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UCLMS Yr 1 Mod 1: Foundations of Health and Medical Practice > Haematology > Flashcards

Haematology Flashcards

1
Q

What are the 3 components of whole blood

A

Red Cells
Platelets
Plasma

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2
Q

What are the 3 types of plasma used for blood transfusions

A

Fresh Frozen Plasma (FFP)
Cryoprecipitate
Plasma for fractionation

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3
Q

What 3 components can be collected from plasma fractionation

A

Albumin
Coagulation factors
Antibodies

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4
Q

What are the 3 cellular components of blood

A

Red Cells
White Cells
Platelets

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5
Q

Where are the cellular components of blood mainly produced

A

Bone Marrow

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6
Q

How many ml of RBC are in a unit for blood transfusions

A

280ml

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7
Q

What temperature are RBC stored at

A

4 degrees C

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8
Q

How long can RBCs be stored for

A

35 days

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9
Q

What is the name of the fluid medium used to store RBCs

A

Additive fluid

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10
Q

What are is the alternative name for Red Blood Cells

A

Eurythrocytes

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11
Q

What is the alternative name for platelets

A

Thrombocytes

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12
Q

How are thrombocytes obtained

A

From pooling platelets extracted from whole blood donations

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13
Q

How many Donors = 1 Pool

A

4 Donors

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14
Q

What is aphaeresis

A

Cell Separator machine used to obtain thrombocytes

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15
Q

What temperature are platelets stored at

A

room temperature

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16
Q

What is done to prevent platelets from clumping together

A

They are agitated on a plate

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17
Q

How long do platelets last, and why not longer

A

7 days, due to risk of bacterial infection

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18
Q

What is required and not required when transiting platelets

A

Correct blood group, no crossmatching required

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19
Q

Where are the plasma components of the blood made

A

liver

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20
Q

What are the 3 plasma components of blood

A

clotting factors
albumin
immunoglobin

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21
Q

What is FFP used for

A

Good source of coagulation factors

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22
Q

What is required and not required when administering FFP

A

Same blood group, no cross-match required

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23
Q

How much is one unit from one donor

A

300ml

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24
Q

what temperature is FFP stored at

A

-30 degrees C

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25
how long can FFP be stored for
up to 1 year
26
How long does it take to thaw FFP
20-30 minutes
27
FFP must be given ASAP, why
coagulation factors degenerate over time
28
What is the average dose of FFP in ml/kg
12-15ml/kg
29
How is cryoprecipitate obtained, and why is it obtained in this way
by thawing plasma slowly to precipitate out the higher molecular weight proteins in the plasma
30
what temperature is FFP defrosted to obtain cryoprecipitate, and for how long
4-8 degrees C overnight
31
What are 2 examples of higher molecular weight proteins in plasma
Fibrinogen | Factor VIII
32
What are Cryoprecipitate a source for during haemorrhage
Fibrinogen
33
What temperature is cryoprecipitate stored at
-30 degrees C
34
How long is Cryoprecipitate stored for
1 Year
35
