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1-12-10 Structure and Morphology of Hematopoeisis: Peripheral Blood and Bone Marrow 1.

Define and use in proper context: Anemia: a decrease of the red cell count, hematocrit, or hemoglo in elow the limits o ser!ed in healthy indi!iduals of the same se", rage, age, and li!ing at the same altitude a o!e sea le!el# Anisocytosis: !ariation in si$e# Basophils: one of three cell types that produce and mature through granulopoiesis %myeloid maturation from myelo lasts&# Basophils are characteri$ed y lue- lac' granules and are in!ol!ed in hypersensitivity reactions# Cytokines: su stances which control the proliferation and differentiation of cells# ("amples of cyto'ines include interleu'ins %pleiotropic class of molecules in!ol!ed in immunity and inflammation&, erythropoietin %produced in 'idney in response to tissue hypo"ia&, )-*S+ %induces proliferation and differentiation of progenitors towards granulocyte production, plus the functional capacity of mature granulocytes&, )M-*S+ %stimulates *+,-)(MM, lymphohematopoeitic cell, and *+,-)M, ultimately increasing the num er of granulocytes, monocytes, eosinophils, platelts, and retics&, throm opoietin %platelet production&# Differential white blood cell count: a total nucleated cell count in the peripheral lood# -t is counted in particle counting de!ices# . c/s are particles etween 01-200 femtoliters in si$e# 3 c/s are lysed so as not to e included in the w c count# 4he !alue is e"pressed as 100567 Eosinophils: of three cell types that produce and mature through granulopoiesis %myeloid maturation from myelo lasts&# (osinophils are characteri$ed y large refractile red-orange granules# 4hey are in!ol!ed in allergic reactions# Granulocyte8 PM9s8neutrophils, eosinophils, asophils# :ll granulocytes are deri!ed !ia granulopoiesis, or the production and maturation of neutrophils5eosinophils5 asophils from myelo lasts in the one marrow# eukocytosis: raised w c count, usually accompanied y an increase in immature leu'ocytes# eukopenia: decreased w c count, which places the patient at increased ris' of infection# 9eutropenia is a specific type of leucopenia in!ol!ing a decrease in circulating neutrophils granulocytes# ymphocytes: cells in!ol!ed in the immune system# : small num er are deri!ed from the one marrow; the ma<ority are formed in lymphoid tissue# 7ymphoctes fall into two groups: B lymphocytes %humoral immunity and -g production& and T lymphocytes %cellular immunity and cyto'ine production&# !e"akaryocyte: one marrow cell responsi le for the production of platelets# =eri!ed from *+,-Meg#

!onocytes: circulating component of the macrophage or mononuclear phagocyte system# 4hey migrate from circulation into tissues where they differentiate into macrophages or histiocytes# Giant cells can also form from histiocytes or monocytes in response to infection or foreign odies# #eutrophils: the most a undant type of w c responsi le for innate immunity# 7i'e other granulocytes, they are produced and mature through granulopoiesis %myeloid maturation from myelo lasts&# #ucleated red cells: normally found in the BM during erythroid maturation, in the form of pronormo lasts, early normo lasts, intermediate normo lasts, and late normo lasts# $latelets: small, irregularly shaped anuclear cells that ha!e roles in hemostasis as well as acting as a reser!oir for growth factors# 4hey are produced produced y mega'aryocytes# Production is regulated y throm opoietin# $oikilocytosis: !ariation in shaped $olycythemia: a synonym for erythrocytes# -t can also refer to an increase in lood !olume that is occupied y r c/s, as measured y hematocrit# %eticulocytes: red cells recently released from the one marrow that are rich in polyri osomes# H synthesis is >?@ complete upon loss of the nucleus# 4he retics can synthesi$e the remaining portion of H using the m39: for glo in chains# 3etics gi!e an indication of the rate of production of red cells# &tem cells: cells that ha!e the a ility to self-renew and diffentiate# 'hrombocytopenia: low platelet % elow 100,000& 'hrombocytosis: high platelet %o!er ?10,000& (. Describe red blood cell production and list the sta"es of red blood cell precursors. (rythroid maturation progresses in the following manner: -n the BM %1-A days&: pronormo lastearly normo lastintermediate normo lastlate normo lastearly reticulocyte -n the peripheral lood %120 days&: reticulocytemature r c 4hus, it ta'es a out 1 wee' for red lood cell de!elopment, and they last in circulation for a out 2 months# ). Define the sta"es of differentiation of neutrophils: 4he process of differentiation of neutrophils is 'nown as granulopoeisis# -n summary, it includes:

-n the BM %1-? days&: myelo lastpromyelo cytemyelocytemetamyelocyte -n the peripheral lood %A hrs&: andsegmented neutrophil

