Blood- diseases

Question 1

What is Haematocrit?

Answer 1

The proportion of cells to liquid in the blood.

If this is very high, the blood is too viscous and this leads to blood clotting problems.

Also known as HCT

Question 2

What is anaemia?

Answer 2

A low haemoglobin count

Question 3

What is leukopenia?

Answer 3

A low white blood cell count

Question 4

What is pancytopenia?

Answer 4

A reduction in the number of all cells.

Question 5

If there is a shortage of more than one cell type then….

Answer 5

The bone marrow is failing.

Question 6

What is Polycythaemia?

Answer 6

Raised hameoglobin levels

Question 7

What is leukocytosis?

Answer 7

A raised white blood cell count

Question 8

What is thrombocythaemia?

Answer 8

A raised platelet count.

Question 9

When there is overproduction of multiple cell types..

Answer 9

It is preneoplastic (precancerous)

Question 10

Compare leukaemia and lymphoma

Answer 10

Leukaemia is the production of neoplastic white blood cells in circulation.

A lymphoma is the production of neoplastic white blood cells that form a tumour

Question 11

Why do we use Blood transfusions>

Answer 11

• To quickly replace blood when it is lost.
• When the patient’s bone marrow cannot produce blood cells.

Question 12

Why do you need to test the blood sample of donated blood before completing a blood transfusion?

Answer 12

As there are other less common antibiodies that could make the blood incompatable

Question 13

What are the 3 components needed to stop bleeding?

Answer 13

1. Vascular component (retraction of the vessel)
2. Cellular component (the number and function of the platelets)
3. Coagulation component (adequate clotting and clot lysis)

Question 14

What investigations are used for haemostasis?

Answer 14

FBC- platelet numbers

Bleeding time

INR- ability of protein to produce prothrombin and thrombin (this is the international normalised ratio)

LFT- checking if the liver has produced clotting factors.

Question 15

what is haemophilia?

Answer 15

The inability of a person to clot.

This is X linked recessive (females are carriers. males suffer)

Question 16

What is thrombophilia?

Answer 16

When the patient has an excessive tendency to clot

Question 17

What is therapeutic Coagulopathy?

Answer 17

Where the coagulation system is manipulated to make clotting less likely. By:

• reducing platelet adhesion and function
• Reducing activity in the coagulation cascade.

We use antiplatelets and anti-coagulants for this.

Question 18

What is Porphyria

Answer 18

Bad

Abnormality of haem metabolism.

Question 19

What are the types of anaemia?

Answer 19

• When you don’t make enough red blood cells (bone marrow issue)
• When you make enough red blood cells but not enough haemoglobin to go in them. (deficency in blood constituents)

Question 20

What type of RBC are shown here?

Answer 20

Microcytic RBC are Cells that are smaller than they should be.

This is caused by Iron deficency and Thalassaemia

Question 21

What type of rbc?

Answer 21

Normacytic red blood cells,

where they are normal sized.

anaemia in this patient is caused by:

• Bleed
• Renal disease
• Chronic disease.

Question 22

What type of RBC?

Answer 22

Macrocytic RBC are larger rbc. They have not shrunk enough

These are caused by a B₁₂ or folate deficiency.

Question 23

What type of RBC

Answer 23

Reticuloyctes.

These are almost mature red blood cells that are released into circulation to replace losses.

Question 24

What are haematinics?

Answer 24

The things used to make RBC:

Vitamin B₁₂

Iron

Folic acid.

Question 25

How do we measure how much iron is in the body?

Answer 25

By measuring ferratin counts.

Question 26

How could a patient be iron deficient?

Answer 26

You can lose iron by bleeding.

Question 27

How could a patient be Vitamin B₁₂ deficient?

Answer 27

Through Veganism or a lack of intrinsic fibre (which is needed to work with the VitB₁₂)

Question 28

How could a patient be folic acid deficient?

Answer 28

Due to a lack of intake or absorption failure.

Question 29

What is Thalassaemia?

Answer 29

When there is normal haem production but there is a genetic mutation of the globin chain.

Question 30

How do we treat thalassaemia?

Answer 30

By giving the patient haemoglobin to subsitute for the haemoglobin they are missing.

Question 31

What is shown here?

Answer 31

Sickle cell anaemia Where a low oxygen environment has caused the RBC shape to change.

Question 32

How do we diagnose anaemia?

Answer 32

* Iron?- is it in normal range * Red cell count and haemocrit?- does the patient have a cell or haemoglobin formation deficency? * MCV image?- What is the likely deficency.

Question 33

How do you treat anaemia?

Answer 33

* Replace haematinics (200mg of FeS0₄ / 1mg IM VitB₁₂/ 5mg folic acid * Replace erythropoietin (To produce RBC) * Transfusions

Question 34

If the patient who is diagnosed with anaemia's blood test shows they have a small MCV what does this mean?

Answer 34

The patient has microcytic blood cells & So the anaemia could be caused by * iron deficency * Thalassaemia

Question 35

If the patient who is diagnosed with anaemia's blood test shows they have a normal MCV what does this mean?

Answer 35

They have normocytic blood cells & The anaemia could be caused by: * a bleed * Renal disease * Chronic disease

Question 36

If the patient who is diagnosed with anaemia's blood test shows they have a large MCV what does this mean?

Answer 36

The patient has macrolytic red blood cells & The anaemia could be caused by: * B₁₂ deficency * Folate deficency

Question 37

A patient diagnosed with anaemia has the following medical history. What do you think of this?

Answer 37

Naproxen is a NSAID. These can cause ulcers. Therefore, the patient may be anaemic due to an ulcer (bleed) We would want to scope them to check for an ulcer. & Check the MCV in the patient's blood test.

Question 38

How do we absorb iron?

Answer 38

Through the jejunum of the small intestine

Question 39

What is the risk of being Vitamin B₁₂ deficient?

Answer 39

The patient's nerve function can be damaged. (can get a poly neuropathy)

Question 40

What do you have to check for patients on warfarin in their blood test?

Answer 40

The patients INR as warfarin affects the prothrombin time.

Question 41

Compare an acute disease and a chronic disease.

Answer 41

An acute disease is an issue now. (lifethreatening). A chronic disease will be an issue in the future (long term like 'chronic' which is a longer word)