Exam Revision Flashcards
1
Q
What blood cell attacks parasited
A
eosinophils
2
Q
what is a circulating macrophage
A
monocyte
3
Q
what do NK cells do
A
virus and tumour destruction
4
Q
red cell lifespan
A
120 days
5
Q
neutrophil lifespan
A
7-8 hours
6
Q
platelet lifespan
A
7-10 days
7
Q
what are blasts
A
nucleated precursor cells
8
Q
what cell are megakaryocytes the precursor of
A
platelets
9
Q
what cell are reticulocytes the precursor of
A
red cell
10
Q
what are myelocytes the precursor for
A
neutrophils
11
Q
where is the first site of haemopoesis in the fetus
A
yolk sac
12
Q
what other sites of haemopoesis are there in the fetus
A
liver by 6 weeks
then spleen by 12 weeks
13
Q
where is the site of haemipoesis in the adult
A
bone marrow
14
Q
what covers the endosteum
A
osteoclast and osteoblasts
15
Q
what is the endosteum
A
the interface between bone and bone marrow
16
Q
what type of marrow increases in elderly
A
yellow (fatty) marrow
17
Q
what happens to the myeloid:erythroid ratio in haemolysis
A
it shows evidence of erytroid hyperplasia so it is reduced
18
Q
what stimulates the maturation of erythroid precursors to become rbcs
A
erythropoietin
19
Q
what tests are used to look at immature cells
A
immunophenotyping
cytochemistry
20
Q
CD20
A
b cells
21
Q
cells of myeloid lineage
A
rbcs platelets granulocytes macrophages dendritic cells
22
Q
cells of lymphoid lineage
A
t cells
b cells
nk cells
dendritic cells
23
Q
what is normal haematocrit
A
50 percent
24
Q
what is koilonychia a sign of
A
iron deficiency
25
leg ulcers sign of
sickle cell
26
bone deformities a sign of
thalassaemia
27
glossitis a sign of
B12 deficiency
28
if there is reduced MCV this indicated
problem with haemoglobinisation
29
if there is large MCV indicated
problem with maturation
30
where does haemoglobin synthesis occur
cytoplasm
31
what anaemias result from decreased porphyrin
lead poisoning
| sideroblastic anaemia
32
difference between blood components and blood products
blood components - one donor - red cells, plasma
| blood products- many donors - albumin, Ig, anti d
33
how much of a therapeutic dose of platelets can you get from one donor
one quarter
34
what anticoagulant is used in donated blood
citrate based
35
how quickly must you obtain a blood donation sample
within 15 mins
36
what temp and for how long are red cells kept at
4 degrees
| 35 days
37
how long and at what temp are platelets stored at
22 degrees
| shelf life five days
38
how long and at what temp is fresh frozen plasma kept at `
-30
| up to two years
39
what type of antibodies are ABO
IgM
40
what chormosomes is our blood group on
chromosome 9
41
what type of antibodies are anti d and irregular antibodies
IgG
42
how soon must red cells be transfused once they have left the fridge
within 4 hours
| after been out for 30 mins must transfuse or disguard
43
what process means that a therapeutic dose of platelets can be obtained from a single donor
apheresis
44
indications for fresh frozen plasma
bleeding
anti coagulant over dose
DIC
45
what three actions should you take in ABO incompatability reaction
Stop transfusion
give IV saline
Obtain bloods!
