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(UNI) Clinical (2nd Year) > Haematology > Flashcards

Haematology Flashcards

1
Q

What does a haematology test test for?

A 
•	Full Blood Count (FBC).
•	Ferritin.
•	B12/Folate.
•	Erythrocyte Sedimentation Rate (ESR).
- C Reactive Protein (CRP).
•	International Normalised Ratio (INR).
- Activated Partial Thromboplastin Time (APTT).
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2
Q

What does an FBC test?

A
  • Red cell count (RBC).
  • Packed cell volume (PCV)/Haematocrit.
  • Mean cell volume (MCV).
  • Haemoglobin (Hb).
  • Mean cell haemoglobin concentration (MCH).
  • Reticulocytes.
  • White blood cell tests (WBC).
  • Platelet count.
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3
Q

Which white blood cells are tested for in an FBC?

A 
o	Neutrophils.
o	Eosinophils.
o	Basophils.
o	Lymphocytes.
o	Monocytes.
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4
Q

Where are red blooc cells produced?

A

In the bone marrow.

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5
Q

What is the life span of red blood cells?

A

120 days.

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6
Q

Where is erythropoetin produced?

A

The kidneys.

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7
Q

What is anaemia?

A

Anaemia is the condition where one has a low RBC count, leading to reduced oxygen supply to tissues, eventually leading to fatigue.

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8
Q

What is polycythaemia?

A

Polycythaemia is the condition where one has a too high RBC count. This can indicate an increased RBC production as a physiological response to hypoxia (low oxygen levels), or malignancy of RBCs. The concentration also increases in dehydration, this is due to the effect of reduced volume.

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9
Q

What is the packed cell volume/haematocrit?

A

This is the ratio of the volume occupied by red blood cells to the total volume of blood. This mirrors the RBC count.

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10
Q

In what conditions is PCV/haematocrit low?

A

PCV is low in any form of anaemia, in haemorrhage, or haemolysis.

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11
Q

IN what conditions is PCV/haematocrit high?

A

It is high in polycythaemia and dehydration.

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12
Q

What is the mean cell volume?

A

This is the average volume of a single red blood cell.

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13
Q

What does a low MCV indicate?

A

A low MCV indicates small RBCs, known as microcytic.

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14
Q

How can small red blood cells be described?

A

Microcytic.

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15
Q

What does a high MCV indicate?

A

A high MCV indicates large RBCs, known as macrocytic.

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16
Q

How can large RBCs be described?

A

Macrocytic.

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17
Q

Iron deficiency can lead to what type of red blood cells? Why?

A

Microcytic. Lack of haem.

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18
Q

Vitamin B12 or folic acid deficiency can lead to what type of red blood cells? Why?

A

Macrocytic. Cells do not mature properly.

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19
Q

In what conditions is MCV raised?

A

MCV is also raised in liver disease, alcoholism, and myxoedema (severe hypothyroidism).

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20
Q

Which blood count parameters are used to detect anaemia?

A

Haemoglobin (Hb) and mean cell haemoglobin (MCH).

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21
Q

What is mean cell haemoglobin?

A

Mean cell haemoglobin (MCH) is the average weight of Hb in an RBC, this is dependent on the size of the cell.

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22
Q

In what condition is MCH low?

A

In microcytic anaemia.

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23
Q

In what condition is MCH high?

A

Macrocytic anaemia.

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24
Q

Low MCH is described as what?

A

Hypochromic.

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25
Q

Visually, how is a lack of Hb in a red blood cell shown?

A

Shown by pale coloured cells.

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26
Q

What are reticulocytes?

A

These are non-nucleated red blood cells and make up 1% of RBCs in a healthy person.

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27
Q

When is an increased production of reticulocytes seen?

A

Increased production of reticulocytes (reticulocytosis) is seen at times of rapid cell production such as haemorrhage or haemolysis.

28
Q

Why is it useful to monitor reticulocytes?

A

To monitor early response to anaemia.

29
Q

What is a blood film?

A

This is when a drop of blood is put on a microscope slide and is used to see the shape of red blood cells.

30
Q

What is ferritin?

A

This is an iron store protein and its serum concentration is closely related to body iron stores.

31
Q

What happens to ferritin levels in chronic iron deficiency anaemia?

A

They are reduced, unless the patient is suffering from renal failure.

32
Q

What happens to ferritin levels in iron overload? What causes this?

A

They are increased. This can be caused by liver disease and cancer.

