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2 - Diseases Of The Human System > Blood Diseases - 1 > Flashcards

Blood Diseases - 1 Flashcards

1
Q

What are the functions of blood?

A
  • transport of nutrients
  • removal of waste
  • transport host defences
  • ability to carry nutrients/waste/defences
  • ability to self repair
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2
Q

What are the components of blood?

A

plasma
RBCs
WBCs
platelets

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3
Q

What are the major types of plasma proteins and what are their functions?

A

Albumin (osmotic pressure)
Globulins (antibodies, transport proteins)
Fibrinogens (blood clotting)
Other (various roles)

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4
Q

What are the abbreviations used in medicine?

A
  • FBC - Full Blood Count
    – Includes ALL of the values below
  • RBC - red blood cells
    – Sometimes referred to as the RCC - red cell count
  • WCC - white cell count
  • PLT - Platelets
  • HCT - Haematocrit
  • MCV - Mean Cell Volume
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5
Q

What is low Hb called?

A

anaemia

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6
Q

What is low WCC called?

A

leukopenia

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7
Q

What is low platelets called called?

A

thrombocytopenia

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8
Q

What is it called when all cells are reduced in the blood?

A

pancytopenia

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9
Q

What does one decreased change in blood count mean?

A

reactive change to the environment

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10
Q

What do multiple decreased changes in blood count mean?

A

bone marrow failure

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11
Q

What is raised Hb called?

A

polycythaemia

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12
Q

What is raised WCC called?

A

leukocytosis

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13
Q

What is raised platelets called?

A

thrombocythaemia / thrombocytosis

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14
Q

What does one increased change in blood count mean?

A

reactive or pre-neoplastic

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15
Q

What do multiple increased changes in blood count mean?

A

pre-neoplastic (myelodysplasia)

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16
Q

What is leukaemia?

A

neoplastic blood malignancy
proliferation of white cells
Usually disseminated

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17
Q

What is lymphoma?

A

neoplastic blood malignancy
proliferation of white cells
a solid tumour

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18
Q

What lineage is the origin of all leukocytes excluding lymphocytes?

A

myeloid stem cells

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19
Q

What lineage is the origin of lymphocytes?

A

lymphoid stem stells

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20
Q

Why is awareness of linage important?

A

cancers derived from different lineages behave differently

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21
Q

What is important to note about blood cancers?

A
  • Any haematological cell line can turn neoplastic at a number of stages
  • The earlier in the cell line this occurs the more potentially aggressive the malignancy
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22
Q

What are the lymphoid blood cancers? acute/chronic

A

Acute lymphoblastic leukaemia
Chronic lymphocytic leukaemia
Hodgkin lymphoma
Non-Hodgkin Lymphoma
Multiple myeloma

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23
Q

What are the myeloid blood cancers? acute/chronic

A

Acute myeloid leukaemia
Chronic myeloid leukaemia
Myeloproliferative disorders

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24
Q

What is porphyria?

A

abnormality of haem metabolism

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25
Q

What are the main groups of porphyria?

A

– Hepatic porphyrias
– Erythropoietic porphyrias

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26
Q

What is the dentally clinically relevant porphyrias type?

A
  • Acute intermittent (AIP)
    – Triggered by medicines including LA
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27
Q

What are the clinical effects of porphyria?

A
  • Photosensitive rash (at any time)
  • Neuropsychiatric disturbance in acute attacks
  • Hypertension & tachycardia

may be fatal

28
Q

What are the two reasons a blood transfusion may occur?

A

o Where one or more components of the blood has to be replaced quickly
- Red cells, platelets, Clotting factors (fresh frozen plasma)

o Where the bone marrow cannot produce blood cells
- Red cells, platelets

29
Q

When would the whole blood be replaced?

A

when patient is losing blood volume very quickly

30
Q

What is the ABO system?

A
  • A: Red blood cells have A antigens.
  • B: Red blood cells have B antigens.
  • AB: Red blood cells have both A and B antigens.
  • O: Red blood cells have neither A nor B antigens.
31
Q

What is the D system?

A

the rhesus factor
can be + or -
important with maternal compatibility

32
Q

What may be detected at the cross matching stage?

A

other cell surface antigens that are irregular

33
Q

When should a blood transfusion be given?

A
  • Blood loss
  • Specific production problems with -
  • RBC, Platelets
  • Plasma proteins
  • clotting factors, albumin, gamma globulins
34
Q

What can happen during transfusions?

A
  • Transfusion reactions
  • Transmission of infection – not yet detected types
35
Q

What are surface antigens made off?