What is the standard dose of cryoprecipitate
10 donors
36
What are the 2 indications where cryoprecipitate should be used
Massive bleeding, where fibrinogen is low | Hypofibrinogenaemia (Rare)
37
What are the three blood groups
A B O
38
Blood groups are ...... on the blood cell surface
antigens
39
What type of inheritance are blood groups A and B
Co-dominant
40
What type of inheritance is Blood group O
Recessive
41
What determines the antigens on the red cell surface
Genetically determined, occur through the presence/absence of certain enzymes acting on the O antigen
42
What blood group does a person with only the Gal Transferase enzyme have
B
43
What blood group does a person with the GalNAc Transferase enzyme have
A
44
What blood group does a person with both GalNAc and Gal Transferase enzymes have
AB
45
What blood group does a person with neither the GalNAc and Gal transferase enzymes have
O
46
How how long before birth do ABO antibodies form
3-6 months
47
What type of antigen are the ABO antibodies, and what 2 things can they do
IgM Agglutinate Activate compliment
48
What 2 things are unusual about the ABO antibodies
They are naturally occurring | Develop antibodies to antigens you don't have
49
What are the antigens on Red cells in blood group A
A
50
What are the antigens on Red cells in blood group B
B
51
What are the antigens on Red cells in blood group AB
A and B
52
What are the antigens on Red cells in blood group O
None
53
What antibodies are present in plasma for those with blood group A
Anti-B
54
What antibodies are present in plasma for those with blood group B
Anti-A
55
What antibodies are present in plasma for those with blood group AB
None
56
What antibodies are present in plasma for those with blood group O
Anti-A and Anti-B
57
Which blood group is the universal recipient
AB
58
Which blood group is the universal donor
O
59
What percentage of people are Rhesus positive
85%
60
What percentage of people are Rhesus negative
15%
61
What determines Rhesus positive/negative
Two Genes, D and d
62
Which alleles code for Rhesus positive
DD or Dd
63
Which alleles code for Rhesus negative
dd
64
What 2 things are anti globulin tests used for
Cross-matching to ensure donor compatibility | Investigate haemolysis
65
What two things are a Direct Antiglobulin Test (DAT) used for
To detect the cause of haemolytic anaemia investigator transfusion reaction Diagnose haemolytic disease in a newborn
66
What is a Direct Antiglobiuin test also know as
Coombs Test
67
What does the DAT determine
If there are any antibodies on the red cell surface
68
What happens during a DAT
Anti-globulin is added to the patient red cells | Red cell aggregation occurs is antibodies are present on the red cell surface
69
What is the Indirect Antiglobulin test used to detect
Antibodies directed against red blood cell antigens
70
What 2 things is an Indirect Antiglobulin test used in preparation for
Blood Transfusion | Pregnancy
71
What temperature are the test RBC incubated at during an IAT
37 Degrees C
72
Why is Antiglobulin added during a DAT or IAT
To detect any antibody present on the red cell surface
73
How is the Indirect Antiglobulin test performed
Patient serum containing antibody is added to test RBCs These are incubated at 37 Degrees C Antiglobulin is added to see for agglutination
74
During an DAT or IAT, what does agglutination mean
Red Cells are coated with a particular antibody
75
What are the 2 main functions of the coagulation system
Control of bleeding | Allow vessels to be repaired
76
What is primary Haemostasis
Formation of platelet plug and vasoconstriction
77
What is secondary haemostasis
Coagulation factors are activated, and thrombin in generated
78
What does thrombin convert fibrinogen into
fibrin
79
What stabilises the soluble clot formed by fibrin
Factor XIII (8)
80
What process breaks down fibrin
fibrinolysis
81
What are the 5 steps in primary haemostasis, starting from injured blood vessel
``` Injured Blood Vessel Exposure of collagen Platelet adhesion Activation and degranulation of platelets aggregation of platelets ```
82
What is von Willebrand factor used for
Platelet adhesion
83
What are the 3 stages of secondary haemostasis