do not remove cannula
46
why is direct coombs test usually negative in ABO reactions
no intact red cell material
47
what is a delayed transfusion reaction usually due to
irregular antibodies
48
is direct coombs test positive in delayed transfusion reaction
yes
49
who do febrile no haemolytic transfusion reactions tend to occur in
people who are transfused more often
50
what mediated febrile non haemolytic transfusion reactions
HLA exposure in previous transfusion
| anti bodies to contaminated white cells
51
what mediated urticarial reactions
IgE
52
what bacterial infections occur in red cells
pseudomonas
| yersinella
53
what bacterial infection occur in platelets
staph, strep, salmonella
54
what virsus cannot be tested for in blood transfusion products
JC virus
55
what is the risk of HIV infection after a transfucsion
1 in 7 million
56
what two things occur in red cell destruction
reticulocytes
| erytroif hyperplasia
57
what is the normal level of reticulocytes in blood
0.3-3 percent
58
what products are produced in extravascular haemolysis
normal products:
unconjugated bilirubinaemia
urobilinogenaemia
59
what products are produced in intravascular haemolysis
haemoglobinaemia
haemoglobinurea
haemosiderinuria
60
give examples of intravascular haemolyissi
```
ABO
G6pD
malaria
pnh
pch
DIC
```
61
what is the function of haptoglobin
it mops up free Hb in blood
62
what happens to haptoglobin levels in haemolysis
decrease
63
which type of coombs test is used to test for haemolytic anaemias
coombs
64
how is hereditary spherocytosis inherited
autosomal dominant
65
how is G6PD deficiency inherited
x linked
66
what is the problem in G6PD
unable to reduce glutathione which is an antioxidant
67
what can autoimmune haemolytic anaemia be divided in to
warm or cold
68
what antibody mediated warm
IgG
69
what antibody mediated cold
IgM
70
what condition arises from mechanical damage eg DIC
MAHA
71
what appears in the blood in burns related haemolysis
microspherocytes
72
what is zieves syndrome
haemolysis
alcoholic liver disease
hyperlipidaemia
73
pappernheimer bodies
b thalassaemia
74
describe the structure of HbH and when is it present
haemoglobin with four beta chains
| alpha thalassaemia
75
what are Heinz bodies
red cell inclusions
| G6PD
76
howell joly bodies
DNA remnant inclusions
| hyposplenism eg sickle cell, post spenectomy
77
morphological features of neutrophil
segmented nucleus
78
morphological features of eosinophils
bilobed nucleus
| orange stain
79
colour of basophils
deep purple stain
80
morphological features of monocyted
kidney bean shaped nucleus
| pale blue cytoplasm
81
most common childhood malignancy
ALL
82
things that make you more at risk of leukaemia
```
benzene
fanconi anaemia
ataxia telangiectasia
downs syndrome
Philadelphia chromosome
```
83
what is a common symptoms in ALL
bone pain
84
where are auer rods seen
AML and APML
85
what antibiotics are given for neutropenic sepsis
taxobactam
| ampercillin
86
what is remission in leukaemua
less than 5 percent blasts
| return of normal erythropoesis
87
treatment of acute promyelocytic leukaemia
vit a analogue and arsenic
88
alcohol induced pain
hodgkins lymphoma
89
b cell zone in lymph node
cortex
90
t cell zone in lymph node
paracortex
91
plasma cell zone in lymph node
medulla
92
high grade non hodgkins lymphomas
burkits
diffuse large B cell
mantle
93
low grade non hodgkins
follicular
small lymphocytic
marginal zone
94
most common hodkins lymphoma
nodular sclerosing
95
best prognosis hodkins lymphoma
lymphocyte dominant
96
worse prognosis hodgkins lymphoma
lymphocyte deplete
97
pathagnomaonic feature of hodgkins
reed Steinberg cells
98
what is the philodelphia chromosome
translocation between 9 and 22
99
what is imatinib and what does it treat
tyrosine kinase inhibitor
| CML
100
secondary causes of polycythaemia
smoking
chronic hypoxia eg COPD
erythropoeitn secreting tumour
101
causes of pseudopolycythaemia
dehydration
diuretics
due to decreases plasma vol not increased red cells
102
what is the mutation on polycythaemia rubra vera
JAK 2
103
what is the erythropoeitn leveln in polycythaemia rubra vera
low
high in secondary polycythaemia
104
treatment of polycythaemia rubra vera
venesect
aspirin
can use chemo in some cases - hydroxycarbamide
105
side effect of hydroxycarbamide
megaloblastic anaemia
106
what is essential thrombocythaemia
increased platelets
107
myelofibrosis
idiopathic or secondary to polycythaemia rubra vera or ET
108
what is seen in the blood on myelofibrosis
marrow failure
leukoerythroblastic blood
tear dropped RBCs
extramedullary haemopoiesis
109
examples of cell cycle specific agents
