in epiphyses and flat bones; it may expand back with increased hematopoiesis need.

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Inactive Bone Marrow

Inactive marrow consists of adipocytes, endothelial cells and reticular cells.

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Thymus

Organ responsible for differentiation of T lymphocytes and production of lymphocytes and cytokines.

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Lymph Nodes

Organs that contain lymphocytes and plasma cells, and can act as a site for hematopoiesis

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Spleen

Organ that proliferates lymphocytes and stores erythrocytes and platelets.

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Extramedullary Hematopoiesis

Hematopoietic activity in non-bone marrow tissues. Most common in the spleen, but can also occur in other tissues

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Mononuclear Phagocyte System

System formerly known as the reticuloendothelial system that removes and destroys blood cells.

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Hematopoietic Microenvironment

Blood cell production is dependent on its structural and chemical surroundings.

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Nonhematopoietic cells

These cells provide structural support, nutrients, and growth factors.

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Hematopoietic Growth Factors

The differentiation and maturation of cells controlled by cytokines, including colony-stimulating factors (CSFs), interleukins (IL).

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Cytokines

Proteins that modulate the functions of other cell types.

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Hematopoietic Stem Cells

Cells located primarily in the bone marrow, that are capable of sustained self-replication

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Differentiation

The commitment of progenitor cells to a particular cell line (or lines)

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Maturation

Development of a differentiated cell into a functional blood cell, corresponding with morphologic changes.

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Colony-Forming Units (CFU)

Stem cells and committed precursor cells, named based on their differentiation degree.

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Precursor Cells

Includes morphologically recognizable cells from blast cells to mature cells. Subdivided into mitotic and post-mitotic pools.

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Erythrocyte Maturation

Cells decrease in size; nucleus condenses/extrudes; cytoplasm becomes less basophilic as maturation progresses.

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Rubriblast

First identifiable erythroid cell, with dark blue-staining cytoplasm and a pale-staining nucleus.

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Prorubricyte

Cell with dark blue cytoplasm, smaller than a rubriblast, with clumped chromatin and no nucleolus.

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Erythropoietin (EPO)

A hormone produced by kidney fibroblasts that stimulates red blood cell production.

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Platelets

Platelets that provide primary hemostasis, sealing small vascular defects/leaks.

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Thrombopoietin (TPO)

Glycoprotein produced in the liver that stimulates the size and number of megakaryocytes.

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Granulocyte Maturation

The maturation marked by production of cytoplasmic granules and increasing nuclear segmention

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Clinical Pathology

The study of disease in live animals, primarily using laboratory diagnostics.

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Anatomic Pathology

Traditional pathology involving necropsy, surgical biopsy, and histopathology.

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Clinical Pathology Divisions

Hematology, cytology, clinical chemistry, and urinalysis.

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Diagnostics

A testable hypothesis regarding diagnosis derived from data.

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Erythrocytes (Red Blood Cells)

Red blood cells, responsible for oxygen transport to tissues.

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Leukocytes (White Blood Cells)

White blood cells, responsible for defense against disease, pathogens, and microorganisms.

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Categories of Leukocytes

Granulocytes and Mononuclear cells

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Granulocytes

Neutrophils, eosinophils, and basophils are named according to staining.

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Embryonic Hematopoiesis

Yolk sac -> Liver & Spleen -> Bone Marrow

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Extramedullary Hematopoiesis Relevance

The ability of other tissues to produce blood cells if needed.

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Nurse Cell

A macrophage surrounded by a cluster of erythroid cells.

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Megakaryocyte Function

In bone marrow, releases platelets into the blood through the endothelial cells.

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Erythropoietin Function

A glycoprotein that stimulates proliferation of mitotic erythropoietin precursor cells, it is also involves in decreasing erthropoietin cell apoptosis.

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Polychromatophilic Erythrocyte

A cell with blue/reddish cytoplasm because it hasn't finished hemoglobin production.

