Benign Haematology

Question 1

what are the components of blood?

4

Answer 1

plasma
white blood cells (neutrophils, monocytes, B/T cells, granulocytes)
red blood cells
platelets

Question 2

what does - leuko refer to?

Answer 2

white blood cell

Question 3

what does -erythro refer to?

Answer 3

red blood cell

Question 4

what does thrombocyto refer to?

Answer 4

platelet

Question 5

what does pan/poly refer to?

Answer 5

all blood cells

Question 6

what does -cytosis refer to?

Answer 6

excess of

Question 7

what does -penia refer to?

Answer 7

lack of

Question 8

what does microcytic mean?

Answer 8

small cell size

Question 9

what does normocytic mean?

Answer 9

normal cell size

Question 10

what does macrocytic mean?

Answer 10

large cell size

Question 11

what is the purpose of blood?

Answer 11

transport oxygen, hormones, nutrients, waste
clotting
immunity - B cells, T cells
temperature regulation

Question 12

where is blood formed and what kind of cells can they become?

3

Answer 12

bone marrow
* myeloid lineage - platelets, RBCs
* lymphoid lineage - WBCs

Question 13

what is anaemia?

Answer 13

low haemoglobin in the blood

Question 14

what is haemoglobin and its composition and what does it do?

3

Answer 14

protein found in red blood cells with iron haem groups
transports oxygen around the body
composed of 2 alpha chains and 2 beta chains with 4 iron haem groups

Question 15

what is the lifespan of a red blood cell and where is it broken down?

2

Answer 15

120 days
brokwn down in spleen and liver

Question 16

what are the causes of anaemia?

4

Answer 16

impaired production - lack of raw materials, EPO,, marrow issue
increased breakdown - issue with RBC, haemoglobin, autoimmune haemolysis
increased demand - pregnancy, growth phases
increased blood loss - acute bleed, mestural bleeding, gastrointestinal losses e.g. cancer

Question 17

what are the symptoms of anaemia?

4

Answer 17

tiredness
shortness of breath
dizziness
palpitations

Question 18

what are the signs of anaemia?

4

Answer 18

pale skin
conjunctival pallor
angular cheilitis
koilonychia - spoon shaped nails

Question 19

what does iron deficiency anaemia result and how is it caused?

1,4

Answer 19

results in impaired haemoglobin production so RBCs are smaller (microlytic)
caused by:
* reduced dietary intake
* impaired absorption (duodenum)
* increased loss (menstrual, GI bleeding)
* increased demands (pregnancy, growth)

Question 20

where does iron absorption take place? what can reduce absorption?

1,2

Answer 20

mainly in duodenum, requires stomach acid
reduced absorption if:
* inflammation in duodenum (coeliacs disease)
* lack of stomach acid (PPI - omeprazole)

Question 21

what is needed for the production of red blood cells?

5

Answer 21

EPO - erythropoietin
iron
vitamin B12
folic acid
protein

Question 22

what causes vitamin B12 deficiency and how does it affect the RBCs?

4

Answer 22

reduced intake
impaired absorption (ileum)
medication side effect (metformin)
results in macrolytic RBCs - large

Question 23

what are the features and management of vitamin B12 deficiency?

3,2

Answer 23

features
* anaemia symptoms
* peripheral neuropathy
* visual changes
management
* oral supplementation
* intra-muscular supplementation

Question 24

where does vitamin B12 absorption take place? what conditions are causes of impaired absorption?

1,4

Answer 24

absorbed in the ileum, required intrinsic factor produced in parietal cells in stomach
causes of impaired absorption:
* pernicious anaemia (no intrinsic factor)
* gastrectomy
* crohn’s disease (ileum inflammation)
* following bowel surgery

Question 25

what is vitamin B12 important in and what does deficiency cause? | 2,3

Answer 25

formation of red blood cells important in neurone function deficiency causes: * neuropathy * balance disturbance * visual changes

Question 26

what is pernicious anaemia?

Answer 26

autoimmune condition where antibodies destroy parietal cells in stomach and can target intrinsic factor itself so no absorption of vitamin B12 in ileum

Question 27

how is pernicious anaemia diagnosed?

Answer 27

blood test to test for antibodies that destroy the parietal cells and intrinsic factor

Question 28

how is pernicious anaemia managed?

Answer 28

intramuscular supplement (3 monthly)

Question 29

where is folic acid absorbed and what causes its deficiency? | 1,4

Answer 29

absorbed in the jejunum caused by: * dietary * medications (methotrexate) * alcohol excess * bowel inflammation

Question 30

what are the symptoms of folic acid deficiency? | 4

Answer 30

fatigue weakness mouth ulcers neurological issues

Question 31

what are the basic investigations for anaemia? | 3

Answer 31

full blood count haemantinics blood test endoscopy/colonoscopy

Question 32

what are the haematinics? | 3

Answer 32

ferritin folate vitamin B12

Question 33

what are the important parameters in a full blood count for anaemia and what are the normal ranges for adults? | 4

Answer 33

haemoglobin (M:135-180 F:115-160) white blood cells (4.00-11.00) platelets (150-400) mean cell colume (78-100)

Question 34

when would a RBC be microlytic? | 3

Answer 34

iron deficiency thalassaemia lead poisoning

Question 35

when would a RBC be normolytic? | 3

Answer 35

bleeding kidney disease anaemia of chronic disease

Question 36

when would a RBC be macrolytic? | 3

Answer 36

folic acid deficiency B12 deficiency alcohol excess

Question 37

what is thalassaemia and what does it result in?

Answer 37

genetic defect in the chains of haemoglobin (autosomal recessive) results in alpha-thalassaemia or beta-thalassaemia RBCs are more fragile and microlytic

Question 38

what organ in the body destroys faulty red blood cells?

Answer 38

spleen detects and destroys red blood cells

Question 39

how do you manage thalassaemia? | 4

Answer 39

**monitoring** **blood transfusions** - healthy RBC **splenectomy** - remove part of spleen so less destruction **bone marrow transplant**

Question 40

what is sickle cell anaemia and what does it result in?

Answer 40

genetic condition - autosomal recessive results in crescent shaped RBCs which are more fragile and easily destroyed

Question 41

what complications can trigger a crisis of sickle cell anaemia? | 4

Answer 41

dehydration infection stress cold weather

Question 42

what are the ways to manage sickle cell anaemia? | 5

Answer 42

avoid triggers antibiotic prophylaxis specialist medications blood transfusions bone marrow transplant

Question 43

what are the oral manifestations of anaemia? | 6

Answer 43

angular cheilitis mucosal atrophy glossitis - smooth or beefy tongue recurrent aphtous stomatitis candidal infection oral dysaethesia - burning mouth

Question 44

what is the test called that is done before a blood tranfusion?

Answer 44

cross-matching - sample taken from recipient and tested against donor's blood

Question 45

what are the complications of blood transfusions? | 5

Answer 45

transfusion associated fever incompatible blood (mis-match) fluid overload anaphylaxis infection

Question 46

what are the important antigens on red blood cells? | 5

Answer 46

A B O AB rhesus (+/-)

Question 47

what are the important antibodies in the blood and which groups have which? | 4

Answer 47

anti-B (group A) anti-A (group B) none (group AB) anti-A and anti-B (group O)

Question 48

what blood can a person with type A+ recieve?

Answer 48

A+ A- O+ O-

Question 49

what blood can a person with type AB- recieve?

Answer 49

AB- A- B- O-

Question 50

what blood can a person with type AB+ recieve?

Answer 50

all blood types A+ A- B+ B- O+ O- AB+ AB-