Hematology ppt flashcards Unit 3



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Hematology PPT Flashcards Unit 3

Factors that regulate the commitment of human hematopoietic progenitor cell to a specific cell line are influenced by what?

  1. Hematopoietic growth factors

  2. Interleukins

  3. microenvironment

What are the growth of these cells dependent on?

  1. Colony stimulating factor (CSF)

  2. Interleukins

The microenvironment of the progenitor cell favors differential development of what two cell series?

  1. Granulocytic (myeloid) series

  2. Macrophage-monocytic series

In addition to the differentiation of granulocytes and monocytes, what also stimulates specific differentiation such as the development of eosinophils?

Colony Stimulating Factor

The development, distribution, and destruction of neutrophils, eosinophils, and basophils are collectively referred to as what?

Granulocytic kinetics

What location in the body do neutrophils, basophils, and eosinophils begin as multipotential cells?

Bone marrow

What location in the body do these cells continue through the processes of differentiation, multiplication and maturation?

Bone marrow

After developing into either band or segmented forms, mature cells enter into what location in the body?

Blood circulation

What is the first identifiable cell in the granulocytic series?

Myeloblast

Myeloblast make up what percentage of the total nucleated bone marrow cells?

One percent

How long does this stage last?

Approximately 15 hours

What cell in this this bone barrow stage lasts about 24 hours and is approximately 3% of the nucleated bone marrow cells?

Promyelocyte

This cell is approximately 12% of the proliferative cells existing in the bones marrow stage.

Myelocyte

The stage from myelocyte to _______ last an average of 4.3 days. Once this stage has been reached, cells have undergone four or five cell divisions. The proliferative ends.

Meatamyelocyte

Once the cell line becomes committed to developing in to a myeloblast, the maturational development from the myeloblast through the myelocyte stage and the mitotic division take place in what is referred to as the bone marrow’s ______ ______. This is also called the mitotic pool and includes cells callable of DNA synthesis.

proliferative compartment

Following the proliferative stage, granulocytes enter a ____-_____ compartment .

maturation-storage compartment

The metamyelocytes and band forms mature into segmented granulocytes in this compartment of the bone marrow. The relative proportions of the cells are approximately 45%______, 34%_____, and 20%______, respectively.

45%Metamyelocytes

35% Band from neutrophils

20% Segmented neutrophils


Segmented neutrophils in the maturation-storage compartment are frequently referred to as the ___ ___.

This constitutes a 4 to 8 day supply of neutrophils.



marrow reserve

It is estimated that neutrophilic granulocytes normally remain in the maturation-storage phase for 7 to _ days.

7 to 10 days

Eosinophils remain for about 2.5 days. And basophils remain in this phase for the shortest period of approximately __ hours.

12 hours

Certain characteristics and physiological regulators promote movement of the granulocytes through the ____ wall of the bone marrow, which, is normally an anatomical barrier.

sinusoid wall

As cells mature, they are able to move through the sinusoid of the bone marrow because of a ___ oversize cell size, a ___ nuclear cytoplasmic ratio, and ____ flexibility and mobility.

decreased

decreased

increased


The peripheral blood circulation is subsequently divided into two pools of equal size. A ___ pool and a ___ pool.

circulating pool

marginating pool




The marginating granulocytes adhere to the ___ of the blood vessels.

endothelium

Mature granulocytes in the peripheral blood are only in transit to their potential sites of action in the ___.

tissue

The process were movement of granulocytes from the circulation pool to the peripheral occur is called?

Diapedesis

The average life span of segmented neutrophilic granulocyte in the circulating blood is about 7 to 10 hours. Once mature cells have migrated in to the tissues, their life spanis considered to be several days unless the cells encounter ___, ___, or ___.

antigens, toxins, or microorganisms

Eosinophils are in the peripheral blood for a few hours and are believed to reside in the ____ for several days.

tissue

Basophils have an average circulating time of about 8.5 hours. If excessive numbers of eosinophils are preens because of a disease state, damage or degenerated eosinophils give rise to ____-____ ____ found in the body secretions such as the sputum and stool.

Charcot-Leyden crystals

If cells are not prematurely destroyed while defending the body, they sew sloughed off with various body secretions, such as the ___, ____, or

______ secretions.



urine

saliva


gastroinestinal secretions

Two stages of granulocytes are observed ion the circulating blood. _____ form and ______ (polymorphonuclear) form.

Band form

segmented (polymorphonuclear) form



Both the band form of neutrophils, eosinophils, and basophils and, in the final stage of maturation, the segmented neutrophils, and basophils are the cell forms normally found in the ___ ___.

circulating blood

Which mature form of granulocyte typically has an elongated nucleus?