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Reticulocyte

Visual term used when stained with new methylene blue to identify cell type.

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Non-regenerative Anemia

Severe anemia due to low erythropoietin levels, often seen in renal failure.

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Primary Hemostasis

The process where platelets aggregate to seal minor blood vessel defects.

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Thrombocytes

Avian, reptilian, amphibian, and fish equivalent of mammalian platelets; nucleated cells.

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Megakaryocytes

Cells that produce platelets in mammals.

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Thrombocytosis

Condition of having an abnormally high number of platelets.

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Thrombocytopenia

Condition of having an abnormally low number of platelets.

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Secondary Hemostasis

The process of blood clotting involving fibrin formation for larger vascular defects.

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Study Notes

Clinical Pathology

  • Clinical pathology addresses pathology concerns of live patients via lab diagnostics.
  • Laboratory diagnostics include hematology, cytology, and clinical chemistry.

Anatomic Pathology

  • Anatomic pathology covers necropsy, surgical biopsy, and histopathology

Relationship Between Clinical and Anatomic Pathology

  • Crossover occurs; some pathologists gain dual certifications
  • Clinical pathologists examine bone marrow core biopsies
  • Anatomic pathologists sometimes perform cytology

Diagnostic Approach

  • Clinical pathology uses lab results for diagnosis
  • Radiology may be needed in addition to laboratory findings

Focus of the Course

  • Covers pathophysiology's effects on tests
  • Includes theory of tests, with an emphasis on the interpretation of test results for understanding conditions.

Course Instructors

  • Instructors include Dr. Noll, Dr. Conrado, Dr. Adela Farkas and Cheryl Stockman

Course Assignments

  • Quizzes are primarily multiple-choice or short answer questions in Canvas
  • Assignments consist of eight projects and four laboratory sessions

Lab Sessions

  • Lab sessions involve normal and abnormal hematology, including red and white blood cells, and cytology
  • Microscopy experience and exposure to common abnormalities is the goal
  • Attendance determines lab grades, and makeup labs are available

Discussion Sessions

  • Attendance is mandatory in discussion sessions that involve question-and-answer formats utilizing provided lab data sets

Exams

  • Three exams will be given, covering hematology/coagulation, cytology, and clinical chemistry
  • Exams consist of multiple-choice questions or short answer questions
  • Examiners will provide reference intervals, so memorization is not required

Textbooks and Reading Lists

  • Dr. Harvey's "Veterinary Hematology" is the recommended textbook for dogs and cats
  • Shalman's "Veterinary Hematology" offers comprehensive information

Blood Cell Categories

  • Erythrocytes (red blood cells/erythron), leukocytes (white blood cells/leukon), and platelets/thrombocytes (thrombon) are the major categories
  • Erythrocytes transport oxygen
  • Leukocytes aid in defending against disease and microorganisms
  • Platelets play a key role in primary hemostasis

Leukocyte Subcategories

  • Leukocytes are divided into granulocytes and mononuclear cells
  • Granulocytes are distinguished by granule staining, including neutrophils, eosinophils, and basophils
  • Mammalian granulocytes are also referred to as polymorphonuclear cells because of their segmented and elongated nucleus

Hematopoiesis

  • Hematopoiesis, also known as hemopoiesis, pertains to the production and development of blood cells
  • Erythropoiesis, leukopoiesis, and thrombopoiesis are its three components

Maintenance of Blood Cell Numbers

  • Due to their limited lifespan, blood cells require continuous replenishment
  • Blood cell numbers are maintained via interaction between hematopoietic organs (mainly bone marrow) and humoral regulatory molecules
  • The balance between cell production and loss determines circulating cell numbers or volume

Organs Involved in Hematopoiesis

  • Organs include bone marrow, thymus, lymph nodes, spleen, mononuclear phagocyte system, and liver

