Blood Flashcards
acute lymphadenitis morphology
reactive germinal centres with mitotic figures
chronic lymphadenitis morphology
Bcell - follicular hyperplasia with oblong germinal centres surrounded by naive b cells
t cell - paracortical hyperplasia
lymphoid sinus histiocytosis cause
cancer (drained into lymphocyte)
morphology splenomegaly
red pulp congestion then fibrosis
white pulp necrosis from haemolytic strep
Increased bleeding time
due to platelet disorders
TTP
inherited/ acquired deficiency ADAMTS13
high molecular weight vWF
microthrombi
transient neurological
HUS
post viral/ verotoxin producing ecoli
Congenital haemorrhagic disorder plt disfunction
Both AR
Bernard soulier GP1b/IX mild bleeding
Thrombasthenia GP11b111a signif bleed
vWD bloo results
inc bleeding time and PTT (due to vWF helping VIII stabilisation)
Haemophilia inheritence
X linked recessive
Main cause DIC
gram -ve sepsis
Order of how common blood types
00
A
B
AB
Intravasc/ extravasc haemolysis
extra in spleen
both conjugated hyperbilirubinaemia and reduced haptoglobin
intra haemoglbinaemia and haemoglobinurea
G6PD defiicincy
X linked
intra and extravasc haemolysis
heinz bodies (also in thalassaemia)
Sickle cell cause
substitution valine for glutamic acid on beta globin chain
BM shows normoblastic hyyperplasia
Less severe sickle cell
heterozygous, <6m fetal Hb, hydration (otherwise sickle loads)
Beta thalassaemia clinical signs
iron overload, marrow expansion, haemolytic anaemia
Beta thalassaemia major blood smear
anisocytosis, hypochromia, target cells, stippled and fragmented RBCs
Hydrops fetalis
alpha thalassamia no alpha chains, death in utero
Warm antibodies
autoimmune haemolysis
37 degrees igG
60% idiopathic
lymphoma, leukamia, SLE
Cold agglutinins
Autoimmune haemolysis <30degrees
IgM and complement
acute mycoplasma and EBV
chronic idiopathic lymphoma
Cold haemolysin
Autoimmune haemolysis <30 degrees
IgG complement
post infective: measles, mumps, mycoplasma
Blood film traumatic haemolysis
schistocytes
e.g. metallic valve
Megaloblastic anaemia blood film
megaloblastic cells, metamyelocytes and hypersegmented neutrophils
Iron deficiency anaemia blood levels
LOW iron, ferritin, plasma transferrin saturation
INC TIBC
Anaemia chronic disease cause and blood levels
serum iron low, ferritin high,
TNF and IL1 -> blocked ferroportin macrophages, ferritin stuck in macrophages
Basophilia
assoc CML and myeloproliferative disorders
interleukins causing lymphopoesis
CKit ligand and IL7
ALL
85% pre B cell
children
can have neurological sequelae
anaemia, thrombocytopenia, >30% lymphoblasts
good prognosis
CLL
most common adult leukaemia
M>F 60yo
hepatosplenomegaly
lymphocytosis
Poor prognosis
Burkitts lympmhoma
african assoc EBV
other HIV
mature B cells
mandible growth african
ileocaecal or peritoneal mass other
Multiple myeloma
benz jones protein
MIP1a and RANKL stimulate osteoclasts
renal failure and infection
Hodgkins lymphoma
common young adults
painless single mass
reed sternberg cells
assoc EBV
AML
> 20% myeloid blasts in BM
auer rods
M>F 15-39
less CNS involvement than ALL
CML
splenomegaly ++
basophilia
t(9,22) philadelphia chromosom
BCR-ABL
BM transplant in stable phase curative
Polycythaemia vera BM
early - ypercellular with giant plts and megakaryocyte fragments
late - marrow fibrosis with extramedullary haematopoesis and organomegally
