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benign haematology Flashcards

1
Q

describe the components and functions of blood

A

the four main components are plasma, white blood cells, red blood cells and platelets

the functions of blood are transportation, clotting, immunity and temperature regulation

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2
Q

what is anaemia

A

low haemoglobin in the blood

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3
Q

what are the different causes of anaemia

A

impaired production
increased breakdown (haemolysis)
increased demand
increased blood loss

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4
Q

what are the oral manifestations of anaemia

A
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5
Q

what are the common haematology blood tests

A
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6
Q

what is the role of blood transfusions in the management of haemotology patients

A
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7
Q

what is found in plasma

A

salts, glucose, amino acids, vitamins, proteins, urea, hormones and coagulation factors

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8
Q

what is included in the white blood cell category

A

neutrophils, monocytes, b cells, T cells and granulocytes

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9
Q

function of platelets

A

clotting

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10
Q

what does cytosis mean

A

excess of

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11
Q

what does penia mean

A

lack of

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12
Q

what does microcytic mean

A

small cell size

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13
Q

what does normocytic mean

A

normal cell size

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14
Q

what does microcytic mean

A

large cell size

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15
Q

what are the two lineages of blood

A

myeloid and lymphoid

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16
Q

what is haemoglobin

A

protein found in red blood cells that transports oxygen around the body

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17
Q

what is essential for haemoglobin function

A

iron

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18
Q

what is the structure of haemoglobin

A

2 alpha chains and 2 beta chains
4 haem groups, the oxygen will bind to the iron ion

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19
Q

what is the life span of a red blood cell

A

120 days, and is broken down in the spleen and in the liver

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20
Q

how many haemoglobin molecules per red blood cell

A

270 million

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21
Q

describe how impaired production of haemoglobin can arise leading to anaemia

A

issue with the marrow, such as congenital aplasia, medication side effects
lack of erythropoietin in chronic kidney disease
lack of raw materials to produce haemoglobin

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22
Q

what are the raw materials for haemoglobin production

A

iron
vitamin b12
folic acid

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23
Q

describe how the increased haemolysis of haemoglobin can arise

A

issues with red blood cells, such as g6pd deficiency, or hereditary spherocytosis
issues with the haemoglobin ie thalassaemia, or sickle cell disease
immune driven impacts ie autoimmune haemolysis

