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POM > Haematology > Flashcards

Haematology Flashcards

1
Q

What is hct (haematocrit)?

A

Percentage volume of blood that is red blood cells.

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2
Q

What is RBC (Red blood cell count)?

A

Number of red blood cells in a given volume of blood.

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3
Q

What is Hb?

A

Haemoglobin concentration.

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4
Q

What is MCV?

A

Average number of red blood cells in volume of blood.

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5
Q

What is MCH?

A

Average amount of haemoglobin in each red blood cell.

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6
Q

What is MCHC?

A

Average amount of haemoglobin compared to size of the cell.

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7
Q

What is anaemia?

A

Anaemia is a reduction in the amount of haemoglobin
in a given volume of blood

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8
Q

What are the two mechanisms that drive anaemia?

A

RBC failure of production or RBC excess loss/destruction

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9
Q

If microcytic anaemia is present what colour are the red blood cells?

A

Hypochromic (pale).

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10
Q

If macrocytic anaemia is present what colour are the red blood cells?

A

Normochromic (normal).

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11
Q

What proportion of normal red blood cells are pale?

A

A third of the diameter.

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12
Q

Why is the centre of the red blood cell pale?

A

Red blood cell have a disc shape. The centre has less haemoglobin and therefore is paler.

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13
Q

Why are hypo-chromic cells pale?

A

Less haemoglobin and flatter cell.

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14
Q

What are the three causes of iron deficiency anaemia?

A

Increased loss (blood loss), insufficient intake, increased requirement.

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15
Q

What are common causes of a loss of iron?

A

Hookworm, gastrointestinal bleeding, heavy menstrual bleeding.

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16
Q

What are common causes of an insufficient intake of iron?

A

Vegetarian diet, Coeliac disease (malabsorption).

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17
Q

What are common causes of an increased requirement of iron?

A

Pregnancy and infancy.

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18
Q

What are symptoms of iron deficiency anaemia?

A

Fatigue, Shortness of breath.

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19
Q

Why are iron deficiency anaemia symptoms caused?

A

Low amounts of haemoglobin means less oxygen to tissues. Reduced rate of respiration causes fatigue.

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20
Q

What should iron deficiency show in the blood test?

A

Increased transferrin and reduced serum ferritin.

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21
Q

What do iron deficiency anaemia and thalassaemia trait cause?

A

Micryocytic red cells.

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22
Q

How can you differentiate iron deficiency anaemia and thalassaemia trait?

A

Electrophoresis of haemoglobin and iron studies.

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23
Q

What do you see in β
thalassemia electrophoresis and why?

A

Raised Haemoglobin A2 is found where there is a reduction in beta globin chains, caused by β
thalassemia (or trait). Allows more delta chains to be incorporated into hemoglobin and so raised HbA2.

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24
Q

Important markers of thalassaemia trait.

A

Raised RBC and normal mchc.

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25
Q

Why do people with anaemia from chronic disease not benefit from iron supplementation?

A

They have high amounts of iron storage. (high ferritin levels).

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26
Q

What causes a reduction in haem?

A

IRON DEFICIENCY
ANAEMIA OF INFLAMMATION/CHRONIC DISEASE

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27
Q

What caused a reduction in globin?

A

THALASSAEMIA

28
Q

What happens to hepcidin in response to iron deficiency anaemia?

A

Downregulated.

29
Q

What happens to hepcidin in response to anaemia of chronic disease?

A

Hepcidin is produced.

30
Q

Explain the process of the absorption of vitamin b12?

A

B12 combines with Intrinsic factor (IF) made in the
gastric parietal cells. B12-IF binds to receptors in the ileum.

31
Q

Deficiency in vitamin b12 can be caused by what?

A

inadequate intake (veganism), inadequate secretion of IF (pernicious anaemia), Malabsorption (coeliac disease), lack of acid in stomach.

32
Q

Lack of vitamin B12 or folic acid causes what?

A

Megaloblastic anaemia.

33
Q

What else can cause macrocytic anaemia?

A

Liver disease and ethanol toxicity.

34
Q

What is haemolytic anaemia

A

Premature destruction of red blood cells.

35
Q

Normal erythrocyte life span?

A

120 days.

36
Q

An increased blue tinge to the
cytoplasm of a red cell is referred to as what?

