301. Heam, general Flashcards

1
Q

What is meant by blasts seen on a blood film?

A

nucleated precursor cells

myelofibrosis, leukeamia, malignant marrow infiltration

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

What are howeel jolly bodies, seen on blood films

A

DNA rememnants from RBC normally removed by spleen

Post splenectomy

Hyposlpenism (sickle cell, coeliacs, UC/crohns)

myelodysplasia, megaloblastic anaemia

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

What is meant by hypochromia seen on blood film

A

Less densestaining of RBC’s due to decreased heamoglobin synthesis.

Seen in IDA thalaseammia and sideroblastic anaemia

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

On a blood film you see leukoeryhtoblastic film. What is this?

A

Immature cells and tear drop RBC’s from heamolysis or marrow infiltration/infection

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

What would you see in a blood film of an individual with DIC, HUS, TTP, pre-eclampsia, Gd6p

A

Schistocytes.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

What is a causes increased neutrophils

A
bacterial infections 
inflammation
myeloproliferative disorders
drugs
disseminated malignancy
stress
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

When are neutrophils decreased

A
Viral infections
Drugs- post chemo
Severe sepsis
Neutrophil antibodies (SLE)
Hypersplenism
Bone marrow failure
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

What causes an increase in lymphocytes?

A

Acute viral infections
Chronic infections (TB, brucelosis)
Leukemias and lymphomas

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

In what scenario would lymphocytes be deplete?

A
Steroids
SLE
Uraemia
Legionarries disease
HIV
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

Eosinophills increase in what scenario?

A

Drug reactions
Allergies
Parasitic infections
Skin disease

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

What is hypereosinophillic syndrome

A

Eosinophilia sustained for 6 weeks leading to end organ damage-

endomyocardial fibrosis, restrictive cardiomyopahty, lung disease, neuropathy and hepatosplenomegaly

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

What causes an increase in monocytes

A

Aftermath of chemo/radiotherapy

Chronic infections

Malignant disease

Myeoldyplasia

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

What causes an increase in basophils?

A

Myeloproliferative disease

Viral infections

IgE mediated hypersensitivity

Inflammatory disorders

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

Describe the anti-coagulation pathway?

A

On contact with broken endothelium factor XII is produced.

XIIa acts on XI

XIa (heparin disrupts this) acts on IX

IXa (+phospholipid +tissue factor) works on X

X turns prothrombin into thrombin

Thrombin turns fibrinogen into fibrin

Thrombin has negative feedback on V and XI

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

What is ESR?

A

Sensitive but not specific indicator of inflamamtion.

RBC fall through medium, if they have inflammatory markers attached they fall quicker and result is higher

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

What is a general way of calculating ESR range?

A

Men- age/2

Woman (age +10) /2

17
Q

What conditions can cause a falsely low ESR?

A

Polycytheamia

Sickle cell anaemia

18
Q

What are the symptoms of hyperviscocity syndrome?

A

Lethargy, confusion, reduced cognition

Chest pain, abdo pain

Visual distrubance

retinopathy, amaurosis fugax - watery car windscreen

19
Q

What are the causes of a high blood viscocity?

A

High red cell

High white cell

Paraproteinaemia

Oral contraceptive, diuretics, Iv IG, EPO, chemo, radio-contrast media

20
Q

What is the treatment for hyperviscocity syndrome?

A

Treatment depends on cause

Venesection- PCV

Leukapheresis- leukaemia

plasmapheresis- myeloma

21
Q

What are the causes of splenomegaly, classified by spleen size

A

Massive- CML, myelofribrosis, malaria, leishmaniasis

Moderate- infection, heam, conn. tissue, others

22
Q

Give some examples of splenomegaly in the following categories:

Infection

Heamatological

Connective tissue disease

Others

A

Infection-EBV, endocarditis, TB, leishmaniasis, schistosomiasis

Heam- heamolytic anaemia, leukaemia, CML,lymphoma

Conn. tissue- RA, SLE

Others- sarcoidosis, portal hypertension

23
Q

What are the indications for a splenectomy

A

Splenic trauma,

hyperslenism

Autoimmune heamolysis

Warm autoimmune heamolytic anaemia

Congential heamolytic anaemia’s

24
Q

What should be done in those post-splenectomy?

A

Pneumoccocal vaccine, heam flu b vaccine, meningococcal vaccine, flu vaccine

Life long prophylactic antibiotics

Seek urgent medical attention in unwell