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Haematology > Basics > Flashcards

Basics Flashcards

1
Q

What are the functions of blood?

A
  1. Transport
    - O2, nutrients, hormones
    - CO2
    - metabolic waste
  2. Hemostasis
  3. Regulation
    - body temperature
    - signal transmission
    - acid/base homeostasis
  4. Protection from pathogens
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2
Q

What is the average blood volume of an adult?

A

7% of TBW (70ml/kg)

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3
Q

Which equation can be used to calculate blood volume and for which patients?

A

> 35kg
Nadler equation

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4
Q

Give the Nadler equation for adult women

A

BV = (0.3669 × H3) + (0.03219 × W) + 0.6041

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5
Q

Give the Nadler equation for adult men

A

BV = (0.3561 × H3) + (0.03308 × W) + 0.1833

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6
Q

What is the estimated blood volume (ml/kg) for neonates?

A

80-85

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7
Q

What is the estimated blood volume (ml/kg) for 1m - 1y?

A

75-80

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8
Q

What is the estimated blood volume (ml/kg) for 13m - 2y?

A

85

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9
Q

What is the estimated blood volume (ml/kg) for 2 - 3y?

A

80

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10
Q

What is the estimated blood volume (ml/kg) for 4 - 6y?

A

76-77

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11
Q

What is the estimated blood volume (ml/kg) for 7 - 14y?

A

70-75

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12
Q

What are the constituents of blood?

A

55% plasma
45% blood cells

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13
Q

What does plasma contain?

A

Water
Plasma proteins
Electrolytes
Hormones
Bioactive substances

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14
Q

Which plasma protein is an important constituent of plasma?

A

Coagulation factors

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15
Q

What is the function of erythrocytes?

A

Transport O2 and CO2
Bicarbonate buffer system

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16
Q

Which antiporter mediates the membrane transport of CO2?

A

Cl-/HCO3- antiporter

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17
Q

What are the characteristics of an erythrocyte?

A

No nucleus or cell organelles
Biconcave shape
Contains hemoglobin

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18
Q

How does an erythrocyte produce energy?

A

Glycolysis and HMP shunt

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19
Q

What is an HMP shunt?

A

Hexose monophosphate shunt found in the pentose phosphate pathway which degrades G6P to provide NADPH and ribose for nucleotide synthesis

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20
Q

How much of the total WBC count consists of neutrophils?

A

60%

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21
Q

What is the function of neutrophils?

A

Acute inflammatory response
Phagocytosis

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22
Q

What are the characteristics of neutrophils?

A

Multilobed nucleus
Granules
- specific
- azurophilic

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23
Q

What do the azurophilic granules in neutrophils contain?

A

Myeloperoxidase
Proteinases
Acid phosphatase
Beta-glucuronidase

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24
Q

What do the specific granules in neutrophils contain?

A

LAP (leucocyte alkaline phosphatase)
Collegenase

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25
Q

What are a high versus low LAP score associated with?

A

High - incr mature WBC (myeloproliferative disorders)
Low - incr immature WBC (CML)

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26
Q

How much of the total WBC count consists of eosinophils?

A

1-3%

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27
Q

What is the function of eosinophils?

A
  1. Defense against parasitic infections
  2. Production of enzymes and proteins
  3. Phagocytosis of antigen-antibody complexes
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28
Q

What mediates the defensive function of eosinophils against helminths?

A

Major basic protein (MBP) production

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29
Q

Which enzymes and proteins do eosinophils produce?

A

Histaminase
Eosinophilic cationic protein
Eosinophil peroxidase
Eosinophil-derived neurotoxin

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30
Q

How much of the total WBC count consists of basophils?

A

0-0.75%

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31
Q

What is the function of basophils?

A

Mediates allergic reactions
Synthesis and release of leukotrienes

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32
Q

What are the characteristics of basophils?

A

Dense, basophilic granules
- heparin
- histamine

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33
Q

How much of the total WBC count consists of monocytes?

A

3-7%

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34
Q

What is the function of monocytes?

A

Differentiates into macrophages
Phagocytosis

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35
Q

What are the characteristics of monocytes?

A

Mononuclear cells
Kidney-shaped nucleus
Large, non-granulated cytoplasm with ground glass appearance

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36
Q

Which leukocyte type is the largest?

A

Monocyte

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37
Q

How much of the total WBC count consists of lymphocytes?

A

25-33%

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38
Q

What are the functions of lymphocytes?

A

80% T cells (adaptive cellular immune response)
15% B cells (adaptive humoral immune response)
5% NK cells (innate immune response)

39
Q

What are the characteristics of lymphocytes?

A

Mononuclear cells
Round, densely staining nucleus
Small, pale cytoplasm

40
Q

What do T cells differentiate into?

A
  1. Cytotoxic
  2. Helper
  3. Regulatory
41
Q

Which receptors do cytotoxic T cells have?

A

CD8 (interact with MHC I)

42
Q

Which receptors do helper T cells have?

A

CD4 (interact with MHC II)

43
Q

Which receptors do regulatory T cells have?

A

CD4
CD25
FoxP3

44
Q

What is the lifespan of a thrombocyte?

A

8-10d

45
Q

What are the characteristics of thrombocytes?

A

Anucleate cytoplasmic discs derived from megakaryocytes
Approx 1/3 stored in spleen

46
Q

Which granules do thrombocytes contain?

A
  1. Dense
    - ADP
    - Ca2+
  2. Alpha
    - vWF
    - fibrinogen
    - fibronectin
47
Q

What are the characteristics of macrophages?

A

Different in each tissue
Activated by y-interferon

48
Q

What are macrophages found in the liver called?

