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BDS2 BAMS > Diseases of the blood > Flashcards

Diseases of the blood Flashcards

1
Q

Function of blood

A
  • Transport oxygen, Nutrients
  • Remove waste
  • Transport host defenses
  • Ability to carry
  • Ability to self repair
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2
Q

Components of blood

A

45% cells (rbc wbc platelets)
55% plasma (proteins, water, electrolytes, lipids, nutrients)

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3
Q

what are thrombocytes

A
  • Platelets = thrombocytes
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4
Q

functions of the plasma proteins

A

Albumins = osmotic pressure

Globulins = antibodies and transport proteins

Fibrinogens = blood clotting

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5
Q

PLT?

A

PLT platelets

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6
Q

PCV

A

PCV packed cell volume

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7
Q

HCT

A

HCT haematocrit

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8
Q

MCV

A

mean cell volume = avg size, vol of rbc

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9
Q

What does mcv tell you?

A

MCV can help you tell you the cause of the anaemia is

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10
Q

what does high HCT tell you?

A

high HCT/pcv MAY indicate dehydration

low HCT/pcv MAY indicate anaemia

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11
Q

Anaemia

A

Anaemia = low haemoglobin, does NOT say anything about the number of rbcs present

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12
Q

Leukopenia

A

Leukopenia = low wcc

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13
Q

Thrombocytopenia

A

Thrombocytopenia = low platelets

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14
Q

Pancytopenia

A

Pancytopenia = low number of all cells (may indicate bone marrow failure)

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15
Q

Polycythaemia

A

Polycythaemia = raised haemoglobin, does NOT say anything about the number of rbcs present

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16
Q

Leucocytosis

A

Leucocytosis = raised wcc

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17
Q

penia = low
themia = high

A
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18
Q

Thrombocythemia

A

Thrombocythemia = raised platelets

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19
Q

Acute porphyria triggered by?

A

drugs, LA

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20
Q

what are the clinical implications of porphyria?

A
  • Blood pressure/ HR control affected may be fatal
  • Seizures
  • Motor and sensory changes
  • Hypertension high BP
  • Tachycardia fast HR
  • photosensitive rash
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21
Q

when would one require a blood transfusion?

A

blood has to be replaced quickly

bone marrow cannot produce blood cells

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22
Q

rhesus disease

A

o Mother rhd –
o Baby rhd +
o Mother rhd antibodies attack baby

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23
Q
  • O universal donor - AB universal recipient
A

A has A1 and A2

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24
Q

why shld blood transfusion be avoided if possible ?

A

o Incompatibility
o Infection like BBV, hep b/c
o RBC lysis
o Prion diseases
o Bacterial infections
o Heart failure from increased volume

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25
Q

Process of transfusion

A
  1. Sample
  2. Tested against ABO and rhesus
  3. Sample tested against donor sample
  4. No coagulation or RBC lysis = success
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26
Q

causes of anaemia (reduced haemaglobin)

A
  1. production issues (rbc prod, heam prod, globin chains prod)
  2. increased losses (blood loss etc)
  3. increased demand (growth and pregnancy)
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27
Q

types of production failure that causes anaemia

A

type 1
marrow fail to prod rbc to package haemoglobin into

type 2
inability to form haem - deficiency state

type 3
inability to form correct globin chains - thalassaemia or sickle cell

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28
Q

what is Hematinic deficiency?

A

iron
vitamin b12
folic acid aka folate

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29
Q

effects of thalassaemia

A

splenomegaly*
cirrhosis*
anaemia
marrow hyperplasia
gallstones

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30
Q

why might blood transfusion not work on thalassemia patients?

A

patient alr has normal haem levels, might result in haem/iron overload -> cirrhosis

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31
Q

whats splenomegaly caused by?

A

Splenomegaly since spleen used to recycle rbc, high turnover rate of rbc, higher reprocessing rate

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32
Q

is sickle cell homozygous or heterozygous dominant/ recessive?

A

homozygous recessive

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33
Q

effects of SCD

A

o anaemia
o episodes of severe pain
o cells change shape after oxygen has been released. The red blood cells then stick together, causing blockages in the small blood vessels.

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34
Q

what can cause achlorhydria

A

drugs such as proton pump inhibitors

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35
Q

whats achlorhydria?

