Benign Haematology Flashcards
have knowledge of components of blood, anaemia and its oral manifestations and haematology blood tests
what are the components of blood?
4
plasma
white blood cells (neutrophils, monocytes, B/T cells, granulocytes)
red blood cells
platelets
what does - leuko refer to?
white blood cell
what does -erythro refer to?
red blood cell
what does thrombocyto refer to?
platelet
what does pan/poly refer to?
all blood cells
what does -cytosis refer to?
excess of
what does -penia refer to?
lack of
what does microcytic mean?
small cell size
what does normocytic mean?
normal cell size
what does macrocytic mean?
large cell size
what is the purpose of blood?
transport oxygen, hormones, nutrients, waste
clotting
immunity - B cells, T cells
temperature regulation
where is blood formed and what kind of cells can they become?
3
bone marrow
* myeloid lineage
* lymphoid lineage
what is anaemia?
low haemoglobin in the blood
what is haemoglobin and its composition and what does it do?
3
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
what is the lifespan of a red blood cell and where is it broken down?
2
120 days
brokwn down in spleen and liver
what are the causes of anaemia?
4
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
what are the symptoms of anaemia?
4
tiredness
shortness of breath
dizziness
palpitations
what are the signs of anaemia?
4
pale skin
conjunctival pallor
angular cheilitis
koilonychia - spoon shaped nails
what does iron deficiency anaemia result in and how is it caused?
1,4
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)
where does iron absorption take place? what can reduce absorption?
1,2
mainly in duodenum, requires stomach acid
reduced absorption if:
* inflammation in duodenum (coeliacs disease)
* lack of stomach acid (PPI - omeprazole)
what is needed for the production of red blood cells?
5
EPO - erythropoietin
iron
vitamin B12
folic acid
protein
what causes vitamin B12 deficiency and how does it affect the RBCs?
4
reduced intake
impaired absorption (ileum)
medication side effect (metformin)
results in macrolytic RBCs - large
what are the features and management of vitamin B12 deficiency?
3,2
features
* anaemia symptoms
* peripheral neuropathy
* visual changes
management
* oral supplementation
* intra-muscular supplementation
where does vitamin B12 absorptio take place? what are the causes of impaired absorption?
1,4
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
what is vitamin B12 important in and what does deficiency cause?
2,3
formation of red blood cells
important in neurone function
deficiency causes:
* neuropathy
* balance disturbance
* visual changes
what is pernicious anaemia?
autoimmune condition where antibodies destroy parietal cells in stomach and can target intrinsic factor itself so no absorption of vitamin B12 in ileum
how is pernicious anaemia diagnosed?
blood test to test for antibodies that destroy the parietal cells and intrinsic factor
how is pernicious anaemia managed?
intramuscular supplement (3 monthly)
where is folic acid absorbed and what causes its deficiency?
1,4
absorbed in the jejunum
caused by:
* dietary
* medications (methotrexate)
* alcohol excess
* bowel inflammation
what are the symptoms of folic acid deficiency?
4
fatigue
weakness
mouth ulcers
neurological issues
what are the basic investigations for anaemia?
3
full blood count
haemantinics blood test
endoscopy/colonoscopy
what are the haematinics?
3
ferritin
folate
vitamin B12
what are the important parameters in a full blood count for anaemia and what are the normal ranges for adults?
4
haemoglobin (M:135-180 F:115-160)
white blood cells (4.00-11.00)
platelets (150-400)
mean cell colume (78-100)
when would a RBC be microlytic?
3
iron deficiency
thalassaemia
lead poisoning
when would a RBC be normolytic?
3
bleeding
kidney disease
anaemia of chronic disease
when would a RBC be macrolytic?
3
folic acid deficiency
B12 deficiency
alcohol excess
what is thalassaemia and what does it result in?
genetic defect in the chains of haemoglobin (autosomal recessive)
results in alpha-thalassaemia or beta-thalassaemia
RBCs are more fragile and microlytic
what organ in the body destroys faulty red blood cells?
spleen detects and destroys red blood cells
how do you manage thalassaemia?
4
monitoring
blood transfusions
splenectomy
bone marrow
what is sickle cell anaemia and what does it result in?
genetic condition - autosomal recessive
results in crescent shaped RBCs which are more fragile and easily destroyed
what complications can trigger a crisis of sickle cell anaemia?
dehydration
infection
stress
cold weather
what are the ways to manage sickle cell anaemia?
5
avoid triggers
antibiotic prophylaxis
specialist medications
blood transfusions
bone marrow transplant
what are the oral manifestations of anaemia?
6
angular cheilitis
mucosal atrophy
glossitis - smooth or beefy tongue
recurrent aphtous stomatitis
candidal infection
oral dysaethesia - burning mouth
what is the test called that is done before a blood tranfusion?
cross-matching - sample taken from recipient and tested against donor’s blood
what are the complications of blood transfusions?
5
transfusion associated fever
incompatible blood (mis-match)
fluid overload
anaphylaxis
infection
what are the important antigens on red blood cells?
5
A
B
O
AB
rhesus (+/-)
what are the important antibodies in the blood and which groups what which?
4
anti-B (group A)
anti-A (group B)
none (group AB)
anti-A and anti-B (group O)
what blood can a person with type A+ recieve?
A+
A-
O+
O-
what blood can a person with type AB- recieve?
AB-
A-
B-
O-
what blood can a person with type AB+ recieve?
all blood types
A+ A-
B+ B-
O+ O-
AB+ AB-
