Haem Week 11 Flashcards

Question

Outline the location of eosinophils

Answer 1

Found in tissues and the bloodstream, especially at sites of inflammation

Answer 2

Relatively short of around 8-12 hours

Answer 3

Bilobed nucleus Large granules

Answer 4

Release histamine, heparin, and other mediators involved in allergic responses

Answer 5

Circulate in blood but are rare compared to other WBC

Answer 6

Short lifespan, usually few hours to few days

Answer 7

Biological process in which cells, such as immune cells, move in response to chemical signals or gradients

Answer 8

Round or irregularly shaped nucleus and minimal cytoplasm

Answer 9

Cell mediated immunity Central role in recognising and attacking infected or abnormal host cells Each type (cytotoxic, helper, regulatory) has distinct function

Answer 10

Blood and lymphatic system, but also present in lymphoid organs such as thymus, lymph nodes and spleen

Answer 11

Varies, some circulate for weeks or months while memory T cells can persist for many years

Answer 12

Round nucleus and larger amount of cytoplasm compared to T cells

Answer 13

Humoral immunity Produce antibodies that can neutralise pathogens, mark them for destruction, or enhance phagocytosis, and has a role in antigen presentation to T cells

Answer 14

Found in lymphoid organs, lymph nodes, the spleen, and in bloodstream Can also be found in peripheral tissues

Answer 15

Variable lifespans; some differentiate into short lived plasma cells that produce antibodies, while other form memory B cells that can persist for years

Answer 16

Abnormal increase in number of WBC in blood, often indicative of immune response to infection or other underlying medical conditions WBC >11,000/microL

Answer 17

Decrease in the total WBC count in the blood, potentially increasing the risk of infections and impairing the immune system’s function

Answer 18

Condition characterised by a deficiency of neutrophils which can make individuals more susceptible to bacterial infections

Answer 19

Reduction in the number of monocytes in the blood, potentially affecting the body’s ability to fight certain infections and inflammatory conditions

Answer 20

Lower than normal count of lymphocytes, which can weaken the immune response and increase vulnerability to infections

Answer 21

When a neutrophil expels nuclear material in the form of neutrophil extracellular traps (NETs)

Answer 22

1. Pathogens exposure - immune system encounters pathogen 2. Antigen ID - immune cells equipped w PRRs recognise conserved molecular patterns found on pathogens 3. PRR binding - PRRs on immune cells bind to PAMPs on pathogen surface > activates immune cell which triggers series of intracellular signalling events to initiate immune response 4. Phagocytosis - engulf pathogen 5. Antigen presentation - dendritic cells present fragments of pathogen’s antigen on surface using MHC markers 6. T cell recognition - Th cells (CD4+) recognise antigen-MHC complexes on dendritic cells, so they then release cytokines that orchestrate immune response / T cytotoxic cells (CD8+) also recognise antigens presented by infected host cells 7. B cell recognition - B cells recognise antigens directly which activates them so that they can differentiate into plasma cells that can produce specific and complementary antibodies

Answer 23

Contributes to host defence by enhancing body’s ability to fight infections and remove damaged cells Activation of complement system leads to cascade of events, including opsonisation of pathogens, inflammation, and formation of membrane attack complexes to directly lyse and destroy target cells

Answer 24

C1 recognises immune complexes formed by binding of IgG or IgM to an antigen

Answer 25

Non-specific activation by bacteria, fungi, and parasites via C3b deposition on the surface of microbes

Answer 26

Mannose binding lectin (MBL) attaches to the mannose sugar residues on bacterial surfaces

Answer 27

Opsonisation - process by which complement proteins coat pathogens, making them more susceptible to phagocytosis Inflammation - increased blood flow and increased recruitment of immune cells and release of inflammatory mediators Punching holes - complement components create pores in membranes of target cells leading to their lysis

Answer 28

Genes that code for MHC proteins in humans

Answer 29

HLA/MHC class 1: HLA-A, HLA-B, HLA-C —> present on almost all nucleated cells and present endogenous peptides to CD8+ cytotoxic cells HLA/MHC class 2: HLA-DP, HLA-DQ, HLA-DR —> primarily found on APCs where they present exogenous peptides to CD4+ helper T cells

Answer 30

Refers to the unique set of characteristics that define an antibody, including the specific shape and structure of its variable domains It is determined by the combination of CDRs within an antibody, and it plays a crucial role in the antibody’s ability to bind to a specific antigen

Answer 31

Epitopes (specific regions on antigens recognised by antibodies) bind to CDRs on antibodies. These interactions are highly specific, like a lock and key mechanism ensuring that each antibody binds only to its corresponding antigen

