Anemia And Leukemia Flashcards
Erythrocytes background
Red cell
4-6 trillion per litre
2 mil die per second
Blood films
1 cell layer thick
Methanol sticks blood to glass slide
Romanowsky staining
Leishman
Wright
May-grunwald
Giemsa
Jenner
Acidic and alkaline components to blood stains
Basic methylene blue stains acidic cell components (nuclear)
Acidic eosin = alkaline (cytoplasm)
PH 6.8
Drying + examination (x50 objective)
Sophisticated manual + digital microscope used
Haemoglobin structure
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
Haemoglobin function
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
What is anaemia?
Haemoglobin conc below normal range (120-170 gpl)
Why does anaemia occur?
Isn’t enough haemoglobin to carry oxygen to organ + tissues
Caused by poor nutrition, infections, chronic diseases, pregnancy issues + family history
Morphological classification of anaemia
Miccrocytic/hypochromic
Iron deficiency
Thalassaemia
Anaemia of chronic disease
Lead poisoning
Normocytic/anaemia
Haemolytic anaemia
Acute blood loss
Bone marrow failure (drugs leukaemia, fibrosis)
Macrocytic
Megaloblastic (vit B12 of folate deficiency)
Non-megaloblastic (alcohol, liver disease, cytotoxic drugs)
Anemia causes
Sickle cell disease
Renal failure
Haemolysis - rbc fragments
Bleeding - polychromatic cells - slightly blue=young red cells
Malaria
Black/dark dots on cells
Anaemia causes
Acute leukaemia - big white cells
myelofibrosis- balloon
Anemia causes
Vitamin deficiency
Liver disease
Main symptoms of anaemia
• Fatigue
• Weakness
• Pale skin
• A fast or irregular heartbeat
• Shortness of breath
• Chest pain
• Dizziness
Iron deficiency anaemia (IDA)
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)
Laboratory investigation – Blood Count and Film
- 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
Leading causes of anaemia
De-deficient blood film
Treatment of Armenia
Iron (ferrous sulphate tablet)
4-6 months
Red cell transfusion
Summary
• Why and how blood films are made
• Hb kinetics
• What is anaemia?
• How anaemia can be classified
• Some causes of iron deficiency