Band form

Which mature form of granulocyte has a characteristic multilobed nucleus?

Segemented Neutrophil

What are the antibacterial substances rich within the granules of segmented neutrophils?

Lysosomal hydrolases, Lysozyme, Myeloperoxidase

How do Eosinophilic granules differ from Neutrophilic granules?

Neutrophilic granules contain Lysozymes

What are the two types of Eosinophilic granules?

Small round granules and large crystalline granules

Which type of Eosinophilic granule does not contain crystalloids?

Small round granules

What are the characteristics of small round granules of mature Eosinophils?

Exist in small quantities and are rich in acid phosphtase

Which type of Eosinophilic granule is more numerous?

Large crystalloid granules

Which type of Eosinophilic granule has an elliptical shape and is larger than neutrophilic granules?

Large crystalloid granules

Which type of Eosinophilic granule has an amorphous matrix surrounding an internal crystalline structure?

Large Crystalline granules

What type of granulocyte has granules that contain both heparin and histamine?

Basophil

Which type of granulocyte has granules that have an enzyme content similar to those of blood basophil?

Mast cells

What are the two cell types included in the mononuclear phagocyte system?

Monocytes and Macrophages

What is the name of a macrophage in the loose connective tissues?

Histiocytes

What is the name of a macrophage in the sinusoids of the liver?

Kupffer cells

What is the name of a macrophage in the bone?

Osteoclasts

What is the name of a macrophage in the nervous system?

Microglial cells

What type of cell changes its name depending on its location within the body?

Macrophage

Which cells, along with the reticular cells of the spleen, thymus, and lymphoid tissues, are collectively referred to as the mononuclear phagocyte system?

Monocytes and Macrophages

Which phagocytic cell is confined to the circulation blood unless recruited in the tissues?

Segmented neutrophil

Which type of cells is formed from the progenitor cells in the bone marrow?

Macrophages

Which cells are derived from the CFU-GM?

Macrophages

Which cell type is influenced by hematopoietic growth factors and transforms into a macrophage in the tissues?

Monocyte

What is the major role of monocytes and macrophages?

Phagocytosis

________ are released into the circulating blood within 12 to 24 hours after their precursors have completed their last mitotic division.

Monocytes

Granulocytes and _______ have no large reserve of cells in a maturation-storage pool.

Monocytes

Once the monocytes have entered the circulation, cells may be located in a _______ or ________ pool.

Circulating/ Marginating

The ratio of monocytic circulating and marginating cells is ______.

1:3.5

What is the circulatory half-life of a Monocyte?

8.5 hours

Monocytic cells in noninflammatory tissue areas have been demonstrated to live for?

Months to years

What is the main function of granulocytic leukocytes?

Phagocytosis

A macrophage can exist as either a _____ or ________ cells.

Fixed/ wandering

Macrophages are important in the processing of _______ as a part of the immune response.

Antigens

______ is an infection-induced syndrome defined as the presence of two or more features of systemic inflammation.

Sepsis

With the presence of two or more of these features, a patient may be experiencing Sepsis.

Fever, hypothermia, Leukocytosis, leuopenia, tachycardia, tachypnea and supranormal minute ventilation

What are the three stages of Phagocytosis?

Movement of cells, Engulfment, Digestion

Which granulocyte attempts to suppress inflammatory tissue reactions to prevent the excessive spread of inflammation?

Eosinophils

What is the primary function of Eosinophils?

To react with products from mast cells, lymphocytes and other soluble substances in the blood.

Eosinophils regulate what types of diseases?

Allergic

What is the name of a Basophil that is in the tissues?

Mast cell

Basophils possess metachromatic granules containing histamine, and proteoglycans and express a high-affinity for which immunoglobulin receptor?

Immunoglobulin E (IgE)

What plays an important role in acute, systemic allergic reactions?

Histamine

In addition to phagocytosis, monocytes are able to synthesize various biologically important compounds such as:

Transferring, complement, interferon, and certain growth factors

In cellular immunity, monocytes assume what role?

The killer role

In the killer role, Monocytes are activated by sensitized lymphocytes in order to _______ offending cells or antigen particles.

Phagocytize

Name the six assessment methods

Total leukocyte count

Differential blood smear evaluation

Absolute cell counts

Erythrocyte sedimentation rate

Assessment of eosinophils and basophils

Leukocyte alkaline phosphatase test



Which test assesses the killing ability of granulocytes?

Nitroblue tetrazolium test (NBT)

How many lobes does a mature segemented neutrophil have?

2-5 lobes

Counting the number of lobes in a mature segmented neutrophil can be performed to determine the ______________?

