CLINICAL WORKSHOP- MENINGITIS: Haematology

Question 1

What is a physical response to infections?

Answer 1

bone marrow produces WBC 
change in white cells
more cytoplasmic vacuoles
more dohle bodies
more neutrophils

Question 2

What is the left shift of white cells in blood?

Answer 2

when the bone marrow produces a lot of white cells in response to severe infection, sometimes, less mature white cells appear in the blood

Question 3

What is toxic granulation?

Answer 3

see more granules in white cells than normal

neutrophils phagocytose organisms and these granules are released into them to lyse them

Question 4

What are cytoplasmic vacuoles and Dohle bodies?

Answer 4

light blue bodies that indicate that neutrophils are responding to infection

Question 5

In severe infections, we see something called disseminated intravascular coagulopathy. What is this?

Answer 5

deal with disseminated intravascular defects
in doing so, we use up clotting factors that help form the stable clot (clotting factors help convert fibrinogen to fibrin)

Question 6

What can you give to help with clotting?

Answer 6

patients with this can be given fibrinogen, clotting factors and platelets in order to help with clotting

Question 7

How does normal clotting work?

Answer 7

a lot of factors work together in order to convert prothrombin to thrombin

thrombin then acts on fibrinogen to make fibrin which is the clot

there are things in the body that dissolve and degrade fibrin as well

plasminogen is converted to plasmin which degrades the clot

this breakdown leads to a build up of fibrin degradation products (D-dimers)

this is one more thing that builds up in disseminated intravascular coagulopathy

Question 8

What do D-dimers do?

Answer 8

D-dimers are present in the body when massive clots are formed in the body and can also be used to diagnose diseases like DVTs or PE

Question 9

What do stimulatory molecules on cell surface of bacteria do?

Answer 9

trigger inflamm cells in body to be activated (monocytes, neutrophils, lymphocytes)
triggers cytokines release
causes fever

Question 10

What do liposaccharides do?

Answer 10

• damage endothelial cells= increase vascular permeability
  lead to hypotension and shock
• activate platelets and clotting factors
  cause DIC, thrombosis and bleeding
• affect the liver
  the liver normally ensures blood glucose levels constant•
• LPS along with other cytokines = lead to hypoglycemia All of this can make a person very ill very fast

Question 11

What causes red rash on skin?

Answer 11

Erythema=dilation of capillaries in skin
= blanching when using the glass on skin test
Purpura= blood leaks in the skin
= non-blanching when using the glass on skin test
Macules = flat red demarkations on the skin
Papules = raised rashes