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Haematology Intro Flashcards

1
Q

Haemopoietic stem cells

A

Capable of stem renewal; can differentiate into a variety of specialised cells.

Can colonise other tissues extramedullary haemopoiesis.

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2
Q

Vital statistics - RBC

A

Red blood cell count - how many?

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3
Q

Vital statistics - Hb

A

Haemoglobin - how effective?

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4
Q

Vital statistics - MCV

A

Mean corpuscular volume - how large?

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5
Q

Vital statistics - biconcave

A

Biconcave flexible disc - shape?

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6
Q

When does the switch from fetal to adult Hb occur?

A

At 3-6 months

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7
Q

Degradation of haem

A

Old or damaged RBC engulfed by macrophages in RES
Haem
Bilirubin - unconjugated bilirubin transported in bound to albumin

Excess unconjugated bilirubin in blood can cause jaundice.

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8
Q

Polycythaemia/ erythrocytosis

A

Increase in RBC

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9
Q

Leucocytosis

A

Increase in WBC

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10
Q

Lymphocytosis
Causes?

A

Increase in lymphocytes

Caused by reactive reasons:
Viral infections
Bacterial infections
Stress - MI/cardiac arrest
Post splenectomy
Smoking

Caused by lymphoproliferative reasons:
Chronic lymphocytic leukaemia
T- or NK- cell leukaemia
Lymphoma - cells spill out of infiltrated bone marrow

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11
Q

Monocytosis
Causes?

A

Increase in monocytes

Caused by bacterial infection
Inflammatory conditions
Carcinoma
Myeloproliferative disorders and leukaemias

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12
Q

Neutrophilia
Causes?

A

Increase in neutrophils

Infection most likely
Also tissue damage, smoking, drugs, myeloproliferative diseases

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13
Q

Eosinophilia
Causes?

A

Increase in eosinophils

Causes by allergic diseases
Drug hypersensitivity
Skin diseases
Parasitic infection
Churg-Strauss (rare autoimmune condition)

Rarely:
Hodgkin lymphoma
Several leukaemias

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14
Q

Basophilia
Causes?

A

Increase in basophils

Caused by immediate hypersensitivity reactions
Ulcerative colitis
Rheumatoid arthritis

Myeloproliferative

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15
Q

Thrombocytosis/ thrombocythaemia

A

Increase in platelets

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16
Q

Panmyelosis

A

Increase in all blood types

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17
Q

Anaemia

A

Decrease in RBC/ Hb

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18
Q

Leucopenia

A

Decrease in WBC

19
Q

Lymphocytopenia

A

Decrease in lymphocytes

20
Q

Monocytopenia

A

Decrease in monocytes

21
Q

Neutropenia
Causes?

A

Decrease in neutrophils

Reduced production:
B12/folate deficiency
Aplastic anaemia
Viral infection
Congenital
Infiltration
Radiation
Drugs

Increased removal or use:
Immune destruction
Sepsis - bone marrow unable to synthesise neutrophils fast enough to maintain circulatory numbers
Splenic pooling

22
Q

Eosinopenia

A

Decrease in eosinophils

23
Q

Basopenia

A

Decrease in basophils

24
Q

Thrombocytopenia

A

Decrease in platelets

25
Pancytopenia
Decrease in all cell lines (RBC, WBC, platelets)
26
Neutrophils
Phagocyte Maturation controlled by G-CSF Recombinant G-CSF given to increase neutrophils eg after sepsis, chemo
27
G-CSF
Cytokine that controls neutrophil maturation. Can cause neutrophilia.
28
Monocytes
Normally the largest cell in blood Differentiate into macrophages Needed for defence against chronic bacterial infections
29
Eosinophils
Immune response against multicellular parasites - Helminths Mediates allergic responses Granules contain array of cytotoxic proteins Inappropriate activation responsible for tissue damage and inflammation — asthma
30
Basophils
Least common in blood Allergy reactions and inflammatory conditions Granules stain deep blue - look like blackberries :)
31
Lymphocytes
Originate in bone marrow - B cells - humoral immunity; produce antibodies - T cells - cellular immunity; CD4+ helper cells, CD8+ cells - NK cells (natural killer) - cell mediated cytotoxicity
32
Current level of knowledge of difference between B- and T-cells?
B-cells = attack invaders outside the cell T-cells = attack infected cells
33
RES Role? Main organs?
(Lymphatic system) Part of immune system made up of monocytes in blood and a network of tissues that contain phagocytic cells. Role is to remove dead or damaged cells and identify and destroy foreign antigens in blood and tissues. Main organs are spleen and liver
34
What are the mcarophage types in: Liver Connective tissue CNS Peritoneal cavity Spleen Skin and mucosa
Kupffer cell Tissue histiocyte Microglia Peritoneal macrophage Red pulp macrophage Langerhans cell
35
Spleen - what is it comprised of? Functions?
Red pulp: sinuses lined by endothelial macrophages and cords (pink) White pulp: similar to lymph nodes (white) Functions: Red pulp - phagocytosis of old/abnormal red cells (and platelets) by macrophages (red pulp macrophage) - blood pooling platelets and red cells - these can be rapidly mobilised during bleeding - extramedullary haemopoiesis White pulp - immunological function - 25% of T cells and 15% of B cells are present in the spleen
36
Through which blood vessel does blood enter the spleen?
The splenic artery
37
Splenomegaly - why would this happen?
Back pressure - portal hypertension in liver disease Over work of red/white pulp Extramedullary haemopoiesis Expands as infiltrated by cells - cancer cells eg leukaemias, other metastases Expands as infiltrated by other material - sarcoidosis
38
How to physically examine for splenomegaly?
Palpate abdomen - spleen should never be palpable below the costal margin
39
What can happen to the blood due to having an enlarged spleen and why?
Enlarged spleen can cause hypersplenism, which in turn can cause low blood counts due to pooling of blood in the enlarged spleen.
40
What is recommended to avoid with splenomegaly?
Sports and vigorous activity - risk of rupture if it’s enlarged and no longer protected by the rib cage.
41
Hypersplenism vs splenomegaly
Hypersplenism refers to the overactivity of the spleen at any size. Splenomegaly refers to the enlargement of the spleen.
42
Hyposplenism Causes?
Lack of functioning spleen tissue. Splenectomy Sickle cell disease GI diseases - coeliac disease - Crohn’s disease - ulcerative colitis Autoimmune disorders - lupus - rheumatoid arthritis
43
What abnormality can be seen in the blood film of a patient with hyposplenism? Why is this?
Howell Jolly bodies - DNA remnants This is because these cells would normally be removed by the fully functioning spleen.
44
What are patients with hyposplenism/patients after a splenectomy at risk of? How is this treated?
Infection from encapsulated bacteria. NHS - Neisseria meningitidis (meningitis) - Haemophilus influenzas - Streptococcus pneumonia Treated by giving vaccinations to provide immunity, as well as life long antibiotics.

MEH (14 decks)

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