A

Reduced iron absorption
(lack of stomach acid therefore no conversion of Fe3+ to 2+, no absorption of nonheme iron)

possible cause of iron deficiency

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36
Q

how does SCD cause ischaemia and tissue necrosis?

A

change in shape of rbc causes the blockage of blood vessels

ischaemia is a restriction in blood supply to any tissue, muscle group, or organ of the body, causing a shortage of oxygen that is needed for cellular metabolism

pain and necrosis results

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37
Q

how is heme iron and non heme iron absorbed

A

heme iron - transporter in intestinal wall

nonheme iron - converted from fe3+ to fe2+ by gastric acids before it can be absorbed by transporters

38
Q

causes of Reduced iron absorption

A
  • Achlorhydria (lack of stomach acid therefore no conversion of Fe3+ to 2+, no absorption of nonheme iron)
  • Coeliac disease
39
Q

causes of iron loss

A

Hidden
- Gastric erosions
- Gastric ulcers
- Inflammatory bowel disease
- Crohns
- Ulcerative colitis
- Bowel cancer

Non hidden
- Haemorrhoids produce fresh blood can see

40
Q

how is b12 absorbed?

A

Intrinsic factor by parietal cells

Binds to B12

Passes to terminal ileum, absorbed specifically by a transporting system

41
Q

causes of lack of b12

A

Lack of intrinsic factor

Strict vegans – lack intake of b12 from meat

Disease of terminal ileum like Crohn’s

42
Q

causes of lack of folate

A
  • Lack intake
  • Jejunal diseases like coeliac
43
Q

alpha
beta
gamma Hb

function of each

A

alpha throughout life

beta - after birth

gamma - removes oxygen from maternal circulation for baby, reduced to none after birth

44
Q

cause of Macrocytic rbc

A

B12, folate deficiency

45
Q

cause of microcytic rbc

A

iron deficiency, thalassemia

46
Q

normoytic cells anaemia

A

(GI) bleeding, renal, chronic diseases

47
Q

Hypochromic

A

= less red, more pale due to less Hb

48
Q

what cells are usually hypochromic

A

microcytic and hypochromic

since there is a iron deficiency, there is less haem, less colour

49
Q

Ansiocytic

A

Ansiocytic = very big cells and very small cells in same sample

50
Q

what do reticulocytes do to the MCV?

A

raises the mcv

The reticulocytes are released prematurely and still have organelles, are larger than normal rbc, increased MCV.

51
Q

signs of anemia

A
  • Pale (mucosa)
  • Tachycardia
  • Sometimes enlarged liver and spleen
  • Smooth tongue and loss of papilla
  • Beefy tongue
52
Q

what clinical manifestation of vit b12 deficiency

A

beefy togue

53
Q

Dental clinical signs of iron deficiency

A
  • Mucosal atrophy
  • Candidiasis
  • Recurrent oral ulcers
  • Sensory changes
  • Smooth tongue
  • Loss of papilla
54
Q

tests for anaemia

A
  • Full blood count
  • Haematinics
  • GI blood loss endoscopy
  • Kidney function
  • Liver function
  • Bone marrow examination
55
Q

treatment for anaemia

A
  • Replace haematinics
  • Transfusion for rbc production failure
  • Erythropoietin for production failure and renal disease
56
Q

normal ferritin levels

A

a. 41-400microgram/L

57
Q

common causes of blood loss

A

a. Young -> alcohol related gastritis, menstrual, blood donations

b. Old -> GIT, peptic ulcers, bowel cancer, NSAIDs, haemorrhoids, rectal bleeding, chronic kidney or liver disease, fragile blood vessels

chronic kidney disease linked to erthyropoetiin then cannot make rbc

58
Q

normal value for mcv

A

80-100fl

59
Q

normal value for hb

A

male 140
female 120g/L

60
Q

normal value for rcc

A

men – 4.0 to 5.9 x 10*12/L

women – 3.8 to 5.2 x 10*12/L

61
Q

normal value for hct

A

men range from 41% to 50%

women is 36% to 48%

62
Q

normal value for plt

A

150,000 to 450,000 platelets/ ml of blood

63
Q

what usually causes hematological cancer?

