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MEH (Milly's) > Blood > Flashcards

Blood Flashcards

1
Q

What is cytopenia?

A

A reduction in the number of blood cells

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2
Q

What is anaemia?

A

Low red cell count

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3
Q

What is leucopenia?

A

Low white blood count

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4
Q

What is neutropenia ?

A

Low neutrophil count

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5
Q

What is thrombocytopenia?

A

Low platelet count

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6
Q

What is pancytopenia?

A

Low red blood cells, white blood cells and platelets

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7
Q

What is a high red cell count?

A

Erythrocytosis

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8
Q

What is a high white blood count?

A

Leucocytosis

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9
Q

What is a high neutrophil count?

A

Neutrophilia

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10
Q

What is high lymphocyte count?

A

Lymphocytosis

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11
Q

What is a high platelet count?

A

Thrombocytosis

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12
Q

What is a neutrophil?

A

The first responder phagocyte, the comment white cell, essential part of the innate immune system

*once mature; circulate in bloodstream then invade a tissue lives there for 1-4 days

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13
Q

How many nuclear lobes do neutrophils normally have? What does too many lobes mean?

A

3-5 segments

Too many could be indicative of a B12 deficiency

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14
Q

How do neutrophils mature?

A 
Myeloblast (immature)
Promyelocyte
Myelocyte
Metamyelocyte
Band cell 
Neutrophil

*controlled by G-CSF

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15
Q

Which pre neutrophil cells can you expect to see in the blood?

A

Band cells and mature neutrophils only

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16
Q

What is the role of the hormone G-CSF?

A
  1. Increase production of neutrophils
  2. Decreases time to release of mature cells from bone marrow
  3. Enhances chemotaxis
  4. Enhances phagocytosis and killing of pathogens
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17
Q

If someone needs more neutrophils eg the patient as severe neutropenia and sepsis after chemo, what can you give them?

A

Recombinant G-CSF

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18
Q

What are some of the causes of neutrophilia?

A 
Infection
Tissue damage
Acute inflammation 
Acute haemorrhage 
Cancer 
Drugs eg steroid 
Cytokines: GCSF
Metabolic/endocrine disorder
Smoking 
Myeloproliferative diseases
19
Q

What are the causes of neutropenia?

A
  1. Reduced production
  2. Increased removal or use:
    - immune destruction
    - sepsis
    - splenic pooling
  3. Others :
    - benign ethnic neutropenia
    - cyclic neutropenia
20
Q

What can cause a reduced production of neutrophils, resulting in neutropenia?

A
  1. B12/folate deficiency
  2. Infiltration of bone marrow by malignancy or fibrosis
  3. Aplastic anaemia (empty bone marrow)
  4. Radiation
  5. Drugs (ie chemo, antibodies, psychotropic drugs)
  6. Viral infections - V COMMON
  7. Congenital disorders
21
Q

What are the consequences of neutropenia?

A
  1. Severe life threatening bacterial infection
  2. Severe life threatening fungal infection
  3. Mucosal ulceration eg painful mouth ulcers

**neutropenic sepsis is a medial emergency. Intravenous antibiotics must be given immediately

22
Q

What are monocytes and what role do they have?

A

Type of white blood cell that become macrophages

  1. Response to inflammation and antigenic stimuli
  2. Migrate to tissue- and become macrophages
  3. They have Lysosomes that contain lysozyme, complement, interleukins, arachidonic acid, CSF
  4. They have a role in Phagocytosis, pinocytosis
23
Q

What is monocytosis?

A

Increase in monocytes count

24
Q

What can cause monocytosis?

A
  1. Chronic inflammatory conditions: RA, Crohn’s disease, Ulcerative colitis
  2. Chronic infection eg TB
  3. Carcinoma
  4. Myeloproliferative disorders/leukaemias: chronic myelomonocytic leukaemia etc
25
Q

What are eosinophils and what is their role?

A

White cells with a life of 8-12 days but spend only 3-8 hrs in circulation

  1. Responsible for dealing with some parasites
  2. Mediator of allergic response
  3. Migrate to epithelial surface and release their granules which are rich in arginine, phospholipid and enzymes
  4. Can phagocytose antigen-antibody complexes
  5. Mediate hypersensitivity reactions eg to drugs, in asthma, skin inflammation
26
Q

What is eosinophilia?

A

Increased number of eosinophils

27
Q

What are the possible causes of eosinophilia?

