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basics Flashcards

1
Q

describe neutrophils

A

polymorphs (take various forms)
phagocyte invaders
attract other cells to site of injury/infection
increased in stress

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2
Q

describe eosinophils

A

bi-lobed, red granules
hypersensitivity reactions
fight parasites
allergic conditions

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3
Q

describe basophils

A

large deep purple
tissue mast cells
mediate hypersensitivity reactions
granules contain histamine

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4
Q

describe monocytes

A

phagocytose invaders
liver longer than neutrophils

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5
Q

describe lymphocytes

A

small with condensed nucleus and rim of cytoplasm
released in response to infection

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6
Q

where is erythropoietin made?

A

kidneys

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7
Q

what is erythropoietin released in response to and what does it stimulate?

A

hypoxia and RBC production

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8
Q

where does red cell destruction occur?

A

liver and spleen
red cells taken up by macrophages

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9
Q

what do the products of red cell destruction make?

A

globin chains = amino acids
haem = iron and bilirubin

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10
Q

what will happen if a cell has no mitochondria?

A

no kreb’s cycle, relies on glucose metabolism

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11
Q

what will happen if a cell has no nucleus?

A

can’t divide, can’t replace damaged proteins, limited lifespan

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12
Q

what will happen if a cell is stuffed with Hb?

A

high osmotic pressure, needs to pump ions to stop swelling

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13
Q

what is iron in its reduced form

A

Fe2+ -> Fe3+ = stopped by NADH (electron donor)

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14
Q

what is needed for cells susceptible for oxidative stress?

A

glutathione, stops H2O2 forming, G6PG = rate limiting enzyme

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15
Q

how is microcytic anaemia seen on blood results?

A

low Hb and low MCV

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16
Q

what is microcytic anaemia due to?

A

haemoglobinisation problems

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17
Q

what are the causes of microcytic anaemia?

A

TAILS
thalassaemia
anaemia of chronic disease
iron deficiency
lead poisoning
sideroblastic anaemia

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18
Q

what is the most common cause of microcytic anaemia?

A

iron deficiency

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19
Q

what is functional iron?

A

haemoglobin

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20
Q

what is transported iron?

A

serum iron, transferrin

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21
Q

what is iron stored as?

A

serum ferritin

22
Q

what inhibits iron transport?

A

hepcidin

23
Q

what is thalassaemia caused by?

A

fucked up globin chain

24
Q

what is iron deficiency anaemia, anaemia of chronic disease caused by?

A

fucked up iron part of the haemoglobin chain

25
Q

what is sideroblastic anaemia caused by?

A

fucked up part of protoporphyrin part of haemoglobin chain

26
Q

what are the 2 haemoglobinopathies?

A

thalassaemia and sickle cell

27
Q

what are the different types of haemoglobin?

A

haemoglobin A - HbA, HbA2, HbF
2 alpha chains
2 beta chains

28
Q

when does sickle cell occur?

A

when there’s a mutation that alters haemoglobin structure

29
Q

what is the diagnostic sign of beta-thalassamia?

A

raised HbA2

30
Q

what are the clinical signs and symptoms of alpha thalassaemia?

A

trait - asymptomatic, possible low MCV
full disease -moderate anaemia, very low MCV
patient presents with jaundice, splenomegaly
fetalis - not compatible with life

31
Q

what are the clinical signs and symptoms of beta thalassaemia?

A

babies - HbF falls - pale, failure to thrive

32
Q

what is the treatment for beta thalassaemia?

A

regular transfusions for live (side effect = iron overload)
meds = desferrioxamine

33
Q

what is the pathophysiology of a sickle crisis?

A

in low O2 levels, HbS polymerises and distorts shape of red cell leading to vaso-occlusion = sickle crisis

34
Q

what investigations are used for sickle crisis?

A

FBC (Hb, RBC)
blood film (target cells, teardrop cells)
haemoglobin electrophoresis = beta thalassaemia (identifies HbS and if HbA2 raised)

35
Q

how do you treat a sickle crisis?

A

acute - analgesia, hydration, oxygen
chronic - if hyposplenism = prophylactic penicillin, folic acid, hydroxycarbamide (hydroxyurea)

36
Q

what are the underlying causes of AOCD?

A

causes of inflammation, autoimmune, malignancy, disease

37
Q

how does AOCD present?

A

microcytic/normocytic anaemia
chronic infection
autoimmune conditions
HIGH SERUM FERRITIN

38
Q

how do you treat AOCD?

A

treat underlying cause
recombinant EPO and iron supplements

39
Q

what are the blood findings of iron deficiency anaemia?

A

decreased functional iron (Hb) + reduced storage iron (low serum ferritin)

40
Q

what are the causes of IDA?

A

diet - vegetarian
pregnancy
blood loss - menorrhagia, GI bleeds (ulcers, tumours) NSAIDs, haematuria
coeliac

41
Q

what does negative iron balance lead to?

A

iron deficient erythropoiesis - falling RBC MCV
microcytic anaemia
epithelial changes - skin, koilonychiaw

42
Q

what is management for IDA?

A

iron supplementation

43
Q

how does lead poisoning present?

A

cognitive defects
peripheral neuropathy
renal dysfunction
neuro signs + microcytic anaemia = LEAD POISONING

44
Q

what is sideroblastic anaemia?

A

impaired haem synthesis as can’t put iron and protoporphyrin together = IRON OVERLOAD

45
Q

how does acquired sideroblastic anaemia present and what are the causes?

A

macrocytic anaemia
myelodysplastic syndromes, drugs and toxins

46
Q

how does congenital sideroblastic anaemia present and how is it passed on?

A

microcytic, hypochromic anaemia
x-linked

47
Q

how does sideroblastic anaemia generally present?

A

weakness, fatigue, difficulty breathing
iron overload -> hepatomegaly/splenomegaly, arrhythmias

48
Q

what investigations are used in sideroblastic anaemia and what will be seen on it?

A

blood film
increased reticulocytes, stippled RBCs (basophilic stippling)

49
Q

what is the management for sideroblastic anaemia?

A

pyridoxine
iron overload = deferoxamine

50
Q

what is the initial investigation for macrocytic anaemia

A

blood smear

Haem (30 decks)

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