Anemia And Leukemia

Question 1

Erythrocytes background

Answer 1

Red cell
4-6 trillion per litre
2 mil die per second

Question 2

Blood films

Answer 2

1 cell layer thick
Methanol sticks blood to glass slide

Question 3

Romanowsky staining

Answer 3

Leishman
Wright
May-grunwald
Giemsa
Jenner

Question 4

Acidic and alkaline components to blood stains

Answer 4

Basic methylene blue stains acidic cell components (nuclear)
Acidic eosin = alkaline (cytoplasm)
PH 6.8
Drying + examination (x50 objective)
Sophisticated manual + digital microscope used

Question 5

Haemoglobin structure

Answer 5

Heterotetremetric configuration = 2x alpha and 2x beta protein subunits of amino acid chains (HbA)
Each subunit is associated with non-protein haem group that holds an iron atom at centre of its protoporphyrin ring

Question 6

Haemoglobin function

Answer 6

Carry oxygen + co2 between lungs + tissue
HbA binds oxygen. albl + a2b2 chains stabilise the molecule. Unloading= b chains pulled apart allowing 2,3 DPG to enter + stabilise the molecule = lower affinity for O2
Haem iron in pyrope groups, = oxygenation + deoxygenation of haemoglobin
Globin chains oh Hb interact with each other in allosteric fashion when binding o2

Question 7

What is anaemia?

Answer 7

Haemoglobin conc below normal range (120-170 gpl)

Question 8

Why does anaemia occur?

Answer 8

Isn’t enough haemoglobin to carry oxygen to organ + tissues
Caused by poor nutrition, infections, chronic diseases, pregnancy issues + family history

Question 9

Morphological classification of anaemia
Miccrocytic/hypochromic

Answer 9

Iron deficiency
Thalassaemia
Anaemia of chronic disease
Lead poisoning

Question 10

Normocytic/anaemia

Answer 10

Haemolytic anaemia
Acute blood loss
Bone marrow failure (drugs leukaemia, fibrosis)

Question 11

Macrocytic

Answer 11

Megaloblastic (vit B12 of folate deficiency)
Non-megaloblastic (alcohol, liver disease, cytotoxic drugs)

Question 12

Anemia causes

Answer 12

Sickle cell disease
Renal failure
Haemolysis - rbc fragments
Bleeding - polychromatic cells - slightly blue=young red cells

Question 13

Malaria

Answer 13

Black/dark dots on cells

Question 14

Anaemia causes

Answer 14

Acute leukaemia - big white cells

myelofibrosis- balloon

Question 15

Anemia causes

Answer 15

Vitamin deficiency
Liver disease

Question 16

Main symptoms of anaemia

Answer 16

• Fatigue
• Weakness
• Pale skin
• A fast or irregular heartbeat
• Shortness of breath
• Chest pain
• Dizziness

Question 17

Iron deficiency anaemia (IDA)

Answer 17

Iron comes from diet = red meat, liver, fish
Essential to form haemoglobin
Causes
Less in nutritional, childhood, crown’s disease surgery
More out chronic blood loss
Increased neeeds, child adolescence pregnancy
Not used well (chronic disorders)

Question 18

Laboratory investigation – Blood Count and Film

Answer 18

• Full Blood Count (FBC) -
• Haemoglobin (Hb) -130-170 g/l
• Red cell count (RBC) -4.4-5.8x 1012/1
• Mean Cell Volume (MCV) -80-99 fl
• Mean Cell Haemoglobin (MCH) 26.0-33.5 pg

Question 19

Leading causes of anaemia

Answer 19

De-deficient blood film

Question 20

Treatment of Armenia

Answer 20

Iron (ferrous sulphate tablet)
4-6 months
Red cell transfusion

Question 21

Summary

Answer 21

• Why and how blood films are made
• Hb kinetics
• What is anaemia?
• How anaemia can be classified
• Some causes of iron deficiency