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Haematology > Cells of the Blood > Flashcards

Cells of the Blood Flashcards

1
Q

What makes up blood

A

Plasma
Buffy coat
Red blood cells (50%)

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2
Q

What cells are in the plasma

A

Clotting factor
Albumin
Antibodies

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3
Q

What cells are in the Buffy coat

A 
Platelet
White cells (leucocytes)
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4
Q

What is the function of blood

A 
Transport oxygen and CO2
Transport nutrients, waste and hormones
Prevent abnormal bleeding and clots 
Phagocytosis 
Antigen recognition and Ab formation
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5
Q

What causes haematological abnormalities

A

High levels of cells
Low levels of cells
Altered function of cells

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6
Q

What is the process of cell formation

A

Haematopoiesis

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7
Q

Where do all cells develop from

A

Pluripotent haematopoetic stem cells in bone marrow

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8
Q

What do lymphocytes form from

A

Lymphoid progenitor cell
Branch of early
NK cells produced
Develop into T or B cells for immune function
B cells then differentiate into plasma cells which make Ab as part of normal immune

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9
Q

What do the other cells form form

A

Myeloid progenitor cell

All cells apart from lymphocytes are myeloid cells

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10
Q

How are RBC formed

A

Erythroblast - contain nucleus
Reticulocyte just before it is released into circulation
Erythrocyte = RBC

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11
Q

What controls formation of RBC

A

Erythropoietin

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12
Q

Where is erythropoietin produced

A

Kidney in response to hypoxia so anaemia in CKD

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13
Q

What are platelets produced from

A

Megakaryocyte

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14
Q

What regulates platelet formation and where is it produced and what is major role and what is the life cycle

A

Thrombopoietin
Produced in the liver
Important role in blood clotting and haemostasis
After 7-10 days platelets leave blood vessel and enter liver / spleen where they are broken down by macrophages

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15
Q

Where is bone marrow found in children and elderly

A 
Children = mostly all bones
Elderly = axial
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16
Q

Where do other cells come from

What cell doesn’t and where does this come from

A

Myeloblast

EXCEPT mast cells which differentiate from myeloid progenitor themselves

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17
Q

What are neutrophils controlled by

A

Interluekin

G-CSF’s

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18
Q

What is the function of neutrophils

A

Ingest and destroy pathogens by phagocytosis

Bacteria and fungi

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19
Q

What are the functions of monocytes

A 
Ingest and destroy pathogens by phagocytosis 
Release cytokines 
Activate other cells of immune 
Differentiate into macrophage in tissue 
Bacteria and fungi
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20
Q

What do monocytes differentiate into

A 
Macrophages in tissue
Kuppfer cells in liver
Langerhans in skin
Brain migrogilia 
Dendritic cells - APC that take up antigen and present on cell surface (have both MHC 1 and 2)
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21
Q

What are eosinophils important in and what are they unable to do
When are eosinophils increased

A

Parasites and allergies
Exocytosis of granules containing cytokines and toxins
Phagocytose (not really)

Increased in

  • drug reactions
  • allergies / atopy
  • parasitic infection
  • skin disease
  • Chrug Strauss
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22
Q

What other cells are important in dealing with parasites

A

Mast cells

Basophils

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23
Q

What causes thrombocytosis (neutrophilia as well)

A

Primary due to overproduction in marrow

  • Myeloproliferative = most common (all 4)
  • Myeloid malignancy
Secondary
Infections
Inflammation - IBD/ RA
Post surgical / trauma / bleeding
Iron deficiency anaemia
Malignancy - lung Ca / NHL etc.
Previous splenectomy
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24
Q

What causes thrombocytopenia

A

Bone marrow failure

  • Malignancy
  • Chemotherapy
  • Aplastic anaemia
  • Vit b12 / folate deficiency

Increased destruction

  • ITP / TTP = severe
  • Alcohol
  • Drugs
  • Hypersplensim

Increased consumption

  • DIC / Haemorrhage = severe
  • Sepsis
  • Pancreatitis
  • Pregnancy

Autoimmune

  • ITP
  • RA
  • SLE
  • Anti-phospholipid

Not produced
- Hepatic failure

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25
Q

What causes neutrophilia

A

Primary to overproduction in marrow

  • Myeloproliferative
  • Myeloid malignancy
Secondary 
Infection
Inflammation / stress - MI / post-op / RA / burns 
Tissue damage
Malignancy 
Drugs e.g. steroid
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26
Q

What causes neutropenia

A 
Marrow failure
Sepsis / Autoimmune   = increased consumption 
Drugs 
Granulomatous disease 
Hyeprsplenism - Felty
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27
Q

What causes lymphocytosis (increased lymphocytes)

A

Leukaemia and lymphoma - particularly CLL
Chronic infection - TB / brucellosis / hepatitis / Pertussis
EBV / HIV
Inflammation - RA

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28
Q

What causes lymphopenia

A 
Bone marrow failure 
Autoimmune
HIV 
Drugs 
Post viral 
Transplant 
GVHD
Post chemo / RT
Steroids
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29
Q

How does RA affect the blood

A 
Anaemia 
Iron / folate deficiency 
Immune haemolysis
Neutropenia 
Immune thrombocytopenia
Cytopenia due to Rx
Felty syndrome - HSM, neutropenia, RA
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30
Q