Answer 32

Innate immunity has a rapid defence whereas adaptive is slower acting Innate immunity is non specific whereas adaptive is tailored to a pathogen Innate immunity has tolerance to self antigens whereas adaptive immunity can distinguish between self and non self

Answer 33

Acute myeloblastic leukaemia Fast growing cancer of the blood and bone marrow characterised by the rapid proliferation of immature myeloid WBC

Answer 34

Acute lymphoblastic leukaemia Rapidly progressing cancer of the blood and bone marrow, primarily affecting lymphoid WBC and often seen in children

Answer 35

Chronic myelogenous leukaemia Slow growing form of leukaemia that originates in myeloid WBC, characterised by the presence of the Philadelphia chromosome and a chronic phase that can transform into an acute phase

Answer 36

Chronic lymphocytic leukaemia A slowly progressing leukaemia primarily affecting lymphocytes, characterised by the accumulation of abnormal WBC in the blood and bone marrow

Answer 37

Multiple myeloma Cancer of plasma cells in the bone marrow, leading to overproduction of abnormal monoclonal antibodies and weakened bone structure

Answer 38

Malignancy characterised by an excess of clonal WBC

Answer 39

A heterogenous group of malignancies that arise from the clonal proliferation of various cell subsets of lymphocytes at different stages of maturation

Answer 40

Malignancies that refer to cancers that have a slow and relatively non-aggressive growth pattern

Answer 41

Malignancies that are characterised by a faster growth rate and a more invasive nature

Answer 42

Lymphoid malignancies that progress rapidly and involve immature or underdeveloped cells

Answer 43

Lymphoid malignancies that progress more slowly and involve mature but abnormal cells

Answer 44

Leukaemia cells (arising from early HSCs) lose their ability to differentiate, resulting in an early block, however they retain their ability to replicate Then, these myeloblasts or lymphoblasts proliferate uncontrollably, occupying space in the bone marrow Then, these cells replace most of the bone marrow cells, crowding sites of normal haematopoiesis Then, they enter peripheral blood Then, they metastasise throughout the body, forming a malignant leukaemia

Answer 45

Fatigue - due to decrease healthy RBC leading to decreased O2 transport Infection - due to fewer functional WBC Bleeding - due to decrease platelets Hepatosplenomegaly - due to infiltration of leukemic cells in these organs Lymphadenopathy - swelling of lymph nodes in response to abnormal proliferation of leukaemia cells Headache - due to increased ICP due to accumulation of leukemic cells and reduced blood flow Arthralgia - joint pain due to leukemic cells infiltration leading to inflammation Skin rashes - T cell infiltration to peripheral skin

Answer 46

Same as acute but it is a monoclonal disorder of LATE HSCs rather than early, meaning the cells are more mature but non-functional

Answer 47

Fatigue - due to reduced healthy RBC and O2 transport Hepatosplenomegaly - infiltration of leukemic cells in these organs Lymphadenopathy - swelling of lymph nodes due to abnormal proliferation of leukaemia cells Arthralgia - joint pain due to leukemic cell infiltration leading to inflammation and discomfort

Answer 48

Organomegaly - due to uncontrolled growth and accumulation of cancerous cells within an organ Bleeding/bruising - malignant tumours invade blood vessels, impairing their integrity or when cancer disrupts normal clotting processes Infection - underproduction of immune cells > weakened immune system Anaemia - abnormal cancerous cells crowd out healthy blood-forming cells in bone marrow Renal failure - abnormal proteins produced by cancer cells > clog and damage filtering units of kidneys Bone pain - infiltration of abnormal cells into bone marrow and subsequent disruption of normal bone structure

Answer 49

Chemicals/radiation - damages DNA increasing risk of mutations Genetic abnormalities - ppl w trisomy 21 have an increased risk of haematological cancers due to genetic factors and abnormal immune function Smoking - carcinogens which increases the risk of developing haematological cancers Viruses - can lead to genetic changes which increases risk of developing haematological cancers Past medical history - history of certain conditions like myelodysplastic syndrome can increase risk of progression to more aggressive cancers Family history - indicate genetic predisposition

Answer 50

Lab test in which a drop of blood is spread thinly on a glass slide and then stained to allow for the microscopic examination of blood ells Enables observation of size, shape, colour, arrangement and inclusions of blood cells

