erythropoietin in polycythemia vera(PV)
EPO decreases due to negative feedback suppressing renal EPO production hematology HirotoShishido
prothrombin gene mutationMutation in 3′ untranslated region →↑production of prothrombin → ↑plasma levels and venous clots. hematology HirotoShishido
affinity of hemoglobin A and F to oxygenFetal hemoglobin (hemoglobin F) is synthesized primarily during fetal development (-8 weeks until term) and consists of the usual 2 alpha chains with 2 gamma chains in place of beta chains. The gamma chains do not bind effectively to 2,3-BPG due to replacement of a ☆histidine residue with serine. hematologyUWorld HirotoShishido
PictureHowell- Jolly bodies
(round, and bigger than pappenheimer)
Functional hyposplenia(eg sickle cell disease), asplenia
Basophilic ★RBC nuclear remnants (do not contain iron)
Usually removed by splenic macrophages
Basophilic stippling (many)
Sideroblastic anemias, thalassemias
Basophilic (★)ribosomal precipitates (do not contain iron)
characteristics of plasma cells☆"Clock-face" chromatin distribution and eccentric nucleus(perinuclear paleness), abundant RER, and well-developed Golgi apparatus.
what is extramedullary hematopoiesis suggestive of☆chronic hemolysis(eg β-thalassemia)
+MF
+toxoplasma, cytomegarovirus, rubella infection(→blueberry muffin rash= dermal extramedullary hematopoiesis) hematologyUWorld HirotoShishido
PictureThe reticulocyte is slightly larger (10 microns) than the mature erythrocyte. Reticulocytes appear basophilic, reticular(net-like) of ☆ribosomal RNA on the Wright-Giemsa-stained smear (A)
brilliant crystal blue, is used to stain reticulocytes (indicated by the arrows in Image B) for an actual count (B) hematologyUWorld HirotoShishido
myoglobin vs hemoglobinmyoglobin→ monomeric protein, primary oxygen storing protein in skeletal and cardiac muscle tissue
p50= 2.8mmHg
hemoglobin→ tetramer cosisting of 2 α and 2 β chains
after binding to one oxygen molecule, the oxygen affinity of other heme molecules increase
p50= 26mmHg hematologyUWorld HirotoShishido
clinical use/ side effects of erythropoiesis-stimulating agents(ESAs)(eg. darbepoetin alpha, erythropoietin)
anemia of chronic kidney disease
thromboembolic events(eg stroke, vascular graft thrombosis) due to increased blood viscosity, ☆ worsening hypertension due to activation of erythropoietin receptors on vascular endothelial and smooth muscle cells hematologypharmacologyUWorld HirotoShishido
leukemoid reactionbenign leukocytosis (>50,000/mm3) that occurs in response to an underlying condition such as severe infection/hemorrhage, solid tumors, or acute
hemolysis
The bone marrow can be normal or hypercellular and responds with
increased bands and ☆early mature neutrophilprecursors (eg, myelocytes),in
contrast to the increased immature cells (eg, promyelocytes, myeloblasts) seen in acute leukemia.
☆↑ALP(vs CML), peripheral smear can show Dohle bodies= ☆basophilic oval inclusions in mature neutrophi... hematologyUWorld HirotoShishido
