Haem Flashcards
is vit K fat or water soluble
fat soluble
what does vit K do to preformed clotting factors to activate them
carboxylates them
what is the difference in terms of blood cells produced in AML and CML
AML- an excess of primitive cells - due to the block in differentiation
CML - an excess of immature blood cells (differentiation is not blocked)
what does a pancytopenia with a macrocytic red cell development suggest?
pernicious anaemia- lack of vit B12 absorption impairs nuclear maturation, affecting all 3 haemopoetic lineages
first line treatment for AI haemolytic anaemia
1mg/kg prednisolone per day and folic acid
what does a low Hb with normal serum ferritin suggest in a pregnant women?
anaemia of pregnancy (physiological)
what is the best test to investigate a haemoglobinopathy
haemoglobin analysis
what is the protein target in NHL treatment
CD20+
what causes the HbS in sickle cell anaemia
the point mutation causing glutamic acid to valine substitution in the beta chain
what is the key characteristic to help you remember a neutrophil on histology
it has a multisegmented nucleus (polymorphonuclear leucocyte)
which blood cell has a characteristic BiLobed nucleus (spectacle shaped nuclei)
eosinophil
which blood cell has a horse shoe-shaped nucleus and a steel grey coloured nucleus
monocyte
is antiphospholipid syndrome an inherited or acquired thrombophillia
acquired
name the 4 causes of inherited thrombophillia
factor V leiden, antithrombin deficiency, protein c and protein s deficiency
which anticoagulant is a direct inhibitor of factor Xa
rivaroxiban
what is the pathology behind sickle cell disease
point mutation in globin gene
predisposes the Hb to polymerisation, resulting in sickled cells
the presence of which cell characterises a Hodgkin’s lymphoma
reed Sternberg cell
name the 3 ‘B’ symptoms in lymphoma that suggest a poor prognosis
weight loss
fever
night sweats
which lymphoma causes severe pain on alcohol consumption
Hodgkin’s lymphoma
what is the NOAC dabigitrans mechanism of action
direct thrombin inhibitor
what is the mechanism of action of rivaroxaban and apixaban
direct factor Xa inhibitors
which drugs are indicated for the treatment of PE/DVT
NOACS
dabigitran, rivaroxaban and apixaban
which lymphoma is ‘itchy skin without a rash’ characteristic of
non Hodgkins lymphoma
which lymphoma is the most common form in the UK
diffuse large B cell lymphoma
who does a burkitt lymphoma typically affect
the young and immunocompromised
in which lymphoma do “B” symptoms occur earlier
occur earlier in Hodgkins lymphoma
what can a chronic lymphocytic leukaemia transform into
a NHL (richter’s transformation)
what is the most common RBC enzyme defect
G6PD deficiency
describe the pathophysiology of a G6PD deficiency
reduced G6PD means reduced glutathione
reduced glutathione means the RBC has an increased susceptibility to oxidative stress
in which condition are Heinz bodies, bite cells and blister cells seen on blood film
G6PD deficiency
can women get a G6PD deficiency
no - X linked recessive- its a mans disease 💪🏽
which disease causes normocytic anaemia, leukopenia and thrombocytopenia
aplastic anaemia
how many segments does the nucleus of a neutrophil have
up to 5
what colour are the granules of eosinophils
bright red/orange
what is the main role of basophils/mast cells
IgE hypersensitivity response
what substance is within the granules of basophils
histamine
what is the function of NADPH
reduces glutathione
what pathway produces NAHPD
pentose phosphate pathway
what converts hydrogen peroxide to water
reduced glutathione
it combats oxidative stress
what is the consequence of G6PD deficiency
reduced NAPDH so
lack of
reduced glutathione
increased build up of free radicals, causing oxidative damage and haemolysis
is hypoproliferative anaemia microcytic, normocytic or macrocytic?
normocytic
what are the 2 main causes of microcytic anaemia
B12 deficiency
folate deficiency
which is absorbed 1st - iron, B12 or folate
1st = folate - in the duodenum and ileum
2nd = B12- absorbed in the terminal ileum, 3rd = iron is absorbed in the proximal small bowel
why do B12 and folate deficiencies cause jaundice
premature haemolysis of RBC in bone marrow
what is the nucleus of neutrophils in patients with a B12/folate deficiency like
hypersegmented nucleus (>5segments)
what Ig are irregular blood allo-antibodies
IgG
how do delayed transfusion reactions occur
complement is NOT activated (like in an acute reaction) so reaction occurs in the spleen where macrophages attack the cells
why is folic acid supplementation needed in HbH disease
increased RBC turnover so increased folic acid demand
why does splenomegaly occur in HbH disease
due to extra medullary haematopoesis
what type of anaemia do you get with HbH disase
hypo chromic microcytic
with mild to severe anaemia
what kind of anaemia do u get with thalassemia trait
asymptomatic to mild
compare the need for blood transfusions in thalassemia intermedia and major
intermedia- they are NOT dependant on transfusions- only when they are ill
major = dependant on transfusions
what tests can u do to diagnose thalassemias
HPLC (high performance liquid chromatography)
Hb electrophoresis
what are the 2 main purposes of blood transuiosn in B thal major
- suppress ineffective erythropoiesis
2. inhibit over-absorption of iron
what is the pathophysiology of sickle cells
point mutation in codon 6 of the beta chain
glutamine –> valine
structure of B chain changed
do you get hypo or hypersplenism in sickle cell
hyposplenism - due to repeated splenic infarcts
in which disease can target cells on blood film be seen
alpha and beta thalassemias
what is seen on blood film when RBCs are damaged
spherocytes
what is seen on blood film if RBCs have oxidative damage
Heinz bodies
compare warm and cold
cold = IgM warm = IgG
