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POM Revision Cards > Haematology > Flashcards

Haematology Flashcards

1
Q

Granulocyte and monocytes growth factors?

A

G-CSF, GM-CSF, cytokines (interleukins)

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2
Q

Megakaryocytopoiesis and platelet production growth factors?

A

Thrombopoietin

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3
Q

Iron deficiency symptoms?

A

Koilonychia, glossitis, angular stomatitis

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4
Q

What are B12 and folate needed for?

A

dTTP synthesis for synthesis of thymidine for DNA synthesis

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5
Q

Disruption of vertical linkages of RBC?

A

Disruption of ankyrin/spectrin vertical linkages causes hereditary spherocytosis (spherocytes, autosomal dominant)

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6
Q

Disruption of horizontal linkages on RBCs?

A

Hereditary elliptocytosis (also in iron deficiency)

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7
Q

What is G6PD important for?

A

Hexose monophosphate (HMP) shunt, coupled to glutathionine metabolism, protects RBC from oxidative damage.

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8
Q

Bohr effect?

A

High CO2, low pH, right shift, O2 release.

cooperativity - O2 affinity of Hb increases as oxygen is added to it.

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9
Q

2,3-BPG

A

Biphosphoglycerate, competitive inhibitor of O2, right shift. Bind to beta-globin chain in central cavity.

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10
Q

Heinz bodies?

A

In G6PD deficiency, irregularly contracted cells

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11
Q

MCV?

A

Hct
—— L
RBC

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12
Q

MCH?

A

Hb
—— g
RBC

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13
Q

MCHC?

A

Hb
—— g/L
Hct

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14
Q

Myeloid growth factors?

A

G-CSF - granulocyte colony-stimulating factors
M-CSF - macrophage colony-stimulating factors
GM-CSF - granulocyte-macrophage colony-stimulating factors

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15
Q

Contents of basophil granules?

A

Histamine, heparin and proteolytic enzymes.

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16
Q

CML cause?

A

Translocation between chromosome 9 (tyrosine kinase) and 22, uncontrolled tyrosine activity.
Tyrosine kinase inhibitor treatment.

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17
Q

Vasoconstriction in primary Haemostasis?

A

Nitric oxide and prostacyclin (vasodilators) concentration lower than endothelin (vasoconstrictor)

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18
Q

Platelet adhesion in primary Haemostasis?

A

Stick to vessel wall directly to collagen through GPIa or to VWF through GPIb receptors.
Causes activation, from disc to rounded shape. Form spicules to encourage platelet interactions.

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19
Q

Platelets release in primary Haemostasis?

A

ADP (binds to P2Y12 receptor and thromboxane A2, positive feedback).
Fibrinogen, VWF.
Prostaglandin thromboxane A2 and prostacyclin (from endothelial cells) from arachidonic acid using cyclo-oxygenase.

20
Q

Fibrinogen?

A

Activates platelets, conformational change, binds to GPIIb/IIIa, platelet plug.

21
Q

Anti-platelet drugs?

A

Aspirin - irreversibly binds COX, platelets cannot produce more but endothelial cells can (as have nucleus).

Clopidogrel - irreversibly blocks ADP receptor P2Y12.

22
Q

Secondary Haemostasis factors?

A

TF + VIIa = IX -> IXa + X -> Xa = II -> IIa
IIa = V -> Va, VIII -> VIIIa, XI -> XIa + platelets
XIa = IX -> IXa
IXa + VIIIa = X -> Xa + II -> IIa
IIa = fibrinogen -> fibrin.

23
Q

Vitamin K?

A

Needed for carboxylation of glutamic acid residues in factors II, VII, IX + X

24
Q

Anticoagulant drugs?

A

Heparin - potentiates antithrombin which inactivates Xa and IIa.
Warfarin - vitamin K antagonist, reduces synthesis of factors II, VII, IX + X by liver.
Direct oral anti coagulants - inhibit thrombin or factor Xa.

25
Q

Protein C?

A

Thrombin binds to thrombomodulin, activates protein C, which inactivates cofactors Va and VIIIa. In presence of cofactor protein S.

26
Q

Fibrinolysis?

