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Immunity, Infection and Haematology > Haematology > Flashcards

Haematology Flashcards

1
Q

What are the 2 main lineages of blood?

A

Myeloid & lymphoid

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2
Q

What cell types are included in the myeloid lineage?

A 
erythrocytes
platelets
neutrophils
eosinophils
basophils
monocytes
macrophages
dendritic cells
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3
Q

What cells types are included in the lymphoid lineage?

A

T and B lymphocytes

NK (natural killer) cells

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4
Q

What is CD34 used for?

A

CD34 is a cell surface glycoprotein. It is an important immunophenotypic marker of HSCs. Small numbers of HSC are usually present in the blood, but increase in number when the marrow is recovering from damage inflicted by cytotoxic drugs or following administration of G-CSF. G-CSF is used to mobilise stem cells into the blood for harvesting for HSC tranpslants.

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5
Q

Where does haemotopoiesis occur in the foetus?

A

At the beginnign of gestation: occurs as transient primitive waves in the extra-embryonic yolk sac. Definitive HSCs the n start to appear in the aorta-gonadal-mesonephros (AGM) region of the developing embryo. HSC then migrate to the foetal liver and then to the bone marrow

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6
Q

Where does haematopoiesis occur in adults?

A

Red marrow of bone marrow, only found in axial skeleton

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7
Q

What is extramedullary haematopoiesis?

A

When haematopoiesis occurs in liver and spleen - this occurs in certain pathologies such as myelofibrosis or untreated thalassaemia

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8
Q

What are the 6 important examples of Haematopoietic growth factors?

A 
Erythropoietin - erythryoid
Thrombopoietin - platelets
G-CSF and GM-CSF - granulocyte, myeloid
IL-5 - eosinophils
IL-3 - stem cell and early progenitors
IL-7 - lymphoid
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9
Q

What are the uses of erythropoietin?

A

Renal failure
Treatment of anaemia
For patients donating their own blood prior to elective surgery
Jehovah’s Witnesses (instead of transfusions)

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10
Q

What are the side effects of Epo?

A

hypertension (dose-dependent), thrombosis, thrombophlebitis

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11
Q

What is Granulocyte CSF (G-CSF) used for?

A
  1. Primary or secondary prevention of infections in neutropenic patients
  2. Mobilisation of stem cells into peripheral blood for stem cell harvests for haematopoietic stem cell transplants
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12
Q

What is Thrombopoitin used for?

A

Immune thrombocytopenia (ITP)
Myelodysplasia
Post chemotherapy

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13
Q

How is bone marrow testing carried out?

A

Sampling bone marrow usually from iliac crest.
Bone marrow trephine - core of bone marrow used to examine overall cellularity and architecture of bone marrow
Bone marrow aspirates - used to assess morphology / numbers of haematopoietic cells at different stages of differentiation and identify normal malignant filtrates

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14
Q

What two cells are the immediate precursors to red blood cells?

A

Normoblasts and reticulocytes

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15
Q

What two cells are the immediate precursors to monocytes?

A

Monoblasts and promonocytes

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16
Q

Where is thrombopoietin produced?

A

Mainly by the liver

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17
Q

Where is erythropoietin produced?

A

90% in the kidney

10% in the liver

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18
Q

What is the main stimulus to erythropoietin?

A

Hypoxia

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19
Q

What is the earliest recognisable erythroid cell in the marrow?

A

Proerythroblast (also called pronormoblast)

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20
Q

What is the difference between reticulocytes and erythrocytes?

A

Immature erythrocytes, containing some ribosomal RNA

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21
Q

What are leukemias?

A

Cancers of haematopoietic cells which arise in the marrow and spread to involve blood and lymph nodes / spleen

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22
Q

What are lymphomas?

A

Cancers of cells in the lymph nodes / spleen which spread to involve bone marrow and blood

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23
Q

What are myelomas?

A

malignancy of plasma cells (in marrow)

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24
Q

What are myeloproliferative disease & myelodysplasia?

A

neoplastic chronic abnormal myeloid proliferation

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25
Q

What globin chains are present in HbA, HbA2 and HbF?

