Study your flashcards anywhere!

Download the official Cram app for free >

  • Shuffle
    Toggle On
    Toggle Off
  • Alphabetize
    Toggle On
    Toggle Off
  • Front First
    Toggle On
    Toggle Off
  • Both Sides
    Toggle On
    Toggle Off
  • Read
    Toggle On
    Toggle Off

How to study your flashcards.

Right/Left arrow keys: Navigate between flashcards.right arrow keyleft arrow key

Up/Down arrow keys: Flip the card between the front and back.down keyup key

H key: Show hint (3rd side).h key

A key: Read text to speech.a key


Play button


Play button




Click to flip

77 Cards in this Set

  • Front
  • Back
What does the Pluripotent Bone Marrow Stem Cell give rise to?
1. Trilineage Myeloid Stem Cell

2. Lymphoid Stem Cell
What committed stem cells does the Myeloid Stem Cell give rise to?
1. Eosinophil Stem cell
2. Granulocyte/Macrophage SC
3. Erythroid/Megakaryocyte SC
What does the Lymphoid Stem Cell give rise to?
1. Pro-B cells -> Plasma cells
2. Pro-NK cells
3. Pro-T cells
What is the difference between the cells derived from the Myeloid and Lymphoid Stem cells?
-Cell derived from the Myeloid cell line differentiate in the Bone Marrow

-Cells from the Lymphoid cell line migrate to Lymphoid organs: Thymus, Lymph nodes, Spleen, MALT
Growth Factors that stimulate Pluripotent Stem Cell to differentiate into Myeloid or Lymphoid Stem Cells
1. SCF
2. IL-6
3. Flt3-ligand
Growth Factor that stimulates differentiation down the Eosinophil Cell line
Growth Factors that stimulate differentiation down the Lymphoid cell line
1. SCF
2. Flt3-ligand
3. IL-7
Growth Factors that stimulate down the Erythroid/Megakaryocyte Cell line
TPO and IL-11
GF that stimulates the Erythroid cell line
GF that stimulates differentiation down the Megakaryocyte/Platelet cell line
TPO = Thrombopoietin
GF that stimulates differentiation down the Monocyte/Macrophage cell line
GF that stimulates differentiation down the Neutrophil cell line
Prenatal Hematopoiesis:
-Hematopoiesis begins in the __1__ at the end of the 3rd week of gestation
-By the end of the 1st trimester, the __2__ develops into the most prominent source of hematopoiesis
-Hematopoiesis begins to occur in the __3__ at around the 4th month of development
1. Yolk Sac and Mesoderm (Intraembryonic Aorta/gonad/mesonephros region)
2. Liver (3 mo - birth)
3. Bone marrow (4 mo onwards)
Where does hematopoiesis take place post-natally?
Bone Marrow
Give 3 reasons as to why Extramedullary Hematopoiesis (outside the BM) might take place
1. Insufficient bone marrow reserve
2. Bone Marrow damage
3. Myeloid neoplasms
List 4 sites where Extramedullary Hematopoiesis may occur
1. Liver (most prominent)
2. Spleen
3. Lymph nodes
4. Soft tissue
What 3 things does Bone Marrow consist of?

Hematopoietic Cells

What are the normal adult ratios of:
1. Hematopoietic cell:Fat
2. Myeloid:Erythroid
1. 1:1

2. 3:1
As we grow older, where is Hematopoiesis usually restricted to?
Flat bones and the ends of Long bones
-Proximal epiphyseal portions of the humerus and femur
Fat = empty spaces
Hematopoietic cells
Label the following Granulocytic Cells through their Maturation
Label the following cells
-Pronormoblast = earliest recognizable erythroid
-Polychromatophilic = has basophilic cytoplasm with pink
-Orthochromatic = cytoplasm is entirely grayish-pink, nucleus is small and pyknotic
What is the 1st anucleated state of Erythroids?
Term defined as the ratio of RBC to Serum expressed in percentages
Term defined as the average calculated volume of a single RBC
Mean Cell Volume (MCV)
Term defined as the average content of Hemoglobin in each RBC
Mean Cell Hemoglobin
Term defined as the average concentration of Hemoglobin in a given volume of packed RBC's
Mean Cell Hemoglobin Concentration
Immature erythrocytes with residual RNA
What is the term to describe Reticulocytes seen on a blood smear?
Polychromasia = cell that is not perfectly pink, but still has a little gray in it
Reticulocytes are bigger and grayer

