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Haematology Week 1 Flashcards

1
Q

What are the 3 types of blood cells?

A

Red blood cell
White blood cell
Platlets

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2
Q

What is the production of blood cells called?

A

Haemopoiesis

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3
Q

What are blood cells made from?

A

Pluripotent stem cells

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4
Q

What are the sites of haemopoiesis in a foetus?

A

Yolk sac

3rd - 7th month - spleen

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5
Q

What is the site of haemopoiesis in infants?

A

Bone marrow - most bones

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6
Q

What is the site of heamopoeisis in adults?

A

Bone marrow of axial skeleton

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7
Q

What are the 5 types of white blood cells?

A 
Eosinophils
Basophils
Neutrophils
Monocytes
Lymphocytes
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8
Q

What do eosinophils look like? What is their function?

A

BI-lobed nucleus
Red granules
Fight parasitic infection
Involved in hypersensitivity

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9
Q

What is the function of basophils?

A

Involved in hypersensitivity - release histamine

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10
Q

What do neutrophils look like? What is their function?

A

Segmented nucleus

Phagocytes, kill with granule contents

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11
Q

What does optical density of RBCs tell you about the concentration?

A

Optical density is proportional to the concentration

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12
Q

What are the 3 layers of blood after being centrifuged?

A

Plasma
Buffy coat - WBC
Red blood cells

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13
Q

What is heamatocrit?

A

Ratio or % of blood that is RBC

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14
Q

What are reticulocytes?

A

Early red blood cells after denucleification

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15
Q

What doe reticulocytes look like compared to RBCs?

A

Bigger

No central pallor

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16
Q

If MCV is low what is the problem?

A

Problem with haemoglobinisation

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17
Q

Is MCV is high what is the problem?

A

Problem with maturation

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18
Q

What are small RBC with low Hb called?

A

Microcytic and hypochromic

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19
Q

What are the components of haemoglobin?

A

Globins

Heam - prophyrin ring and Iron (FE2+)

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20
Q

What are the causes of microcytic anaemia?

A 
Heam deficiency 
    Iron deficiency
    Porphyrin synthesis problem
    Congenital sideroblastic anaemia
Globin deficiency
    Thalassaemia
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21
Q

How is iron stored?

A

In ferritin

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22
Q

What three lab results would confirm a iron deficiency?

A

Low MCV
Low Haemoglobin
Low serum ferritin

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23
Q

What are 3 causes of iron deficiency?

A

Lack of iron in diet
Blood loss - GI, menorrhagia
Malabsorption

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24
Q

What transports iron?

A

Transferrin

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25
Q

Why are macrocytic red cells large?

A

Because of defects in DNA synthesis and nuclear maturation

Failure to become smaller

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26
Q

What are the 2 main causes of macrocytic anaemia?

A

B12 Deficiency

Folate deficiency

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27
Q

Where is B12 absorbed?

A

Ileum

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28
Q

Where is folate absorbed?

A

Duodenum and jejunum

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29
Q

Name 2 symptoms of macrocytic anaemia?

A

Weight loss
Diarrhoea
Jaundice
Sore tongue

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30
Q

Name 3 causes of B12 deficiency?

A 
Veganism
Pancreatitis
Coeliac disease
Crowns disease
Bowel resection
Atrophic gastritis
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31
Q

Name 2 causes of folate deficiency?

A 
Inadequate intake
Malabsorption
Pregnancy
Haemolysis 
Anti convulsants
32
Q

What other conditions if pernicious anaemia associated with?

A

Atrophic gastritis

Hypothyroidism

33
Q

What auto antibodies may be raised in pernicious anaemia?

A

Anti gastric parietal cell

Anti intrinsic factor

34
Q

What is the treatment for pernicious anaemia?

A

Vitamin B12 injections for life

35
Q

Name 2 causes of non-megaloblastic macrocytosis?

A

Alcohol
Liver disease
Hypothyroidism
Marrow failure

36
Q

Where is erythropoietin released from?

37
Q

Which globins make up metal and adult Hb?

A

Fetal - alpha and gamma

Adult - alpha and beta

38
Q

Which chromosome is the alpha gene on?

39
Q

Which chromosome is the beta gene on?

40
Q

What are the 4 classifications of alpha thalassaemia?

