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19. Integrative > 6. Haematology > Flashcards

6. Haematology Flashcards

1
Q

Where are the sites of haemopoiesis throughout the life of a foetus?

A

0-2 months - yolk sac
2-5 months - liver and spleen
5-9 months - bone marrow

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2
Q

What are the sites of haemopoiesis in an infant?

A

Bone marrow of most bones.

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3
Q

Which bones have bone marrow as a site for haemopoiesis in an adult?

A

Vertebrae, ribs, sternum, sacrum + pelvis, proximal ends of femur.

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4
Q

What is produced in bone marrow?

A

RBC, platelets, and most WBC.

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5
Q

What is bone marrow?

A

Soft, spongy, gelatinous tissue in the hollow spaces in the interior of bones.

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6
Q

What are the two types of bone marrow?

A

Red marrow and yellow marrow.

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7
Q

What does red marrow mainly contain?

A

Haematopoietic tissue.

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8
Q

What does yellow marrow mainly contain?

A

Fatty tissue.

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9
Q

What are the stages of myeloid precursors?

A

Myeloblast, promyelocyte, myelocyte, metamyelocyte, band cell, neutrophil.

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10
Q

What are the stages of RBC precursors?

A

Proerythroblasts, early normoblast, intermediate normoblast, late normoblast, reticulocyte, RBC.

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11
Q

What do megakaryocytes in the BM produce?

A

Platelets.

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12
Q

What is platelet production controlled by?

A

TPO - thrombopoietin.

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13
Q

What does the spleen contain?

A

Red and white pulp.

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14
Q

What is the red pulp in the spleen?

A

Sinuses lined by endothelial macrophages and cords.

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15
Q

What is the white pulp in the spleen?

A

Similar structure to lymphoid follicles.

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16
Q

What is the main source of blood for the spleen?

A

The splenic artery.

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17
Q

What is the role of the white pulp of the spleen?

A

Screen for infection.

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18
Q

What is the role of the red pulp of the spleen?

A

Sequester RBC that are damaged.

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19
Q

What are the functions of the spleen?

A

Sequestration and phagocytosis, blood pooling, extramedullary haemopoiesis, immunological function.

20
Q

What is extramedullary haemopoiesis?

A

When pluripotent stem cell proliferate during haematological stress or if marrow fails.

21
Q

What can cause splenomegaly?

A

Back pressure (portal hypertension), overworking red or white pulp, extramedullary haemopoiesis, infiltrated by cancer cells or other material.

22
Q

What are the causes of massive splenomegaly?

A

Chronic myeloid leukaemia, myelofibrosis, chronic malaria, Schistosomiasis.

23
Q

What are the causes of moderate splenomegaly?

A

Chronic myeloid leukaemia, myelofibrosis, chronic malaria, Schistosomiasi, lymphoproliferative disorders, myeloproliferative disorders, liver cirrhosis, infections from EBV.

24
Q

What are the causes of mild splenomegaly?

A

Chronic myeloid leukaemia, myelofibrosis, chronic malaria, Schistosomiasi, lymphoproliferative disorders, myeloproliferative disorders, liver cirrhosis, infections from EBV or hepatitis or endocarditis, sarcoidosis, AI diseases.

25
Q

What are the risks of splenomegaly?

A

Risk of rupture.

26
Q

What is hyposplenism?

A

Lack of functioning splenic tissue.

27
Q

What are the causes of hyposplenism?

A

Splenectomy, sickle cell disease, coeliac disease.

28
Q

What do hyposplenic blood film show?

A

Howell Jolly bodies.

29
Q

What are patients with hyposplenism at risk of?

A

Overwhelming sepsis, particularly from encapsulated organisms.

30
Q

What is cytopenia?

A

Reduced number of blood cells.

31
Q

What is anaemia?

A

Low RBC count.

32
Q

What is leucopenia?

A

Low WCC.

33
Q

What is neutropenia?

A

Low neutrophils.

34
Q

What is thrombocytopenia?

A

Low platelets.

35
Q

What is pancytopenia?

A

Low RBC, WCC, and platelets.

36
Q

What are the causes of immuno thrombocytopenic purpura?

A

Autoantibodies against GP IIb/IIIa and GPIb/IX; secondary to autoimmune disease e.g. SLE, lymphoma, CLL.

37
Q

How is ITP treated?

A

Immunosuppression.

38
Q

What are microangiogpathic haemolytic states?

A

Pathological activation of coagulation causes numerous microthrombi to form in the circulation -> consumption of clotting factors and platelets and haemolytic anaemia.

39
Q

What can reduce production leading to thrombocytopenia?

A

B12 or folate deficiency, cancer or fibrosis of bone marrow, aplastic anaemia, drugs, viruses.

40
Q

What are the consequences of severe thrombocytopenia?

A

Easy bruising, petechiae, purpura, mucosal bleeding, severe bleeding after trauma, intracranial haemorrhage.

41
Q

What can reduce production leading to neutropenia?

A

B12 or folate deficiency, cancer or fibrosis of the bone marrow, aplastic anaemia, radiation, drugs, virus, congenital disorders.

42
Q

What are the consequences of neutropenia?

A

Severe life threatening bacterial or fungal infection, mucosal ulceration.

43
Q

What can reduce production leading to pancytopenia?

A

B12 or folate deficiency, cancer or fibrosis of the bone marrow, idiopathic immune aplastic anaemia, radiation, drugs, virus, congenital disorders.

44
Q

What is aplastic anaemia?

A

Pancytopenia with hypocellular bone marrow in the absence of an abnormal infiltrate with no increase in reticulin.

45
Q

What are the malignancies causing pancytopenia?

A

Haematological - acute and chronic leukaemia, lymphoma, myeloma, myelofibrosis, myelodysplastic syndrome; non-haematological malignancy - prostate, breast, lung.

46
Q

What are the symptoms of pancytopenia? (Break it down into anaemia, thrombocytopenia, neutropenia).

A

Anaemia - fatigue, dizziness, chest pain, shortness of breath.
Thrombocytopenia - bleeding, bruising etc.
Neutropenia - infection, ulcers, fevers.

19. Integrative (7 decks)

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