Embedded RNA
Point out a Reticulocyte on the blood smear

What is this Methylene Blue stain staining in the bottom right pic?
What does the Reticulocyte Count reflect?
Bone Marrow Erythropoiesis
What is the normal range for Reticulocytes in the peripheral blood?
0.5 - 1.5%

**if more, could be indicative of anemia
Define Anemia
Decrease in the RBC mass and the Hemoglobin content in the blood
What 3 lab parameters may be decreased in Anemia?
1. RBC count
2. Hemoglobin
3. Hematocrit
List 6 signs and symptoms common to all forms of Anemia
1. Pallor = pale skin & mucosa
2. Easy fatigability
3. Dyspnea upon exertion
4. Koilonychia
5. Tachycardia, Angina
6. Dizziness

Severe, prolonged Anemia
What is the flattening of nails with spoon-shaped concavity called?

What is the cause?
What are the 3 Pathophysiologic classifications of Anemia?
1. Blood loss
2. Increased rate of destruction (hemolytic anemias)
3. Impaired Red Cell production
List the 3 Morphologic Classifications of Anemia based on Cell Size (MCV)
1. Macrocytic
2. Normocytic
3. Microcytic
List the 2 Morphologic Classifications of Anemia based on Hemoglobin Concentration (MCHC)
1. Normochromic

2. Hypochromic (increased central pallor)
What would be a cause of Macrocytic Anemia (increased RBC size)?
Megaloblastic Anemia due to Vitamin B12 or Folate deficiency
What could be 3 causes of Microcytic, Hypochromic anemia? (small RBC size, low Hb concentration)
1. Iron Deficiency
2. Thalassemia
3. Anemia of Chronic Disease
Term for variation in RBC size
Anisocytosis (reflected in the RDW)

*the bigger the Red Cell Distribution Width (RDW) = the greater the Anisocytosis
Term for the variation in RBC shape
What is the type of Anemia with Acute Blood Loss?
Normochromic, normocytic anemia
What may Acute Blood Loss result in?

Why is the Hematocrit decreased if the patient survives?

When does Reticulocytosis peak?
Decreased blood volume resulting in Shock and possible death

Hemodilution caused by a shift of water from the interstitium to maintain blood volume (but RBC % decreases = low Hematocrit)

7-10 days after acute event
What type of Anemia is present initially with Chronic Blood Loss? What type ensues later?
Normochromic, normocytic anemia

Iron deficiency = Microcytic, Hypochromic Anemia
At what sites is Chronic Blood Loss common?
1. GI -> ulcer in stomach, colon cancer
2. GU -> bladder stones, kidney stones
3. Menstrual bleeding
Give an example of Chronic Blood Loss that may NOT result in Iron Deficiency anemia
Internal blood loss -> pulmonary hemorrhage that gets resolved and the iron is taken up by macrophages in the blood

**External blood loss results in Hypochromic, Microcytic anemia
What are the 3 main features common to all forms of Hemolytic Anemias?
1. Premature RBC destruction (normal lifespan = 120 days)
2. Increased Hb catabolism
3. Increased BM erythropoiesis and increased Erythropoietin = Reticulocytosis
What are the 2 classifications of Hemolytic anemias based on site?

What are the 2 classifications of Hemolytic anemias based on Pathogenetic mechanism?
Intrinsic (Intracorpuscular) abnormality

