Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

Metabolism, Endocrinology, Haematology > Haematology Session 1 > Flashcards

Haematology Session 1 Flashcards

1
Q

Give examples of haemopoietic tissue.

A
  • Pelvis
  • Sternum
  • Skull
  • Ribs
  • Vertebra
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

Where does haemopoiesis occur?

A

Fetus: liver and spleen
Adult: bone marrow

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

What is a trephine biopsy?

A

Analysis of a liquid bone marrow sample (needle into posterior iliac crest).

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

What are the functions of erythropoietin and thrombopoietin?

A

EPO: secreted by kidney, RBC production stimulation when oxygen is low

TPO: produced by liver and kidney, regulates platelet production

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

What determines haemopoietic stem cell differentiation?

A
  • Hormones

- Transcription factors

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

What do common myeloid progenitor differentiate into?

A

Cells involved in clotting.

  • Platelets (Thrombopoiesis)
  • Basophils (Granulopoiesis)
  • Neutrophils
  • Monocytes (Monocytopoiesis)
  • Eosinophils
  • Erythrocytes (Erythropoiesis)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

What do common lymphoid progenitors differentiate into?

A

Lymphocytes - B and T (Lymphopoiesis)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

What is extramedullary haemopoiesis?

A

When haemopoietic stem cells mobilise into circulating blood/colonise other tissues, eg. in thalassaemia

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

What are sources of haemopoietic stem cells?

A
  • Bone marrow aspiration
  • Umbilical cord stem cells (cord bank)
  • G-CSF mobilised blood stem cells (leukapharesis)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

What is the reticuloendothelial system?

A

Part of immune system that removes dead or damaged cells and identifies + destroys foreign antigens in blood and tissue via phagocytosis. Mainly spleen and liver.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

What are some macrophages in blood?

A
  • Kupffer cells (liver)
  • Microglia (CNS)
  • Red pulp macrophage (spleen)
  • Langerhans cell (skin + mucosa)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

What do RES cells do in the spleen?

A

Dispose of damaged and old red blood cells.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

What is the function of red and white pulp in the spleen?

A

Red pulp: endothelial macrophages/cords, removes RBC

White pulp: similar to lymphoid follicle, where WBCs with pathogen will be destroyed.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

What are the functions of the spleen (adults)?

A
  • Phagocytosis (old cells removed by macrophages)
  • Blood pooling in spleen (mobilising during bleeding)
  • Extramedullary haemopoiesis (pluripotent stem cell proliferation during haematological stress)
  • Immunological functions (T 25% and B 15% cells)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

How does blood enter the spleen?

A

Splenic artery

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

What is splenomegaly?

A

Enlarged spleen

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

What are the causes of splenomegaly?

A
  • Portal hypertension (cirrhotic liver - blood not passing so more drains into the splenic artery)
  • Overwork
  • Extramedullary haemopoiesis (as in fetal development)
  • Infiltration by cells OR granulomas
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

How to examine the spleen?

A
  • Should not be palpable below costal margin
  • Palpate in right iliac fossa
  • Feel for movement against hand during inspiration
  • Feel for splenic notch
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

What can cause massive splenomegaly?

A
  • Chronic myeloid leukaemia

- Myelofibrosis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

What can cause moderate splenomegaly?

A
  • Lymphoma
  • Leukaemias
  • Liver cirrhosis
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

What can cause mild splenomegaly?

A
  • Endocarditis
  • Sacroidosis
  • Autoimmune disease (eg. systemic lupus erythematosus)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

Why can splenomegaly result in a low blood count?

A

All the cells pool in the spleen and not many left in circulating blood.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

Why is splenomegaly risky?

A

Spleen can rupture as not protected by the ribs anymore - can bleed out.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

What is hyposplenism and what are the causes of it?

A

Lack of functioning splenic tissue.

