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MBChB 4 > Haematology > Flashcards

Haematology Flashcards

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1
Q

What are the primary sites of haematopoiesis prior to birth?

A
  • Liver
  • Spleen
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2
Q

What does a “left shift” describe, with regards to haematopoiesis?

A
  • Increased number of immature blood cells
  • Increase in band neutrophils
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3
Q

What is the most common cause for a left shift in blood production?

A

Infection

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4
Q

What are the two types of bone marrows and how do they differ?

A

Red Marrow: Haematopoietic

Yellow Marrow; Fatty tissue, not haematopoietic

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5
Q

What is the function of stem cell factors and what produces it?

A

Production: Stromal cells

Function: Promotes all haematopoiesis

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6
Q

what is the function of granlocyte monocyte stimulating factor (GM-CSF)?

A

Production: Endothelial cells + T cells

Function: Mitosis and differentiation of granulocyte cells

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7
Q

When is synthetic GM-CSF given?

A

IV Sargramostim

Given after bone marrow transplantation to treat neutropaenia

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8
Q

What is the function of granulocyte colony stimulating factor?

A

Promotes mitosis, differentiation, and activity of granulocyte colony-forming units; promotes neutrophil activity

Available as a recombinant DNA form (filgrastim injection), which is used to treat neutropenia following chemotherapy or radiation therapy

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9
Q

When is synthetic G-CSF given?

A

Available as a recombinant DNA form (filgrastim injection), which is used to treat neutropenia following chemotherapy or radiation therapy

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10
Q

What is the life span of erythrocytes?

A

120 days

Enters peripheral blood as reticulocytes

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11
Q

What does an elevated reticulocyte count suggest?

A

Increased reticulocytes = increased erythropoiesis
e.g. incrased haemolysis

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12
Q

What does a decreased reticulocyte count suggest?

A

Decreased reticulocytes = decreased erythropoiesis

(e.g. aplastic anaemia)

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13
Q

What are the reference ranges for haemoglobin?

A

♂ 13.5–17.5 g/dL

♀ 12–16 g/dL

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14
Q

What does the mean corpuscle volume measure?

A

Average volume of one red blood cell

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15
Q
  1. What does an increased MCV suggest?
  2. What does a decreased MCV suggest?
A
  1. Increased: macrocytic red blood cells - vitamin B 12 deficiecny
  2. Decreased: microcytic red blood cells - iron deficiecny
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16
Q

What does mean corpuscle haemoblin measure?

A

The average haemoglobin mass of one rbc

17
Q
  1. What does an increased MCH suggest?
  2. What does a decreased MCH suggest?
A
  1. Increased MCH = hyperchromic - B12 deficiency
  2. Decreased MCH = hypochromic - iron deficiency
18
Q

What does absolute reticulocyte count measure?

A

The fraction of reticulocytes of all circulating RBCs. Represents erythropoietic activity.

19
Q

what does the corrected reticulocyte count measure?

A

Absolute reticulocyte count × (patient hematocrit/normal hematocrit)

20
Q

What is the reticulocyte production index?

A

Absolute reticulocyte count/reticulocyte maturation time × (patient hematocrit/normal hematocrit)

21
Q

what does anisocytosis means and how is it measured?

A
  1. Meaning: Increased variation in RBC size
  2. Measured: red blood cell distribution width
22
Q

What are the components that may be affected and cause primary homeostatic failure?

A
  • Platelet disorders / deficiency
  • Disorders of vessel walls
    (e. g. henoch schonlein purpura)
23
Q

What factors affect secondary haemostasis?

A
  • Coagulation cascade problems
24
Q

What factors are involved in the intrinsic pathway?

A

12

11

9

8

25
Q

What factors are invovled in the extrinsic pathway?

A
  • Tissue factor
  • Factor 7
26
Q

How is the intrinsic pathway measured?

A

Activated Partial Thromboplastin Time

(Also measured the common pathway)

Measures the time it takes for the intrinsic system to produce fibrin polymers following activation by the addition of phospholipids

(APTT)

27
Q

What may increased the APTT?

A

Lupus anti-coagulant (actually prothombotic but for some reason increases APTT)
Haemophilia A or B
VWD (carries factor 8)
Unfractionated heparin
DIC

Hepatic failure

28
Q

How is the extrinsic pathway measured?

A

Prothrombin Time

Measures the time it takes for the extrinsic system to produce fibrin polymers following activation by thromboplastin and calcium. Normal value range: 11–15 seconds.

(measured extrinsic and common pathway)

29
Q

What factors may prolong the prothrombin time?

A

Factor 7 mutation

Warfarin

Vit K deficiency (malabsorption / depeltion of gut biome)

Hepatic failure
DIC

Autoantibodies (SLE)

30
Q

What will hyperfibrinolysis result in?

A

Pathological fibrinolysis → bleeding

Excessive plasmin activity causes increased fibrin degradation → Blood clots become unstable or dissolve shortly after forming

31
Q

What factors may cause hyperfibrinolysis?

A
  • Parneoplastic effect of prostate cancer
  • Surgery in tPA-rich organs such as the prostate and uterus
  • DIC
  • Coagulation lysis therapy from stroke
32
Q

How is the common pathway measured?

A

Thrombin Time

Measures the time it takes for fibrin polymers to form after adding thrombin

Only measured the common pathway

33
Q

How is fibrin deficiecny tested?

A

Reptilase

Measures the time it takes for fibrin to form after adding reptilase

34
Q
A

MBChB 4 (9 decks)

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