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Z MD1 Intersystems > blood and anaemia > Flashcards

blood and anaemia Flashcards

1
Q

normal number of RBCs

A

3-5x10^12/litre

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2
Q

normal number of WBCs

A

2-6x10^9/litre

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3
Q

normal number of platelets

A

150-400 x 10^9/litre

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4
Q

how often do you replace blood cells

A 
RBCs = 120 days
WBCs = 3-5 days
platelets = 10 days
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5
Q

what are sites of haemopoiesis in embryos, children and adults

A

embryos = yolk sac
6 weeks-7months = liver and spleen
7months-adults = bone marrow

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6
Q

what are the 4 divisions that a CFU myeloid progenitor cell can turn into

A

BFU - RBC
CFUmeg - megakaryocyte
CFUgranulocyte - monocytes, neutrophils, eosinophils
CFUbaso - basophils

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7
Q

which two “end stage” blood cells are from the same precursor

A

monocytes and neutrophils

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8
Q

how do the precursor blood cells know when to leave the BM

A

changes in adhesion molecules

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9
Q

what is the important thing to remember about the haemopoietic growth factors

A
  • the effects are mediated through specific receptors (different effects on different receptors)
  • multiple GFs affect every part of the pathway (redundancy)
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10
Q

what are the important haematinics required for haemopoiesis

A

iron
vitamin B12
folate

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11
Q

what are the three “parts” of the RBC

A

membrane
Hb
enzymes

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12
Q

what is vitamin B12 important for

A

rapidly producing cells

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13
Q

what are the main reasons why we see vitamin B12 deficiency

A

dietary deficiency
poor absorption
metabolic pathway problem

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14
Q

what are the main reasons why we see folate deficiency

A

dietary deficiency

drugs

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15
Q

terms for low RBCs/WBCs and platelets (together and individually)

A 
pancytopaenia = all
anaemia = RBC
leukopenia/neutropenia/lymphopaenia = WBC
thrombocytopaenia = platelets
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16
Q

what are the terms for too many RBCs, WBCs and platelets

A 
RBCs = polycythaemia
WBCs = leukocytosis
platelets = thrombocytosis
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17
Q

what are the terms for RBCs, WBCs and platelets not “working properly”

A 
RBC = dyserthropoiesis
WBC = white cell function defect
platelet = platelet function defect
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18
Q

what is the definition of anaemia

A

a Hb level below that which is normal for age and gender

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19
Q

what is the REALLY IMPORTANT formula we have to know for haematology

A

tissue oxygen deliver = CO x Hb x %O2Sat x 1.34

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20
Q

what is the difference of the impact of anaemia in acute and chronic settings

A 
acute = only able to compensate for a low Hb with increased HR
chronic = able to also compensate with an increased SV
21
Q

clinical signs of anaemia

A
  • pale
  • lethargic
  • failure to thrive
  • hypoxic
  • ischaemia
  • tachycardia
22
Q

what are the 3 major causes of anaemia

A

failure of production
increased destruction/loss
inappropriate production

23
Q

what are the signs of increased production of blood cells

A

reticulocytes

polychromasia

24
Q

what are the signs of increased destruction of blood cells

A

jaundice
haptoglobins
LDH

25
Q

what is the sign of haemolysis due to membrane dysfunction of the RBC

A

spherocytes

26
Q

what are the signs of haemolysis due to enzyme dysfunction of the RBC

A

blister/bit cells

spherocytes

27
Q

what is the sign of haemolysis due to dysfunction in the Hb

A

sickle cells

28
Q

what are the causes of RBC membrane dysfunction causing haemolysis

A

hereditary spherocytosis

hereditary pyropoikilocytosis

29
Q

what are the causes of RBC enzyme dysfunction causing haemolysis

A

G6PD - common

pyrovate kinase

30
Q

what are the causes of RBC Hb dysfunction causing haemolysis

A

thalassemia
sickle cell
unstable Hb

31
Q

what tests do you perform if you see spherocytes on a blood slide

A

E5M

32
Q

what test do you perform if you see bite cells/blister cells on a blood slide

A

G6PD assay

33
Q

what tests do you perform if you see sickle cells on a blood slide

A

Hb electrophoresis

HPLC

34
Q

what are the 3 main causes external to the red cell that cause haemolysis

A

immune mediated
mechanical
infection

35
Q

what is the most common cause of mechanical haemolysis

A

sepsis

36
Q

what would you see on a blood slide with immune mediated haemolysis

A

spherocytes

agglutination

37
Q

what would you see on a blood slide with mechanical mediated haemolysis

A

microangiopathic

38
Q

what would you see on a blood slide with infection mediated haemolysis

A

parasites

39
Q

what are the 3 major reasons for anaemia due to failure of production

A

haematinics
marrow failure/suppression
marrow invasion

40
Q

what are the main things that cause microcytic anaemia

A
  • blood loss
  • iron deficiency
  • thalassemia
41
Q

what are the main things that cause macrocytic anaemia

A

vitamin B12 deficiency
folate deficiency
liver disease
drugs

42
Q

what is the difference in information that you get via a bone marrow examination by aspirate or by trephine

A 
aspirate = can see morphology of the cells
trephine = can see the architecture of the bone marrow
43
Q

which chromosome are the ABO genes located on

A

ABO = chromosome 9

H gene = chromosome 19

44
Q

what is the association between the H substance and ABO

A

H substance is the precursor protein for ABO antigens. The bodys transferases convert the H antigen to the A, B antigens, or don’t convert it = O

45
Q

ABO genes code for…

A

transferase enzymes which add sugars to H substance

46
Q

what is the most important antigen for the rhesus blood group system

A

D
D = positive
no D = negative

47
Q

what is the difference between the antibodies made for ABO or for Rh

A

ABO - naturally occurring Ab

Rh - antibodies only made after exposure

48
Q

what are the antibodies made by different blood groups against ABO

A 
A = Antib B
B = anti A
AB = no antibodies
O = anti A and Anti B
49
Q

which blood types can each blood group receive

A 
A = A or O
B = B or O
AB = A or B or O or AB
O = only O

Z MD1 Intersystems (10 decks)

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