A

t-PA (tissue plasminogen activator) + plasminogen bind to lysine residues on fibrin together which converts plasminogen -> plasmin.
Plasmin breaks down fibrin, fibrinogen and factors Va and VIIIa.
Plasmin inhibited by anti plasmin + alpha-2-macroglobulin.

27
Q

Thrombolytic therapy and antifibrinolytic drugs?

A

Thrombolytic therapy - recombinant t-PA for ischaemic stroke + pulmonary emboli.

Antifibrinolytic drugs - tranexamic acid - synthetic derivative of lysine that binds to plasminogen and prevents activation through competitive inhibition.

28
Q

PT vs APTT?

A

PT - extrinsic factors, prolonged = reduction in activity of VII, X, V, II or fibrinogen. Recombinant thromboplastin used as source of TF and phospholipid.

APTT - intrinsic factors, prolonged can be haemophilia A (factor VIII deficiency), B (factor IX deficiency), factor XI deficiency, or factor XII deficiency (no bleeding).

29
Q

Proteins in plasma?

A

Make up 7% of plasma.
Serum albumin (55%) - produced in liver, transports lipids, hormones and ions. Maintains osmotic pressure of plasma.
Globulins (35%) - alpha, beta and gamma globulins.

30
Q

Alpha globulins?

A

Alpha-1-antitripsin - inhibits proteases to protect tissues from enzymes like neutrophil elastase.

Alpha-2 - haptoglobulin (binds to haemoglobin then removed from spleen, used in haemolytic anaemia diagnosis) and alpha-2 macroglobulin (protease inhibitor which inactivates fibrinolysis).

31
Q

Beta and gamma globulins?

A

Beta globulin - complement protein C3 + C4, transferrin from liver (transports iron and ferritin).

Gamma globulin - immunoglobulins, acute phase C reactive protein.

32
Q

A, B, and O antigen formation?

A

specific monosaccharides added onto common glycoprotein and fucose stem
A - enzyme adds N-acetyl galactosamine to H stem.
B - enzyme adds galactose to H stem.
O - only H stem.

33
Q

RBC cell membrane?

A

Biconcave, lipid bilayer supported by protein cytoskeleton. Has transmembrane proteins which maintain integrity, elasticity and shape.

34
Q

Haem group made of?

A

1 porphyrin ring and Fe2+.
Iron recycled in haemolysis, whilst catabolism releases bilirubin which is excreted in bile.

35
Q

Foetal vs adult Hb?

A

Adult - 2 alpha and 2 beta globin chains.
Foetal - 2 alpha and 2 gamma globin chains.

36
Q

ALL?

A

Acute lymphoblastic leukaemia - mostly in children.
Bone marrow infiltrated with lymphoblasts so impaired haemopoiesis and circulating lymphocytes
Thrombocytopenia so easy bruising, pale skin due to anaemia.

37
Q

CLL?

A

Chronic lymphocytic leukaemia
Smear/smudge cells

38
Q

AML?

A

Acute myeloid leukaemia
Auer rods (abnormal lysosomes), myeloblasts, monoblasts.
Anaemia symptoms, spontaneous bleeding, petechiae.

39
Q

CML?

A

Philadelphia translocation between chromosome 9 and 22, band forms, left shift. Eosinophils and basophils elevated.
Tyrosine kinase inhibitors needed

40
Q

What is in FFP and who is it given to?

A

Clotting factor - given for prolonged APTT + PT.

41
Q

What is in cryoprecipitate and who is it given to?

A

Contains fibrinogen, factor VIII, VWF + fibronectin.

42
Q

Polycythaemia vera?

A

Too many RBCs, blood doping/over transfusion, increase in erythropoietin, increases Hb, RBC + Hct.

pseudo = decreased plasma volume

43
Q

Haematocrit?

A

Percent by volume of RBCs in blood

44
Q

Iron functions

A

O2 transport in haemoglobin and mitochondrial proteins
Stored at ferritin in liver, absorbed in duodenum
Transferrin transports iron in plasma

45
Q

Antithrombin?

A

Inactivates thrombin and factor Xa, potentiated by heparin.

POM Revision Cards (7 decks)

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