Hematopoesis
How would a histology slide of a healthy adult liver differ from a fetal liver in the second trimester?
Fetal liver would show developing erythrocytes- extra medullary hematopoiesis will be occurring physiologically in the liver at 2nd trimester
Name the 3 things we need for myeloid stem cell to mature into myeloid megakaryocyte/erytrhocyte progenitor for erythropoiesis
Erythropoietin, IL-3, IL-4
What gives reticulocytes their characteristic "reticular pattern" and would you find them in bone marrow or in circulation?
Polyribosomes; they are in circulation (Reticulocytes are in peRipheRal blood)
Also- they enter circulation after the nucleus gets expulsioned
Serum vs plasma?
Serum has no fibrinogen
Which defense mechanism of a neutrophil binds and kills pathogenic microbes?
neutrophil extracellular traps
Calculate bone marrow cellularity for a 50 year old patient
100- 50 (+/- 10%)= ~40-60%
What 2 things do we need to go from a common myeloid progenitor to a megakaryocyte erythrocyte progenitor in thrombocytopoesis?
GM-CSF and IL-3
Name the cell! (granulopoesis)
Large round to oval nucleus with minimal basophilic cytoplasm, has NO granules, and one or more nuclei
Also- this cell is in the bone marrow (not in circulation)
Myeloblast- the first recognizable precursor in the granulocytic series
Which globIN chain predominates in adults? Follow up question- what is the most common hemoglobin make up for adults?
Bonus- which chain is mutated in sickle cell
B-globin; HbA is 2 alpha chains + 2 beta chains
Bonus: sickle cell pts have point mutations in B chain gene
Which cell plays a big role in immediate/ delayed hypersensitivity reactions seen in bronchial asthma or allergic skin reactions that are obscured by dark purple granules?
BONUS: name 4 most important specific granules
Basophils
Heparin (anticoagulant)
Histamine (vasodilation)
Heparin sulfate (vasodilation)
Leukotrienes (pulmonary airway constriction)
If you did not produce IL-3, which cells would not develop properly?
IL-5 develops eosinophils
GM-CSF (myeloid progenitor cells) G-CSF (neutrophil precursors)
Normoblast (aka orthochromatic erythroblast), reticulocyte, RBC
During which cell stage in granulopoesis are azurophillic granules (primary) formed? What about Secondary/specific granules?
Promyelocytes (Promyelocytes are MPO positive) *P is positive and primary
Myelocytes are the maturation stage we would see secondary granules begin to form, representing either PMN, basophil, or eosinophil (also, last stage of mitosis is seen at this stage)
What is the marker for a mature neutrophil? Which granule is that in- primary, secondary, or tertiary?
Leukocyte alkaline phosphatase (LAP)are in secondary granules
These cells reside in marrow/lympn nodes and are described as terminally differentiated B lymphocytes. He also says these are considered pathogenic if seen in peripheral blood.
Which cell feeds iron to erythrocytes and engulfs the nucleus the erythrocyte spits out?
Macrophages
Why do immature erythroid cells (pro erythroblast and basophilic erythroblast) have more basophilic cytoplasm?
RNA be doing the most and our ribosomes are synthesizing hemoglobin
Let's say you are in some type of infectious/inflammatory state (or have a neoplastic disorder). What cell type in granulopoetic line would you see in peripheral blood that is NOT normally present?
Metamyelocyte - these babies pathologic
What is the outcome of oxygen-dependent neutrophil killing that allows us to make "super killers" in the phagolysosome?
The creation of hypochlorous acid (HOCl) which is 1000X more effective bactericide than H2O2
What is defective in patients with chronic granulomatous disease that makes them have serious chronic infections and granulomas?
Defects in oxygen-dependent killing, no NADPH oxidase complex (which is what the oxygen-dependent pathway relies on for its killing)
You calculate your 30 year-old patient's bone marrow cellularity to be 30%. What does this look like on a histology slide, and what diagnosis are you worried about?
BONUS- what would you expect MCV and RPI to be in this diagnosis
100-30 (+/- 10%)= ~60-80% normal
Hypocellular with adipose tissue in bone marrow= consider aplastic anemia
MCV normal, RPI decreased
Order these from immature to mature:
basophilic erythroblast, normoblast, pro erythroblast, reticulocyte, polychromatophillic erythroblast, erythrocyte
Proerythroblast (immature)
Basophillic erythroblast
Polychromatophillic erythroblast
Normoblast
Reticulocyte
Erythrocyte
CD3 and CD4 are markers for ___
CD3 and CD8 are markers for ____
CD19 and CD20 are markers for ____
Helper T cells; Cytotoxic T cells; B cells
CD3 is in both Th and Tc because CD3 is the marker for T cells
Name the 4 important (the ones he highlighted red) specific granules in eosinophils that allow us to have cytotoxic effects on protozoans and helminthic parasites
MBP (binds Fc and disrupts parasite membrane), ECP (fragments parasites), EPO (macrophage killing), and EDN (ribonuclease/antiviral)
Leukotrienes - pulmonary airway constriction