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XY1110 > Haematology 1 > Flashcards

Haematology 1 Flashcards

1
Q

What are the functions of the blood?

A

Delivers nutrients to tissues
Removal of waste materials
Communication route
Suspensions of cellular elements- allows biochemical tests to be carried out.

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2
Q

What is transported in the blood?

A

Oxygen
Carbon dioxide
Nutrients
Hormones
Heat
Waste products

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3
Q

What is regulated in the blood?

A

Homeostasis of:
Body fluids
pH
Temperature
Cell water content

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4
Q

What does the blood protect against?

A

Excessive loss by clotting
Infections (WBC)

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5
Q

What are the blood components?

A

Cells (RBC, WBC, platelets) and soluble factors (water, proteins, gases and nutrients)
Plasma- WBC and platelets
Serum- allows the clot to form, efficiently removes RBC

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6
Q

Another name for red blood cells

A

erythrocytes

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7
Q

Another name for white blood cells

A

leukocytes
Lymphocytes are a type of leukocyte

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8
Q

Another name for platelets

A

thrombocytes

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9
Q

Another name for factor

A

protein

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10
Q

How long do lymphocytes last?

A

Long-lived and last for years

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11
Q

How long do most other blood cells last?

A

Hours/days/weeks

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12
Q

What is the RBC and platelet number like?

A

It remains relatively stable

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13
Q

What is the WBC count like?

A

It varies depending on invading pathogens/foreign antigens

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14
Q

Another name for blood cell production

A

haematopoiesis

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15
Q

What are pluripotent stem cells?

A

They differentiate into blood cell types

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16
Q

What is erythropoiesis?

A

The production of red blood cells

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17
Q

Where do red blood cells originate from?

A

The myeloid stem cell
Same as granulocytes, monocytes, mast cells (MC), megakaryocytes

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18
Q

What ejects the nucleus to form reticulocyte? (immature RBC)

A

Proerythrocyte

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19
Q

Name some features of the RBC

A

Anuclear with no other organelles
binconcave discs
Contains the protein haemoglobin (Hb)- which carries oxygen to all the cells and some carbon dioxide to the lungs.

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20
Q

What is included in a Hb molecule?

A

4 haem groups with a iron (Fe 2+) ion
Allows binding of the 4 x O2

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21
Q

What factor increases the oxygen transport efficiency?

A

Lack of nucleus and organelles

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22
Q

Where does erythropoiesis occur?

A

In the bone marrow (BM) red pulp

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23
Q

How long do RBCs live for?

A

Approximately 120 days

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24
Q

How are the dead cells removed from circulation?

A

By the spleen and the liver

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25
Q

What happens to the breakdown products?

A

They are recycled and reused

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26
Q

What is the process of erythropoiesis?

A

Low oxygen concentration is sensed by the kidneys which release erythropoietin (EPO).
This then stimulates differentiation of HSC to RBC
Reticulocytes (immature RBC) enter circulation and mature in 1-2 days
Homeostasis with the blood oxygen

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27
Q

All blood cells are derived from which cell type?

A
  1. Common lymphoid precursor
  2. Common myeloid precursor
  3. Haematopoietic stem cell
  4. Neural stem cell progenitor
  5. Promonocyte
    Answer: 3
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28
Q

How many oxygen molecules can bind to two haemoglobin molecules?

A
  1. 2
  2. 4
  3. 6
  4. 7
  5. 8
    Answer: 5
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29
Q

What word refers to the production of red blood cells?

A
  1. Angiogenesis
  2. Erythropoiesis
  3. Haemostasis
  4. Haematopoiesis
  5. Homeostasis
    Answer: 2
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30
Q

What do WBCs (leukocytes) contain?

A

A nucleus and organelles but no Hb

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31
Q

What does granular mean and give examples

A

Granular- contains vesicles (‘granules’ can be stained)
e.g. neutrophils, eosinophils, basophils

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32
Q

What does Agranular mean and give examples

A

Does not contain granules
e.g. lymphocytes, monocytes

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33
Q

How long do WBCs last and what is their function?

A

May live for several months/years
Function- to combat invading microbes.

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34
Q

Where do the WBCs go during infection?

A

WBCs leave bloodstream during infection and collect at sites (tissues) of invasion- diapedesis (extravasation)

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35
Q

Features of WBC: neutrophils

A

Majority of WBC (70%) and granulocytes (90%)
Short-lived (0.5-3 days)
Granular cytoplasm with multilobular nucleus
Accumulates rapidly at sites of infection/injury
- Phagacytose
- Secrete enzymes

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36
Q

Features of WBC: eosinophils

A

Moderately short-lived (5-12 days)
Most abundant in small intestine
Prominent cytoplasmic granules for immune response to helminths and parasites
Degranulation- release of granule contents into extracellular space

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37
Q

Features of WBC: basophils

A

Found in low numbers in the blood, similar to mast cells
Roles in allergy (type I hypersensitivity) and autoimmune disorders
Granules contain heparin (anticoagulant), cytokines and lipid mediators

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38
Q

Features of WBC: lymphocytes

A

B cells and T cells (with many subtypes).
Derived from lymphoid precursor
Mediate the innate and adaptive immune response
1. Plasma B cells secrete antibodies
2. Memory B cells speed up subsequent response to infection
3. Cytotoxic T cells induce cell death of infected/ cancerous cells

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39
Q

Features of WBC: monocytes

A

Agranular myloid cell in the bloodstream
Mobilised to inflammatory sites after neutrophils
Differentiate into tissue-resident macrophages

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40
Q

How are platelets produced?