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24
Q

what is spherocytosis

A

this is when the red blood cell is spherical instead of biconcave

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25
what can lead to increase haemoglobin demand resulting in anaemia
pregnancy and growth phases in children
26
what can cause increased blood loss leading to anaemia
acute bleeding ie tooth extraction menstrual bleeding gastrointestinal losses
27
what are the symptoms of anaemia
tiredness shortness of breath dizziness palpitations
28
what are the signs of anaemia
pale skin conjunctival pallor
29
what is the difference between symptoms and signs
symptoms are what the patient feels and tells you whereas signs are what you actually notice
30
what are the classical signs of anaemia
angular cheilitis koilonychia
31
what is koilonychia
spoon shaped nails due to iron deficiency
32
what are the haematinics
iron folate vitamin b12 deficiency in these can cause anaemia
33
what is iron deficiency anaemia
this is a reduction in iron leading to impaired haemoglobin production, and as a result, the red blood cells are smaller ie microcytic
34
what are the causes of iron deficiency anaemia
reduced dietary intake impaired absorption in the duodenum increased loss of blood through menstruation etc increased demands due to pregnancy or growth
35
what does iron deficiency anemia present as in the red blood cells
microcytic red blood cells
36
describe iron absorption
this takes place mainly in the duodenum, and requires stomach acid. there is reduced absorption if there is inflammation in the duodenum, as seen in coeliac disease or if there is lack of stomach acid such as seen in the taking of omeprazole which is a proton pump inhibitor
37
how can iron deficiency be managed
oral supplementation and IV supplementation if severe
38
what are the causes of vitamin b12 deficiency
reduced intake impaired absorption medication side effects eg metformin
39
what are the features of vitamin b12 deficienchy
anaemia symptoms peripheral neuropathy visual changes
40
what does vitamin b12 deficiency do to the red blood cells
makes them macrocytic
41
how can vitamin b12 deficiency be managed
oral supplementation and intra muscular supplementation
42
what is b12 important for
neuron development
43
why does vitamin b12 deficiency lead to peripheral neuropathy
b12 is important for neuron development so when there is deficiency, patients can feel tingling in the hands or feet or experience visual impairment
44
which muscle is injected when there is vitamin b12 deficiency
deltoid
45
how is vitamin b12 absorbed
in the ileum, alongside intrinsic factor
46
what are the causes of impaired vitamin b12 absorption
pernicious anaemia gastrectomy crohns disease following bowel surgery ie any inflammation in the bowels
47
what is pernicious anaemia
loss of production of intrinsic factor so b12 cannot be absorbed through the gut autoimmune condition, seen commonly in middle aged patients. the antibodies destroy parietal cells in the stomach, and can target intrinsic factor itself
48
how is pernicious anaemia managed
IM supplementation, 3 monthly
49
where is folic acid absorbed
jejunum
50
what are the causes of folic acid deficiency
dietary deficiencies medications alcohol excess bowel inflammation
51
what can be caused by folic acid deficiency in foetal development
spinal bifida
52
how is folic acid deficiency managed
simple oral replacement
53
what are the two main methods for investigation of anaemia
blood tests endoscopy/colonscopy
54
what are the four blood tests for detecting anaemia
Full blood count Ferritin Folate B12
55
when would you consider doing an end/colonoscopy to test for anaemia
if suspicious of gi bleeding, eg blood in the stool, weight loss or an elderly patient
56
what is ferritin
the molecule in which iron is stored in cells, which is raised when there is infection or inflammation
57
what is the full blood count blood test
includes lots of information, but the important parts are: - haemoglobin - white cell count - platelets - mean cell volume
58
what is WCC
white cell count
59
what is the mean cell volume
MCV
60
what does a microcytic red blood cell indicate
iron deficiency thalassamemia lead poisoning
61
what does a normocytic cell indicate
bleeding kidney disease anaemia of chronic diseases
62
what does a microcytic cell indicate
folic acid deficiency b12 deficiency alcohol excess
63
what is the MCV value for microcytic cells
less than 80
64
what is the MCV value for normocytic cells
80-100
65
what is the MCV value for microcytic cells
mcv greater than 100
66
what is thalassaemia
a genetic defect in the protein chains which make up haemoglobin it is an autosomal recessive gene defect can affect the alpha or the beta chains. because this makes the red blood cells more fragile, the spleen detects this and destroys the damaged red blood cells
67
what type of anaemia is associated with thalassaemia
microcytic
68
how to manage thalassaemia
monitoring, if minor blood transfusions splenectomy bone marrow transplant
69
what is sickle cell anaemia
a genetic condition that results in crescent shaped red blood cells. autosomal recessive genetic mutation the crescent shape leads to the red blood cells being more fragile and more easily destroyed
70
when is screening for sickle cell anaemia carried out
in newborns
71
what does sickle cell anaemia do for malaria
makes it less severe
72
what can lead to complications with sickle cell anaemia
known as crises, the complications are triggered by dehydration, infections, stress and cold weather
73
how is sickle cell anaemia managed
avoid triggers antibiotic prophylaxis specialist medications blood transfusions bone marrow transplant
74
what are the oral manifestations of anaemia
angular cheilitis mucosal atrophy glossitis, which can be smooth or beefy recurrent aphthous stomatitis candidate infections oral dysaesthesia
75
what is oral dysaesthesia
this is a burning mouth sensation caused by the nerve endings in the mouth misfiring
76
which anaemia increases the chance of angular cheilitis
iron deficiency anaemia
77
what is atrophic glossitis
this is when there is iron deficiency leading to a smooth tongue
78
angular cheilitis
79
atrophic glossitis from iron deficiency causing smooth tongue
80
beefy tongue
81
recurrent aphthous stomatitis
82
candidal infection
83
what is the most common blood transfusion
packed red cells, meaning a unit of red blood cells are given to the patient. some patients can get platelets or clotting factors if needed
84
what are the possible indicators for blood transfusions
anaemia acute blood loss from trauma surgery complex haematological conditions
85
what are the important antigens on red blood cells
A B O AB
86
what are the important antibodies in the blood
anti B anti A , one, neither or both of these
87
what is essential to be carried out before administering a blood transfusion
check the recipients blood group before giving the blood, and cross match the blood types
88
what is cross matching of blood
this is when a sample is taken from the recipient and is tested against the donors blood
89
what are the complications of blood transfusions
- transfusion associated fever - incompatible blood - fluid overload - anaphylaxis - infection
90
what is TACO
transfusion associated circulatory overload
91
what does incompatible blood lead to
haemolysis

Human Systems and Anatomy (57 decks)

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