Embryonic Hematopoiesis

  • Hematopoiesis initially occurs in the yolk sac during the embryonic stage
  • Subsequently, the liver and spleen take over, followed by the bone marrow
  • Lymph nodes mainly produce lymphocytes

Extramedullary Hematopoiesis (EMH)

  • Other hematopoietic tissues can revert and begin producing blood cells under certain conditions
  • EMH commonly occurs in the spleen and liver
  • Lymph nodes continue producing lymphocytes throughout the life of the patient

Bone Marrow

  • The bone marrow produces blood cells in adult animals
  • Serves as storage and reserve for mature cells.
  • Includes iron and lipid storage
  • Active (red) marrow is retained in flat bones but recedes from long bone shafts as one ages
  • Inactive (yellow) marrow consists of adipocytes, endothelial cells, and reticular cells

Bone Marrow Sampling

  • Areas of active bone marrow should be targeted for sampling
  • Flat bones like the sternum, ribs, pelvis, and vertebrae retain more active bone marrow
  • The sternum is often sampled in horses
  • In small animals, clinicians sample the humerus, but they risk missing active bone marrow if it is inactive.

Other Organs

  • The thymus facilitates T lymphocyte differentiation, especially in early development
  • Lymph nodes proliferate lymphocytes and produce plasma cells
  • The spleen proliferates lymphocytes, serves as an erythrocyte and platelet reservoir, removes damaged or old red blood cells, and is a common EMH site

Spleen's Role

  • Facilitates hemoglobin degradation and iron storage
  • Splenic macrophages are capable of removing abnormal red cell structures without destroying the cells (pitting function)
  • EMH in the spleen commonly involves one or multiple cell lines
  • Aspirates are commonly taken of the spleen to check for abnormalities

Mononuclear Phagocyte System

  • Facilitates blood cell removal/destruction, degrades hemoglobin, stores iron, and secretes factors that influence hematopoiesis
  • Liver and lymph node macrophages participate

Liver

  • Stores vitamins, produces coagulation factors and erythropoietin precursor, and functions as a site for EMH

Non-Mammalian Hematopoiesis

  • Blood cells are produced in the kidney, liver, and spleen of fish and amphibians
  • Reptiles produce blood cells in the spleen and bone marrow
  • Birds produce blood cells primarily in the bone marrow

Bone Marrow Microenvironment

  • Structural elements and chemical surroundings are essential for blood cell production
  • Disruption of the microenvironment can disrupt hematopoiesis, even if the hematopoietic cells are normal

Bone Marrow Structural Elements

  • Reticular cells and trabeculae serve as scaffolding for hematopoietic cells
  • Extracellular matrix includes collagen, fibronectin, and proteoglycans
  • Adipocytes store lipids
  • Highly vascular organ
  • Nerves provide regulation

Circulation in the Bone Marrow

  • Blood flows into sinuses lined by endothelial cells
  • Endothelial lining controls cell release into the bloodstream, which prevents immature cells from exiting
  • Endothelial cell damage can result in immature cells being released into circulation

Hematopoietic Growth Factors

  • Aid in the development and differentiation of blood cells
  • Colony-stimulating factors (CSFs) and interleukins (IL) are examples of soluble circling glycoproteins that bind to membrane receptors on target cells
  • Erythropoietin and thrombopoietin are examples of poietins.

Cytokines

  • Proteins that modulate the functions of other cell types
  • Produced by activated macrophages or lymphocytes, as well as endothelial cells, epithelial cells, or connective tissue cells
  • Interleukins (IL) are a subtype of cytokine that influences hematopoiesis

Stem Cells

  • Pluripotent stem cells are primitive, undifferentiated cells that can create any myeloponic cell
  • These cells are located in the bone marrow but can't enter circulation
  • Capable of sustained self-replication
  • Division and differentiation of stem cells result in other cell lines
  • Cells become committed to specific lineages, which is irreversible
  • Pluripotent stem cells can produce all cell types, including lymphocytes
  • A small number of stem cells can repopulate the entire lymphohematopoietic system
  • Stem cells are not a large number of ceels in normal situation and present mostly in the resting state

