Clinical haematology Flashcards
What does the colour of a RBC indicate?
- 1/3 of the cell needs to be white to be normal
- largely a uniform size between them all
What causes a high WBC count? Leukocytosis
- infection
- post op, or traumatic event
- leukaemia
What causes a low WBC count? Leukopenia
- chemotherapy: neutropenia —> sepsis - Drugs - Severe infection - Immune disorders
What are neutrophils?
- common phagocytic cells
- increase with bacterial infection
- most common
How do Lymphocytes respond to reaction?
- increase during viral infection - can appear reactive or atypical
How do children’s WBC count differ from and adults?
- children have a reversed differential - higher lymphocytes than neutrophils: immune system is still developing up to around age 10
What is the Erythrocyte Sedimentation Rate ?
- how long does it take for the RBC take to sediment - an increase in acute phase proteins causes faster sedimentation - non-specific
How do Babies blood counts present differently?
- higher Hb - HIgher WBC and Hct/PCV - HIgher WBC
How do children’s blood count present differently?
- lower Hb - reversed differential
How does ethnicity affect the blood count results?
Africans/ Afro caribbeans - lower neutrophil - slightly lower platelet counts
What are some causes of Normocytic Anaemias?
- Blood loss - Chronic diseases - Renal failure, decreased Epo production - other acute reasons ( usually in 20’s)
What are some causes of Microcytic Anaemia?
- Iron deficiency - Thalassaemia
What are some causes non-megaloblastic Macrocytic anaemias?
- Large RBC with no DNA involvement
- Alcohol
- Liver Disease
What are some causes of megaloblastic macrocytic anaemia?
- Large RBC with DNA affected
- B12 & Folate deficiency
- Chemotherapy
- AZT ( HIV treatment)
What are the clinical symptoms of B12 and folate deficiency?
- weight loss
- fatigue
- Glossitis (swollen tongue)
- jaundice
- dementia
- paraesthesia
- neuropathy
Define Poikilocytosis.
variation in RBC shape
Define Anisocytosis.
Variation in RBC size
Define Dimorphic RBC.
- responding anaemia or post-transfusion, where there is a variety of different RBCs
What is Thrombocytopenia and what are its two presenting forms?
Low platelets due to
> Decreased production
- Congenital (rare)
- Acquired: BM damage due to drugs, Alchohol, Blood malignancy
> Increased destruction
- Congenital ( from maternal antibodies)
- Aquired: ITP (idiopathic), Infections, drug-induced
Describe the morphology and occurrence of left-shifted immature neutrophils.
- during infections, Myeloproliferative disorders (MPD), Leukemias
Describe the morphology and occurrence of Toxic granulation
- Acute infection
- dark granulated cytoplasm
Describe the morphology and occurrence of Mylocytes v. Immature
- Severe Infections
- Leukemias
- BM
Describe the morphology of hypersegmented (right-shifted) neutrophils
- Megaloblastic conditions
- B12 & Folic acid deficiency
- multilobular in appearance
What is Lymphocytosis and when would it present?
- higher than normal lymphocyte levels in an FBC or in a blood film
Presents in
- Viral infections: measles, chickenpox, IM
- Some bacterial infections
- Stress-related: Post MI
- Vigorous exercise
- smoking
- LPD’s i.e CLL (chronic lymphatic leukaemia)
