DUMS powerpoint- the science and spleen

Question 1

terminilogy- philia/ cytosis?

Answer 1

too much

Question 2

thrombophilia meaning?

Answer 2

too much clotting

Question 3

thrombocytosis meaning?

Answer 3

too many platelets

Question 4

terminology- penia?

Answer 4

too little

Question 5

terminology- dys?

Answer 5

abnormal growth

Question 6

life span of red cells?

Answer 6

120 days

Question 7

how many red cells are lost/ produced per second?

Answer 7

2.5 million red cells are lost/made per second

Question 8

life span of platelet?

Answer 8

life span of platelet is 7-10 days

Question 9

how many platelets are made per second?

Answer 9

1 million platelets are made every second

Question 10

average lifespan of neutrophils?

Answer 10

life span of neutrophils is 7-8 hours

Question 11

how many neutrophils are made/ destroyed every second?

Answer 11

1-2 million neutrophils are made/destroyed every second

Question 12

how are platelets formed?

Answer 12

from the budding of a megakaryocyte

Question 13

Explain how erythrocytes and platelets are produced from stem cells

Answer 13

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

Question 14

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

Answer 14

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

Question 15

explain how granulocytes and macrophages are produced from stem cells

Answer 15

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

myeloblast?

5. GMP (granulocyte monocyte progenitor)
6. Macrophage or granulocyte

Question 16

what is the role of neutrophils?

Answer 16

play a role in acute inflammation

Question 17

name the 3 granulocytes

Answer 17

neutrophils
Eosinophils
Basophils

Question 18

what do neutrophil granules contain?

Answer 18

Lysozyme and myeloperoxidase

Question 19

Role of eosinophils?

Answer 19

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

Question 20

what colour do eosinophils granules stain?

Answer 20

red/pinky/orangey

Question 21

what colour do neutrophils granules stain?

Answer 21

‘neutral’ pink granules

Question 22

what colour do basophils granules stain?

Answer 22

blue/ purpley granules

Question 23

what role do Basophils play?

Answer 23

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

Question 24

Explain how RBC are made in response to hypoxia

Answer 24

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

Question 25

where are RBC broken down and how?

Answer 25

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)

Question 26

where is blood made as a foetus?

Answer 26

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

Question 27

where is blood made at birth?

Answer 27

-mostly bone marrow may still be producing from liver and spleen if needed

Question 28

where is blood made as an adult?

Answer 28

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

Question 29

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

Answer 29

adult= iliac crest/ sternum child= tibial marrow cavity

Question 30

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

Answer 30

Red marrow= active Yellow marrow= inactive

Question 31

what is red marrow Vs yellow marrow made of?

Answer 31

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

Question 32

what pulp is in the spleen?

Answer 32

Red pulp and white pulp

Question 33

what is the red pulp in the spleen?

Answer 33

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

Question 34

what is the role of white pulp in the spleen?

Answer 34

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

Question 35

splenomegaly presentation?

Answer 35

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

Question 36

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

Answer 36

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

Question 37

what is hypersplenism?

Answer 37

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

Question 38

what are causes of splenomegaly?

Answer 38

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

Question 39

what is Felty's syndrome?

Answer 39

important cause of splenomegaly!! -infective endocarditis, RA + low WBC

Question 40

most common cause of hyposplenism?

Answer 40

splenectomy

Question 41

causes of hyposplenism?

Answer 41

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

Question 42

blood film of someone with hyposplenism?

Answer 42

Abnormal red cells as vascular sieve is lost

Question 43

what are indications to splenectomy?

Answer 43

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

Question 44

what spleens are more susceptible to truama?

Answer 44

diseased spleens are more susceptible to trauma

Question 45

what is seen in the blood film after splenectomy?

Answer 45

Howell Jolly Bodies, target cells

Question 46

why is there pancytopenia in hypersplenism?

Answer 46

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

Question 47

what are Howell- Jolly bodies?

Answer 47

remnants of RBC nuclei that are normally removed by the spleen

Question 48

what do target cells look like?

Answer 48

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

Question 49

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

Answer 49

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

Question 50

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

Answer 50

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

Question 51

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

Answer 51

using immunisations and prophylactic antibiotics