  • Splenectomy (eg. cancer)
  • Sickle cell disease
  • GI disease (Crohn’s, coeliac, colitis)
  • Autoimmune disorders (Hashimoto’s, arthritis, lupus)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
Q

How is hyposplenism recognised on a blood film?

A

Howell Jolly bodies - DNA remnants (small purple dots) that would normally be removed by spleen if functioning.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
26
Q

What are hyposplenic patients at risk of?

A

Encapsulated bacteria.

  • Meningococcus
  • Haemophilus influenzae
  • Streptococcus pneumoniae

Must get lifelong antibiotic prophylaxis + immunisation

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
27
Q

What is the function of erythrocytes?

A
  • Carry O2 to tissues
  • Carry haemoglobin
  • Remove CO2 from tissues
  • Maintain haemoglobin in reduced state
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
28
Q

What is measured in tests for RBCs?

A
  • Red blood cell count (how many)
  • Haemoglobin (effectiveness)
  • Mean corpuscular volume (how large)
  • Diameter (normal 8 micrometres)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
29
Q

What are the two configurations of haemoglobin?

A

Oxyhaemoglobin (relaxed) and deoxyhaemoglobin (tightly bound)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
30
Q

What is spherocytosis and what proteins are involved?

A

Haemolytic anaemia from cells being round, less deformable and fragile - removed by spleen

  • Spectrin - links membrane to actin cytoskeleton
  • Ankyrin - links integral membrane proteins to spectrin actin skeleton
  • Band 3 - chloride/bicarbonate exchanger
  • Protein 4.2 - ATP binding protein, regulates association of band 3 w/ ankyrin
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
31
Q

How is the haem group degraded?

A
  • Fe2+ recycled = bilirubin
  • Unconjugated bilirubin transported in the blood bound to albumin
  • Taken up by liver and conjugated with GLUCURONIC ACID
  • Secreted in bile in duodenum
  • Glucuronic acid removed by bacteria = bilirubin converted to UROBILINOGEN and then oxidised to STERCOBILIN
  • Then excreted in faeces
  • Some urobilinogen converted to UROBILIN when transported to kidney
  • Excreted in urine
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
32
Q

What is cytopenia?

A

Reduction in the number of red blood cells.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
33
Q

What does the suffix -penia mean?

A

Decrease in count of certain cells (for all but RBCs, where it’s anaemia)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
34
Q

What does the suffix -cytosis mean?

A

Increase in count of certain cells

Leucocytosis, Erythrocytosis, Monocytosis, Panmyelosis, Lymphocytosis, Thrombocytosis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
35
Q

What does the suffix -philia mean?

A

Increase in count of certain cells

Neutrophilia, Basophilia, Eosinophilia

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
36
Q

What is the function of neutrophils?

A
  • Phagocyte, most common white cell
  • Part of innate immune system
  • Invade tissues from bloodstream
  • Granules in cytoplasm = digestive enzymes to kill pathogens
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
37
Q

How is maturation of neutrophils controlled and what is recombinant G-CSF?

A
  • Maturation controlled by G-CSF hormone (increased production, release of mature cells from bone marrow and phagocytosis)
  • Recombinant G-CSF is given to patients with severe neutropenia after chemo to generate more neutrophils
38
Q

What are causes of neutrophilia?

A
  • Infection
  • Cytokines (G-CSF)
  • Myeloproliferative disese
  • Acute haemorrhage (more cells in circulating blood)
39
Q

What happens during neutrophilia?

A

Cells that usually stick to the side of a blood vessel (marginated) are released and so neutrophil count rises

40
Q

What is neutropenia caused by?

A
  • Reduced cell production
B12/folate deficiency, 
Infiltration so no room for production, 
Radiation (kills mature cells)
Drugs (chemo, antibiotics, anti-epileptics - poison BM)
Viral infection
Congenital 
Aplastic anaemia (empty bone marrow)
  • Increased removal of use
Immune destruction (autoantibodies)
Sepsis - unable to generate enough to maintain circulatory numbers
Splenic pooling - less in circulation
41
Q

What is neutropenic sepsis?

