FBC Flashcards

1
Q

What are the 3 cell lines of haematopoiesis?

A

-Red cells (carry oxygen)
=Produced under the influence of erythropoietin from the kidneys

-Platelets (haemostasis)
=Thrombopoietin from liver

-White cells (immune system)
=Granulocyte Colony Stimulating Factor (GCSF) creates neutrophils. Also immune cells: monocytes, eosinophils and basophils (all myeloid cells) and lymphocytes (lymphoid)

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2
Q

Where does blood come from?

A
  • Bone marrow

- Stem cells (stem cell= blast primitive daughter cell= more mature= mature cell)

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3
Q

What are the names of the red blood cell during haematopoiesis?

A
  • Pronormoblast
  • Basophilic normoblasts
  • Polychromatophilic normoblast
  • Orthochromic normoblast
  • —Reticulocyte
  • RBC
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4
Q

What happens to a lymphocyte when it leaves the bone marrow?

A
  • T-cells (helper CD4 and cytotoxic CD8) or B-cells in lymphatic system
  • Proliferates when target antigen found
  • T-cells final effector cells
  • B cells return to marrow to be plasma cells to secrete antibody
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5
Q

Where to blood cells die?

A

-Liver and spleen
=Reticuloendothelial system
-Macrophages destroy

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6
Q

What is FBC and how is it measured?

A
  • Count all cells

- Cells through beam of light

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7
Q

What are the normal values for FBC?

A
  • Haemoglobin= 130-180g/L (females) OR 115-160g/L (males)
  • Mean Cell Volume= 78-98 fL
  • White cell count= 4-11 x 10*9/L
  • Platelets= 150-400 x10*9/L
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8
Q

Plasma vs serum

A

-Plasma - Blood minus cells, but with clotting proteins present. Centrifuge anticoagulated blood and extract the clear fraction. Used for coagulation tests.
-Serum – Plasma minus clotting proteins. Centrifuge clotted blood and remove clear fraction. Used for most biochemical tests and non-coagulant proteins e.g. albumin

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9
Q

What is a blood group?

A

RBCs are “grouped” based on the antigens on their cell membrane. The most important systems are ABO and RhD. Group is determined by the presence/absence of the A and B and RhD antigens. You have natural antibodies against A or B antigens that you lack

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10
Q

What is an antibody screen?

A

If you are exposed to antigens that you lack (e.g. by transfusion or pregnancy) you may develop allo-antibodies against them: this is sensitisation. Screening detects these antibodies: we avoid choosing blood that you would react against. RhD is the most important example

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11
Q

What is group and save?

A

consists of three steps:
(i)blood grouping
(ii) antibody screening and
(iii) saving appropriate blood for the patient. Saved blood is group compatible and appropriate to the patient’s antibodies. This process is mostly done electronically with automated analysers.

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12
Q

What is cross-matching?

A

this final test ensures compatibility of the donor blood cells with the recipient’s serum. Donor cells and patient serum are mixed to look for reactions. This excludes most serious in compatibilities

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13
Q

What is a coagulation screen?

A

screening test which measures the prothrombin time (PT), the activated partial thromboplastin time(aPTT) and, typically, fibrinogen concentration. PT and aPTT are not influenced by platelet count since a platelet substitute is added as a reagent in the test

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14
Q

Describe primary and secondary homeostasis

A

1ohaemostasis is the interaction between vessel wall and platelets to form the platelet plug. Failure causes mucocutaneous bleeding pattern.

2o haemostasis involves the coagulation “cascade” forming the fibrin mesh. Failure causes soft tissue bleeds e.g. muscle haematoma or haemarthrosis.

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15
Q

Auto vs allo

A

In immunology, Auto refers to ‘self’ tissue and ‘allo’ to ‘non-self’ tissue e.g. auto/ allo antibodies, auto/allo stem cell transplant etc. Alloimmunity is an immune response to non-self antigens (from the same species) e.g. in the process of sensitisation in transfusion(above). Autoimmunity is an immune response to self antigens e.g in autoimmune haemolysis

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16
Q

Macrocytic vs megaloblastic

A

Macrocytic refers to RBCs with a high MCV. There are many causes, but one is the presence of megaloblasts – defective red cell precursors in the marrow. This happens in haematinic deficiency, and some other cases of defective DNA synthesis

17
Q

What is Polycythaemia?