A

Polychromasia.

37
Q

What does polychromasia indicate?

A

A young red blood cell which tells us that there is an increase in erythropoiesis which is a response to haemolysis.

38
Q

What are Reticulocytes?

A

Reticulocytes are newly produced, relatively immature red blood cells.

39
Q

What does Reticulocytosis indicate?

A

Reticulocytosis may occur as a response to bleeding or
red cell destruction (haemolysis)

40
Q

What will be raised in full blood count is patient has reticulocytosis?

A

Reticulocytes and MCV. Young red cells are about 20% larger than mature red cells so if there is an increased proportion of young red cells (polychromasia/reticulocytes) in the circulation, the average cell size (MCV) will be increased

41
Q

What are the consequences of red blood cell sickling?

A

Haemolysis and vaso-occlusion.

42
Q

What causes ‘sickling’ in sickle cell disease?

A

Polymerization of hemoglobin S that make red blood cells less flexible.

43
Q

What causes symptoms of anaemia in patients with sickle cell disease?

A

HbS has a lower affinity for oxygen than HbA.

44
Q

What is the spleen involved in?

A
  • Immune defence
  • Breakdown and removal of old, malformed or damaged red blood cells.
45
Q

What causes the spleen to no longer work in sickle cell patients?

A

Repeated splenic vaso-occlusion.

46
Q

What is it called when the spleen no longer works?

A

Functional hypospleenism.

47
Q

What might you recommend to someone with hypospleenism?

A

Antibiotics. Might also recommend immunisations.

48
Q

Why does polycythaemia happen?

A

Too little plasma. Blood becomes too thick.

49
Q

What does polycythaemia increase the risk of?

A

Thrombosis.

50
Q

What are raised in a patient with polycythaemia?

A

Hb, Hct and RBC.

51
Q

What is infectious mononucleosis?

A

Swollen lymph glands, fever, sore throat. Resulting from Epstein‒Barr virus infection.

52
Q

What is seen on the blood film of a patient with Infectious Mononucleosis?

A

Scalloped margins and ‘hugging’ of the surrounding red blood cells. Lymphocytes that have intensely basophilic (blue) cytoplasm.

53
Q

What do we see on the blood film of a patient with CLL?

A

Smear cells. Lymphocytes.

54
Q

What helps confirm diagnosis of CLL?

A

Flow cytometry. Profile of cell surface markers expressed by lymphocytes.

55
Q

How can blast cells be recognised?

A

Large size, high nucleus/cytoplasmic ratio.

56
Q

Why does the philadelphia chromosome leads to CML?

A

BCR::ABL1 gene on philadelphia chromosome encodes a protein with uncontrolled tyrosine kinase activity, which gives rise to leukaemic clone.

57
Q

How can you treat CML?

A

Tyrosine kinase inhibitors. These block tyrosine kinase and so there is no signal for cell to divide.

58
Q

CML key symptom?

A

Splenomegaly.

59
Q

How do you differentiate acute lymphoblastic leukaemia and acute myeloid leukaemia on a blood film?

A

Cytoplasm in blasts of AML contain
granules. Very irregular shape of the nuclei seen in acute lymphoblastic leukaemia.

60
Q

What is pancytopenia?

A

Deficiency of all three cellular components of the blood (red cells, white cells, and platelets).

61
Q

What kind of cells do you see on blood film of acute myeloid leukaemia?

A

Myeloblasts, Nucleated red blood cell

62
Q

What kind of cells do you see on blood film of chronic myeloid leukaemia?

A

Increased granulocyte precursors: myelocytes and metamyelocytes (‘left shift’).

63
Q

Test for infectious mononucleosis?

A

Monospot test or looking for IgM antibodies to Epstein-Barr Virus (EBV).

64
Q

Metabolic effects of leukaemia?

A

High levels of uric acid and renal failure

65
Q

What is a specific indicator of bacterial infection seen in neutrophils on blood film?

A

Presence of clear vacuoles within the cytoplasm of the neutrophils.

66
Q

How to optimise image when using a light microscope?

A

Step 1: Focus the image. Step 2: Focus the condenser. Step 3: Adjust the field iris. Step 4: Adjust the condenser iris.

POM (41 decks)

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