Haematology

Question 1

What haematological values in blood results indicate anaemia or iron?

Answer 1

Haemoglobin
Mean cell volume
Ferritin 
Vitamin B12
Folate

Question 2

What haematological values in blood results indicate platelet dysfunction?

Answer 2

Platelets

Bleeding time

Question 3

What haematological values in blood results indicate clotting dysfunction?

Answer 3

Prothrombin time
Activated partial thromboplastin time
Bleeding time

Question 4

What haematological values in blood results indicate malignancy or something else?

Answer 4

White blood cells
Neutrophils 
Lymphocytes 
Eosinophils 
Reticulocytes

Question 5

How would you categorise haematological symptoms?

Answer 5

Anaemia
Bleeding
Clotting
Malignancy

Question 6

What is serum iron?

Answer 6

measure of the ferric (Fe3+) ions bound to serum transferrin

Question 7

What is serum ferritin?

Answer 7

: intracellular iron storage protein whose levels are indicative of the body’s total iron stores (can be increased in inflammatory disorders so interpret with other results).

Question 8

What does a raised reticulocyte count indicate?

Answer 8

Anaemia in which the blood cells are being destroyed in the periphery

Adaptation to high O2 demands

Question 9

What are the causes of acute leukocytosis (high leukocytosis)?

Answer 9

Infection, inflammation, post-surgery

Stress respond or steroid medication

Acute leukaemia

Question 10

What are the causes of chronic leukocytosis (high leukocytosis)?

Answer 10

Chronic infection, smoking

Leukaemia, lymphoma

Pregnancy

Question 11

What are the main white blood cells?

Answer 11

Neutrophils, lymphocytes

Question 12

What is leukopenia?

Answer 12

Low white blood cell count

Question 13

What are the causes of leukopenia (low leukocytosis)?

Answer 13

Infection

Medication (chemo)

B12/folate deficiency

Autoimmune disease

HIV

Question 14

What is neutropenic sepsis?

Answer 14

When neutrophil counts are low (<1.5) there is a higher infection risk. For this reason, if a neutropenic patient is febrile it is a medical emergency that requires prompt treatment with broad-spectrum intravenous antibiotics. This is known as neutropenic sepsis or febrile neutropenia.

Question 15

What are the causes of lymphocytosis?

Answer 15

Viral infection
Smoking
Hyposplenism/post-splenectomy
Malignancy: leukaemia and certain types of lymphoma
Pertussis: rates are increasing in the U.K. with decreased vaccination rates

Question 16

What are the causes of lymphopenia?

Answer 16

Infection
Older age (rarely clinically significant in this context)
Alcohol excess
HIV
Autoimmune disease
Bone marrow disease
Medications: cytotoxic agents, immunosuppressants
Renal failure

Question 17

What are the causes of monocytosis?

Answer 17

Bacterial infection
Autoimmune disease
Steroids

Question 18

What are the causes of monocytopenia?

Answer 18

Is not usually clinically relevant unless it is very low (i.e. near 0)

Question 19

What are the causes of eosinophilia?

Answer 19

Allergies/atopy
Parasitic infection
Autoimmune disease (e.g. vasculitis)
Medications (e.g. antibiotics, anti-epileptics, allopurinol)
Gastrointestinal disease (e.g. eosinophilic oesophagitis)
Respiratory disease (e.g. asthma)

Question 20

What are the causes of basophilia?

Answer 20

Allergic reactions/atopy
Iron deficiency 
Chronic inflammation
Hypothyroidism
Infection
Haematological malignancies (myeloproliferative disorders)

Question 21

What are the causes of an elevate blast count?

Answer 21

Acute leukaemia
Myeloproliferative disorders
Reactive (severe infection or treatment with G-CSF)
Cytotoxic agents (chemotherapy)

Question 22

What are causes of acute thrombocytopenia? (low platelet count)

Answer 22

Consumption (e.g. infection, bleeding)
Acute viral infection
Medications (e.g. antibiotics, anti-epileptics, cytotoxic agents)
Disseminated intravascular coagulation/microangiopathic haemolytic anaemia (e.g. TTP, HUS)
Heparin-induced thrombocytopenia (HIT)
Immune thrombocytopenic purpura (ITP)

Question 23

What are causes of chronic thrombocytopenia? (low platelet count)

Answer 23

Hypersplenism
Cirrhosis
Alcohol excess
Medications (e.g. anti-epileptics, cytotoxic agents)
ITP
Autoimmune disease
B12/folate deficiency
Iron deficiency
HIV
Hepatitis B/C
Haematological disease
Bone marrow failure

Question 24

What are causes of thrombocytosis? (high platelet count)

Answer 24

Reactive: inflammation/infection
Myeloproliferative disorders: typically essential thrombocythaemia although any myeloproliferative disorder can elevate platelet counts
Iron deficiency
Hypospenlism/post-splenectomy
Underlying malignancy: likely secondary to underlying inflammatory processes