Initiation Propagation Amplification
84
What 3 conversions happen during initiation
Factor VIIa and Tissue Factor combine to form TF-VIIa complex TF-VIIa complex converts IX to IXa TF-VIIa complex converts X to Xa
85
What 3 conversions happen during propagation
Factor XI converted to XIa XIa converts IX to IXa IXa and VIIIa convert X to Xa
86
What 2 conversions happen during amplification
Xa converts II to IIa | IIa converts fibrinogen to soluble fibrin
87
What is an alternative name for Factor II
Prothrombin
88
What is an alternative name for Factor IIa
Thrombin
89
Which factor converts Soluble fibrin into insoluble cross-linked fibrin
Factor XIIIa (8a)
90
During secondary haemostasis, which 3 stages require Calcium 2+ ions
Conversion of IX to IXa Conversion of X to Xa Conversion of II to IIa
91
During secondary haemostasis, which 2 stages require Platelet phospholipid
Conversion of X to Xa | Conversion of II to IIa
92
What are 3 examples of natural anticoagulants
Antithrombin Protein C Protein S
93
How is the coagulation system controlled
Inhibition on thrombin formation and breakdown of fibrin clots
94
What 2 factors does antithrombin inhibit
Factor Xa and Thrombin
95
What 2 factors does protein S and activated protein C inhibit
Factors V and VIII
96
During fibrinolysis, what is plasminogen converted into
plasmin
97
What does plasmin do during fibrinolysis
converts fibrin into fibrin degradation products
98
What does Alteplase (t-Pa) do
thrmobolyse (break down) the patient clot
99
Which test would be used to investigate possible defects in primary haemostasis
PFA-100
100
What 3 things usually causes defects in primary haemostasis
Platelet number Platelet function von Willebrand disease
101
What is thrombocytopenia
Low platelets
102
What characterises primary haemostasis defects
muco-cutaneous bleeding
103
What are 9 examples of muco-cutaneous bleeding
``` Easy/spontaneous blruising Petechiae/purpura Epistaxis (Nose Bleeds) Menorrhagia (heavy periods) Prolonged bleeding following minor trauma Operative bleeding Intramuscular haematoma (rare) Intracranial haemorrhage (rare) Join bleeds (very rare) ```
104
What are 4 examples of causes for acquired secondary haemostasis
Liver Disease drugs Vitamin K deficiency Consumption
105
What is an example of a Vitamin K dependant factor
VII
106
How does warfare act in treating Vitamin K Deficiency
Prevents Vitamin K recycling
107
What are 2 examples of deficient factors causing inherited haemophilia
Factor VII and IX deficiency
108
Which Factor deficiency causes Haemophilia A deficiency
Factor VIII (8)
109
Which factor deficiency causes Haemophilia B
Factor IX Deficiency
110
How is Haemophilia inherited
Sex Linkage
111
Which chromosome is haemophilia carried on
X chromosome
112
Which type of haemophilia is more common
Haemophilia A
113
Which pathway are Factors VIII and IX involved in
Intrinsic pathway
114
What do deficiencies in factors VIII and IX result in, with respect to the intrinsic pathway
Prolonged activated partial thromboplastin time
115
What is given to severe haemophiliacs prophylactically
Regular coagulation factors
116
What 3 things constitute an abnormal coagulation screening
APTT prolonged PT Normal TT Normal
117
What pathway is APTT
Intrinsic Pathway
118
What pathway is PT
Extrinsic Pathway
119
What pathway is TT
Final Common Pathway
120
What does APTT stand for
Activated Partial Thromboplastin Time
121
What does PT stand for
Prothrombin Time
122
What does TT stand for
Thrombin Time
123
What is used to treat Bleeding Disorders as a general measure
Tranexamic Acid
124
What does tranexamic acid do
Inhibit break down of blood clots (fibrinolysis)
125
What is Venous Thromboembolism (VTE)
When Thrombosis blood clots affect the arterial system
126
What are 5 risk factors for VTE
``` Increasing age Obesity Dehydration Significantly reduced mobility Abnormal clotting conditions ```
127
What is thrombophilia
tendency to thrombosis
128
What is the name given to the administration of drugs to prevent VTE
Thromboprophylaxis
129
What e the 3 categories in Virchrow's Triad
Blood Hypercoagulability Venous Stasis/Abnormal Flow Injury to the Vessel Wall
130