Differentiation vs. Maturation

  • Differentiation is the commitment of primitive cells to a particular cell line or cell lines
  • Maturation is the development of a differentiated cell into a functional blood cell
  • Cells become more and more different as they continue in their development

The Term "Myeloid"

  • The term "myeloid" can be used in different ways
  • In the context of bone marrow, the myeloid to erythroid ratio (M:E ratio) refers to granulocytes or monocytes, but not lymphocytes
  • Myeloid leukemias are neoplasms of hematopoietic cells that are non-lymphoid by definition
  • Myelo can also refer to the bone marrow in general

Colony-Forming Units

  • Colony-forming units (CFU) are stem cells at various levels, named based on what they can produce
  • CFU-L (lymphoid) and CFU-GEMM (granulocyte, erythroid, monocyte, megakaryocytic) are examples

Precursor Cells

  • Recognizable during cell counts and are the maturing cells in bone marrow evaluation
  • Stem cells basically look like small lymphocytes, making them nearly unrecognizable

Erythrocyte Maturation

  • Decrease in cell size as maturation progresses
  • Nucleus becomes more condensed and is eventually extruded (in mammals)
  • Nuclei of erythroid cells should have an almost perfectly round shape
  • Cytoplasm becomes less basophilic (blue) and more red as hemoglobin is produced and RNA levels are reduced
  • Red cell precursors may cluster around a macrophage (nurse cell) to receive iron and have their defective cells and extruded nuclei phagocytized.

Rubroblast

  • The first identifiable erythroid cell is characterized
  • Typically presents as a large and round cell with dark blue cytoplasm
  • The rubroblasts contain round shaped nuclei that tend to stain dark purple during Romanowski staining

Prorubricyte

  • Cells morph into dark blue cytoplasm, though smaller than rubroblast
  • Exhibits more clumped chromatin and lacks nucleoli

Rubricyte

  • Further diminishing in size with paler cytoplasm along with a more clumped nucleus
  • Is divided sometimes among basophilic and polychromatophilic rubricytes
  • Polychromatophilic cells show visible red color due to its product of hemoglobin

Metarubricyte

  • The nucleus completely condenses during this stage
  • The cytoplasm has a polychromatophilic appearance (blue + red staining)

Polychromatophilic Erythrocyte

  • Characterized as having the nucleus has been extruded
  • Cytoplasm exhibits bluish coloration due to the presence and usage of ribosomes & RNAs

Mature Erythrocyte

  • Stains red, also known as acidophilic
  • Exhibits reticulocytes when stained in New Methylene Blue Stain

Reticulocyte vs. Polychromatophilic Erythrocyte

  • A polychromatophilic erythrocyte is named based on the stain that's used to detect hemoglobin synthesis rather then its maturity, it is differently colored compared to a normal red cell
  • If stained with new methylene blue, it's called a reticulocyte and exhibits a precipitative reticular material

Hormone Regulation

  • Hormones are vital to normal production of erythropoiesis
  • Erythropoietin is a key player in regulation, along with other things such as IL-3

Erythropoietin

  • Erythropoietin Is a glycoprotein produced by peritubular interstitial fibroblasts in the kidney and made by hepatocytes and Ito cells in the liver
  • EPO production is stimulated when there's low oxygen that leads to decreased circulation

Effects of Erythropoietin

  • Inhibits apoptosis of erythroid progenitor cells
  • In chronic renal failure EPO levels decrease, which can lead to severe anemia
  • Stimulates proliferation of erythropoietin precursors
  • Horses do not release reticulocytes during anemic conditions

