General haematology

Question 1

Where are the RBCs produced throughout life?

Answer 1

Yolk sac (1 month)
Liver (2-birth)
All bone marrow (1-10yrs)
Mainly axial marrow (vertebra/pelvis) (10-death)

Question 2

3 important haematopoietic growth production hormones?

Answer 2

G-CSF: 
- granulocyte colony stimulating factor
EPO: 
- erythropoietin produced in kidney
- if reduced, leads to hypoxia
TPO:
- thrombopoietin produced in liver 
- if reduced, leads to thrombocytopenia

Question 3

Mean cell volume

Answer 3

A. microcytic <80fl (iron deficiency)
B. normocytic 80-100 fl
C. macrocytic >100 fl (B12/folate deficiency)

Question 4

What is reticulocyte count

Answer 4

number of young, recently released from bone marrow RBC

Question 5

In a patient with anaemia why would reticulocyte count increase?

Answer 5

normal response: to replenish the loss due to haemolysis or bleeding

Question 6

In a patient with anaemia why would reticulocyte count decrease?

Answer 6

there is a problem with bone marrow production of RBC

Question 7

-cythaemia def?

Answer 7

increased number

Question 8

• cytosis

Answer 8

increased number

Question 9

-cytopenia

Answer 9

reduced number

Question 10

Reactive def?

Answer 10

reactive cause can be due to anything (inflam, infection, autoimmune, etc) but not neoplastic

Question 11

Reactive conditions with increased lymphocytes?

Answer 11

1. lymphocytosis

2. polycolonal gammaglobulinaemia

Question 12

Reactive conditions with increased myeloid cells?

Answer 12

• thrombocytosis
• neutrophilia
• polycythaemia

Question 13

Polycythaemia def?

Answer 13

Increased Hb, raised Hct

Question 14

Relative causes of polycythaemia?

Answer 14

• dehydration,
• diuretics,
• alcohol (due to reduced plasma volume, no change in absolute RBC mass, proportionate increase )

Question 15

Primary causes of polycythaemia?

Answer 15

• ruba vera

Question 16

Secondary causes of polycythaemia?

Answer 16

• hypoxia
• smoking,
• altitude,
• tumours

Question 17

Diffirentiation beteween Primary vs secondary causes of polycythaemia

Answer 17

Secondary: JAK2 unmutated, EPO increased

Primary: JAK2 mutated
EPO suppressed

Question 18

Thrombocytosis clonal causes

Answer 18

Myeloproliferative disorders (MPN)

Question 19

Thrombocytosis spurious causes

Answer 19

FBC machine counts something else as platelets)

Question 20

Leukocytosis def?

Answer 20

Mainly neutrophilia and lymphocytosis

Question 21

Reactive causes of anything

Answer 21

• Trauma (e.g. by surgeon)
• Smoking
• Infection
• Inflammation
• Steroids
• Non haematological Malignancy
• Splenectomy

Question 22

Myeloid differentiation

Answer 22

RBC
Platelets
Eosinophil,
Neutrophil, Basophil

Question 23

Lymphoid differentiation

Answer 23

B lymphocyte
T lymphocyte
Natural killer cells

Question 24

2 O/E signs of thrombocytopenia?

Answer 24

1. petechiae (pin prick bruises)

2. Ecchymoses (wide spread bruises)