33
Q

In what conditions are folate and vitamin B12 reduced in?

A

These are both reduced in folate deficiency, vitamin B12 anaemia, and pernicious anaemia.

34
Q

What is pernicious anaemia?

A

A lack of intrinsic factor which aids B12 absorption.

35
Q

What causes folate and vitamin B12 deficiencies?

A

Folate and vitamin B12 deficiencies are often due to poor diet and malabsorption, and can also be caused by chronic alcoholism, liver disease, and some drugs (metformin).

36
Q

How are folate and vitamin B12 deficiencies refered to?

A

These anaemias are known as megaloblastic anaemias, effecting macrocytic cells.

37
Q

What percentage of total WCC is made up of neutrophils?

A

50-70%.

38
Q

What causes an increase in neutrophils?

A

Infection and tissue damage.

39
Q

Neutropenia (low count of neutrophils) is associated with what?

A

Malignancy and drug toxicity.

40
Q

What percentage of total WCC is made up of basophils?

A

0.4-1%.

41
Q

What percentage of total WCC is made up of by eosinophils?

A

1-3%.

42
Q

What are eosinophils associated with?

A

Antigens/antibody reactions.

43
Q

What percentage of total WCC is made up of by monocytes?

A

4-6%.

44
Q

What percentage of total WCC is made up of by lymphocytes?

A

25-35%.

45
Q

What are lymphoctyes?

A

The primary component of the immune system. B and T cells.

46
Q

What is leukopenia?

A

Abnormal decrease in the number of white blood cells.

47
Q

What is neutropenia?

A

Abnormal decrease in the number of neutrophils.

48
Q

What is agranulocytosis?

A

Severe reduction of granulocytes (basophils, eosinophils, and neutrophils).

49
Q

What are granulocytes?

A

Basophils, eosinophils, and neutrophils.

50
Q

What is the main function of platelets?

A

The main function of platelets is to form a plug at sites of damage to the vascular endothelium.

51
Q

When may platelet levels fall?

A

Levels may fall a little in pregnancy and following viral infections. A large decrease can be seen in bone marrow failure due to a decrease in production. A decrease in platelets is also seen in auto immune conditions, where there is an increase in platelet destruction.

52
Q

What is thrombocytopenia?

A

This is a condition where one suffers with a reduced platelet count.

53
Q

What can thrombocytopenia cause?

A

This can lead to increased bleeding due to a reduction in clotting.

54
Q

What can thrombocytopenia be caused by?

A

It can be caused by malignancy of bone marrow, inflammatory diseases, in response to blood loss, severe infectious illness, and due to bone marrow depression due to certain medication.

55
Q

What are ESR and CRP non-specific indicators of?

A

Inflammation or infection.

56
Q

What is the ESR?

A

Erythrocyte sedimentation rate is the measure of settling rate of red blood cells in anticoagulated blood in one hour (mm/hr).

57
Q

When is a faster ESR seen?

A

A quicker sedimentation rate is seen in infection, so ESR can be used to determine infection. A high ESR occurs when protein in blood is elevated such as in inflammatory disease and non-specific infection.

58
Q

What is CRP?

A

C-Reactive Protein is produced by the liver in response to inflammatory cytokines (another non-specific indicator of inflammation, trauma, bacterial infection, etc.). CRP reacts faster than ESR, rising in hours rather than days. These time differences allow for timescale to be worked out.

59
Q

What is INR?

A

This is used to measure the anticoagulant effect of warfarin and other anticoagulant drugs. It can also be used to describe the condition of someone’s coagulation if they have a blood clotting condition.

60
Q

In what condition will INR increase?

A

INR will increase in severe liver disease.

61
Q

What does a very rapid INR show?

A

A very rapid rise shows organ/liver failure and possibly sepsis.

62
Q

What should the INR be of someone who isn’t on anticoagulants or doesn’t have a clotting disorder?

A

1.

63
Q

For most indications requiring chronic anticoagulation, what INR should be aimed for?

A

2-3.

64
Q

For patients with recurrent DVT/PE and those with a mechanical heart valve, what INR should be aimed for?

A

3-4.

65
Q

What is activated partial thromboplastin time (APTT)?

A

This is used to monitor the effectiveness of unfractionated heparin and also sometimes used to measure liver failure and u usual blood clotting.

66
Q

What is target APTT?

A

Target APTT is usually between 1.5 and 2.5 times the normal (control) value of 24-36 seconds.

(UNI) Clinical (2nd Year) (19 decks)

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