1. Disorders of the Blood

Question 1

Functions of blood (3)

Answer 1

Transport nutrients
Removal of waste
Transport host defences

Question 2

Blood composition (5)

Answer 2

Cell components
Plasma proteins
Lipids
Nutrients
Water

Question 3

What are albumin and globulin useful for

Answer 3

Oncotic pressure

Question 4

Types of blood investigations (7)

Answer 4

FBC/CBC
RBC
RCC
WCC
PLT - platelets
HCT - haematocrit
MCV - mean cell volume

Question 5

What is HCT and usual value (2)

Answer 5

Proportion/ratio of cells to liquid

0.4/0.5

Question 6

Types of blood disorders (7)

Answer 6

Anaemia
Leukopenia
Thrombocytopenia
Pancytopenia
Polycythaemia
Leucocytosis
Thrombocythaemia

Question 7

Definition of anaemia

Answer 7

Low Hb

Question 8

Definition of leukopenia

Answer 8

Low WCC

Question 9

Definition of thrombocytopenia

Answer 9

Low platelets

Question 10

Definition of pancytopenia

Answer 10

All cells reduced (pan = all)

Question 11

What can one of the following blood disorder be attributed to
Anaemia
Leukopenia
Thrombocytopenia
Pancytopenia

Answer 11

Reactive change to the environment

Question 12

What can multiple of the following blood disorders be attributed to
Anaemia
Leukopenia
Thrombocytopenia
Pancytopenia

Answer 12

Bone marrow failure

Question 13

Definition of polycythaemia

Answer 13

Raised Hb

Question 14

Definition of leucocytosis

Answer 14

Raised WCC

Question 15

Definition of thrombocythaemia

Answer 15

Raised platelets

Question 16

What can one of the following blood disorders be attributed to
Polycythaemia
Leucocytosis
Thrombocythaemia

Answer 16

Reactive or pre-neoplastic

Question 17

What can multiple of the following blood disorders be attributed to
Polycythaemia
Leucocytosis
Thrombocythaemia

Answer 17

Pre-neoplastic (myelodysplasia)

Question 18

Definition of leukaemia (2)

Answer 18

Neoplastic proliferation of white cells

Usually a disseminated malignancy

Question 19

Definition of lymphoma

Answer 19

Neoplastic proliferation of white cells

Usually a solid tumour

Question 20

When would a blood transfusion be given (2)

Answer 20

One of more components of the blood has to be replaced quickly (trauma)
Bone marrow cannot produce enough blood cells

Question 21

Indications for blood transfusion (2)

Answer 21

Blood loss

Specific production problems

Question 22

Transfusion complications (3)

Answer 22

Incompatible blood (fever, jaundice, death)
Fluid overload (HF)
Transmission of infection (BBVs)

Question 23

Components of haemostatic disorders (3)

Answer 23

Vascular component
Cellular component
Coagulation component

Question 24

What is the vascular component of haemostatic disorders

Answer 24

Retraction of vessels (collagen disorder)

Question 25

What is the cellular component of haemostatic disorders

Answer 25

Platelet number and function (aspirin and NSAIDs irreversible break platelets)

Question 26

What is the coagulation component of haemostatic disorders

Answer 26

Adequate clotting and clot lysis (number and range of clotting factors, thrombotic/thrombolytic system balance)

Question 27

When may blood disorders be assumed clinically (2)

Answer 27

History of prolonged bleeding after extractions/minor cuts | If purport, ecchymosis and petechiae are visible

Question 28

Blood disorder investigations (4)

Answer 28

FBC (platelet number) Bleeding time (platelet function) INR/APPT LFT (clotting function synthesis)

Question 29

Definition of haemophilia (2)

Answer 29

Inherited bleeding disorder | Deficiency in FVIII or IX

Question 30

Who does haemophilia affect (2) and why

Answer 30

Males Females are carriers Sex-linked recessive condition

Question 31

Definition of thrombophilia and example

Answer 31

Excessive tendency to clot | Usually DVT

Question 32

Why might thrombophilia be life-threatening

Answer 32

Pulmonary embolism formation

Question 33

What can exacerbate thrombophilia (5)

Answer 33

``` Thrombo-promoting actions Smoking Immobility (travel) Surgery Pregnancy Medicines (oestrogen only contraceptive pill) ```

Question 34

Definition of therapeutic coagulopathy (2)

Answer 34

Medical manipulation of the coagulation system | Makes clotting less likely

Question 35

Function of therapeutic coagulopathy (2)

Answer 35

Reduce platelet adhesion and function (prevent arterial thrombosis) Reduce coagulation cascade activity (prevent venous thrombosis)

Question 36

Types of anti platelet drugs (5)

Answer 36

``` Aspirin Dipyridamole Clopidogrel Prasugrel Ticagrelor ```

Question 37

Types of anticoagulant drugs (5)

Answer 37

``` Warfarin Heparin Apixaban Dabigatran Rivaroxiban ```

Question 38

Definition of porphyria

Answer 38

Abnormality of haem metabolism

Question 39

Types of porphyria (2)

Answer 39

Hepatic porphyria | Erythropoietic porphyria

Question 40

Clinically relevant types of porphyria (3)

Answer 40

Variegate Acute intermittent Hereditary co-porphyria

Question 41

Clinical effects of porphyria (5)

Answer 41

``` Photosensitive rash (at any time) Neuropsychiatric disturbances in acute attacks (motor/sensory changes, seizures, autonomic disturbances) HTN Tachycardia May be fatal (Death ```

Question 42

Triggers of porphyria (5)

Answer 42

``` Poorly understood Drugs Pregnancy Acute infections Alcohol Fasting ```