A

Medical emergency - must be given antibiotics (IV) immediately

42
Q

What are consequences of neutropenia?

A
  • Severe fungal and bacterial infection

- Mucosal (mouth) ulceration

43
Q

What are monocytes?

A
  • Largest cells, migrate into tissues to become macrophages or dendritic cells
  • Antigen presenting
  • Phagocytosis and cellular debris breakdown
  • Defend against CHRONIC BACTERIAL INFECTIONS (eg. TB)
44
Q

What causes monocytosis?

A
  • Bacterial infection
  • Inflammatory conditions (eg. IBD)
  • Carcinomas
  • Leukaemias
45
Q

What are eosinophils?

A
  • Cells responsible for defence against multicellular parasites (helminths, worms)
  • Mediate allergic responses
  • Live for 8-12 days
  • Phagocytose antigen-antibody complexes
46
Q

What cytotoxic proteins are in the granules of eosinophils?

A
  • Elastase

- Eosinophilic cationic protein

47
Q

What are causes of eosinophilia?

A

Common:

  • Allergies
  • Drug hypersensitivity
  • Churg-Strauss condition (inflammation of small blood vessels)
  • Skin disease
  • Parasitic infection

Rare:

  • Different leukaemias (eg. eosinophilic)
  • Hodgkin lymphoma
48
Q
  • What are basophils?
A
  • Cells active in allergic reactions + inflammation

- Kind of look like a berry due to granules that may even cover nucleus and stain deep purple

49
Q

What do basophilic granules contain?

A
  • Histamine
  • Heparin
  • Hyaluronic acid
  • Serotonin
50
Q

What are the causes of neutrophilia?

A

Reactive:

  • Hypersensitivity reactions (eg. drugs)
  • Ulcerative colitis
  • Rheumatoid arthritis

Myeloproliferative:

  • eg. chronic myelogenous leukaemia
  • Systemic mastocytosis
51
Q

What are lymphocytes?

A

Cells originating in bone marrow:

  • T cells - immunity; CD4+ helper cells, CD8+ , attack infected cells
  • B cells - immunoglobulin-forming, attack invaders outside
  • Natural killer cells - kill virally infected cells
52
Q

What are the causes of lymphocytosis?

A

Reactive:

  • Viral & bacterial infections
  • Post-splenectomy as many pool in spleen

Malignant:

  • T cell/NK cell leukaemia
  • Lymphoma
  • Chronic lymphocytic leukaemia
53
Q

What are abnormal results?

A

Results outside normal range, however that only makes up for 95% of population so it’s possible to be outside and still normal and inside range but abnormal (if dropped from a previous reading)

Normal changes in age & sex

54
Q

How are abnormal haematology results interpreted?

A
  • Clinical context
  • Previous FBCs

Explained by change/disease

55
Q

What can lead to errors in pathology results?

A
  • Specimen mix up
  • Right result applied to the wrong patient
  • Wrong delivery method of specimen
  • Wrong bottles
  • Pooling samples (when patient difficult to bleed
56
Q

What is the full blood count?*

A
  • Automated test (high output)
  • Greater accuracy
  • Red cells (count, Hb)
  • Platelets (count, size)
  • White cells (count)
57
Q

What technique is used by the FBC analyser?

A

Spectrophotometry

  • Amount of light absorbed by sample proportional to amount of compound within it
  • Calibration curve to determine sample concentration
  • Hypotonic solution to lyse cells
58
Q

What is the other technique used by the FBC analyser?*

A

Flow cytometry
- Single file line of cells passes through a light beam and impedance is counted
Forward scatter = bigger cell size

59
Q

What is the flow cytometry differential?*

A
  • Forward scatter = size
  • Side scatter = granules, mono/polymorphonuclear
  • Myeloperoxidase (granulocyte enzyme) activity
60
Q

What is packed cell volume?

