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Basics Flashcards

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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
What are a high versus low LAP score associated with?
High - incr mature WBC (myeloproliferative disorders) Low - incr immature WBC (CML)
26
How much of the total WBC count consists of eosinophils?
1-3%
27
What is the function of eosinophils?
1. Defense against parasitic infections 2. Production of enzymes and proteins 3. Phagocytosis of antigen-antibody complexes
28
What mediates the defensive function of eosinophils against helminths?
Major basic protein (MBP) production
29
Which enzymes and proteins do eosinophils produce?
Histaminase Eosinophilic cationic protein Eosinophil peroxidase Eosinophil-derived neurotoxin
30
How much of the total WBC count consists of basophils?
0-0.75%
31
What is the function of basophils?
Mediates allergic reactions Synthesis and release of leukotrienes
32
What are the characteristics of basophils?
Dense, basophilic granules - heparin - histamine
33
How much of the total WBC count consists of monocytes?
3-7%
34
What is the function of monocytes?
Differentiates into macrophages Phagocytosis
35
What are the characteristics of monocytes?
Mononuclear cells Kidney-shaped nucleus Large, non-granulated cytoplasm with ground glass appearance
36
Which leukocyte type is the largest?
Monocyte
37
How much of the total WBC count consists of lymphocytes?
25-33%
38
What are the functions of lymphocytes?
80% T cells (adaptive cellular immune response) 15% B cells (adaptive humoral immune response) 5% NK cells (innate immune response)
39
What are the characteristics of lymphocytes?
Mononuclear cells Round, densely staining nucleus Small, pale cytoplasm
40
What do T cells differentiate into?
1. Cytotoxic 2. Helper 3. Regulatory
41
Which receptors do cytotoxic T cells have?
CD8 (interact with MHC I)
42
Which receptors do helper T cells have?
CD4 (interact with MHC II)
43
Which receptors do regulatory T cells have?
CD4 CD25 FoxP3
44
What is the lifespan of a thrombocyte?
8-10d
45
What are the characteristics of thrombocytes?
Anucleate cytoplasmic discs derived from megakaryocytes Approx 1/3 stored in spleen
46
Which granules do thrombocytes contain?
1. Dense - ADP - Ca2+ 2. Alpha - vWF - fibrinogen - fibronectin
47
What are the characteristics of macrophages?
Different in each tissue Activated by y-interferon
48
What are macrophages found in the liver called?
Kupffer cells
49
What are macrophages found in connective tissue called?
Histiocytes
50
What is the function of macrophages?
1. Phagocytosis - bacteria - RBCs - cellular debris 2. Antigen presentation - MHC II
51
What do mast cells originate from?
Basophils
52
What is the function of mast cells?
Binds Fc portion of IgE to membrane -> mast cell degranulation -> release of histamine, heparin, tryptase and eosinophil chemotactic factors
53
What are the characteristics of dendritic cells?
Derived from myeloid or lymphoid precursors Express MHC II and Fc receptor
54
What is the function of dendritic cells?
1. Phagocytosis 2. Antigen-presenting cell (APC) 3. Links innate and adaptive immune response
55
What are dendritic cells found in the skin referred to as?
Langerhans cells
56
What are the characteristics of plasma cells?
Eccentric nucleus Clock-face appearance chromatin Abundant rough ER Well-developed Golgi Do not circulate in peripheral blood
57
Which mnemonic can be used to remember the constituents of whole blood count?
Never Let Monkeys Eat Bananas Neutrophils > leucocytes > monocytes > eosinophils > basophils
58
What is bone marrow?
Spongy, soft tissue within the hollow spaces of cancellous bone
59
What does bone marrow contain?
1. Haematopoetic stem cells 2. Stromal cells
60
What is the function of bone marrow?
Haematopoesis Filtration of RBCs Houses immune cells
61
What are the 2 types of bone marrow?
Red marrow Yellow marrow
62
What is the location of red marrow?
Flat bones (sternum, skull, vertebrae, scapula, pelvic) Long bones (metaphysis, epiphysis)
63
What is the location of yellow marrow?
Long bones (shaft and diaphysis)
64
What is the function of red marrow?
Haematopoesis Turns into yellow marrow with age
65
What is the function of yellow marrow?
Not haematopoetic Can become red marrow
66
What is the composition of red marrow?
1. Haematopoetic compartment - haematopoetic stem cells - vascular compartment 2. Stroma
67
Which cells can transform red marrow into yellow marrow and how?
Adventitial reticular cells by accumulating fat
68
What are the stromal cells of bone marrow?
Adventitial reticular cells Mesenchymal stem cells Macrophages
69
Define haematopoesis
The process by which multipotent haematopoetic stem cells differentiate into myeloid/lymphoid precursor cells and eventually into mature blood cells
70
What do myeloid precursor cells differentiate into?
Erythroblasts Megakaryoblasts Monoblasts Myeloblasts
71
What do lymphoid precursor cells differentiate into?
NK cells B cells T cells
72
What do myeloblasts differentiate into?
Neutrophil Eosinophil Basophil
73
Which growth factors are required for haematopoesis?
SCF GM-CSF G-CSF M-CSF EPO TPO
74
What produces stem cell factor?
Stromal cells of BM
75
What produces granulocyte-monocyte colony-stimulating factor?
Endothelial cells T cells
76
What produces granulocyte colony-stimulating factor?
Endothelial cells Macrophages
77
What produces macrophage colony-stimulating factor?
Endothelial cells Macrophages
78
What produces EPO?
Fibroblast-like interstitial cells surrounding peritubular capillaries of kidneys and hepatocytes
79
What produces TPO?
Liver (parenchymal cells and sinusoidal endothelial cells) Kidney (PCT cells)
80
What is the therapeutic use of GM-CSF?
Sargramostim - synthetic recombinant drug - treatment of neutropenia - myeloid reconstitution after BMT - myelodysplasia - aplastic anemia
81
What is the therapeutic use of G-CSF?
Filgrastim - synthetic recombinant drug - treatment of neutropenia - BM recovery
82
What is the main site of erythropoiesis from week 3 - 8?
Yolk sac
83
Where is definitive haematopoiesis derived from?
Stem cells observed on dorsal aorta (aorta-gonads-mesonephros region)
84
What are the major haematopoetic organs from 6 weeks of fetal life to 6-7 months?
Liver and spleen Bone marrow from month 6-7
85
What are the characteristics of a haemopoietic stem cell?
CD34 +ve CD38 -ve Lin- Appearance of small/medium lymphocyte
86
How does assay of very early progenitors differ to late progenitors?
Very early - culture on bone marrow stroma Late - semi-solid media
87
Name stromal cells
Adipocytes Fibroblasts Osteoblasts Endothelial cells Macrophages
88
What do stromal cells secrete?
Collagen Glycoproteins - fibronectin - thrombospondin Glycosaminoglycans
89
What are mesenchymal stem cells also known as?
1. Multipotent mesenchymal stromal cells 2. Adherent stromal cells
90
What enhances stem cell mobilisation?
Growth factors eg G-CSF
91
What enhances stem cell homing?
Chemokine gradient using stromal derived factor 1 (SDF-1)
92
What are the receptors on stem cells for jagged proteins on stroma?
KIT NOTCH
93

Haematology (2 decks)

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