Answer 51

Darker cells with central pallor

Answer 52

Larger, segmented purple nuclei

Answer 53

Represented as small dots

Answer 54

Diagnosis - crucial for confirming or ruling out haematological malignancies such as leukemia, lymphoma and myeloma Classification - classify specific subtype and stage of malignancy Staging - determine extent and progression of malignancy and spread Monitoring - response to Rx, assess disease remission, and detect relapse Rx guidance - determine most appropriate Rx strategies, including chemotherapy, targeted therapy, or bone marrow transplantation

Answer 55

Enables the analysis of cell surface markers and intracellular proteins on individual cells in a blood or bone marrow sample Detect and quantify abnormal cell populations such as leukemic blasts, lymphoma cells, and myeloma cells Helps differentiate b/w diff types of haem malignancies Allows assessment of Rx response Provides immunophenotypic info which is crucial for tailoring Rx

Answer 56

Immaturity of cell

Answer 57

Lymphoid lineage

Answer 58

Myeloid lineage

Answer 59

Cytogenics Flow cytometry Next gen sequencing Gene profiling PCR

Answer 60

Used for staging CLL Categorises Pt into one of 3 clinical stages based on extent of lymphocyte involvement and presence of anaemia or thrombocytopaenia Helps in determine the prognosis and guiding Rx decisions w early typically requiring less aggressive Rx compared to late stages

Answer 61

Patients have fewer than 3 enlarged lymph node groups and no anaemia or thrombocytopenia Prognosis of >15 yrs

Answer 62

Patients have 3 or more enlarged lymph node groups and no anaemia or thrombocytopenia Prognosis 7-8 years

Answer 63

Patients have anemia and/or thrombocytopenia regardless of number of enlarged lymph node groups Prognosis of 5-6 years

Answer 64

Induction - primary goal is to rapidly reduce number of cancer cells using intensive therapy e.g chemo Consolidation - following success phase, aims to eliminate any remaining cancer cells often involving additional chemo or stem cell transplantation Maintenance - lower dose, long term therapy administer to prevent re-emergence of malignancy

Answer 65

Curative option for some haematological malignancies, involving the infusion of healthy stem cells from a donor to replace the patients diseased bone marrow, enabling new blood and immune system to develop

Answer 66

Targeted therapies that can be designed to recognise and bind to specific antigens present on surface of cancer cells Used as standalone Rx or combined w chemo Can exert therapeutic effects through various mechanisms including immune system activation, interference w cell signalling pathways and direct cytotoxicity against cancer cells E.g rituximab for B cell lymphomas and alemtuzumab for CLL

Answer 67

Reciprocal translocation between chromosomes 9 and 22 leads to the BCR-ABL fusion gene This encodes for a constitutively active tyrosine kinase This activation stimulates intracellular signalling pathways that promote cell growth, survival and division This results in uncontrolled proliferation of myeloid cells, especially granulocytes, in the bone marrow and peripheral blood The accumulation of these abnormal myeloid cells can lead to symptoms of CML such as fatigue, enlarged spleen, and increased WBC counts

Answer 68

TKIs such as imatinib and dasatinib work by binding to active site of BCR-ABL protein, inhibiting its kinase activity By blocking the BCR-ABL kinase, these drugs effectively suppress the aberrant signalling pathways that drive uncontrolled cell proliferation in CML

Answer 69

MPNs are a group of rare blood disorders characterised by the overproduction of mature blood cells in the bone marrow Caused by genetic mutations in HSCs leading to uncontrolled growth of blood cells

Answer 70

Essential thrombocythemia (ET) Polycythemia Vera (PV) Primary Myelofibrosis (PMF) Chronic myeloid leukemia (CML)

Answer 71

Rare blood disorder where the bone marrow produces too many RBC, WBC and platelets leading to an increased risk of blood clots and other complications Has raised haemtocrit, may have Splenomegaly, may have high platelets, may have high leukocytes

Answer 72

Overproduction of platelets, potentially resulting in abnormal blood clotting or bleeding Has normal haematocrit, may have Splenomegaly, may have high leukocytes

Answer 73

MPN where bone marrow develops fibrous tissue, impairing its ability to produce normal blood cells and leading to anaemia and an enlarged spleen

Answer 74

Rare and serious blood disorder characterised by a significant reduction in the number of blood cells, including RBC and platelets in the bone marrow Occurs when bone marrow fails to produce adequate amount of blood cells Can be acquired or congenital, but it can also be idiopathic

Answer 75

CBC to assess low blood cell counts Bone marrow biopsy or aspiration to confirm reduction in haematopoietic cells

Answer 76

Blood transfusions Medications to stimulate blood cell production Immunosuppressive therapy Bone marrow transplantation

Answer 77

Fatigue Pallor Petechiae Infection Dyspnea Bleeding Headache