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Exodontia > Blood constituents, haematopoiesis and transfusion > Flashcards

Blood constituents, haematopoiesis and transfusion Flashcards

1
Q

% plasma of total blood

A

55%

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2
Q

What is buffer coat and what % of total blood

A

Leukocyte and platelets

<1% total blood

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3
Q

% erythrocytes of total blood

A

45%

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4
Q

Haematocrit of normal blood

A

0.45

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5
Q

How much blood do adults have

A

5L

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6
Q

Haematopoiesis

A

Formation of blood cells
Multipotential haematopoietic stem cell (pluripotent) –> common myeloid progenitor and common lymphoid progenitor
Common myeloid progenitor –> Mekakaryocyte, erythrocyte (red cells), mast cell, myeloblast
Megakaryocyte –> thrombocytes (platelets)
Myeloblast –> basophil, neutrophil, eosinophil, monocyte (white cells)
Monocyte –> macrophages
Common lymphoid progenitor –> natural killer cell (large granular lymphocytes) and small lyphocyte
Small lymphocyte –> T lymphocyte and B lyphocyte (white cells)
B lymphocyte –> plasma cell (white cell)

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7
Q

Blood constituents

A

Red cells, platelets, white cells

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8
Q

Where does haematopoiesis occur?

A

In bone marrow
-children: all bones
-adults: axial skeleton (e.g. bertebrae, ribs, pelvis)
Embryo: yolk sac then liver and spleen

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9
Q

Stem cells are pluripotent

A

Self replicating

Differentiate into mature cells

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10
Q

Mature cells have a finite lifespan in blood

A

Red cells: 120 days
White cells: 6 hours
Platelets: 7-10 days
-old/ dying cells removed by spleen

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11
Q

What stimulates/ controls blood cell production?

A

Hormones

  • red cells: erythropoietin (EPO)
  • white cells: granulocyte colony stimulating factor (GCSF)
  • platelets: thrombopoietin (TPO)
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12
Q

Red cells

A

Simple cells with no nucleus or mitochondria
Biconcave disc to maximise SA to volume ratio - flexible
Contain haemoglobin - carries oxygen

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13
Q

How many red blood cells does blood contain?

A

4 x 10^12 /L

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14
Q

Haemoglobin

A

Tetramer of 4 polypeptide chains - 2 alpha and 2 beta (each contains molecule of haem)
Reversibly binds oxygen in lungs
Releases oxygen to tissues

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15
Q

Anaemia types

A

Low haemoglobin
Acute e.g. blood loss
Chronic e.g. vitamin deficiencies, sickle cell disease

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16
Q

Anaemia symtpoms

A

Fatigue
Dizziness
Pallor
Headaches

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17
Q

Polycythaemia

A 
> in red cells
-> erythropoietin
-hypoxia
< in plasma voume 
-dehydration
-smokers
18
Q

Platelets

A 
Tiny anucleate cells
Made from megakaryotes in bone marrow
Circulate in resting state
Bind to damaged vessel wall - plug hole
Stop bleeding
19
Q

Normal number of platelets in blood

A

140-400 x 10^9 /L

20
Q

Low platelets

A

Thrombocytopenia

  • platelets <80 increased risk of bleeding
  • platelets <20 spontaneous bleeding/ bruising
21
Q

High platelets

A

Thrombocytosis

> rates of arterial and venous thrombosis

22
Q

Neutrophils

A

Phagocytose and kill bacteria
> in bacterial infections (neutrophilia)
Release cytokines which cause symptoms e.g. temperature

23
Q

Low neutrophils

A

Neutropenia

e. g. after chemotherapy
- frequent and severe infections

24
Q

Lymphocytes

A

Fight viral infections
-e.g. high numbers (lymphocytosis) in EBV infection (glandular fever)
B cells make antibodies
T cells are cytotoxic/ helper cells

25
Q

Lack of lymphs

A

Results in immunodeficiency

-e.g. HIV virus infects CD4 T cells

26
Q

Plasma proteins

A

Vast majority albumin
-there to maintain oncotic pressure in blood and carries proteins
Carrier proteins for nutrients, hormones etc.
Immunoglobulins
Coagulation proteins

27
Q

Immunoglobulins

A

Produced by plasma cells in response to exposure to a foreign substance
Different classes (IgG, IgA, IgM, IgE)
Basis of vaccination

28
Q

Coagulation factors

A

Series of proteins that circulate in inactive form
Function is to make blood clot
Convert soluble fibrinogen into insoluble fibrin polymer

29
Q

Overactivity of coagulation factors

A

Thrombosis (formation of a blood clot inside a blood vessel, obstructing the flow of blood through the circulatory system)

30
Q

Failure of coagulation factors

A

Bleeding

31
Q

Blood transfusion

A

Red cells, platelets, plasma (fresh frozen plasma), white cells (very rarely), specific proteins e.g. clotting factors
Similar to tissue transplantation e.g. donors and recipients need to be matched to avoid rejection

32
Q

Red cell transfusion

A

Carry proteins on their surface (antigens) which differ between individuals
Inherited
Over 400 different systems of red cell antigens
2 most important: ABO and Rhesus

33
Q

ABO blood groups

A 
4 groups: A, B, AB, and ABO
Inheritance:
-O is recessive, so O = O,O
-A = AA or AO
-B = BB or BO
-AB = AB
34
Q

ABO blood groups UK population

A 
O = 45%
A = 40%
B = 12%
AB = 3%
35
Q

Rhesus blood groups

A 
Complex system of C, D and E antigens
D is most important
-D is dominant so DD or Dd = D positive
-d is a null product, dd = D negative
85% of population D positive
If you are D negative you can make anti D
36
Q

Blood groups

A

Make antibodies if exposed to antigens you don’t have
-blood tranfusion
-pregnancy
All transfusions are ABO and RhD compatible
Pregnant women given anti D to prevent sensitisation

37
Q

Advantages of blood transfusion

A

Can be life saving

Precious resource BUT can have serious, life threatening complications

38
Q

Indications for blood transfusion

A

Hypovolaemia due to blood loss
Severe anaemia with symptoms due to inadequate tissue oxygenation (transfusion trigger often = 80 g/L)
Anaemia that cannot be corrected by bone marrow function

39
Q

Blood transfusion not indicated for

A

Iron deficiency or B12/ folate deficiency.
Minor blood loss, especially if fit and healthy
Asymptomatic anaemia

40
Q

Risks of blood transfusion

A 
ABO incompatibility reaction – can be rapidly fatal
Delayed transfusion reactions
Febrile reactions, urticarial reactions
Fluid overload, pulmonary oedema
Infections:
-bacterial
-viral (HIV, hepatitis B and C)
-malaria
-prions (vCJD)
Long term – iron overload: damage to heart, liver

Exodontia (21 decks)

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