A

dna mutation, like translocation

switches off TSG or switches on oncogene

64
Q

leukaemia vs lymphoma

A

leukemia begins in the bone marrow and affects blood cell manufacturing

lymphoma affects cells in the immune system and tends to be found in the lymph nodes

65
Q

clinical presentation of leukemia

A

anemia

neutropenia (infection and reduced neutrophils)

thrombocytopenia (bleeding due to reduced platelets)

66
Q

pathogenesis of leukamia?

A

clonal proliferation of leukaemia cells, replacing normal productive bone marrow cells, leading to marrow failure

67
Q

signs of anaemia

A

pale
signs of cardiac failure eg tachycardia or breathlessness
nail changes

68
Q

signs of neutropenia

A

infections of
mouth
throat
chest
skin
perianal

reactivation of latent infections
- Tb
- HSV
- zoster virus

unusual patterns of infection and rapid spread, fever, chills, unusual pathogens

69
Q

signs of thrombocytopenia

A

bleeding,
bruising ,
bleeding on probing
petechiae,
minor cuts fail to clot,
heavy menstral flow = menorrhagia

70
Q

acute or chronic leuakaemia worse?

A

acute more life threatening

71
Q

acute lymphoblastic vs acute myeloid

A

acute lymphoblastic - kids , quick development, lymphadenopathy common

acute myeloid - elderly

72
Q

chronic lymphocytic vs chronic myeloid

A

chronic lymphocytic - b cell, older adults, males, mostly asymptomatic, may not require treatment

chronic myeloid - neutrophils, translocation, older age, male

73
Q

what happens when lymphocytic turns lyphoblastic

A

more aggressive, require treatment eg monoclonal antibody treatment

74
Q

is hodgkin lymphoma more common or non hodgkin

A

non

75
Q

symptoms of lymphoma

A

fever night sweats
weak weight loss
swelling and lumps in neck armpits groin

76
Q

staging lymhpoma

A

number of nodes involved
site
extra nodal involvement
systemic symptoms

77
Q

what is the cure prognosis for hodgkin lymphoma

A

stage 1 and 2 over 90%

stage 3 and 4 50-70%

older people do less well

78
Q

hodkin vs non hodgkin lymphoma cell types involved

A

b and t cells for NHL

reed sternberg cells for HL

79
Q

causes of non hodgkin lymphoma

A

persistent low level microbial infection like ebv, hiv -> chronic activation of the lymphoid system

autoimmune diseases like sjogren syndrome, rheumatoid, peptic ulcer

immunosupression
- aids
- drugs from post transplant

80
Q

lymphoma can follow from tx of other diseases eg. chemo for leukemia can lead to lymphoma development

A
81
Q

what is the cure prognosis for non hodgkin lymhpoma?

A

> 50% will relapse after tx
aggressive disease that is hard to cure

82
Q

what is induction remission maintenance and relapse

A

induction = large dose of chemo to remove disease and reset to normal state

remission = normal bone marrow, no disease

maintenance = low level of tx for many years

relapse = return of disease if not fully cured

83
Q

what does chemo target

A

cells wil high turnover rate but might cause hairloss and GUT problems since lining of git has higher turnover

84
Q

what does radiotherapy target

A

cells with high cell divison rate

cytotoxic effect of ionizing radiation beam, new tech is able to target specific sites , less unwanted side effects

85
Q

risk of radio and chemotherapy

A

higher risk of new cancers later in life

86
Q

how do monoclonal antibodies work?

A

they kill certain cell groups from circulation by using cell recognition

(artificial monoclonal antibodies have CD antigens to target IL messengers and growth factors, controlling tumour growth)

87
Q

2 types of haemopoietic stem cells

A

allogenic from live donor
autologous from ownself

88
Q

what makes allogenic haemopoietic stem cell transplant so dangerous? (10% mortality)

A

graft vs host disease (total marrow failure)

since the host needs to total body irradiation before the transplant from a donor, they have zero bone marrow.

if the host body rejects the graft and starts attacking host, host has zero bone marrow and will die

89
Q

Definition of leukaemia

A

Bone marrow malignancy which causes Disseminated neoplastic proliferation of wbc

90
Q
A

BDS2 BAMS (27 decks)

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