A

Silent alpha trait
Alpha thal trait
HbH disease
Hb barts hydrops fetalis

41
Q

What happens to the excess beta globin in HbH disease?

A

Forms beta4 - incapable of carrying oxygen

42
Q

What mode of inheritance is HbH?

A

Autosomal recessive

43
Q

What are the 3 classifications of beta thalassaemia?

A

Beta thal trait
Beta thal intermedia
Beta thal major

44
Q

What physical feature might you see in beta thal major and why?

A

Heptosplenomegaly, skeletal changes - extra medullary heamopoiesis

45
Q

What mutation causes sickle cell disease?

A

Point mutation of beta global gene

46
Q

What type of haemoglobin in seen in sickle cell disease?

A

HbS - alpha 2 beta s 2

47
Q

What do HbS become distorted?

A

When exposed to low O2

48
Q

What is the main problem with sickled cells?

A

They cause vessel occlusion and ischaemia

49
Q

Name 3 causes of sickle cell crisis?

A

Hypoxia
Dehydration
Cold exposure
Stress, fatigue

50
Q

When might someone with sickle trait have symptoms?

A

At altitude under anaesthetic - hypoxia

51
Q

What long term preventative treatment can be given in sickle cell anaemia?

A 
Education - avoiding triggers
Vaccination
Prophylactic penicillin
Folic acid supplements
Hydroxycarbanide
52
Q

What mode of inheritance is sickle cell anaemia?

A

Autosomal recessive

53
Q

What is the function of DMT-1?

A

Transports iron into duodenal enterocyte

54
Q

What is the function of ferroportin?

A

Facilitates iron export from the enterocyte to transferrin

55
Q

What is the function of hepcidin?

A

Down regulates ferroportin in response to iron overload - limits iron uptake

56
Q

What causes iron overload in hereditary haemochromatosis?

A

Reduced hepcidin synthesis

57
Q

What is the treatment of hereditary heamochromatosis?

A

Regulary venesection

58
Q

What is the treatment of secondary iron overload in patients with anaemia?

A

Iron chelating agents e.g. desferrioxamine

59
Q

What is the difference between blood products and blood components?

A

Blood components are made from 1 or a small number of donors blood
Blood products can be made from 1000’s of donors blood

60
Q

On which chromosome is blood group gene?

A

Chromosome 9

61
Q

Why do people have antibodies to blood that is not their own?

A

Because bacteria can mimic other blood groups so you make antibodies against these non self antigens

62
Q

What does the indirect anti globulin or indirect coombs test do?

A

Tests for irregular antibodies

63
Q

What 3 things should you do in the case of an immediate haemolytic transfusion reaction?

A

Stop transfusion, iv fluids, take blood samples

64
Q

What is the definition of haemolysis?

A

Premature red cells destruction -shortened red cells survival

65
Q

What is the difference between compensated and decompensated haemolysis?

A

Compensated - Hb level maintained

Decompensated - Hb level falls

66
Q

What is the bone marrow response to haemolysis?

A

Reticulocystosis

Erythroid hyperplasia

67
Q

What is extravascular haemolysis?

A

Destruction of red cells in liver and spleen

68
Q

What is intravascular haemolysis?

A

Red cells destroyed in the circulation

69
Q

What is the difference between products of extravascular and intravascular haemolysis?

A

Extravascular - normal products in excess

Intravascular - abnormal products - may be life threatening

70
Q

Name 3 side effects of oral iron supplements?

A

Constipation, heart burn, black stools

71
Q

By how much should iron rise per week if patient is compliant with treatment?

A

10g/l/week

72
Q

Is anti gastric parietal cell antibody more sensitive or specific?

A

Sensitive - most patients with pernicious anaemia have it, not everyone with the antibody has anaemia

73
Q

Is anti intrinsic factor more sensitive or specific?

A

Specific - if present it is always pernicious anaemia - but it is not always present

74
Q

What is the pathogenesis of pernicious anaemia?

A

Autoimmune condition causing destruction of gastric parietal cells - which make intrinsic factor that binds to B12

75
Q

If patient has low B12 and Folate what must you do and why?

A

Replace B12 first - otherwise it may cause subacute degeneration of the cord

Haematology (5 decks)

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