A

By splintering of megakaryocytes (Mk) in red bone marrow into 2000-3000 fragments

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41
Q

What hormone controls the HSC differentiation into Mk and platelets?

A

Thrombopoietin

42
Q

Features of platelets

A

Contains many vesicles but no nucleus
Platelets facilitate blood clotting
Can survive for 5-9 days

43
Q

What is the RBC count for both females and males?

A

Females- 4.8 x 10 ^6 /microliter
Males- 5.4 x 10 ^6 /microliter

44
Q

What is the platelets count?

A

1.5- 4 x 10 ^5 /microliter

45
Q

What is the WBC count?

A

5-10 x 10 ^3 /microliter

46
Q

What is the WBC count (%) for each individual one?

A

Neutrophil- 60-70%
Eosinophil- 2-4%
Basophil- 0.5-1%
Lymphocyte- 20-25%
Monocyte- 3-8%

47
Q

Which short-lived granulocyte is considered a ‘first-line responder’ and is rapidly recruited to sites of inflammation and injury?

A
  1. Basophil
  2. Eosinophil
  3. Erythrocyte
  4. Macrophage
  5. Monocyte
  6. Neutrophil
    Answer: 6
48
Q

Which of these myeloid cells is not typically tissue-resident?

A
  1. Alveolar macrophage
  2. Hofbauer cell
  3. Langerhans cell
  4. Microglia
  5. Monocyte
    Answer: 5
49
Q

Which of the following is anuclear?

A
  1. Basophil
  2. Macrophage
  3. Megakaryocyte
  4. Monocyte
  5. Neutrophil
  6. Platelet
    Answer: 6
50
Q

What is the sequence of responses that stop bleeding?

A
  1. Vascular constriction
  2. Platelet plug formation
  3. Blood clotting (coagulation)
51
Q

What factors are involved in clotting?

A

Coagulation factors

52
Q

Name 2 ways it can be activated?

A

Extrinsic pathway
Intrinsic pathway

53
Q

Where does it converge on?

A

Prothrombinase formation, which leads to the common pathway.

54
Q

What could a rupture in the endothelial lining lead to?

A

Blood loss

55
Q

What do the smooth muscle do to prevent this from happening?

A

The smooth muscle surrounding the endothelium constricts

56
Q

What happens to damaged endothelium?

A

It secretes endothelin which binds to receptors on smooth muscle cells, initiating constriction

57
Q

What are the different functions of platelets?

A
  1. Homeostasis
  2. Inflammation
  3. Antimicrobial activity
  4. Angiogenesis
  5. Tumor growth and metastasis
58
Q

Names of several family of receptors?

A
  1. Integrins
  2. Prostaglandin receptors
  3. Lipid receptors
  4. Transmembrane receptors
  5. Tyrosine kinase receptors
  6. Selectins
  7. Immunoglobin superfamily receptors
59
Q

What is the process of platelet activation and plug formation?

A
  1. Activation of surface receptors increases platelet
    [Ca 2+]
  2. Platelet conformational (shape) change to spiny spherical shape (extended pseudopodia)
  3. Activated platelets release granule contents (ADP, serotonin, fibronectin, von Willebrand factor; vWF)
60
Q

What are the remaining stages to platelet activation and plug formation?

A
  1. Increased platelet [Ca 2+] also stimulates membrane phospholipase A2 activity
  2. Phospholipase A2 liberates arachidonic acid from membrane phospholipids
  3. Arachidonic acid is converted to prostaglandin H2 (PGH2) by cyclooxygenase 1 (COX-1)
  4. PGH2 id further metabolised to thromboxane A2 (TXA2) by thromboxane synthase
61
Q

What is the function of vWF?

A

Promotes platelet adhesion to exposed collagen (temporary plug formation)

62
Q

What is the function of ADP?

A

Stimulates platelet aggregation

63
Q

What is the function of serotonin (5HT) and TXA2?

A

Induces smooth muscle contraction and platelet aggregation

64
Q

Features of von Willebrand factor (vWF)

A

Is a multimeric glycoprotein
Made of identical subunits that contain binding sites for both platelet glycoprotein receptors and collagen
- Many different functional domains
- High molecular weight multimers (HMWM) support this binding

65
Q

Is the initial haemostatic platelet plug stable?

A

It is not stable and would be washed away by circulation

66
Q

What do two of the converging pathways act to produce via activation of a cascade of coagulation factors?

A

Thrombin
- Extrinsic- quick; intrinsic- slow

67
Q

What is thrombin and its function?

A

It is an enzyme that converts soluble plasma fibrinogen into insoluble, cross-linked fibrin

68
Q

What are the components like in circulation?

A

They are normally inert

69
Q

What initiates a cascade of events?

