blood and anaemia Flashcards by Alaina Francis

normal number of RBCs

3-5x10^12/litre

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normal number of WBCs

2-6x10^9/litre

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normal number of platelets

150-400 x 10^9/litre

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how often do you replace blood cells

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

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what are sites of haemopoiesis in embryos, children and adults

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

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

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

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

monocytes and neutrophils

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

changes in adhesion molecules

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

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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what are the important haematinics required for haemopoiesis

iron
vitamin B12
folate

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what are the three “parts” of the RBC

membrane
Hb
enzymes

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what is vitamin B12 important for

rapidly producing cells

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what are the main reasons why we see vitamin B12 deficiency

dietary deficiency
poor absorption
metabolic pathway problem

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what are the main reasons why we see folate deficiency

dietary deficiency

drugs

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

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

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

RBCs = polycythaemia
WBCs = leukocytosis
platelets = thrombocytosis

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

RBC = dyserthropoiesis
WBC = white cell function defect
platelet = platelet function defect

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what is the definition of anaemia

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

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

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

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

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

clinical signs of anaemia

pale
lethargic
failure to thrive
hypoxic
ischaemia
tachycardia

what are the 3 major causes of anaemia

failure of production
increased destruction/loss
inappropriate production

what are the signs of increased production of blood cells

reticulocytes

polychromasia

what are the signs of increased destruction of blood cells

jaundice
haptoglobins
LDH

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

spherocytes

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

blister/bit cells | spherocytes

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

sickle cells

what are the causes of RBC membrane dysfunction causing haemolysis

hereditary spherocytosis | hereditary pyropoikilocytosis

what are the causes of RBC enzyme dysfunction causing haemolysis

G6PD - common | pyrovate kinase

what are the causes of RBC Hb dysfunction causing haemolysis

thalassemia sickle cell unstable Hb

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

E5M

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

G6PD assay

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

Hb electrophoresis | HPLC

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

immune mediated mechanical infection

what is the most common cause of mechanical haemolysis

sepsis

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

spherocytes | agglutination

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

microangiopathic

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

parasites

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

haematinics marrow failure/suppression marrow invasion

what are the main things that cause microcytic anaemia

- blood loss - iron deficiency - thalassemia

what are the main things that cause macrocytic anaemia

vitamin B12 deficiency folate deficiency liver disease drugs

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

``` aspirate = can see morphology of the cells trephine = can see the architecture of the bone marrow ```

which chromosome are the ABO genes located on

ABO = chromosome 9 | H gene = chromosome 19

what is the association between the H substance and ABO

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

ABO genes code for...

transferase enzymes which add sugars to H substance

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

D D = positive no D = negative

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

ABO - naturally occurring Ab | Rh - antibodies only made after exposure

what are the antibodies made by different blood groups against ABO

``` A = Antib B B = anti A AB = no antibodies O = anti A and Anti B ```

which blood types can each blood group receive

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