Where is the most common location for a VTE
Lower limb in the legs
131
What are the 3 most common symptoms of Deep Vein Thrombosis (DVT)
Pain Swelling Erythema
132
What is the most serious for of VTE
Pulmonary Embolism
133
What are 3 common symptoms of Pulmonary Embolisms
Shortness of Breath Chest Pain Haemoptysis (coughing up blood)
134
How do Pulmonary Embolisms form
Clot forms, usually in a deep vein | Clot becomes dislodged and moves to the pulmonary arteries
135
After 2 years, what are the chances of a recurrent VTE
20%
136
After 10 Years, what are the chances of recurrent VTE
30%
137
What are the chances of post-thrombotic syndrome aft DVT
Around 20%
138
What are the chances of pulmonary hypertension after Pulmonary Embolism
up to 4%
139
What are the 2 broad goals of treating VTE
Stop the Thrombus getting worse | Prevent the recurrence of the thrombus
140
What is used mainly to treat VTE
Anticoagulant
141
What is given to treat VTE in selected scenarios
Thrombolysis
142
What are anticoagulants and thrombolysis associated with
Bleeding
143
Name 3 examples of anticoagulants
Heparin Direct Oral Anticoagulants (DOACs) Warfarin
144
What are two ways of thromboprophylaxis, giving an example for each
Drugs - Heparin | Mechanical - Compression Stockings
145
What is Anaemia
The number of red blood cells, or their oxygen-carrying capacity is insufficient to meet physiological needs
146
What is the commonest cause of anaemia worldwide
Iron Deficiency
147
What is the daily production of RBCs
200 billion
148
What is the lifespan of a RBC
120 days
149
How many RBCs are destroyed each second
2.5 million
150
What is a reticulocyte
immature RBC
151
What is the 1 main difference between the reticulocyte and the mature RBC
Reticulocyte has RNA
152
What is the name of the Blood Stem Cell
Hemoatopoic Stem Cell
153
What is the major function of the RBC
Oxygen Carrier
154
What is the structure of haemoglobin (4)
Tetramer of 4 global folded proteins 2x alpha chains 2x beta chains 4 Haem groups
155
What 2 components make up the Haem group
Iron | Porphyrin Ring
156
What is the oxygen delivery equation
DO2 = Q x (Hb x SaO2 x 1.34 +(PaO2 x 0.003)) ``` DO2 = Oxygen Delivery Q = Cardiac Output Hb = Haemoglobin SaO2 = Arterial O2 Saturation (PaO2 x 0.003) = Amount of O2 dissolved in the blood ```
157
What is erythropoiesis
The generation of Red Blood Cells
158
What are the 3 stages to recover from Low blood O2 Level
Kidneys increase production of erythropoietin Stem Cells increase Red Cell production O2 blood levels return to normal
159
Where is erythropoietin produced
Kindeys
160
What disease can impact the levels of erythropoietin
Chronic Kidney Disease
161
What is Normoxia
Normal Blood Oxygen Levels
162
What is Hypoxia
Low Blood Oxygen Levels
163
Which transcription factor increases the production of erythropoietin
HIF-1a (alpha)
164
Which protein is the signal transducer for erythropoietin
JAK2
165
What breaks down RBCs
Mcrophages
166
Where are RBCs broken down (3)
Spleen Liver Red Bone Marrow
167
What are RBCs broken down into
Haem | Globin
168
What happens to the broken down Globin
Broken down further into amino acids, which are then re-used for protein synthesis
169
What happens to the broken down haem
Fe3+ extracted
170
What protein transfers the iron from the haem
Transferrin
171
What does Fe3+ and Transferrin become in the liver
Ferratin
172
Where does Transferrin transport Fe3+
Back to the Red Bone Marrow
173
What 5 ingredients are required for erythropoiesis in the Red Bone Marrow
``` Fe3+ Globin Vitamin B12 Folic Acid Erythropoitin ```
174
What is billirubin fromed from
broken down haem
175
Where is bilirubin formed
Liver
176
What issue can stimulate the production of erythropoietin
Hypoxia
177
What is the average range of Hb levels in adult males
135-170 g/l
178
What is the average range of Hb levels in adult females
115-150 g/l
179
In Anaemia, what component of blood is at the highest proportions
Plasma
180
In Polycythemia, what component of blood is at the highest proportions
Haemocrit
181
What are the components measured in a full blood count
Haemoglobin White Cell Count Platelet Count
182
What are the 4 Red Cell Indicies