!yeloblast: %*+,-)M& first morphologically-recogni$ed cell in the myeloid cell series %neutrophils5monocyte, eosinophils, asophil&# -t is at the myelo last stage where the lineages for monocytes, eosinophils, asophils, and neutrophils ranch off# $romyelocyte: granulocyte precursor in the one marrow de!eloping from the myelo last into a myelocyte# !yelocyte: young cell in the one marrow de!eloping from promyelocytes into metamyelocytes !etamyelocyte: last stage of myeloid maturation in the one marrow# Metamyelocytes are deri!ed from myelocytes and gi!e rise to ands in the peripheral lood# 4hey are characteri$ed y a bent nucleus, lac' of nucleoli, and more prominent cytoplasmic granules# Band form: second to last stage of granulopoeisis, and the first of two located in the peripheral lood# Bands are deri!ed from BM metamyelocytes and will gi!e rise to a mature granulocyte# 4hey are characteri$ed y a really curved nucleus# :ll though all granulocytes ha!e a and form in de!elopment, the term B and cellC usually implies a neutrophilic lineage# Band count is used to measure inflammation % andemia8e"cess of ands& &e"mented form: this is the mature neutrophils with a multi-lo ed nucleus# *. Define the eosinophil and the basophil and their basic functions. (osinophils and asophils are granulocytes that go through the same process of granulopoeisis that neutrophils do %as shown a o!e&# (osinophils are distinguished y their large refractile red-orange granules# 4hey are in!ol!ed in allergic reactions# Basophilsa re characteri$ed y blue-black granules# 4hey are in!ol!ed in hypersensitivity reactions# +. Define the lymphocyte, the ori"in of lymphocytes, the subtypes and their role in the immune system. 7ymphocytes are cells in!ol!ed in the immune system# 4hey originate from the bone marrow %a small num er& and lymphoid tissue %the ma<ority&# 4here are two su types of lymphocytes: B-lymphocytes: humoral immunity5production of anti odies '-lymphocytes: cellular immunity5production of cyto'ines in!ol!ed in cellular immune reactions .. Define the monocyte and state its ori"in and function. Monocytes are the circulating component of the macrophage or mononuclear phagocyte system# 4hey ha!e a common BM precursor with granulocytes %the myelo last, or *+,-)M&#

Myelo lastmono lastpromonocytemonocytehistiocytegiant cell Monocytes migrate from circulation into tissues where they differentiate into macrophages or histiocytes %histiocytes are tissue macrophages&# Monocytes and histiocytes can also coalesce to form giant cells#

/. ist the methods of measurement of blood cells. 3B* count: measured in particle counting de!ices that re either electronic particle counting or light scattering particle counters# 3B* count is e"pressed 10A5m7 Hemoglo in: measured in a spectrophotometer after con!ersion to cyanmethemoglo in, or a$ohemoglo in# Hematocrit: the percentage of lood !olume made up y red cells, measured y centrifuging the lood to separate cells from the plasms# Hematocrit can also e calculated from M*DEr c num er# 4otal .B* count: total nucleated cell count in the peripheral lood, counted y particle counting de!ices# 3B*/s are lysed so that they are not included# 4he .B* is e"pressed as 100567# =ifferential .B* count: will include 9eutrophils: raised in acterial or acute !iral infections 7ymphocytes: raised in some !iral infections and lymphocytic leu'emia; decreased in H-D Monocytes: raised in infection (osinophils: raised in parasitic infection, asthma, allergy Basophils: increased in BM-related conditions li'e leu'emia or lymphoma M*D %mean corpuscular5cell !olume&: 0ctE105%BC%1012& 4his is the a!erage volume of red cells in femtoliters M*H %mean cell hemoglo in&: 0bE105%BC%1012& 4his is the mean hemoglobin content of red cells measured in picograms M*H* %mean cell hemoglo in concentration&: 0b50ct 4his is the mean hemo lo in concentration e"pressed in percentage Platelets 1. ist the sites of bone marrow in the child and adult. %ed marrow is active# 2ellow marrow is inactive and is fatty# -n the child, acti!e marrow fills nearly all ones#

-n the adult, red marrow is located BcentrallyC in the axial skeleton, sternum, ribes, vertebrae, skul, pelvis, and proximal ends of the long bones# Moreo!er, the red marrow in a child is nearly all one marrow cells with little fat# -n contrast, an F0 year old senior has only 20@ cellularity in red marrow, the remainder eing fat# 3. ist the composition of bone marrow and the methods used to study it. Bone marrow is composed of: fat, erythorid precursors, neutrophil precursors, mega'aryocytes, lymphocytes, plasma cells, eosinophil precursors, asophil precursors, monocytes5histiocytes, mast cells, !essels, and ony tra eculae# Methods used to study BM include: BM aspirate and BM iopsy# Gnce o tained, the samples are stained with .right-)iemsa, cytochemicals, and immunocytochemicals# 14. Define and classify the chronic and acute myeloid and lymphoid leukemias. !yeloid leukemias encompass leu'emias of one or more of the following cell lines: erythroid, neutrophils, monocytes, eosinophils, asophils, and mega'aryoytes# -t can e acute or chronic# Acute myeloid leukemia has proliferation of myo lasts with little or no differentiation eyond the last stage# Chronic myeloid leukemia has proliferation of myo lasts in!ol!ing differentiation into all of the normal stages of neutrophils differentiation# -n other words, the leu'emia cells closely resem le normal neutrophils precursors# ymphoid leukemias include neoplastic proliferation of the bone marrow lymphocyte pool# Howe!er, unli'e myeloid cells, lymphoid cells are primarily found in lymphoid tissues such as lymph nodes and the spleen# 9eoplastic proliferation of the lymphoid tissue pools are called lymphomas# 7ymphoid leu'emias can e acute or chronic: Acute lymphoblastic leukemia has proliferation of lymphoblasts with little or no differentiation of the cells eyond the last stage# :cute leu'emias will cause death in less than A mo if not treated; cells are poorly differentiated# Chronic lymphoblastic leukemia is proliferation of lymphocytes at mature differentiation stages# *77s are classified y immunophenotypic and morphogenic features# *hronic leu'emias will cause death after one year or more if untreated; cells are differentiated to more mature stages than the last cell eukemic phase of lymphoma refers to lymphomas that may disseminate and in!ol!e the BM and peripheral lood resembling an acute or chronic leukemia depending on the stage of differentiation of the lymphoma cell# $lasma cell myeloma is a clonal proliferati!e disorder of plasma cells that is primarily a BM disease with lytic bone lesions and %rarely& presents as a leu'emia process 'nown as plasma cell leukemia,a late stage leu'emic phase with plasma cells appearing in the peripheral lood#