A

Kupffer cells

49
Q

What are macrophages found in connective tissue called?

A

Histiocytes

50
Q

What is the function of macrophages?

A
  1. Phagocytosis
    - bacteria
    - RBCs
    - cellular debris
  2. Antigen presentation
    - MHC II
51
Q

What do mast cells originate from?

A

Basophils

52
Q

What is the function of mast cells?

A

Binds Fc portion of IgE to membrane -> mast cell degranulation -> release of histamine, heparin, tryptase and eosinophil chemotactic factors

53
Q

What are the characteristics of dendritic cells?

A

Derived from myeloid or lymphoid precursors
Express MHC II and Fc receptor

54
Q

What is the function of dendritic cells?

A
  1. Phagocytosis
  2. Antigen-presenting cell (APC)
  3. Links innate and adaptive immune response
55
Q

What are dendritic cells found in the skin referred to as?

A

Langerhans cells

56
Q

What are the characteristics of plasma cells?

A

Eccentric nucleus
Clock-face appearance chromatin
Abundant rough ER
Well-developed Golgi
Do not circulate in peripheral blood

57
Q

Which mnemonic can be used to remember the constituents of whole blood count?

A

Never Let Monkeys Eat Bananas
Neutrophils > leucocytes > monocytes > eosinophils > basophils

58
Q

What is bone marrow?

A

Spongy, soft tissue within the hollow spaces of cancellous bone

59
Q

What does bone marrow contain?

A
  1. Haematopoetic stem cells
  2. Stromal cells
60
Q

What is the function of bone marrow?

A

Haematopoesis
Filtration of RBCs
Houses immune cells

61
Q

What are the 2 types of bone marrow?

A

Red marrow
Yellow marrow

62
Q

What is the location of red marrow?

A

Flat bones (sternum, skull, vertebrae, scapula, pelvic)
Long bones (metaphysis, epiphysis)

63
Q

What is the location of yellow marrow?

A

Long bones (shaft and diaphysis)

64
Q

What is the function of red marrow?

A

Haematopoesis
Turns into yellow marrow with age

65
Q

What is the function of yellow marrow?

A

Not haematopoetic
Can become red marrow

66
Q

What is the composition of red marrow?

A
  1. Haematopoetic compartment
    - haematopoetic stem cells
    - vascular compartment
  2. Stroma
67
Q

Which cells can transform red marrow into yellow marrow and how?

A

Adventitial reticular cells by accumulating fat

68
Q

What are the stromal cells of bone marrow?

A

Adventitial reticular cells
Mesenchymal stem cells
Macrophages

69
Q

Define haematopoesis

A

The process by which multipotent haematopoetic stem cells differentiate into myeloid/lymphoid precursor cells and eventually into mature blood cells

70
Q

What do myeloid precursor cells differentiate into?

A

Erythroblasts
Megakaryoblasts
Monoblasts
Myeloblasts

71
Q

What do lymphoid precursor cells differentiate into?

A

NK cells
B cells
T cells

72
Q

What do myeloblasts differentiate into?

A

Neutrophil
Eosinophil
Basophil

73
Q

Which growth factors are required for haematopoesis?

A

SCF
GM-CSF
G-CSF
M-CSF
EPO
TPO

74
Q

What produces stem cell factor?

A

Stromal cells of BM

75
Q

What produces granulocyte-monocyte colony-stimulating factor?

A

Endothelial cells
T cells

76
Q

What produces granulocyte colony-stimulating factor?

A

Endothelial cells
Macrophages

77
Q

What produces macrophage colony-stimulating factor?

A

Endothelial cells
Macrophages

78
Q

What produces EPO?

A

Fibroblast-like interstitial cells surrounding peritubular capillaries of kidneys and hepatocytes

79
Q

What produces TPO?

A

Liver (parenchymal cells and sinusoidal endothelial cells)
Kidney (PCT cells)

80
Q

What is the therapeutic use of GM-CSF?

A

Sargramostim - synthetic recombinant drug
- treatment of neutropenia
- myeloid reconstitution after BMT
- myelodysplasia
- aplastic anemia

81
Q

What is the therapeutic use of G-CSF?

A

Filgrastim - synthetic recombinant drug
- treatment of neutropenia
- BM recovery

82
Q

What is the main site of erythropoiesis from week 3 - 8?

A

Yolk sac

83
Q

Where is definitive haematopoiesis derived from?

A

Stem cells observed on dorsal aorta (aorta-gonads-mesonephros region)

84
Q

What are the major haematopoetic organs from 6 weeks of fetal life to 6-7 months?

A

Liver and spleen
Bone marrow from month 6-7

85
Q

What are the characteristics of a haemopoietic stem cell?

A

CD34 +ve
CD38 -ve
Lin-
Appearance of small/medium lymphocyte

86
Q

How does assay of very early progenitors differ to late progenitors?

A

Very early - culture on bone marrow stroma
Late - semi-solid media

87
Q

Name stromal cells

A

Adipocytes
Fibroblasts
Osteoblasts
Endothelial cells
Macrophages

88
Q

What do stromal cells secrete?

A

Collagen
Glycoproteins
- fibronectin
- thrombospondin
Glycosaminoglycans

89
Q

What are mesenchymal stem cells also known as?

A
  1. Multipotent mesenchymal stromal cells
  2. Adherent stromal cells
90
Q

What enhances stem cell mobilisation?

A

Growth factors eg G-CSF

91
Q

What enhances stem cell homing?

A

Chemokine gradient using stromal derived factor 1 (SDF-1)

92
Q

What are the receptors on stem cells for jagged proteins on stroma?

A

KIT
NOTCH

93
Q
A

Haematology (2 decks)

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