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Human Systems and Anatomy > benign haematology > Flashcards

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
Q

what can lead to increase haemoglobin demand resulting in anaemia

A

pregnancy and growth phases in children

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26
Q

what can cause increased blood loss leading to anaemia

A

acute bleeding ie tooth extraction
menstrual bleeding
gastrointestinal losses

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27
Q

what are the symptoms of anaemia

A

tiredness
shortness of breath
dizziness
palpitations

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28
Q

what are the signs of anaemia

A

pale skin
conjunctival pallor

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29
Q

what is the difference between symptoms and signs

A

symptoms are what the patient feels and tells you whereas signs are what you actually notice

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30
Q

what are the classical signs of anaemia

A

angular cheilitis
koilonychia

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31
Q

what is koilonychia

A

spoon shaped nails due to iron deficiency

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32
Q

what are the haematinics

A

iron
folate
vitamin b12

deficiency in these can cause anaemia

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33
Q

what is iron deficiency anaemia

A

this is a reduction in iron leading to impaired haemoglobin production, and as a result, the red blood cells are smaller ie microcytic

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34
Q

what are the causes of iron deficiency anaemia

A

reduced dietary intake
impaired absorption in the duodenum
increased loss of blood through menstruation etc
increased demands due to pregnancy or growth

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35
Q

what does iron deficiency anemia present as in the red blood cells

A

microcytic red blood cells

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36
Q

describe iron absorption

A

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

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37
Q

how can iron deficiency be managed

A

oral supplementation and IV supplementation if severe

38
Q

what are the causes of vitamin b12 deficiency

A

reduced intake
impaired absorption
medication side effects eg metformin

39
Q

what are the features of vitamin b12 deficienchy

A

anaemia symptoms
peripheral neuropathy
visual changes

40
Q

what does vitamin b12 deficiency do to the red blood cells

A

makes them macrocytic

41
Q

how can vitamin b12 deficiency be managed

A

oral supplementation and intra muscular supplementation

42
Q

what is b12 important for

A

neuron development

43
Q

why does vitamin b12 deficiency lead to peripheral neuropathy

A

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
Q

which muscle is injected when there is vitamin b12 deficiency

A

deltoid

45
Q

how is vitamin b12 absorbed

A

in the ileum, alongside intrinsic factor

46
Q

what are the causes of impaired vitamin b12 absorption

A

pernicious anaemia
gastrectomy
crohns disease
following bowel surgery
ie any inflammation in the bowels

47
Q

what is pernicious anaemia

A

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
Q

how is pernicious anaemia managed

A

IM supplementation, 3 monthly

49
Q

where is folic acid absorbed

A

jejunum

50
Q

what are the causes of folic acid deficiency

A

dietary deficiencies
medications
alcohol excess
bowel inflammation

51
Q

what can be caused by folic acid deficiency in foetal development

A

spinal bifida

52
Q

how is folic acid deficiency managed

A

simple oral replacement

53
Q

what are the two main methods for investigation of anaemia

A

blood tests
endoscopy/colonscopy

54
Q

what are the four blood tests for detecting anaemia

A

Full blood count
Ferritin
Folate
B12

55
Q

when would you consider doing an end/colonoscopy to test for anaemia

A

if suspicious of gi bleeding, eg blood in the stool, weight loss or an elderly patient

56
Q

what is ferritin

A

the molecule in which iron is stored in cells, which is raised when there is infection or inflammation

57
Q

what is the full blood count blood test

A

includes lots of information, but the important parts are:

  • haemoglobin
  • white cell count
  • platelets
  • mean cell volume
58
Q

what is WCC

A

white cell count

59
Q

what is the mean cell volume

A

MCV

60
Q

what does a microcytic red blood cell indicate

A

iron deficiency
thalassamemia
lead poisoning

61
Q

what does a normocytic cell indicate

A

bleeding
kidney disease
anaemia of chronic diseases

62
Q

what does a microcytic cell indicate

A

folic acid deficiency
b12 deficiency
alcohol excess

63
Q

what is the MCV value for microcytic cells

A

less than 80

64
Q

what is the MCV value for normocytic cells

A

80-100

65
Q

what is the MCV value for microcytic cells

A

mcv greater than 100

66
Q

what is thalassaemia

A

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
Q

what type of anaemia is associated with thalassaemia

A

microcytic

68
Q

how to manage thalassaemia

A

monitoring, if minor
blood transfusions
splenectomy
bone marrow transplant

69
Q

what is sickle cell anaemia

A

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
Q

when is screening for sickle cell anaemia carried out

A

in newborns

71
Q

what does sickle cell anaemia do for malaria

A

makes it less severe

72
Q

what can lead to complications with sickle cell anaemia

A

known as crises, the complications are triggered by dehydration, infections, stress and cold weather

73
Q

how is sickle cell anaemia managed

A

avoid triggers
antibiotic prophylaxis
specialist medications
blood transfusions
bone marrow transplant

74
Q

what are the oral manifestations of anaemia

A

angular cheilitis
mucosal atrophy
glossitis, which can be smooth or beefy
recurrent aphthous stomatitis
candidate infections
oral dysaesthesia

75
Q

what is oral dysaesthesia

A

this is a burning mouth sensation caused by the nerve endings in the mouth misfiring

76
Q

which anaemia increases the chance of angular cheilitis

A

iron deficiency anaemia

77
Q

what is atrophic glossitis

A

this is when there is iron deficiency leading to a smooth tongue

78
Q
A

angular cheilitis

79
Q
A

atrophic glossitis from iron deficiency causing smooth tongue

80
Q
A

beefy tongue

81
Q
A

recurrent aphthous stomatitis

82
Q
A

candidal infection

83
Q

what is the most common blood transfusion

A

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
Q

what are the possible indicators for blood transfusions

A

anaemia
acute blood loss from trauma
surgery
complex haematological conditions

85
Q

what are the important antigens on red blood cells

A

A B O AB

86
Q

what are the important antibodies in the blood

A

anti B anti A , one, neither or both of these

87
Q

what is essential to be carried out before administering a blood transfusion

A

check the recipients blood group before giving the blood, and cross match the blood types

88
Q

what is cross matching of blood

A

this is when a sample is taken from the recipient and is tested against the donors blood

89
Q

what are the complications of blood transfusions

A
  • transfusion associated fever
  • incompatible blood
  • fluid overload
  • anaphylaxis
  • infection
90
Q

what is TACO

A

transfusion associated circulatory overload

91
Q

what does incompatible blood lead to

A

haemolysis

Human Systems and Anatomy (57 decks)

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