A

Interacting with signalling agents

70
Q

Examples of a signalling event

A

pathogen, damage

71
Q

A rupture of a blood vessel exposes what?

A

A glycoprotein called tissue factor (TF)

72
Q

What does tissue factor bind to?

A

TF binds factor VII (readily present in the blood) to form a dimer protein complex- TF-VII

73
Q

What is serine protease and what does it do?

A

TF-VII is a serine protease and it activates factor X to factor Xa as well as factor IX to IXa

74
Q

What is the function of IXA?

A

IXA also activates factor X to factor Xa- amplifying mechanism

75
Q

Coagulation-intrinsic pathway
Ruptured blood vessels expose what?

A

Prekallikrein (PK) and high molecular weight kininogen (HMWK) which complex and activate factor XIIa

76
Q

Which actives which factor?

A
  • XIIa activates factor XI into XIa
  • XIa* activates factor IX into Ixa
  • IXa activates factor X into Xa
77
Q

What factor does it begin with and what does it form?

A

Begins with factor X (produced in the liver) which is activated to form factor Xa
Xa forms a dimer with factor Va to form prothrombinase
Prothrombinase converts prothrombin (II) to thrombin (IIa)

78
Q

Thrombin (serine protease) converts what to what?

A

Converts fibrinogen into insoluble fibrin, which cross-links and stabilises clot

79
Q

Features of coagulation with thrombin

A
  1. Amplication- positive feedback loop
  2. Polymerised fibrin is held together by non-covalent and electrostatic forces
80
Q

What is required for normal clot formation?

A

Vitamin K- synthesis of 4 clotting factors

81
Q

What helps dissolve small, unwanted clots?

A

Plasmin- fibrinolytic system

82
Q

Natural coagulants- features of Tissue-factor pathway inhibitor (TFP1)

A

Produced by epithelial cells ; inhibits TF

83
Q

Features of antithrombin

A

Inhibits IIa, xa, IXa, XIa, XIIa

84
Q

Features of thrombomodulin

A

Released by endothelium, converts thrombin to inactive form

85
Q

Features of prostacyclin I2 (PGI2)

A

Released by endothelium, inhibits platelet activation (1 degree homeostasis)

86
Q

Features of protein C

A

Activated by thrombin; inhibits V and VIII

87
Q

Pharmacological anticoagulants- warfarin and its features

A

In the form of tablets, formation of vitamin-dependent clotting factors
e.g. II, VII, IX, X

88
Q

Heparin and its features

A

Occurs naturally in the blood, but also a drug (injection or i.v. drip)
Activates antithrombin III to inactivate thrombin, prevents formation of fibrin/clot

89
Q

Clotting factor deficiencies- low concentration of clotting factor proteins- disseminated intravascular coagulation

A

Overactive clotting obstructs:
- small vessels
- depletes platelets and factors
- Causes excessive bleeding

90
Q

Vitamin K deficiency

A

Impaired activation of zymogen factors II (thrombin), VII, IX, and X causing impaired clotting

91
Q

Liver disease

A

Impaired liver function- impaired production of clotting factors by liver parenchymal cells

92
Q

Overdevelopment of circulating anticoagulants

A

Decreased clotting, similar symptoms to haemophilia

93
Q

Features of haemophilia

A

Impaired blood clotting due to lack of clotting factors:
- low concentration of either VIII or IX

94
Q

How is haemophilia caused?

A

Caused by genetic mutations in one of the genes coding for these factors.
- Haemophilia A- VIII mutation and deficiency
- Haemophilia B- IX mutation and deficiency

95
Q

What are the symptoms of haemophilia?

A

Prolonged bleeding, internal bleeding (joint pain, bruising), small increased risk of brain haemorrhage

96
Q

What type of genetic mutation is haemophilia?

A

X-linked recessive gene mutation- affected father, unaffected mother, unaffected son, carrier daughter, unaffected son and carrier daughter

97
Q

What is von Willebrand disease (vWD)

A

A genetic defect in vWF (platelet adhesion)
vWF is a glycoprotein that helps form a platelet plug

98
Q

What are the 4 types of vWD?

A

Type 1- most common, reduced [vWF], only a problem following surgery
Type 2- abnormal vWF function- more frequency bleeding
Type 3- most severe and rare- extremely low [vWF]
Acquired- non-genetic, usually associated with blood, immunological, or heart problems

99
Q

Mechanical tissue disruption activates the extrinsic coagulation cascade through exposure of which glycoprotein?

A
  1. Factor IIa
  2. Factor XI
  3. Fibrin
  4. Fibrinogen
  5. Tissue factor
  6. Von Willebrand factor
    Answer: 5
100
Q

Which serine protease catalyses the production of thrombin from prothrombin?

A
  1. Antithrombin
  2. TF-VII complex
  3. Plasmin
  4. Prothrombinase
  5. Protein C
    Answer: 4
101
Q

Which of the following is a non-genetic coagulation disorder?

A
  1. Acquired vWD
  2. Haemophilia type A
  3. Haemophilia type B
  4. Type 1 vWD
  5. Type 2 vWD
  6. Type 3 vWD
    Answer: 1

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