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Haematology > DUMS powerpoint- the science and spleen > Flashcards

DUMS powerpoint- the science and spleen Flashcards

1
Q

terminilogy- philia/ cytosis?

A

too much

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2
Q

thrombophilia meaning?

A

too much clotting

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3
Q

thrombocytosis meaning?

A

too many platelets

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4
Q

terminology- penia?

A

too little

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5
Q

terminology- dys?

A

abnormal growth

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6
Q

life span of red cells?

A

120 days

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7
Q

how many red cells are lost/ produced per second?

A

2.5 million red cells are lost/made per second

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8
Q

life span of platelet?

A

life span of platelet is 7-10 days

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9
Q

how many platelets are made per second?

A

1 million platelets are made every second

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10
Q

average lifespan of neutrophils?

A

life span of neutrophils is 7-8 hours

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11
Q

how many neutrophils are made/ destroyed every second?

A

1-2 million neutrophils are made/destroyed every second

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12
Q

how are platelets formed?

A

from the budding of a megakaryocyte

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13
Q

Explain how erythrocytes and platelets are produced from stem cells

A
  1. LT-HSC (stem cell)
  2. ST-HSC (stem cell)
  3. MPP (multipotent progenitors)
  4. CMP (common myeloid progenitors)
  5. MEP (megakaryocyte erythroid progenitor)
  6. Erythtrocyte or platelet
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14
Q

Explain how B lymphocytes, T lymphocytes and NK cells are produced from stem cells

A
  1. LT-HSC (stem cell)
  2. ST- HSC (stem cell)
  3. MPP (multipotent progenitor)
    4.CLP (common lymphoid progenitor)
  4. Pro T, Pro NK or Pro B
  5. T cells, NK cells, B cells
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15
Q

explain how granulocytes and macrophages are produced from stem cells

A
  1. LT-HSC (stem cell)
  2. ST-HSC (stem cell)
  3. MPP (multipotent progenitors)
  4. CMP (common myeloid progenitors)

myeloblast?

  1. GMP (granulocyte monocyte progenitor)
  2. Macrophage or granulocyte
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16
Q

what is the role of neutrophils?

A

play a role in acute inflammation

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17
Q

name the 3 granulocytes

A

neutrophils
Eosinophils
Basophils

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18
Q

what do neutrophil granules contain?

A

Lysozyme and myeloperoxidase

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19
Q

Role of eosinophils?

A

-Defend against parasites (protozoan and helminthic infections)
-Play a role in allergy

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20
Q

what colour do eosinophils granules stain?

A

red/pinky/orangey

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21
Q

what colour do neutrophils granules stain?

A

‘neutral’ pink granules

22
Q

what colour do basophils granules stain?

A

blue/ purpley granules

23
Q

what role do Basophils play?

A

-play a role in IgE mediated reactions (e.g. type 1 hypersensitivity reaction which would be an allergic reaction that occurs immediately)

24
Q

Explain how RBC are made in response to hypoxia

A

-Hypoxia sensed by hypoxia sensor in kidney
-EPO (erythropoiten) produced by the kidneys
-EPO stimulates RBC production
-EPO drops and this process is repeated

25
Q

where are RBC broken down and how?

A

Most are broken down in the spleen
-Globin is broken into amino acid chains
-Haem is recycled into iron + bilirubin, the bilirubin is taken to the liver to be conjugated and excreted as bile (this colours the urine and faeces)

26
Q

where is blood made as a foetus?

A

haemopoietic stem cells originate in mesoderm
5 weeks- circulating progenitors are detectable
starts at 6 weeks- liver
until 10th week- Yolk sac
3rd- 7th month- spleen
starts at 16th week- bone marrow

27
Q

where is blood made at birth?

A

-mostly bone marrow

may still be producing from liver and spleen if needed

28
Q

where is blood made as an adult?

A

bone marrow in the axial skeleton (skull, ribs, sternum, pelvis and proximal femur)

29
Q

where do you get bone marrow biopsy from adult and young child?

A

adult= iliac crest/ sternum
child= tibial marrow cavity

30
Q

what are the types of marrow and which is active/ inactive?

A

Red marrow= active
Yellow marrow= inactive

31
Q

what is red marrow Vs yellow marrow made of?

A

red marrow= haemopoietically active
-contains blood stem cells that can become RBC, WBC or platelets

yellow bone= fatty and inactive
-contains stem cells that can become cartilage, fat or bone cells

32
Q

what pulp is in the spleen?

A

Red pulp and white pulp

33
Q

what is the red pulp in the spleen?

A

Red pulp contains:
-sinusoids (vascular part)
-cords (contain macrophages to break down RBC)

It is basically a vascular sieve
-phagocytosis old RBCs and breaks them into iron and bilirubin

34
Q

what is the role of white pulp in the spleen?

A

IMMUNOLOGICAL RESPONSE

the white pulp contains PALS (periarterial lymphoid sheath)
-this contains T and B cells which react with antigens on antigen presenting cells in the blood

35
Q

splenomegaly presentation?

A

triad of:
-Dragging LUQ sensation
-discomfort eating
-pain (secondary to infarction)

36
Q

what is moderate splenomegaly in the Western world most often due to?

A

In the western world splenomegaly is most often due to portal hypertension or blood disease

37
Q

what is hypersplenism?

A

-Splenomegaly
-Fall in 1 (+) components in blood
-Cytopenia fixed by splenectomy

38
Q

what are causes of splenomegaly?

A

Increased function, increased blood flow and cancerous infiltration

-Increased function: haemolysis, infection (mononucleosis), autoimmune disease (RA), extramedullary haematopoiesis

-Increased blood flow: portal hypertension

-Cancerous infiltration: leukemia, lymphoma, myeloproliferative

39
Q

what is Felty’s syndrome?

A

important cause of splenomegaly!!

-infective endocarditis, RA + low WBC

40
Q

most common cause of hyposplenism?

A

splenectomy

41
Q

causes of hyposplenism?

A

-splenectomy (most common)
-sickle cell disease
-coeliac diease
-sarcoidosis
-iatrogenic

42
Q

blood film of someone with hyposplenism?

A

Abnormal red cells as vascular sieve is lost

43
Q

what are indications to splenectomy?

A

-splenic trauma (very vascular)
-hypersplenism
-AI haemolysis

44
Q

what spleens are more susceptible to truama?

A

diseased spleens are more susceptible to trauma

45
Q

what is seen in the blood film after splenectomy?

A

Howell Jolly Bodies, target cells

46
Q

why is there pancytopenia in hypersplenism?

A

as the cells get trapped in the spleen (reticuloendothelial system)

47
Q

what are Howell- Jolly bodies?

A

remnants of RBC nuclei that are normally removed by the spleen

48
Q

what do target cells look like?

A

‘Mexican hat cells’
-central staining, ring of pallor and peripheral staining

49
Q

how long do you have to avoid contact sport after EBV and why?

A

avoid contact sport for 2 months after EBV (Regardless of whether theres splenomegaly or not)
-as diseased spleens are more susceptible to trauma

50
Q

what are you at increased risk of by doing a splenectomy?

A

-Hyposplenism (splenectomy is most common cause of hyposplenism)
-Increased lifelong infection risk from encapsulated organism (strep pneumoniae, H influenzae, menningococcus)

51
Q

how can you reduce the risks of lifelong infection from splenectomy?

A

using immunisations and prophylactic antibiotics

Haematology (23 decks)

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