All

Question 1

What’s the normal platelet count

Answer 1

150 - 400 x 10^9 / l

Question 2

About plasminogen

Answer 2

Plasminogen is a zymogen released from the liver. It usually wouldn’t interact with tPA but when a clot forms, the two assemble on the clot’s surface and therefore interact and Plasminogen is activated and becomes Plasmin.

Question 3

Where is Ferroportin found

Answer 3

duodenal enterocytes
hepatocytes
macrophages of spleen (interact with iron from old or damaged RBCs)

Question 4

What can cause Anaemia of Chronic Disease

Answer 4

malignancy 
chronic infections e.g. TB and HIV 
heart failure 
rheumatoid arthritis 
SLE

Question 5

pathogenesis of anaemia of chronic disease

Answer 5

the disease makes you unwell. 
you get increased cytokine release. 
cytokines have many affects that ultimately lead to anaemia: 
- they block iron utilisation by the RBCs
- increase RBC death 
- stop EPO from increasing 
- increase Ferritin production 
- stop iron flowing out of cells 
- contribute to anaemia 

Anaemia of Chronic Disease is the anaemia seen in patients with chronic disease

as you have:

• increased RBC death
• reduced RBC production
• lower availability of iron

lab signs of being ill:

• C reactive protein
• increased ESR
• Increased Ferritin , F8, Fibirongen , Immunoglobulins

In AoCD, the patient won’t have bleeding nor bone marrow infiltration nor B12 or Folate deficiency

Examples of cytokines include TNF-alpha and Interleukins

Question 6

Pernicious Anaemia

Answer 6

autoimmune attack on parietal cells in stomach
therefore no intrinsic factor
reduced B12 absorption

Question 7

MCH and MCV in Alpha + and Alpha 0

Answer 7

Alpha + MCV 77 MCH 26

Alpha 0 MCV 66 MCH 24

Question 8

In Thalassaemia Trait how do you distinguish between alpha and beta thalassaemia trait

Answer 8

do haemoglobin electrophoresis

if HbA2 is high (above 3.5%) then it is Beta TT

if HbA2 is normal or low then it’s Alpha TT

Question 9

Iron deficiency and AoCD versus VitB12 and Folate deficiency

Answer 9

ID and ACD
early stages –> normochromic normocytic anaemia
then microcytic anaemia

B12.and FA
microcytic megaloblastic anaemia

Question 10

Anaemia classification

Answer 10

hypo chromic microcytic

normochromic normocytic

normochromic macrocytic

Question 11

megakarocyte

Answer 11

originate in megakarocytes (which differentiate from myeloid stem cells)

megakarocutes undergo granulation during maturation

platelets then break off from the cytoplasm of the megakarocyte

approximately 4000 platelets made per megakarocyte

Question 12

Howell-jolly body

Answer 12

a nuclear remnant in a RBC

commonest cause is lack of splenic function as spleen’s supposed to remove these tiny bits of nuclear material

Question 13

MAHA

Answer 13

microangiopathic haemolytic anaemia

microorganisms that causes acquired haemolytic anaemia

Question 14

MCH

vs

MCHC

Answer 14

MCH
the amount of haemoglobin a given volume of blood divided y the number of red blood cells in the same volume

the amount of haemoglobin per red blood cell
absolute amount of HB in one RBC

Hb ./ RBC

MCHC
the amount of haemoglobin in a given volume of blood divided by the proportion of the sample represented by red blood cells.

concentration of Hb in a RBC - it’s related to its shape

Hb / Hct

Question 15

Bleeding Time

Answer 15

400mm Pressure Cuff

3 - 8 mins

Question 16

Sickle Emergency

Answer 16

blood pressure below 90/60 
neurological signs of symptoms 
SpO2 <92% on air
Hb < 5 or a drop more than 4g/dl from normal 
priapism for more than four hours