Erythropoietin Continued

  • Primarily upregulates red cell production.
  • Chronic renal failure can result in very low erythropoietin, leading to severe, non-regenerative anemia
  • No clinical test is available to measure erythropoietin in dogs; deduce based on renal disease
  • Speeds up red cell production, accelerating it
  • Decreases apoptosis in red cells
  • Releases immature red blood cells into circulation for dogs, cats, rodents, and rabbits; look for these immature cells to determine if anemia is regenerative; this will be discussed later in the course
  • Horses and ruminants aren’t reliable in releasing reticulocytes

Other Hormone Regulation

  • Not just restricted to red cell production; can increase platelet numbers as well, with mild erythropoietin increase, and very high levels shift production to red cells and away from platelets
  • With iron deficiency anemia, thrombocytosis can be seen; this will be discussed in another lecture
  • Testosterone and anabolic steroids increase erythropoietin production
  • Estrogen decreases response to erythropoietin, creating possible anemia with estrogen-producing tumors or iatrogenic causes
  • Thyroxine indirectly stimulates erythropoietin production, which increases tissue oxygen demand and results in hypoxia

Platelets

  • Provide primary hemostasis, where they cover small defects in blood vessels
  • Circulate in blood and are sticky, causing them to seal off defective areas
  • Platelets are non-nucleated cells or cell fragments in mammals

Thrombocytes

  • Found in birds, fish, amphibians, and reptiles; they are used interchangeably with platelets in mammals
  • Thrombocytosis: too many platelets
  • Thrombocytopenia: too few platelets

Blood Smears

  • Should not be taken too seriously because they do not necessarily mean the platelets have increased activation in our patient
  • In bird blood, thrombocytes present challenges in distinguishing it between lymphocytes

Megakaryocytes

  • Produce platelets in mammals
  • Distinctive large cells found in bone marrow aspirates or the spleen with large nuclei
  • Nucleus replicates, but cells don’t divide physically, resulting in large, multilobulated nucleus
  • Cytoplasm is full of granules that become platelet granules
  • Immature megakaryocytes have blue cytoplasm with less cytoplasm overall
  • Mature megakaryocytes appear as a mass of nuclei with pinkish granulation in the cytoplasm
  • Megakaryocytes release cytoplasmic extensions that break off and reseal to form platelets
  • Can sometimes be found in the spleen or lung and occasionally in blood smears

Thrombopoietin (TPO)

  • Glycoprotein produced mostly in the liver but also in bone marrow and kidney
  • Stimulates megakaryocyte and platelet production
  • Increases the size and number of megakaryocytes and stimulates them to release platelets from cytoplasm
  • Synergizes with erythropoietin and affects erythropoietin production
  • Regulation is tricky as the body cannot directly sense platelet needs
  • Thrombopoietin receptors can be found on circulating platelets and endothelial cells
  • Less platelets results in less binding of thrombopoietin, leading to more free thrombopoietin
  • Less platelet surface area = More Free thrombopoietin = Stimulate Platelet Production

Tricky Thing about Platelets

  • Production is tied to platelet breakdown due to membrane aging and desialization
  • Cleared by the Ashwell-Morell receptor, which stimulates platelet production
  • Really low platelets can result in not enough platelet breakdown to stimulate platelet production
  • Chronic thrombocytopenia can make it hard for the body to respond, even if the cause is removed
  • The immune system could be attacking platelets and megakaryocytes
  • With really low platelets caused by immune-mediated thrombocytopenia, the body has a hard time responding to increases of platelets, even after the cause has been suppressed.
  • Solutions to this problem can be blood transfusions or platelet-rich plasma to give platelets from an external source

Platelet Regulation Summary

  • Free thrombopoietin is mostly regulated by binding to platelet membranes. The less platelets, the more free thrombopoietin and stimulation
  • Thrombopoietin production must be uninhibited in order to stimulate production
  • Cats are generally have much larger platelets, while dogs have platelets that are more similar in size
  • Increased platelet production leads to extra-large platelets in circulation

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