Extrinsic (Extracorpuscular) abnormality
List 8 features of Intravascular Hemolysis
1. Hemoglobinemia = free Hb conc. in plasma increases
2. Decreased serum Haptoglobin = Hb released from RBC's binds to Haptoglobin
3. Hemoglobinuria = appears after the haptoglobin binding capacity has been saturated
4. Hemosiderinuria
5. Increased Bilirubin leading to Jaundice
6. Increased Fecal Urobilin
7. Increased Serum Lactate Dehydrogenase
8. Methemalbuminemia = heme combining with Albumin
What is the unique feature of Extravascular Hemolysis?
Splenomegaly = damaged RBC's are sequestered in the Spleen and phagocytized by Splenic Macrophages
List 5 features of Extravascular Hemolysis
1. Jaundice and Pigment gallstones
2. increased Fecal Urobilin
3. Decreased serum Haptoglobin
4. Increased serum LDH
5. Splenomegaly
What are the Intrinsic Abnormalities causing Hemolytic Anemias?
Hereditary Membrane disorders, enzyme deficiencies, or hemoglobin synthesis disorders
Acquired membrane defects
What is an example an Acquired Intrinsic Abnormality causing Hemolytic Anemia?
Paroxysmal Nocturnal Hemoglobinuria
What in general causes Extrinsic Hemolytic Anemias? (4)
1. Anti-body mediated
2. Mechanical trauma (DIC, HUS, prosthetic cardiac valves)
3. Infections (malaria)
4. Chemicals (lead)
Autosomal Dominant disorder that is due to a defect invloving Spectrin in the RBC membrane, which causes a decrease in the RBC surface membrane
Hereditary Spherocytosis
Explain the Pathogenesis of Hereditary Spherocytosis
1. decreased membrane stability
2. loss of membrane
3. Spherocytes
4. Destruction in the spleen b/c spherocytes are not flexible
Mutations in these 4 skeletal membrane proteins can cause Hereditary Spherocytosis
1. Ankyrin
2. Band 3
3. Spectrin (most common)
4. Band 4.2
List 5 pathologic findings of Hereditary Spherocytosis
1. Spherocytes
2. Increased Osmotic Fragility = is not biconcave so can't expand
3. Splenomegaly (red pulp congestion)
4. Pigment gallstones = heme catabolism -> increased bilirubin
5. Increased MCHC = jam-packed with Hb
Hereditary spherocytosis
-uniformly red
-lack central pallor

**Autoimmue Hemolytic Anemias also cause Spherocytes
What disorder is exemplified here? How do you know?
What are the 3 clinical features of Hereditary Spherocytosis?
1. Anemia = due to lysis of Spherocytes
2. Splenomegaly = spherocytes are sequestered and destroyted
3. Jaundice and pigment gallstones = RBC lysis -> Hb catabolism -> heme -> biliverdin -> unconjugated bilirubin -> Jaundice or Pigment Gallstones
What is Hereditary Spherocytosis at an increased risk of?
Aplastic crisis due to Parvovirus B19 infection
What is the treatment for Hereditary Spherocytosis?
-splenectomy cures the anemia but does not abolish the defect
-Spherocytes are still present in blood but aren't lysed due to spleen removal
Explain how G6PD deficiency causes hemolytic anemia
1. G6PD produces NADPH
2. NADPH is needed to make Reduced Glutathione
3. Reduced Glutathione reduces Oxidative stresses to RBC's

**Deficiency causes Oxidative stress leading to Hemolysis of RBC's
How is G6PD deficiency inherited?
X-linked = predominantly MALES affected
What are the 2 G6PD deficiency variants?
1. African = 10-60% activity

2. Mediterranean = <10% activity

**due to defective protein folding = decreased half-life and activity
What does the Blood Smear of G6PD deficiency appear as?
Heinz bodies = clumps of oxidized hemoglobin within RBC

Bite cells = Heinz bodies "eaten" by splenic macrophages

**Heinz bodies are visualized with Methylene Blue and Crystal Violet stains
What pathway is G6PD involved in?
Hexose-Monophosphate Shunt pathway
What are the clinical features of G6PD deficiency?
Hemolysis (episodic hemolytic anemia)
What can precipitate Oxidative Stress in G6PD deficiency?
1. Drugs
2. Infections
3. Fava beans (Mediterranean)
What does G6PD deficiency protect against?
Falciparum malaria
A 7-year-old girl is referred to your hematology clinic after several abnormal blood tests, which include increased Mean Corpuscular Hemoglobin Concentration and an increased RBC osmotic fragility. You discover that one of the child's parents suffers from a genetic blood disorder.
Hereditary Spherocytosis
-Autosomal dominant disorder in RBC membrane protein
-Spherocytes -> Hemolytic Anemia
Heinz bodies = clumps of oxidized Hb within the RBC

G6PD deficiency
What are these called?
What disease?
Left = bite cells
Right = Heinz bodies

G6PD deficiency
What is on the left and right?

What disease?
A 35-year old AFRICAN-AMERICAN man comes to your office after noticing that his urine has become tea-colored. He tells you that he has just returned from a trip to Kenya where he had taken PRIMAQUINE to guard against contracting malaria. Upon finding HEINZ BODIES on his peripheral blood smear, you suspect that his dark urine will likely resolve on its own shortly.
G6PD deficiency