Mean Cell Volume Red Cell Distribution Width Packed Cell Volume Red Cell Count
183
How is the Haemoglobin levels measured and expressed
Photometric method | expressed as a concentration g/L
184
How are white cells identified and expressed
Any cell with a nucleus is assumed to be a white blood cell | Expressed as n x10^9 /L
185
How are red cells and platelets identified, differentiated and expressed
Cells without a nucleus are considered Red Cells or Platelets Differentiated by Size RBC Expressed as n x10^12/L Plts expressed as n x10^9/L
186
What are the three MCV subclasses of anaemia
Microcytic Normocytic Macrocytic
187
What is the MCV of microcytic cells
MCV <80fl
188
What is the MCV of normocytic cells
MCV 80-100fl
189
What is the MCV of macrocytic cells
MCV >100fl
190
What does a normal Red Cell distribution width mean (within the reference range of 11-15%)
There is a uniform cell population (all the cells are a similar size)
191
What does an abnormal Red Cell Distribution width mean
Both large and small cells are present
192
What 3 things is the packed Cell Volume derived from
Haemoglobin Red Cell Count Mean Cell Volume
193
What is used to differentiate Reticulocyte from an erythrocyte
Reticulocytes have RNA
194
What are 2 typical identifiers of iron deficiency anaemia blood films
Pencil Cell | Hypochromic Cell
195
What is typical of sickle cell anaemia blood films
Notable sickle-shaped red cells
196
What is typical of megaloblastic anaemia blood films
Hypersegmented nucleophile (due to B12 deficiency)
197
What is typical of haemolytic anaemia (G6PD deficiency)
Cytoplasm pertrusion
198
What is typical of Autoimmune Haemolytic anaemia blood films
Darker, solid RBCs
199
What is typical of thalassaemia blood films
Pale RBCs with ringed cytoplasm
200
What are 5 examples of inadequate RBC production
``` Haematinic Deficiency Reduced Globin Chain Production Bone Marrow Failure Inability to utilize Iron Insufficient EPO Production ```
201
What is Iron required for
Haem production
202
What is B12 and Folate required for
DNA production
203
Which compounds are deficient in Haematinic deficiency
Fe and B12/Folate
204
What si reduced globin chain production
Problem with the globin genes, leading to thalassaemias
205
What are the 13 Common symptoms for anaemia
``` Yellowing Eyes Paleness Cold Skin Yellowing Skin Shortness of Breath Weakness Changed stool colour Fatigue Dizziness Low Blood Pressure Heart Palpitations Rapid Heart Rate Enlarged Spleen ```
206
What are the 4 symptoms of sever anaemia
Fainting Chest Pain Angina Heart Attack
207
What are the changes in Full Blood count and Red Cell Indices in Iron Deficiency Anaemia
``` Lowered Haemoglobin Increased Platelet Count decreased MCV (microcytic) increased Red Cell Distribution Width Decreased PCV Decreased Red Cell Count ```
208
What is anisopoikilocytosis
shape variation
209
What is anisocytosis
Size Variation
210
What are the changes in Full Blood count and Red Cell Indices in B12 or Folate Deficiency
``` Reduced Haemoglobin Normal/Lower Platelet Count Increased MCV (Macrocytic) Increased Red Cell Distribution Volume Reduced PCV Reduced Red Cell Count ```
211
What are the changes in Full Blood count and Red Cell Indices in Acute and Chronic Haemorrhage
``` Reduced haemoglobin Normal/raised platelets Increased Red Cell Distribution Width Reduced PCV Reduced Red Cell Count ```
212
What are the differences between Acute and Chronic Haemorrage
Normal MCV in Acute | Lowered MCV in Chronic
213
What can Chronic Blood Loss Lead to
Iron Deficiency
214
What are the changes in Full Blood count and Red Cell Indices in Haemolysis
Lowered Haemoglobin Normal or Lowered Platelet count Lowered/Normal/Raised MCV Raised RCDW
215
What causes the Sickle Cell Shape in sickle cell anaemia
Single base substitution causes the Beta Subunit of haemoglobin to have a different shape, leading to polymerisation of the Haem, and the sickle-cell shape
216
What are the changes in Full Blood count and Red Cell Indices in Anaemia of Chronic Diseas
Lowered Haemoglobin

UCLMS Yr 1 Mod 1: Foundations of Health and Medical Practice (6 decks)

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