A

Increased concentration of red cells. Haematocrit (HCT) is raised.*

-Absolute (increased red cell mass)
=Primary – Polycythaemia Rubra Vera (myeloproliferative condition)
=Secondary – Increased EPO – Chronic hypoxia (COPD, altitude), renal tumours

-Relative (reduced plasma volume)*
=Acute dehydration, alcohol

18
Q

Causes of microcytic hypochromic anaemia

A

-Iron deficiency
-Thalassaemia
-Lead poisoning
-Some cases of chronic disease

19
Q

Causes of normocytic normochromic anaemia

A

-Chronic disease
-Bone marrow failure
-Acute blood loss
-Haemolytic anaemia
-Mixed iron/ B12/ folate deficiency

20
Q

Causes of macrocytic anaemia

A

-B12/ folate deficiency
-Reticulocytosis/ haemolysis
-Liver disease
-Pregnancy
-Alcohol
-Myelodysplasia

21
Q

Causes of iron deficiency anaemia

A

-Chronic blood loss – menstrual, GI
-Reduced intake – diet, gastrectomy, coeliac disease
-Increased demand – growth in children, pregnancy

22
Q

Causes of folate deficiency

A

-Reduced intake – diet, alcohol, malabsorption (coeliac disease, gastrectomy etc)
-Increased requirements – pregnancy
-Drugs – methotrexate, phenytoin

23
Q

Causes of B12 deficiency

A

Reduced intake – dietary, malabsorption (pernicious anaemia, gastrectomy, terminal ileal disease

24
Q

Causes of haemolytic anaemia

A

-Inherited
=Haemoglobinopathies – Sickle cell disease, thalassaemia
=Membrane defects – Hereditary spherocytosis or elliptocytosis
=Enzyme defects – G6PD

-Acquired
=Immune-mediated – Autoimmune haemolytic anaemia
=Non-immune mediated – Microangiopathic haemolytic anaemia (MAHA) (e.g. DIC, TTP), valve haemolysis, infection (e.g. malaria)

25
Q

Causes of high neutrophils

A

Bacterial infections
Inflammation & necrosis
Corticosteroids
Malignancy
Myeloproliferative disorders

26
Q

Causes of low neutrophils

A

Post chemotherapy
Viral infections
DrugsB12/folate deficiency
Bone marrow failure – myelodysplasia, leukaemia,
infiltration
Autoimmune

27
Q

Causes of high lymphocytes

A

Viral infections
Chronic lymphocytic leukaemia (CLL)
Chronic infections
Other chronic leukaemias & lymphomas

28
Q

Causes of low lymphocytes

A

Viral infection
HIV
Post chemotherapy/radiotherapy
Drugs e.g. steroids
Bone marrow failure/ haematological malignancies

29
Q

Causes of high monocytes

A

Infection
Chronic inflammatory or infective disorders e.g. RA, IBD, SLE, TB
Malignancies e.g. myelodysplasia, leukaemia

30
Q

Causes of low monocytes

A

Acute infections
Corticosteroids
Haematological malignancies

31
Q

Causes of high eosinophils

A

Allergy – asthma, hay fever etc
Parasite infections
Skin disease
Drug reactions
Malignancy e.g Hodgkin’s disease
Hypereosinophilic syndrome

32
Q

Causes of high platelets

A

Primary – essential thrombocytosis, other MPDs
Secondary – Inflammation, infection, malignancy, post-splenectomy, iron deficiency

33
Q

Causes of low platelets

A

-Increased destruction
= Immune: ITP, SLE, drugs
= Non–immune: MAHA (DIC TTP,HUS), hypersplenism

-Decreased production - bone marrow failure, B12/folate deficiency, myelosuppression

34
Q

Causes of pancytopenia

A

Non-haematological - B12/folate deficiency, Liver disease (hypersplenism), severe infection, chemotherapy, bone marrow infiltration (TB, carcinoma)

Haematological - Leukaemia, myelodysplasia, myelofibrosis, aplastic anaemia, lymphoma, myeloma