anti metabolites eg methotrexate. hydroxyurea
| mitotic spindle eg taxotere, alkaloids
110
what phase of cell cycle do antimetabilites work
s phase
111
phase of cell cycle that mitotic spindle effect
m phase
112
difference between cell cycle specific and non cell cycle specific in terms of dose and duration
cell cycle specific - duration more important than dose
| non specific - dose more important than duration
113
examples of non cell cycle specific agents
alkylating agents - melphalon, platinum
anthracyclins
chlorambucil
114
primary haemostasis
platelet plug formation
115
causes of impaired primary haemostasis
```
ehloer danlos
henoch schlon pupura
scurvy
aplastic anaemia
DIC, ITP
von willebrand deficiency
```
116
how is vonwillebrand deficiency inherited
autosomal dominant
117
infectins which can cause a failure of platelet production
EBV, CMV, varicella
118
treatment of TTp
plasmapheresis
119
what can cause multiple clotting factor deficincies
liver disease
warfarin therapy or vit k deficiency
dic
120
what clotting factor is particularly low in liver disease
7
121
why is vit K sometimes reuced in coeliac and crohns
it is a fat soluble vitamin absorbed in upper GI tract
122
what is Christmas disease
haemophilia B
123
which type of haemophilia is more common
A
124
what gene is haemophilia carried on
X linked
125
what is deficient in haemophilia a
eight
126
deficient in haemophilia b
nine
127
what is prolonged in haemophilia
APPT
| PT normal
128
what is the clot rich in arterial thrombosis
platelet
129
what is the clot rich in in venous thrombosis
fibrin
130
how would you monitor low molecular weight heparin
anti factor 10a assay
131
how would you monitor unfractionated heparin
APPT
132
what is Virchow triad
hypercoagulability
stasis
vessel wall damage
133
what is factor 5 leidan
resistance to activated protein
134
name an acquired cause of thrombophilia
antiphospholipid syndrome
135
how is antiphospholipid syndrome treated
aspirin and warfarin
because it is both a problem with primary and secondary haemostasis
136
when do you treat factor five leidan with anticoagulation
only if recurrent VTEs
| can give prophylaxis in periods on known risk eg pregnancy or surgery
137
indications for lifelong coagulation
recurrent venous thrombosis
rheumatic mitral valve disease
atrial fibrillation
prosthetic heart valves
138
mode of action of low molecular weight heparin
potentiated anti thrombin III and results in inactivation of factor 10a
139
mode of action unfractionated heparin
inactivates factor 2a (thombin)
140
side effects of heparin
thrombocytopenia
| osteoporosis if used long term
141
how is heparin overdose treated
stop heparin - short half life
| in severe bleeds give protamine sulphate
142
what is used if patient is resistant to warfarin
phenindone
143
mode of action of warfarin
inhibits vitamin K
144
What clotting factors need vit K to be carboxylated
2, 7, 9, 10
also protein c and s
145
where is vit k synthesised
liver
146
what is used to monitor warfarin
INR
147
how is warfarin overdose treated
stop warfarin
give vit K
give clotting factors (FFP)
148
how long does vit K take to take effect
6 hours
149
mode of action dabigatran
direct thrombin inhibitor
150
mode of action of ribaroxaban/apixaban
direct factor Xa inhibitors
151
when are new anticoagulants used
all are used in elective HIP and KNEE surgery for DVT
can be used for AF
can be used for DVT/PE treatment
152
mode of action of aspirin
inhibits COX
153
mode of action of clopidogrel
ADP receptor antagonist
154
moe of action of dypyramidole
phosphodieterase inhibitor
155
mode of action of abciximab
GP IIb/IIIb inhibitor
156
how long should antiplatelets be stopped prior to surgery
7 days
157
what antiplatelet prevents aggregation of platlets
abciximab
158
what tissue factors does protein c inactivate
Va and VIIIa
159
what stimulates protein c and s
thrombin production
160
what breaks down the fibrin clot
plasmin
161
why can CLL be more difficult to treat with chemotherapy and radiotherapy
mutations of p53 can occur - cell does not apoptose in response to damage
162
why are high grade/acute cancers of the blood more responsive to chemo
chemo targets rapidly dividing cells - cells are divinding rapidly in acute leukaemias/high grade
163
why are deaths due to fungal infection decreasing in chemotherapy patients
all who are high risk are given prophylactic antifungals eg itraconozole
164
what scan is used in hodgkins lymphoma to better target radio/chemo
PET scan
165
name a monoclonal antibody
rituximab
166
what does rituximab bind to
CD20 on malignant b cells
167
when is rituximab used
b cell NHL
