Blood Cell Abnormalities

Question 1

Leukaemia definition?

Answer 1

Bone marrow disease, and cancer, which causes overproduction of myeloid or lymphoid cells

Question 2

4 types of classification of leukaemia?

Answer 2

Acute lymphoblastic Acute myeloid Chronic lymphocytic Chronic myeloid

Question 3

Acute vs chronic leukaemia?

Answer 3

Causes death in a matter of days, weeks or months if left untreated vs causes less impairment of function of normal tissues and will eventually lead to death

Question 4

4 causes of leukaemias?

Answer 4

• Mutations in proto-oncogenes or tumour suppressor genes occur in a primitive cell that gives it a growth or survival advantage - Leukaemic clone behaviour can include growth without growth factors, continued proliferation without maturation and failure to undergo apoptosis - Acute leukaemias often result from mutations in genes encoding transcription factors so cells proliferate without maturing (lymph and myelo blast cells are produced) - In chronic leukaemia, intracellular signalling pathways are activated so cells continue to divide but are still mature

Question 5

4 direct effects of leukaemia?

Answer 5

• Bone pain - Hepatomegaly - Splenomegaly - Lymphadenopathy

Question 6

4 indirect effects of leukaemia?

Answer 6

• Fatigue - Fever - Bruising - Lumps and swelling

Question 7

Essential investigation performed for leukaemia?

Answer 7

Flow cytometry used to perform analysis on bone marrow

Question 8

Anaemia definition?

Answer 8

Reduction in Hb concentration below normal

Question 9

4 causes of anaemia?

Answer 9

• Reduced production of RBC’s by bone marrow - Loss of blood from body - Reduced survival of RBC’s in circulation (haemolysis) - Increased pooling of RBC’s in an enlarged spleen

Question 10

Microcytic anaemia?

Answer 10

RBCs are small, can be judged by blood film or measuring MCV on an RBC counter. Are usually hypochromic

Question 11

3 common causes of microcytosis?

Answer 11

• Iron deficiency anaemia - Anaemia of chronic disease - Thalassaemia

Question 12

3 causes of iron deficiency anaemia?

Answer 12

Increased blood loss, e.g gastrointestinal or menstrual bleeding

Insufficient intake- dietary or malabsorption

Increased requirements- pregnancy or infancy

Question 13

5 causes of ACD?

Answer 13

Rheumatoid Arthritis

Autoimmune disease

Malignancy

Kidney disease

Infections like TB or HIV

Question 14

Distinguishing between iron deficiency and ACD?

Answer 14

Question 15

Macrocytic anaemia?

Answer 15

Abnormal haemopoiesis so red cell precursors continue to synthesise Hb and other proteins but don’t divide

Megaloblastic erythropoiesis- specifically a delay in maturation of nucleus while cytoplasm matures and cell grows. Megaloblasts are seen in the bone marrow, not blood film

Question 16

5 causes of macrocytic anaemia?

Answer 16

Lack of vitamin B12 or folic acid

Use of drugs interfering with DNA synthesis

Liver disease and ethanol toxicity

Recent major blood loss with adequate iron stores (reticulocytes increased)

Haemolytic anaemia (reticulocytes increased)

Question 17

Megaloblastic anaemia?

Answer 17

Abnormal bone marrow erythroblast

Larger size and shows nucleocytoplasmic dissociation

Anaemia caused by B12 or folate deficiency

Requires bone marrow examination

Question 18

3 normocytic anaemia mechanisms?

Answer 18

Recent blood loss

Failure of production of RBCs

Pooling of red cells in the spleen

Question 19

4 causes of normocytic anaemia?

Answer 19

Haemorrhage, trauma

Bone marrow failure or infiltration

Hypersplenism

Early stages of iron deficiency

Question 20

2 facts about reticulocyte count?

Answer 20

Higher RNA content of reticulocytes stained blue

Increased reticulocyte count is a response to haemolytic anaemia and recent blood loss or a response to treatment with iron, vitamin B12 or folic acid