Cells of the Blood Flashcards
How is Bone Marrow Sampled?
Aspiration - cytology
Trephine Biopsy - histology
Usually from Iliac Crest
What is the function of White Blood Cells?
What is the Life Expectancy of a White Blood Cell?
Combat Pathogens and other foreign substances that enter the body.
Live for a few hours to a few days
How are Red Blood Cells removed from the Circulation?
What is the Life Expectancy of a Red Blood Cell?
Phagocytic Macrophages in the Liver and the Spleen
120 days - wear and tear from squeezing through capillaries
What are the two arms of Haematopoeisis?
Myeloid and Lymphoid
What is the function of Neutrophils?
Phagocytosis
First on the scene
60-70% of WBCs
What is the function of Basophils?
Intensify inflammatory response in allergic reactions
What is the function of Eosinophils?
Combat effects of histamine in allergic reactions
Destroy certain parasitic worms
What is the function of Monocytes?
Convert to macrophages
Then phagocytosis
What is the function of lymphocytes?
B cells develop into plasma cells
Plasma cells sector antibodies
T cells attach invading viruses and cancer cells
NK cells attack a variety of infectious microbes
How are phagocytes attracted to microbes and inflamed tissues?
Chemotaxis
Chemoattractants and Chemorepellants
What is a Platelet?
Fragments of megakaryoctes, enclosed by a piece of plasma membrane
No nucleus
Megakaryocytes are huge cells in the red bone marrow which split into 2000-3000 fragments
Platelets stick together and to endothelium
What is the normal range for Haemoglobin concentration?
Male: 13.0-18.0 g/dL
Female: 11.4-16.5 g/dL
What is Mean Cell Volume?
What is the normal range for Mean Cell Volume?
A representation of how big the RBCs are
77-96 fL
What is the normal range for platelets?
150-400 x10^9/L
What is the normal range for White Blood Cells?
4-11 x10^9/L
What is the normal range for Neutrophils?
2.0-7.5 x10^9/L
What is the normal range for Lymphocytes?
1.3-4 x10^9/L
What would raised neutrophils indicate?
Bacterial Infection
What would a raised White Blood Cell count suggest in absence of infection?
Haematological Malignancy
What what raised lymphocytes suggest?
Viral Infection
What what raised eosinophils suggest?
Parasitic Infection
Hoe are Red Blood Cells made?
ERYTHROPOIESIS
In Red Bone Marrow
Proerythroblast -> ejects nucleus -> Reticulocyte
Stimulated by Erythropoietin
Released by the kidneys in response to reduced oxygen supply to the kidneys and other organs
Where is Red Bone Marrow found?
Axial Skeleton
Head, trunk, epiphyses of femur and humerus, pectoral and pelvic girdles
What is Anaemia?
Absolute reduction in Haemoglobin
<13.5g/dL in men
<11.5g/dL in women
What is Microcytic anaemia and what are the causes?
Anaemia with Low MCV (<77)
Iron Deficiency
excessive loss, dietary inadequacy, failure of absorption, excessive demands
What is Normocytic anaemia and what are the causes?
Anaemia with normal MCV
(77-95)
Recent Bleeding
Chronic disease (kidneys-EPO)
Preganancy
What is Macrocytic anaemia and what are the causes?
Anaemia with high MCV (>95)
B12 deficiency
Pernicious anaemia (intrinsic factor antibodies, unable to absorb B12)
Folate Deficiency
Alcohol Excess
What fluid is given to known alcoholics in A&E?
Pabrinex
Multivitamins, B12, folate
Where is Vitamin B12 obtained from?
How is Vitamin B12 absorbed?
Meat, eggs and dairy
Binds to intrinsic factor in the stomach then absorbed in the terminal ileum
Where is Folate obtained from?
Green leafy vegetables, nuts and liver
What is Acute Lymphoid Leukaemia?
Who is it seen in most commonly?
B or T cell Malignancy
Good Prognosis - goes down as age goes up
Commonest childhood cancer
What is Acute Myeloid Leukaemia?
How is it treated?
Who is it seen in most commonly?
High neutrophils, basophils and eosinophils
Intensive Chemotherapy
Most common leukaemia in adults
What is Chronic Lymphoid Leukaemia?
How is it treated?
Who is it seen in most commonly?
B and T cell malignancy
Asymptomatic in 90% at presentation (seen in routine FBC)
Non-curative management
Disease of the elderly, especially males
What is Chronic Myeloid Leukaemia?
How is it treated?
Who is it seen in most commonly?
Insidious presentation - splenomegaly
Philadelphia chromosome in >80%
Treated with imatinib (monoclonal antibody to suppress bone marrow)
Typically 40-60 year olds
What is lymphoma?
What are the two types?
Malignant tumour of the lymphatic system
Hodgkin’s and Non-Hodgkin’s
How is Hodgkin’s lymphoma characterised?
Histologically - multinucleate giant cells - Reed-Sternberg cells
Present with an enlarged lymph node, typically lower neck or supraclavicular
B Symptoms - drenching night sweats, fever and weight loss
What is the prognosis of Non’Hodgkin’s Lymphoma?
Low Grade - good prognosis but not usually curable
High Grade - More aggressive but usually curative
What is Myeloma?
Who does it affect most commonly?
How does it present?
What tests are done?
How is the diagnosis confirmed?
Malignant proliferation of plasma cells
Increased osteoclastic activity - bone marrow destruction and bone marrow failure
Incurable, relapsing/remitting disease
Generally effect older people
Bone Pain (back ache)
Hypercalcaemia (breakdown of bone)
Anaemia
Renal Impairment
Urine Protein Electrophoresis
looking for Bence-Jones protein
Bone marrow sample and skeletal survey
Hypercalcaemia Symptoms
Bones - bone pain
Groans - constipation, abdominal pain
Stones - renal stones
Moans - depression
