Haematology 2

Question 0

Full blood count

Answer 0

Measure of multiple parameters to asses the cellular elements of blood
3 key parameters:
Haemoglobin-> O2 carrying cap acting
Platelets-> clotting
White cells-> infection

Question 1

What is blood?

Answer 1

5 litres in 70kg person 
45% is RBC
1% is white blood cells and platelets
55% is plasma 
Serum is the liquid you have left after plasmas forms a clot 
Transport of-> water, food, gases, metabolites, hormones, 
Immunity 
Heat transport
Clotting/ repair

Question 2

Red cells

Answer 2

Use hb rather than number of red cells-> O2 carrying capacity
Measured in g/l
Haematocrit-> % of blood volume that is red cells l/l
Primarily for gas exchange
Buffers acidity
Biconcave and no nucleus

Question 3

Platelets

Answer 3

Clotting especially in high flow areas
Circulate as smooth discs, become spiky when activated
Life span 7-14 days

Question 4

White cells

Answer 4

Key mediators of immune function
Phagocytotic-> granulogytes and monocytes
Lymphoid white cells-> Bs and Ts

Question 5

Neutrophils

Answer 5

Phagocytosed bacteria 
Kill bacteria with hydrogen peroxide and oxygen free radicals
Multi lobed nucleus
Many fine red granules
8 hours life span

Question 6

Monocytes

Answer 6

Macrophages in transit
Phagocytose any dead/dying cells or acellular material
Contain phagocytotic vacuoles
More within tissues

Question 7

Eosinophils

Answer 7

Vital for anti parasite immunity
Allergic respone
Linked to IgE
Characteristic bilobed nucleus and red granules

Question 8

Basophils

Answer 8

Function not clear
May be important against parasites
Important in anaphylaxis
Obscured by dark blue granules-> histamine

Question 9

Lymphocytes

Answer 9

Roundish nucleus
Blue cytoplasm
Atypical lymphocytes (glandular fever) stick to surrounding red cells

Question 10

Anaemia occurs when:

Answer 10

Reduced production of red cells
Increased destruction of red cells
Increased loss of red cells

Question 11

Polycythaemia occurs when

Answer 11

Over production in marrow

Reduced plasma

Question 12

Assessing anaemia

Answer 12

MCV-> mean cell volume-> how big the red cells are
Microcytic-> small-> can’t make hb properly
Macrocytic-> big-> bone marrow problems
MCH-> mean cell Haemoglobin-> how red the cell is
Hypochromic anaemia-> reduced Haemoglobin
Reticulo types-> fresh RBCs-> start off big and get smaller as they mature-> big is maturation problems

Question 13

Microcytic anaemia

Answer 13

Thalassaemia
Iron deficiency-> bleeding, pregnancy, malabsorption, lack of iron in diet
Chronic disease ->kidney, body tries to keep iron from bacteria
Sideroblastic anaemia-> bone marrow produces ringing sideroblasts rather than healthy red blood cells
Most important cause-> blood loss

Question 14

Macrocytic anaemia

Answer 14

Reticulocytosis-> increased MCV increased Reticulocytosis
-haemorrhage until iron deficiency causes microcytosis
-haemolysis
Megloblastic anaemia-> impaired DNA synthesis in marrow precursor cells-> abnormally large red blood cells-> megaloblasts to Macrocytes
- either B12 or folate deficiency
-B12 normally absorbed via IF in the ileum
-lack of IF production-> pernicious anaemia
-removal of ileum
-inadequate folate intake-> alcoholics and patients with malabsorption
-also have neutropenia and thrombocytopenia
Marrow dysfunction-> secondary to renal, liver, thyroid dysfunction
Chemotherapy
Marrow diseases

Question 15

Changes to platelets

Answer 15

Thrombocytosis-> increased platelets-> inflammation or infection or over marrow production
Thrombocytopenia-> reduced platelets-> consumption by clotting-> bleeding! infection, liver disease, under production

Question 16

Changes to white cells

Answer 16

May be a cause or consequence of other pathology
Neutrophilia-> reaction to infection
Neutropenia-> under production or over consumption
Monocytsis-> chronic inflammation TB, malaria
Eosinophila-> parasites, fungi, allergies