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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
What causes neutrophilia
Primary to overproduction in marrow - Myeloproliferative - Myeloid malignancy ``` Secondary Infection Inflammation / stress - MI / post-op / RA / burns Tissue damage Malignancy Drugs e.g. steroid ```
26
What causes neutropenia
``` Marrow failure Sepsis / Autoimmune = increased consumption Drugs Granulomatous disease Hyeprsplenism - Felty ```
27
What causes lymphocytosis (increased lymphocytes)
Leukaemia and lymphoma - particularly CLL Chronic infection - TB / brucellosis / hepatitis / Pertussis EBV / HIV Inflammation - RA
28
What causes lymphopenia
``` Bone marrow failure Autoimmune HIV Drugs Post viral Transplant GVHD Post chemo / RT Steroids ```
29
How does RA affect the blood
``` Anaemia Iron / folate deficiency Immune haemolysis Neutropenia Immune thrombocytopenia Cytopenia due to Rx Felty syndrome - HSM, neutropenia, RA ```
30
What is the ranges of Hg in M | <70 and >70
135-170 | 116-156
31
What is the ranges of Hg in F | <70 and >70
120-160 | 108-143
32
What should RBC be
4-5 x10^12
33
What should platelets be
150-400
34
What should WBC be
4-10
35
What should neutrophils be
1.5-7
36
What should lymphocytes be
1.5-4
37
What should monocytes be
0.2-0.8
38
What should eosinophils be
0.1-0.5
39
What should basophils be
0.01-0.1
40
What are the main haematological tests
``` FBC Blood film Bleeding time Reticulocyte count Chemical assay - iron, B12, folate Marrow aspirate LN biopsy Imaging ```
41
How do you treat haematological problems
``` Blood transfusion Haematinics - iron / b12 / folate Coagulation factor Plasma exchange Transplant - stem cell / bone marrow Cytotoxic drugs Immunosupression Inhibitors of coagulation / fibrinolysis ```
42
What is the spleen
Acts as a blood filter Red pulp where RBC go to mature White pulp for immune function
43
What does hypersplenism cause
Pancytopenia (lower number of all cells)
44
What does hyposplenism cause
Infection with encapsulated bacteria Red cell changes - Howel Jolly Requires immunisation and Az
45
What are causes of splenomegaly (enlargement of spleen)
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
What haemolytic disorders cause splenomegaly
``` Congenital anaemia's - Heriditary spherocytosis - Thalassaemia - Sickle cell Megaloblastic anaemia Haemolytic anaemia - often warm AB Autoimmune ```
47
What infections cause splenomegaly
Acute - EBV / CMV Chronic bacteria - TB / brucella Parasitic - malaria / schistosomiasis
48
What disorders cause massive splenomegaly
``` Myelofibrosis CML Malaria Gaucher Visceral leishmaniasis ```
49
What does target cell on blood film suggest
``` Sickle cell Thalasseamia Iron deficiency anaemia Hyposplenism / post-splenectomy Liver disease ```
50
What does tear drop poikilocytes
Myelofibrosis
51
What does spherocytes suggest
Hereditary spherocytosis | Autoimune haemolytic anaemia
52
What does basophilic stippling suggest
Lead poison Thalassemia Sideroblastic anaemia Myelodysplasia
53
What do Howell-Jolly bodies suggest
Hyposplenism | Severe anaemia
54
What do Heinz bodies suggest
G6PD deficinecy | Thalassemia
55
What do schistocytes 'helmet cell' suggest
``` Intravascular haemolysis HUS DIC TTP Mechanical heart valve ```
56
What do pencil poikilocytes suggest
Iron deficiency anaemia
57
What do Burr cells suggest
Uraemia | Pyruvate kinase deficiency
58
What do hypersegmented neutrophils suggest
Megaloblastic anaemia - b12 / folate
59
Look at differentiation from multi potential stem cell
OK - immunological notes
60
Reed Sternberg
Hodkin's lymphoma
61
Smudge
CLL | Also spear
62
Rouleux
MM
63
Auer rods
AML
64
What do you get after splenectomy
``` 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
Indications for splenectomy
``` Trauma Spontaneous rupture - EBV Hypersplenism - Hereditary spherocytosis - Autoimmune haemolytic (warm) Malignancy Cyst / abscess ```
66
What causes hyposplenism
``` Splenectomy Sickle cell Coeliac Graves SLE Amyloid ```
67
What do sideroblasts suggest
Myelodysplastic syndrome
68
What organisms common post splenectomy
Pneumoccocus H.influenza Meningococcal
69
Complications post splenectomy
Haemorrhage Infections Thrombocytosis - give aspirin Pancreatic fistula
70
What changes to RBC
Howel Jolly | Target cells
71
Can WBC be normal in infection
Yes cause recruited but also used up
72
What happens if bone marrow destroyed
Extra-medullatry sites take over e.g spleen for RBC production Can result in RBC looking different and splenomegaly
73
Starry sky
Burkitt lymphoma

Haematology (13 decks)

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