A

combination of different chain sugars

36
Q

What will happen in cross-matching testing if the blood has antibodies for the transfused blood?

A

agglutination

37
Q

What are tranfusion complications?

A
  • Incompatible blood -RBC lysis
    -Fever, jaundice, death!
  • Fluid overload - Heart failure
  • Transmission of infection
38
Q

What is anemia?

A
  • Anaemia is a reduction in HAEMOGLOBIN in the blood from the NORMAL values for that population
39
Q

What are the two ways anemia can arise?

A
  • Haemoglobin issues can be from an inability to make the HAEM (usually iron deficiency) or inability to make the correct GLOBIN chains – can be Thalassemia, Sickle Cell or other ‘haemoglobinopathies’
40
Q

What can the size of the red blood cells indicate?

A

the size of the red blood cells (MCV) can give a clue as to the CAUSE of the anaemia

41
Q

What does anaemia have nothing to do with?

A

Anaemia is nothing to do with the numbers of red blood cells – anaemia can happen with too many OR to few red cells

42
Q

What are the problem anemia causes?

A

o reduced PRODUCTION
o increased LOSSES
o increased DEMAND

43
Q

Why would there be reduced RBCs?

A

marrow failure

44
Q

Why would there be reduced Hb?

A
  • deficiency states - Fe, Folate, Vit B12
  • abnormal globin chains
    oThalassaemia
    oSickle Cell
  • chronic inflammatory disease
45
Q

What is aplastic marrow?

A

bone marrow cannot make enough RBCs resulting in aplastic anaemia

46
Q

What are haematinics?

A

things used to make the red blood cells

47
Q

What are the 3 haematinic deficiencies?

A
  • Iron
  • Vitamin B12
  • Folic Acid (folate)
48
Q

What are the sources of iron?

A

meat
green leafy veg
iron tablets

49
Q

How is heme iron absorbed?

A

transported directly through intestinal cell walls in heme transporters

50
Q

How is non-heme (Fe3+) iron absorbed?

A

cannot be absorbed and requires conversion to Fe2+ by stomach acid to be transported through intestinal cell wall

51
Q

What are both types of iron stored as in the intestine?

A

ferritin

52
Q

What are diseases reducing iron absorption?

A
  • Achlorhydria - Lack of stomach acid no conversion of non-haem iron
    may be Drug induced (Proton Pump Inhibitors) (lansoprazole, omeprazole)
  • Coeliac Disease
53
Q

What are vitamin B12 sources?

A

Milk and diary
Eggs
Meat
Fish
Poultry

54
Q

How are vitamin B12 supplements given?

A

injections
oral

55
Q

Diseases that affect folic acid absorption also affect…

A

iron absorption

56
Q

What are the reasons for vitamin B12 deficiency?

A
  • Lack of intake – strict vegans
  • Lack of intrinsic factor
  • Autoimmune stomach disease – Pernicious anaemia
  • Gastric disease
  • Disease of terminal Ilium
  • Crohn’s disease
57
Q

What are folic acid sources?

A

leafy green veg

58
Q

What are the reasons for folic acid deficiency?

A
  • Lack of intake
  • Peculiar diet habits
  • Absorption failure
  • Jejunal disease – coeliac disease
  • Usually seen co-deficient with iron
59
Q

What can folic acid deficiency lead to in fetal life?

A

neural tube defects
- spina bifida

60
Q

How can haematinic deficiencies be recognised?

A

blood tests

61
Q

What are b globin chains better at?

A

better at removing oxygen from maternal circulation for babies needs

62
Q

What is thalassaemia?

A

normal haem production Genetic mutation of globin chains

Alpha chains (alpha thalassaemia) in Asians

Beta chains (beta thalassaemia) in Mediterraneans

63
Q

What are the clinical effects of thalassaemia?

A

Chronic anaemia

Marrow hyperplasia (skeletal deformities)

Splenomegaly

Cirrhosis

Gallstones

64
Q

What is the management of thalassamia?

A

blood transfusions

65
Q

What is important to prevent during blood transfusions as treatment in thalassemia in regards to the liver?

A

prevent iron overload leading to cirrhosis as there is normal haem production

66
Q

What is sickle cell anaemia?

A

Abnormal B Globin chains
* Change shape in low oxygen environments
* Prevent RBC from passing through the capillaries
* Tissue ischaemia – pain and necrosis
* Heterozygous (sickle cell trait)
* Homozygous (sickle cell disease)

2 - Diseases Of The Human System (19 decks)

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