8) Bleeding Dysfunction Flashcards

1
Q

What can cause neutrophilia?

A
Bacterial infection 
Cancer
Myeloproliferative disease
Drugs e.g. Steroids 
Smoking
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2
Q

What are the functions of monocytes?

A

Respond to inflammation and antigenic stimuli

Phagocytosis and pinocytosis

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3
Q

What can cause monocytosis?

A

Chronic inflammatory conditions: RA, SLE, UC, Crohn’s
Chronic infection: TB
Malignancy
Myelodysplasia

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4
Q

What is the function of eosinophils?

A

Mediate hypersensitivity reactions

Phagocytosis

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5
Q

What can cause eosinophilia?

A

Allergic diseases
Parasitic infections
Churg-Strauss
Lymphomas and leaukemias

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6
Q

What is the function of basophils?

A

Allergic reactions and inflammatory conditions

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7
Q

What can cause basophilia?

A

Immediate hypersensitivity reactions
UC
RA
Myeloproliferative: CML

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8
Q

What can cause a lymphocytosis?

A

Viral and bacterial infections
Stress related: MI, cardiac arrest
CLL
Lymphoma

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9
Q

What can cause a thrombocytosis (reactive)?

A

Infection and inflammation
Post surgery
Malignancy
Bleeding

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10
Q

What primary haematological conditions can result in thrombocytosis?

A

Essential thrombocythemia
CML
Myelofibrosis
Polycythemia vera

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11
Q

What is the pathophysiology behind leucoerythroblastic anaemia?

A

Due to space occupying lesions in bone marrow

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12
Q

Why may there be anaemia in renal disease?

A

Lack of erythropoietin

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13
Q

How can there be secondary polycythemia in renal disease?

A

Post renal transplant (EPO production)

Renal tumour

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14
Q

Why might there be high white cell count in renal disease?

A

Inflammation
Underlying connective tissue disease
Infection

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15
Q

Why might there be a low white cell count in renal disease?

A

Immunosuppression

Drugs

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16
Q

What might there be a high platelet count in renal disease?

A

Reactive

Due to bleeding

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17
Q

What might there be a low platelet count in renal disease?

A

Effect or uraemia on production of platelets

Haemolytic uraemia syndrome

18
Q

How should anaemia in renal disease be managed?

A

Treatment with erythropoietin

Iron infusion

19
Q

What might there be anaemia in rheumatoid arthritis?

A

Blood loss due to NSAIDs

Anaemia of chronic disease

20
Q

What might there be a high WCC in rheumatoid arthritis?

A

Inflammation

Infection

21
Q

What might there be a low WCC in rheumatoid arthritis?

A

Drugs e.g. Methotrexate

Reactive neutropenia

22
Q

What might there be a high platelet count in rheumatoid arthritis?

A

Bleeding related to NSAID use

23
Q

What might there be a low platelet count in rheumatoid arthritis?

A

Drugs
Autoimmune
Splenomegaly

24
Q

What is the role of the vessel wall during the clotting cascade?

A

Vasoconstriction
Production of Von Willebrand’s factor
Exposure of collagen and tissue factor

25
Q

What are the function of platelets?

A

Adhesion
Secretion- ADP, thromboxane, fibrinogen
Aggregation
Coagulation factor activation

26
Q

What are some natural anticoagulants?

A

Protein C and S
Anti-thrombin
Tissue factor pathway inhibitor

27
Q

How can we measure coagulation in the body?

A

Prothrombin time
Activated partial thromboplastin time
Thrombin time

28
Q

What is prothrombin time?

A

Measure of clotting time by extrinsic pathway

29
Q

What is activated partial thrombolplastin time?

A

Speed of blood clotting by intrinsic and common coagulation pathways

30
Q

What is thrombin time?

A

Measure time it takes for a clot to form in plasma after excess thrombin has been added

31
Q

What is INR?

A

Normalised ratio of prothrombin time

32
Q

Describe the features of hereditary haemorrhagic telangiectasia:

A

Autosomal dominant
Dilated microvascular swellings
Chronic bleeding problems

33
Q

What acquired problems can affect blood vessels?

A

Senile purpura
Steroids
Infection - measles, meningococcal
Scurvy

34
Q

How do problems with blood vessels present clinically?

A

Easy bruising
Spontaneous bleeds from small vessels
Seen on skin and mucous membranes

35
Q

What can cause disorder to platelet function?

A

Bernard-Soulier
Aspirin/NSAIDs/clopidogrel
Uraemia
Myeloma

36
Q

What is Von Willebrand’s disease?

A

Abnormal platelet adhesion to vessel wall
Reduced vWF production
Bleeding tendency

37
Q

How does Von Willebrand’s disease present clinically?

A

Skin and mucous membrane bleeding- epistaxis, gum bleeding, bruising
Prolonged bleeding after trauma - heavy periods, post surgery/dental

38
Q

What conditions can affect coagulation factor function?

A

Haemophilia A and B
Liver disease
Warfarin
Vitamin K deficiency

39
Q

How do problems with clotting factors present clinically?

A
Recurrent haemarthroses
Muscle haematoma
Joint pain 
Prolonged bleeding post trauma and operation 
Intracerebral haemorrhage
40
Q

What physiological factors affect the rate of red cell production?

A
Exercise
Altitude
Age
Sex
Temperature
41
Q

What are some differences between thrombocytopenia due to marrow failure and thrombocytopenia due to peripheral destruction?

A

Increased progenitor cells and increased breakdown products in peripheral destruction