Haematology

Question 1

Answer 1

Question 2

also define main conditions

Answer 2

• sickle cell disease
  
  • a group of inherited health conditions that affect the red blood cells. The most serious type is called sickle cell anaemia
  • ​​People with sickle cell disease produce unusually shaped red blood cells that can cause problems because they do not live as long as healthy blood cells and can block blood vessels.

Question 3

also define main conditions

Answer 3

• marlaria
  
  • serious and sometimes fatal disease; four kinds of malariaparasites infect humans
• hyperspenism
  
  • a common disorder characterized by an enlarged spleen which causes rapid and premature destruction of blood cells
• hemoglobinopathies
  
  • sickle cel
  • thalassaemia
  • hereditary spherocytosis
  • hereditary elliptocytosis
  • hereditary stomatocytosis

Question 4

Answer 4

Question 5

Answer 5

• remember - the microcytic anaemias are due to a reduction in Hb prod/ functionality, for whatever reason
  
  • i think
• iron deficient anaemia
  
  • what it says on the tin
• thalassaemia
  
  • produce either no or too little haemoglobin

Question 6

Answer 6

• remember, macrocytic anaemias normally don’t have a primary pathology with the erythrocyte itself, rather they’re due to issues with the production of the RBC, ie EPO production or space within the bone marrow
• lack of space due to neoplastic growth in r bone marrow
• aplastic anaemia > pancytopenia
• chronic kidney disease (less EPO)
• hypothyroidism (less EPO apparently)

Question 7

Answer 7

• remember, macrolytic anaemias are due to a lack of DNA precursor production, and what can cause that?…
• megaloblastic: B12/ folate deficiency (pernicous anaemia)
• non-megaloblastic:
  
  • alcohol abuse
  • hypothyroidism
  • pregnancy

Question 8

name 1, 2, 3, 4, 5, 6, 7, 8, a & b

Answer 8

• 1: protozoa
• 2: sporozoa
• 3: malaria
• 4: vector: female Anophales mosquito
• 5: P. falciparum
• 6: P. vivax
• 7: P. malariae
• 8: P. ovale
• a: plasmodium
• b: sporozoite

Question 9

what is the most common cause of pul embolism

Answer 9

DVT

Question 10

what is the molecule that’s needed for b12 absorption

Answer 10

intrinsic factor

Question 11

and name 2 of the main anticoagulants

Answer 11

• heparin
• warfarin

Question 12

Answer 12

Question 13

Answer 13

Question 14

and define condition

Answer 14

• ITP (immune thrombocytopenic purpira)
  
  • happens when your immune system mistakenly attacks and destroys platelets, which are cell fragments that help blood clot. In adults, this may be triggered by infection with HIV , hepatitis or H. pylori

Question 15

and define condition

Answer 15

• TTP (thrombotic thrombocytopenia purpira)
  
  • VWF multimers need molecule ADAMTS13 to convert into VWF monomers (functional)
  • lack of ADAMTS13 means that you’re stuck with the VWF mutimers which can coagulate together and form platelet microthrombi
    
    • this uses up platelets and causes thrombocytopenia

*give bad score unless mentioned ADAMTS13 (imagine my friend adam in this section to help with memory)

Question 16

Answer 16

• TTP (thrombotic thrombocytopenia purpura) can lead to microangiopathic haemolytic anaemia
  
  • TTP microthrombi can lead to MAHA by litterally shearing the platelets into ‘Schistocytes’ which get destroyed

Question 17

and define condition

Answer 17

• Von Willebrand disease is a lifelong bleeding disorder in which your blood doesn’t clot well. People with the disease have low levels of von Willebrand factor, a protein that helps blood clot, or the protein doesn’t perform as it should.

Question 18

Answer 18

• Hemophilia is a rare disorder in which your blood doesn’t clot normally because it lacks sufficient blood-clotting proteins (clotting factors)
• Hemophilia A = factor 8 deficiency
• Hemophilia B = factor 9 deficiency

Question 19

and define condition

Answer 19

• disseminated intravascular coagulation/ consumption coagulopathy
  
  • essentially uncontrolled activation of coagulation pathways
  • aquired
  • involves both thrombus formation and excessive bleeding (the excess clotting uses up all the clotting factors causing bleeds at any location of even slight endothelial damage)

Question 20

Answer 20

• lymphoma
  
  • neoplastic disease of mature lymphocytes in lymphatic tissue
  • this cancer can be found anywhere that grown lumphocytes live (peripheral lymph nodes or any lymph tissue like parts of the gut and tonsils)
  • normally a solid tumour
  • Hodgkin or non hodgkin (maj)

Question 21

Answer 21

• myeloma
  
  • neoplastic disease of plasma B cells
  • therefore lots of the same monoclonal antibody is in the body (aka paraprotein)
  • this clogs up the kidneys and takes up bone marrow space so pancytopenia and anaemia

Question 22

Answer 22

• leukemia
  
  • chronic, acute, myeloid and lymphocytic
  • a malignant progressive disease in which the bone marrow and other blood-forming organs produce increased numbers of immature or abnormal leucocytes. These suppress the production of normal blood cells, leading to anaemia and other symptoms.
• note: im slightly confused as lukemia is defined as ‘cancer of the white blood cells’ however surely in myeloid leukemia you could have excessive erythrocyte production? oh well

Question 23

Answer 23

• myeloproliferative diseases
  
  • characterised by an increase in associated cells (i think)
  • cells involved = megakaryocyte and platelets, and erythrocytes (and fibroblasts)

Question 24

Answer 24

• polycytaemia rubra vera
  
  • usually a single haematopoetic stem cell that has an issue with JAK2 gene (so think of 2 jacks sitting by this bit of the diagram)
  • usually EPO from kidney has to activate JAK2 which causes stem cell division, but mutations keep JAK2 ‘on’ all the time
  • more RBC increase thrombus risk
  • leads to myelofibrosis: JAK2 mutations cause fibrosis of r bone marrow therefore blood cells can’t form (anaemia, leukopenia, thrombocytopenia (>pancytopenia))
    
    • this is bc as well as increasing RBC prod, JAK2 mutation increases megakaryocyte prod, therefore more platelets, platelets release cytokines which activate fibroblasts which engage in fibrosis
• eseential thrombocytopenia is a myeloproliferative neoplasm (from mutated neoplastic heamatopoietic stem cell)
• myelofibrosis it’s self is considered a form of chronic leukemia - the bone marrow is replaced by fibrous scar tissue
  
  • when it occurs on it’s own it’s called primary myelofibrosis, but can also occur due to external stimuli (as explained above)

Question 25

Answer 25

Question 26

Answer 26

B cells

Question 27

Answer 27

Question 28

include percentages

Answer 28

Question 29

Answer 29

• Reed–Sternberg cells
  
  • think about a really stern looking ice cube amoungst some weeds