A
  1. allergic diseases: asthma, eczema, hay fever, urticaria, aspergillosis
  2. Drug hypersensitivity: penicillin
  3. Churg-strauss
  4. Parasitic infection: round worm, tapeworm, flukes
  5. Skin diseases: bullous pemphigoid
  6. Hodgkin lymphoma (common in children and young adults)
  7. Acute lymphoblastic leukaemia
  8. Acute myeloid leukaemia
  9. Myeloproliferative conditions
  10. Eosinophils leukaemia
  11. Ideopathic hypereosinophilic syndrome
28
Q

What are basophils and what is their role?

A

Least common but largest white cells (blackberry appearance)

  1. Active in allergic reactions and inflammatory conditions
  2. Have dense granules that contain histamine, heparin, hyaluronic acid and serotonin
29
Q

What is basophilia?

A

Increase in basophil count

30
Q

What are some causes of basophilia?

A

Reactive:

  1. Immediate hypersensitivity reactions
  2. Ulcerative colitis
  3. Rheumatoid arthritis

Myeloproliferative:

  1. Chronic myeloid leukaemia
  2. Systemic mastocytosis
31
Q

What are the 3 types of lymphocytes and where do they originate from?

A

B cells (humoral immunity)-antibody forming cells

T cells (cellular immunity)- CD4+ helper cells, CD8+ cells

NK cells (cell mediated cytotoxicity)

All originate in the bone marrow

32
Q

What is lymphocytosis?

A

Increase in lymphocyte count

33
Q

What are the causes of lymphocytosis?

A

Reactive:

  1. Viral infections
  2. Bacterial infections (especially whooping cough)
  3. Stress related: MI/cardiac arrest
  4. Post splenectomy
  5. Smoking

Lymphoproliferative ie malignant:

  1. Chronic lymphocytic leukaemia
  2. Lymphoma (cells ‘spill’ out of infiltrated bone marrow)
34
Q

What are the causes of pancytopenia?

A
  1. Reduced production
  2. Increased removal:
    - immune destruction (rare)
    - splenic pooling ~ hyersplenism
    - haemophagocytosis (chewing up of cell in bone marrow, v rare)
35
Q

What can cause the reduced production of blood cells resulting in pancytopenia?

A
  1. B23/folate deficiency
  2. Bone marrow infiltration by malignancy
  3. Marrow fibrosis
  4. Idiopathic immune aplastic anaemia (empty bone marrow)
  5. Radiation
  6. Drugs
  7. Viruses (EBV, viral hep, HIV)
  8. Congenital bone marrow failure
36
Q

What will aplastic anaemia look like under a microscope?

A

When looking at bone marrow there will be very few blood cells, it will be almost all fat cells because the bone marrow is considered ‘empty’

37
Q

What is aplastic anaemia?

A

Pancytopenia with a hypocellular bone marrow in the absence of an abnormal infiltrate and with no increase in reticulin (fibrosis)

38
Q

What sort of malignancies can cause pancytopenia?

A

Haematological malignancies:

  1. Acute and chronic leukaemia
  2. Lymphoma
  3. Myeloma
  4. Myelofibrosis

Non-haematological malignancies:
Eg prostate, breast and lung cancer

39
Q

What are the symptoms of pancytopenia?

A

They are a collection of the symptoms of anaemia, thrombocytopenia, neutropenia and the underlying cause

40
Q

What are the symptoms of anaemia?

A

Fatigue
Dizziness
Chest pain
Shortness of breath

41
Q

What are the symptoms of thrombocytopenia?

A

Bleeding
Bruising
Etc

42
Q

What are the symptoms of neutropenia?

A

Infections,
Ulcers,
Fevers,
Etc

43
Q

What is special about the haemopoietic stem cell (HPSC)?

A
  1. It has the greatest power of self-renewal compared to any other adult tissue
  2. It can renew itself and differentiate into a variety of specialised cells, dependent on the stimuli
  3. It can be mobilised out of the bone marrow into circulation blood
  4. Can undergo apoptosis
44
Q

How can HPS cells be obtained?

A
  1. Aspiration of bone marrow (rare)
  2. Use GCSF to ‘push’ stem cells into circulation and then the blood can be taken and stem cells obtained by leucopheresis
  3. Umbilical cord stem cells taken at the time of normal delivery

MEH (Milly's) (39 decks)

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