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POM > Blood Cell Abnormalities > Flashcards

Blood Cell Abnormalities Flashcards

1
Q

What is anaemia?

A

The reduction in Hb in a given volume of blood below what is expected in a healthy person

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2
Q

What is microcytic anaemia?

A

RBC size is reduced- usually also hypochromic

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3
Q

What are common causes of microcytic anaemia?

A

Defect in haem synthesis
Iron deficiency
Anaemia of chronic disease
Defect in globin synthesis (thalassemia)

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4
Q

What are causes of iron deficiency?

A 
Increased blood loss
Insufficient intake  (dietary/ malabsorption)
Increased requirement (pregnancy, infancy)
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5
Q

What is macrocytic anaemia?

A

RBC increased in size- usually also polychromatic
Result of abnormal haemopoiesis so red cell precursors continue to generate Hb and other cellular proteins but fail to divide normally

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6
Q

What is megaloblastic erythropoiesis?

A

Delay in maturation of nucleus whilst cytoplasm continues to mature and cell continues to grow.
Megaloblasts often seen in blood marrow not blood film

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7
Q

What are common causes of macrocytic anaemia?

A

Lack of B12 or folate
Liver disease and ethanol toxicity
Haemolytic anaemia (increased reticulocytes)
Pregnancy
Use of drugs interfering with DNA synthesis
Major blood loss with inadequate iron stores

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8
Q

What are causes of normocytic anaemia?

A

Recent blood loss- GI haemorrhage, trauma
Failure in production of RBCs- early stages if iron deficiency, bone marrow failure or suppression, bone marrow infiltration e.g. leukaemia
Pooling of red cells in spleen- hypersplenism e.g. liver cirrhosis, splenic sequestration in sickle cell anaemia

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9
Q

What are stages of iron depletion?

A

Iron depletion: storage iron reduced or absent
Iron deficiency: low serum iron and transferrin saturation
Iron deficiency anaemia: low haemoglobin and haematocrit

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10
Q

What are clinical features of iron deficiency anaemia?

A

pallor, fatigue, breathlessness, impaired development in children

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11
Q

What are common causes of anaemia of chronic disease?

A 
Rheumatoid arthritis
Autoimmune disease
Malignancy
Infectors such as TB and HIV
Kidney disease
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12
Q

What’s the pathophysiology of anemia of chronic disease?

A

cytokines such as TNF and interleukin alpha in chronic disease lead to decrease in erythropoietin production and prevents normal flow of iron from duodenum to RBCs

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13
Q

What are laboratory clues of ACD?

A

High ferritin
Low transferrin
C-reactive protein is high
Erythrocyte sedimentation rate is high (unlike iron deficiency)

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14
Q

What is polycythaemia?

A

Too many red cells in circulation- Hb, RBC and Hct all increased
Pseudopolycythaemia = reduced plasma volume
True polycythaemia = increase in total red cells in circulation

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15
Q

What are causes of polycythaemia?

A

Blood doping or over transfusion
Appropriately increased erythropoietin- e.g. result of hypoxia
Inappropriate erythropoietin synthesis/ use- e.g. from renal tumour secretion

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16
Q

What is polycythaemia vera?

A

Independent of erythropoietin
Intrinsic bone marrow disorder (myeloproliferative neoplasm) leading to hyperviscosity (thick blood)
This can lead to vascular obstruction and venous or arterial thrombosis
Drugs given to reduce bone marrow production of RBCs or blood can be removed to reduce viscocity

17
Q

What is chronic leukaemia?

A

Benign- will last a while before death

18
Q

What is acute leukaemia?

A

Malignant- leads to death in short amount of time and is aggressive

19
Q

What is lymphoid leukaemia?

A

affects B, T or NK lineage

20
Q

What is myeloid leukaemia?

A

Affects a combination of granulocytic, monocytic, erythroid or megakaryocytic lineage

21
Q

What is leukaemia?

A

Cancer of the blood, bone marrow disease

22
Q

What are causes of leukaemia?

A

Results from series of mutations in single lymphoid or myeloid stem cell
Mutations leads to progeny of cell to show abnormalities in proliferation, differentiation and survival- leads to steady expansion of leukemic clone

23
Q

What is acute lymphoblastic anaemia?

A

Increase in very immature cells (lymphoblasts)

Bone marrow is infiltrated by immature lymphoblasts resulting in impaired haematopoiesis

24
Q

What are causes of acute lymphoblastic anaemia?

A

Causes usually unknown, sometimes mutagenic drugs or exposure to irradiation or chemicals in utero, possibly delayed exposure to pathogen

25
Q

What are haematological features of acute lymphoblastic anaemia?

A

anaemia, neutropenia, thrombocytopenia, replacement of normal bone marrow with lymphoblasts

26
Q

What is treatment for acute lymphoblastic anaemia?

A

Supportive (red cells, platelets, antibodies)
Intrathecal chemotherapy
Systemic chemotherapy

27
Q

What is acute myeloid leukaemia?

A

Occurs in late middle and old age
Often result of many sequential mutations
Leukaemia may be (in part) a result of spontaneous mutations and (in part) a consequence of exposure to environmental mutagenic influence

28
Q

What is chronic myeloid leukaemia?

A

Increase in all granulocytes- neutrophils, eosinophils and basophils

29
Q

What causes CML?

A

Translocation between chromosomes 9 and 22
Philadelphia chromosome is an abnormally short chromosome 22 due to translocation and causes CML
The mutation involves activation of a signalling pathway (BCR-ABL1 protein)
Cells can proliferate without growth factors
ABL1 gene codes tyrosine kinase enzyme
Philadelphia chromosome made up of genes BCR-ABL1- this gene encodes a protein with uncontrolled tyrosine kinase activity- gives rise to leukaemia clone

30
Q

What is the treatment of CML?

A

inhibition of tyrosine kinase can read to remission and could be a potential cure

31
Q

What is chronic lymphoid leukaemia?

A

Leukaemia cells are mature but there are abnormal B, T and NK cells
There’s uncontrolled proliferation of leukemia clones replacing normal cells but dont work

POM (48 decks)

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