A

The proportion of blood made up of RBCs (haematocrit)

  • Used to measure polycythaemia
  • Reduced by venesection/drugs
61
Q

What is the haemoglobin g/L?

A
  • Gender and age specific
  • Measures haemoglobin concentration in the blood
  • Clotted sample/in vitro haemolysis will reduce Hb
62
Q

What is the red cell count (x10 12L)

A

Number of red blood cells in a given volume.

  • Used to assess anaemia and erythrocytosis
  • If RCC elevated, more likely to be a true polycythaemia
63
Q

What is mean cell volume?

A

Mean RBC size as measured by the amount of light scattered as they pass single file past the laser.
- Screening cause of anaemia

64
Q

What can cause a high MCV?

A
  • Megaloblastic anaemia
  • Myeloma
  • Haemolytic anaemia
65
Q

What can cause a low MCV?

A
  • Iron deficiency anaemia
  • Thalassaemia
  • Lead poisoning
66
Q

What is red cell distribution width?

A
  • Variation in RBC size
  • Anisocytosis
  • Helps assess anaemia cause
67
Q

What is mean cell haemoglobin?

A

Average measure of the amount of Hb in each RBC

- Assessment of anaemia: low in iron deficiency, higher in macrocytic anaemia

68
Q

Wha is mean cell haemoglobin concentration?

A

Haemoglobin/Mean cell volume x Red cell count

  • Reduced in hypochromia
  • Increased in spherocytosis
  • Not v. useful
69
Q

What is the reticulocyte count?

A
  • Size + RNA content
  • High in haemolytic anaemia, recovery from BM suppression
  • Reduced in BM failure
70
Q

What is a blood film and when is it made?*

A
  • Small drop of blood onto glass slide, fixed with methanol and stained to visualise under microscope
  • Used when results are abnormal or where abnormal cells are suspected
71
Q

What is the meaning and parameter of:

  • Macro/microcytic
  • Hypo/hyperchromic?
A

Macrocytic: MCV, large RBCs
Microcytic: MCV, small RBCs
Hypochromic: MCH, pale
Hyperchromic: MCH, more Hb

72
Q

What is anisocytosis?*

A

Variation in RBC size

73
Q

What is dimorphism?*

A

Two distinct populations of red cells

74
Q

What is poikilocytosis?*

A

Abnormally shaped RBCs

75
Q

What is spherocytosis?*

A

Spherical RBCs

76
Q

What is elliptocytosis?*

A

Elliptical RBCs

77
Q

What are echinocytes, acanthocytes and keratocytes?*

A

Spiculated cells

78
Q

What are sickle cells?*

A

Crescent-shaped cells in sickle cell disease

79
Q

What are target cells?*

A

RBCs with a dark area in middle of area of central pallor

80
Q

What are schistocytes?*

A

Red cell fragments

81
Q

What is polychromasia?*

A

Presence of reticulocytes

82
Q

What are Howell-Jolly bodies?*

A

DNA/nuclear fragments present in erythrocytes.

83
Q

What is basophilic stippling?*

A

RNA inclusions in cells

84
Q

What are Peppenheimer bodies?

A

Iron inclusions in cells

85
Q

What are Heinz bodies?*

A

Denatured haemoglobin

86
Q

What are Haemoglobin H inclusions?*

A

‘Golf ball cells’

87
Q

What features would be seen in iron deficiency anaemia?*

A
  • Normal/low reticulocyte count
  • Low Hb and MCV
  • Pencil cells, hypochromic and microcytic
88
Q

What features would be seen in spherocytosis?*

A

Higher reticulocyte count, higher mean cell haemoglobin concentration

89
Q

What would be seen in Vit. B12 deficiency?*

A
  • Oval macrocytes
  • Howell-Jolly bodies
  • Low red cell/reticulocyte count
  • Low Hb
90
Q

How to prevent platelets clumping in a sample?

A

Try citrate (green tube) sample

Metabolism, Endocrinology, Haematology (16 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions