Haematology Intro Flashcards
1
Q
What are the components of blood and their products?
A
- plasma
- clotting/coagulation factors
- albumin
- antibodies
- buffy coat
- platelets
- white cells/leukocytes
- red blood cells
2
Q
What are 3 functions of blood?
A
- transport
- gases (red cells)
- nutrients, waste, messages (plasma)
- maintainance of vascular integrity
- prevention of leaks (platelets, clotting factors)
- prevention of blockages (anticoagulants, fibrinolytics)
- protection from pathogens
- phagocytosis + killing (granulocytes/monocytes)
- antigen recognition + antibody formation (lymphocytes)
3
Q
What are features of stem cells?
A
- totipotent
- self-renewal
- home to marrow niche
- binnary fission + flux through differentiation pathways, amplify numbers
- flux regulated by hormones/growth factors
4
Q
What is erythoid differentiation?
A
- errythroblast -> reticulocyte -> erythrocyte
- erythropiotein
- made in kidney, response to hypoxia
- reticulocyte count- measure of red cell production
5
Q
What is polycythaemia?
A
- abnormally inc. concentration of haemoglobin in blood
- reduction of plasma volume OR inc. in red cell number
- primary disease
- secondary condition
- respiratory/circulatory disorders
- cancer
6
Q
What are features of anaemia?
A
- poor gas transfer
- dyspnoea
- fatigue
- dec. production
- haemolytics deficiency (Fe, folate, vit B12)
- congenital- thalassaemias
- inc loss
- bleeding
- haemolysis
7
Q
What are red cell abnormalities?
A
- microcytes- abnormally small red blood cells
- certain anaemias
- macrocytes
- polychromasia- abnormally high number of immature red blood cells
* 10g/L/day
8
Q
What are features of platelets?
A
- haemostasis
- production regulated by thrombopoietin
- produced in liver
- regulation by platelet mass feedback
- agonists used theraputically (romiplostim, etrombopag
- 7 day lifespan
9
Q
What are platelet abnormalities?
A
- thrombocytosis- high platelet count
- thrombocytopenia- deficiency of platlets
- altered function
- drugs
10
Q
What are features of neutrophils?
A
- ingest + destroy pathogens, esp bacteria + fungi
- interleukins + CSFs (colony stimulating factors)
- granulocyte-colony stimulating factor (G-CSF) (GM-CSF)
- regulate production
- regulation by immune responses
- 1-2 day lifespan
- speed of reponse- few hrs
11
Q
What is neutrophil differentiation?
A
- blast (acute myeloid leukemia)
- promyelocyte
- myelocyte
- metamyelocyte
- neutrophil
12
Q
What is neutrophilia?
A
- leukocytosis of neutrophils- high number of neutrophils
- infection
- left shift, toxic granulation
- inflammation
- e.g. MI, rheumatoid arthritis
- G-CSF used theraputically
- neutropenia
- mobilisation of stem cells
- race
- dec. production
- drugs
- marrow failure
- inc. consumption
- sepsis
- autoimmune
- altered function
- e.g. chronic granulomatous disease
13
Q
What are monocytes?
A
- reticuloendothelial system
- ingest + destroy pathogens, esp bacteria + fungi
- subset of monocytes migrate into tissues + become macrophages
- many months lifespan
- some populations of macrophages self-maintaining
- dentritic cells
- weeks lifespan
14
Q
What are features of lymphocytes?
A
- adaptive vs innate immune system
- immunological memory
- surface antigens: CD markers
- lymphocytosis
- inc. lymphocytes in blood
- infectious mononucleosis
- pertussis
- lymphopenia
- dec. lymphoctyes in blood
- usually post-viral
- lymphoma
- subtypes
- B cells- make antibodies
- T cells- Helper, cytotoxic, regulatory
- NK cells
- produced in bone marrow
- B cells in bone marrow, T cells in thymus
- circulate in blood, lymph, lymph nodes
- differentiate into effector cells in secondary lymphoid organs
- each naive cell has unique surface receptors
15
Q
What are features of antibodies?
A
- adaptors between pathogens + clearance systems
- opsonisation- make foreign cell more susceptible to phagocytosis
- fix complement
- block binding
16
Q
What is repertoire diversity?
A
- combinatorial diversity- within each chain
- junctional diversity
- combinatorial diversity- between chains
- mistakes cause lymphoid malignancy
17
Q
What is B cell positive and negative selection?
A
In bone marrow:
- positive selection- gene rearrangement for a funtional receptor, the cell is selected to survive
- negative selection: tolerance- if receptor recognises ‘self’ antigens, cell is triggered to die
18
Q
What are the two classes of Human Leukocyte Antigen (HLA)?
A
- class I- displays internal antigens on all nucleated cells
- class II- displays antigens eaten by professional antigen presenting cells
- immune cells use HLA -barcode on cells to idetify; self vs non-slef cells + uninfected vs infected cells
- an immune response is tiggered if an infected cell is identified
19
Q
What are abnormalities with plasma?
A
- too much- paraproteins
- too little- clotting factors (haemophilia)
- abnormal function- clotting factors (haemophilia)
20
Q
What is involved in a full blood count?
A
- haemoglobin
- male (135-170 g/L)
- female (120-160 g/L)
- RBC (4-5 1012/L)
- platelets (150-400 109/L)
- WBC (4-10 109/L)
- neutrophils (1.5-7 109/L)
- lymphocytes (1.5-4 109/L)
- monocytes (.2-.8 109/L)
- eosinophils (0.1-0.5 109/L)
- basophils (.01-.1 109/L)
no ‘primitive’ cells
21
Q
What are other diagnostic tools?
A
- clotting times for clotting factors
- bleeding time for platelets
- (platelet and leukocyte function tests)
22
Q
What are involved in chemical assays?
A
- iron (ferritin)
- B12
- folate
23
Q
What are other diagnostic tools?
A
- marrow aspirate + trephine biopsy
- lymph node biopsy
- other organ biopsy
24
Q
What imaging tests are performed?
A
- CT angiogram
- plain film
- CT scan
25
What are different haematological treatments?
* replacement
- blood
- haematinics
- coagulation factors
- plasma exchange
* transplantation
* drugs
- cytotoxics
- monoclonal antibodies
- inhibitors of cellular proliferation
- immunosuppressants
- inhibitors of coagulation
- inhibitors of fibrinolysis