Hypersegmentation index (NHI)

Conditions such as Sepsis and chronic nephritis will create a shift in what direction?

Right

The NHI is clinically useful in the diagnosis of_________

B12 and folic acid deficiency

What are the three types of ways to calculate Neutrophilic Hypersegmentation Index?

Lobe average

Percentage of neutrophils with five or more lobes

Hypersegmentation index


This method of NHI calculations is determined counting the number of lobes in a number of neutrophils and dividing by the total number of neutrophils

Lobe Average

This method of NHI calculations is done by counting the number of lobes in randomly selected segmented neutrophils. Add up the total number of lobes for each segmented neutrophils counted and divide by the total number of cells counted.

Percentage of neutrophils with five or more lobes


This method of NHI calculations uses a minimum of 200 segmented cells.

Hypersegmentation index

An NHI value greater than 16.9 indicates _________?

Hypersegmentation

What kind of disorder of granulocytes range from general increases or decreases in the total leukocyte count?

Nonmalignant disorders of granulocytes

What is an example of a qualitative disorder of granulocytes

A defect of the killing ability of leukocytes

True or False?

A variety of laboratory tests can be used to asses disorders related to granulocytes and monocytes.



True

True or False?

Leukocytosis is defined as a decrease in the concentration of percentage of any of the leukocytes in the peripheral blood: neutrophils, eosinophils, basophils, monocytes, or lymphocytes.



False. Leukocytosis is an increase in the concentration or percentage of any of the leukocytes in the peripheral blood: neutrophils, eosinophils, basophils, monocytes, or lymphocytes.

What is defined as a decrease in the total leukocyte count?

Leukocytopenia

Nonmalignant leukocytosis can be caused by: (Increase or Decrease)
A. ________ movement of immature cells out of the bone marrow’s proliferative compartment

B. ________ mobilization of cells from the maturation-storage compartment of the bone marrow to the peripheral blood

C. ________ movement of mature cells from the marginating pool to the circulating pool

D. ________ movement of mature cells from the circulation into the tissues



A. Increased

B. Increased

C. Increased

D. Decreased



True or False?

Neutrophilia and Eosinophilia are qualitative disorders.



False. They are quantitative disorders

What is an increase in number or neutrophils?

Neutrophilia

True or False?

Neutrophilia can be present in some forms of leukemia and nonmalignant conditions (such as inflammatory conditions or infection)



True

Name 7 physical stimuli that can cause neutrophilia

Heat, cold, surgery, burns, vigorous exercise, nausea, and vomiting

True or False?

Some drugs and hormones can not produce neutrophilia



False. Some drugs and hormones may produce neutrophilia

Define eosinophilia

Increased numbers of eosinophils

When can eosinophilia be observed?

In active allergic disorders such as asthma and hay fever

What can be found in the tissues, exudates, sputum, and stool of patients with active eosinophilic inflammation?

Chorcot-Leyden crystals

Define basophilia

An abnormal increase in the number of basophils

True or False?

The number of circulating basophils is not affected by factors such as time of day, age, and physical activity



True

What can cause an increase in basophils?

Hormones can cause in increase in basophils

What kinds of disorders can basophilia be seen in?

Ulcerative colitis and chronic sinusitis

What is known as an increase in the number of monocytes in the blood?

Monocytosis

Why is the association of monocytosis with disease not entirely accurate?

Because the normal value of circulating monocytes is not precisely defined

Define Leukocytopenia

A reduction in the number of leukocytes in the blood

What is the major leukocyte type associated with leukocytopenia or granulocytopenia?

The segmented neutrophil

How can abnormalities of mature granulocytes be observed?

Through stained smears of peripheral blood

What is defined as a condition in which prominent dark granulation (fine or heavy) can be observed in band and segmented neutrophils or monocytes

Toxic granulation



What is toxic granulation frequently associated with?

Infectious states

What kinds of conditions can toxic granulation be seen in?

Burns, malignant disorders, or the result of drug therapy

What is defined as inclusion bodies as single or multiple (light-blue staining inclusions) on Write-stained blood smears?

Dohle Bodies

Where are Dohle Bodies usually seen?

Near the periphery of the cytoplasm

Where are Dohle Bodies predominantly seen?

In neutrophils

Dohle Bodies may be seen in _______ or ________.

Monocytes or lymphocytes

What do Dohle bodies represent?

Aggregates of rough endoplasmic reticulum

What kinds of conditions may be associated with Dohle Bodies?

Viral infections, burns, certain drugs, and May-Hegglin anomaly

What is most frequently seen in segmented neutrophils with more than five lobes or nuclear segments?

Hypersegmentation



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