What is the ranges of Hg in M

<70 and >70

A

135-170

116-156

31
Q

What is the ranges of Hg in F

<70 and >70

A

120-160

108-143

32
Q

What should RBC be

A

4-5 x10^12

33
Q

What should platelets be

A

150-400

34
Q

What should WBC be

A

4-10

35
Q

What should neutrophils be

A

1.5-7

36
Q

What should lymphocytes be

A

1.5-4

37
Q

What should monocytes be

A

0.2-0.8

38
Q

What should eosinophils be

A

0.1-0.5

39
Q

What should basophils be

A

0.01-0.1

40
Q

What are the main haematological tests

A 
FBC
Blood film 
Bleeding time 
Reticulocyte count 
Chemical assay - iron, B12, folate
Marrow aspirate
LN biopsy
Imaging
41
Q

How do you treat haematological problems

A 
Blood transfusion
Haematinics - iron / b12 / folate
Coagulation factor
Plasma exchange
Transplant - stem cell / bone marrow 
Cytotoxic drugs
Immunosupression 
Inhibitors of coagulation / fibrinolysis
42
Q

What is the spleen

A

Acts as a blood filter
Red pulp where RBC go to mature
White pulp for immune function

43
Q

What does hypersplenism cause

A

Pancytopenia (lower number of all cells)

44
Q

What does hyposplenism cause

A

Infection with encapsulated bacteria
Red cell changes - Howel Jolly
Requires immunisation and Az

45
Q

What are causes of splenomegaly (enlargement of spleen)

A

Infections
Leukaemia + lymphoma
Myeloproliferative disorder
Portal hypertension 2 to cirrhosis
Haemolytic disorders
Autoimmune - SLE / Felty / RA / sarcoid/. amyloid
Storage pool disorder - Hauchers / Niemann-Pick

46
Q

What haemolytic disorders cause splenomegaly

A 
Congenital anaemia's
- Heriditary spherocytosis
- Thalassaemia
- Sickle cell
Megaloblastic anaemia
Haemolytic anaemia - often warm AB 
Autoimmune
47
Q

What infections cause splenomegaly

A

Acute - EBV / CMV
Chronic bacteria - TB / brucella
Parasitic - malaria / schistosomiasis

48
Q

What disorders cause massive splenomegaly

A 
Myelofibrosis
CML
Malaria
Gaucher
Visceral leishmaniasis
49
Q

What does target cell on blood film suggest

A 
Sickle cell
Thalasseamia
Iron deficiency anaemia
Hyposplenism / post-splenectomy 
Liver disease
50
Q

What does tear drop poikilocytes

A

Myelofibrosis

51
Q

What does spherocytes suggest

A

Hereditary spherocytosis

Autoimune haemolytic anaemia

52
Q

What does basophilic stippling suggest

A

Lead poison
Thalassemia
Sideroblastic anaemia
Myelodysplasia

53
Q

What do Howell-Jolly bodies suggest

A

Hyposplenism

Severe anaemia

54
Q

What do Heinz bodies suggest

A

G6PD deficinecy

Thalassemia

55
Q

What do schistocytes ‘helmet cell’ suggest

A 
Intravascular haemolysis
HUS
DIC
TTP 
Mechanical heart valve
56
Q

What do pencil poikilocytes suggest

A

Iron deficiency anaemia

57
Q

What do Burr cells suggest

A

Uraemia

Pyruvate kinase deficiency

58
Q

What do hypersegmented neutrophils suggest

A

Megaloblastic anaemia - b12 / folate

59
Q

Look at differentiation from multi potential stem cell

A

OK - immunological notes

60
Q

Reed Sternberg

A

Hodkin’s lymphoma

61
Q

Smudge

A

CLL

Also spear

62
Q

Rouleux

A

MM

63
Q

Auer rods

A

AML

64
Q

What do you get after splenectomy

A 
Immunisation - 2 weeks before or 2 weeks after  
- Pneumococcal every 5 years 
- H.influeza
- Meningococcal A+C 
- Annual infleunza
Life long Ax - penicillin or amoxicillin
65
Q

Indications for splenectomy

A 
Trauma
Spontaneous rupture - EBV 
Hypersplenism
- Hereditary spherocytosis 
- Autoimmune haemolytic (warm) 
Malignancy 
Cyst / abscess
66
Q

What causes hyposplenism

A 
Splenectomy
Sickle cell
Coeliac
Graves
SLE
Amyloid
67
Q

What do sideroblasts suggest

A

Myelodysplastic syndrome

68
Q

What organisms common post splenectomy

A

Pneumoccocus
H.influenza
Meningococcal

69
Q

Complications post splenectomy

A

Haemorrhage
Infections
Thrombocytosis - give aspirin
Pancreatic fistula

70
Q

What changes to RBC

A

Howel Jolly

Target cells

71
Q

Can WBC be normal in infection

A

Yes cause recruited but also used up

72
Q

What happens if bone marrow destroyed

A

Extra-medullatry sites take over
e.g spleen for RBC production
Can result in RBC looking different and splenomegaly

73
Q

Starry sky

A

Burkitt lymphoma

Haematology (13 decks)

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