A

HbA: 2 alpha, 2 beta
HbA2: 2 alpha, 2 delta
HbF: 2 alpha, 2 gamma

26
Q

What is methaemoglobin?

A

Hb with oxidised iron

27
Q

What is the role of 2,3-diphosphoglycerate?

A

Increases oxygen delivery to tissues

28
Q

Why is the dissociation curve of HbF a different shape to that of HbA?

A

Gamma-chains cannot bind 2,3-DPG

29
Q

Approximately what percentage composition of whole blood is cells?

A

45%

30
Q

What is blood serum?

A

Whole blood with all cells and clotting factors removed

31
Q

What are the causes of macrocytic anaemia?

A

B12 and folate deficiency
Alcohlism and liver disease
Impaired red cell production
Haemolytic anaemia

32
Q

How does B12 and folate deficiency cause macrocytic anaemia?

A

They are closely involved in the production of DNA

33
Q

What are the causes of aplastic anaemia? (bone marrow failure)

A 
certain viruses (hep B)
excessive doses of cytotoxic drugs / radiation
idiosyncratic reactions to drugs
34
Q

What does the direct Coombs’ test aim to identify?

A

Antibody bound to patient’s RBC

35
Q

What are the causes of normocytic anaemia?

A

Anaemia of chronic disease
Acute blood loss
Mixed deficiency anaemia
Bone marrow failure / ineffective erythropoiesis

36
Q

What are the causes of microcytic anaemia?

A

Iron deficiency anaemia

Haemoglobinopathies (thalassemia, sickle cell disease)

37
Q

Which type of thalassemia is asymptomatic?

A

beta-thalassaemia minor

38
Q

What is the underlying pathology in thalassaemia?

A

Ineffective production of globulin chains

39
Q

How are platelets produced?

A

Budding off of megakaryocytes

40
Q

What is present inside dense granules in platelets?

A

ADP, serotonin, catecholamines, Ca2+

41
Q

What is present inside alpha granules in platelets?

A

Clotting factors: FV, FVIII, fibrinogen, vWF

42
Q

Which receptor mediates a strong bond between platelets in a thrombus?

A

GpIIIb/IIIa

43
Q

What factor released by endothelial cells causes platelet activation?

A

ADP

44
Q

What factors require vitamin K for their synthesis?

A

Prothrombin, FVII, FXI, FX

45
Q

What is the first reaction in activation of the extrinsic pathway of the clotting cascade?

A

Tissue factor binds to FVII

46
Q

What is the most important physiological mechanism for haemostasis in venous vessels?

A

Coagulation cade.

platelets for arterial circulation

47
Q

What are the hereditary disorders of platelets?

A

Bernard-Soulier syndrome - platelet membrane GPIb

Glanzmann’s thrombasthenia - GPIIb/IIIa

48
Q

What are the causes of acquired thrombocytopenia?

A

Autoimmune destruction

Bone marrow failure

49
Q

What are the hereditary clotting factor disorders?

A 
Haemophilia A (FVIII deficiency)
Haemophilia B (FIX deficiency)
50
Q

What is fibrinolysis?

A

Process of fibrin clot degradation

51
Q

Where is tissue plasimogen activator produced?

A

Endothelial cells

52
Q

What induces the release of tPA?

A

Thrombin

53
Q

What is the role of activated protein C?

A

Degrade FVa and FVIIIa

54
Q

What does anti-thrombin do?

A

Inactivate thrombin & FXIa, FXa and FXIa

55
Q

What is the most important anticoagulant control mechanism operating on the venous side of the circulation?

A

Protein C system

56
Q

How is protein C activated?

A

Thrombin enzymatically cleaves Protein C

57
Q

What is the most common hereditary thrombophilia?

A

Factor V Leiden mutation

58
Q

What is Activated Partial Thromboplastin Time (APTT) used to investigate?

A

Activity of intrinsic & common pathway of coagulation cascade

59
Q

What is prothrombin time used to investigate?

A

Activity of extrinsic & common pathway of coagulation cascade

60
Q

What is Bernard-Soulier syndrome?

A

Deficiency of platelet membrane GPIb

61
Q

What is Glanzmann’s Thrombasthenia?

A

Deficiency of GPIIb/IIIa

Immunity, Infection and Haematology (6 decks)

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