Haematopoiesis

Question 1

sites of human haematopoiesis - foetus

Answer 1

yolk sac
liver and spleen
bone marrow

Question 2

sites of human haematopoiesis - infant

Answer 2

all bone marrow

Question 3

sites of human haematopoiesis - adult

Answer 3

central skeleton
proximal ends of femur

Question 4

what can a multipotent haematopoietic stem cell (haemocytoblast) differentiate into

Answer 4

haemocytoblat
common myeloid progenitor
common lymphoid progenitor

Question 5

what can common myeloid progenitor cells differentiate into

Answer 5

megakarocyte
erythrocyte
mast cell
myeloblast

Question 6

what do megakarocytes differentiate into

Answer 6

thrombocytes

Question 7

what can myeloblasts differentiate into

Answer 7

basophils
neutrophils
eosinophils
monocytes

Question 8

what do monocytes differentiate into

Answer 8

macrophages

Question 9

what can common lymphoid progenitor cells differentiate into

Answer 9

natural killer cells (large granular lymphocytes)
small lymphocytes

Question 10

what can small lymphocytes differentiate into

Answer 10

T lymphocytes
B lymphocytes

Question 11

what do B lymphocytes differentiate into

Answer 11

plasma cells

Question 12

what cell types are found in bone marrow

Answer 12

stromal cells
fibroblasts
adipocytes
macrophages
endothelial cells
osteoblasts and osteoclasts

Question 13

control of adult haematopoiesis - extrinsic signalling

Answer 13

growth factors
- cell survival/proliferation
- differentiation
- maturation
- activation
adhesion molecules
- interact with ECM

Question 14

control of adult haematopoiesis - intrinsic signalling

Answer 14

transcription factors

Question 15

what is erythropoiesis regulated by

Answer 15

renal erythropoietin which is stimulated by tissue oxygen

Question 16

what is myelopoiesis regulated by

Answer 16

G-CSF - granulocytes
M-CSF - macrophages
IL-5 - eosinophils

Question 17

what is thrombopoiesis regulated by

Answer 17

thrombopoietin from liver
feedback mechanism controls platelet count

Question 18

types of white blood cell

Answer 18

neutrophils
lymphocytes
monocytes
eosinophils
basophils

Question 19

too much (-cytosis)

Answer 19

erythrocytosis
leucocytosis
thrombocytosis

Question 20

too little (-cytopaenia)

Answer 20

anaemia (red)
leucopenia (white)
thrombocytopenia (platelets)
pancytopenia (all)

Question 21

anaemia symptoms

Answer 21

lethargy
SOB
chest pain
headache, dizziness
pallor
depend on degree of anaemia, speed and comorbidities

Question 22

examples of anaemia

Answer 22

blood loss
reduced RBC production
increased RBC destruction

Question 23

reduced RBC production

Answer 23

deficiency - iron, b12, folate
malignancy
chronic disease, kidney disease
thalassaemia
bone marrow failure

Question 24

increased RBC destruction

Answer 24

haemolysis, e.g. autoimmune
sickle cell disease

Question 25

iron deficieny

Answer 25

chronic blood loss - menstruation, GI bleeding dietary - veggie, vegan, toddlers malabsorption - coeliac, gastric surgery increased requirements - pregnancy, growth

Question 26

megaloblastic anaemia

Answer 26

defective DNA synthesis during RBC production causing cell growth without division macrocytic anaemia usually due to b12 or folate deficiency

Question 27

macrocytic anaemia (increased MCV)

Answer 27

anisocytosis, oval macrocytes neutropaenia with hyper segmented neutrophils thrombocytopaenia reduced reticulocytes non haematological effects

Question 28

folate dietary sources

Answer 28

green veg folate free diet causes deficiency in weeks

Question 29

folate deficiency

Answer 29

inadequate intake malabsorption - coeliac excess consumption - pregnancy drugs - e.g. anticonvulsants

Question 30

b12 dietary

Answer 30

meat dairy fish

Question 31

b12 deficiency

Answer 31

vegan diet autoimmune - pernicious anaemia malabsorption - gastric/ileal surgery

Question 32

haemolytic anaemia

Answer 32

excessive/premature RBC breakdown - spherocytes or fragments - anaemia and reticulocytosis - raised bilirubin and LDH extra or intravascular many causes - inherited or acquired

Question 33

polycythaemia/erythrocytosis

Answer 33

increased haematocrit and haemoglobin absolute increased red cell mass - primary: polycythaemia rubra vera - secondary: increased EPO, chronic hypoxia, renal tumours relative/apparent reduced plasma volume

Question 34

what are white cells called

Answer 34

leucocytes

Question 35

types of white cell

Answer 35

monocyte lymphocyte neutrophil eosinophil basophil

Question 36

leucocytosis

Answer 36

too many white cells

Question 37

leucopenia

Answer 37

too little white cells

Question 38

neutrophilia

Answer 38

infection inflammation malignancy bone marrow infiltration steroids pregnancy g-csf

Question 39

monocytosis

Answer 39

acute or chronic infection connective tissue disease

Question 40

eosinophilia

Answer 40

allergy parasites skin diseases drugs

Question 41

main type of leucopaenia

Answer 41

neutropenia

Question 42

reasons for leucopenia

Answer 42

infections - recurrent bacterial skin - mouth ulcers - overwhelming sepsis - unusual infections

Question 43

thrombocytosis

Answer 43

too many platelets

Question 44

primary thrombocytosis

Answer 44

essential thrombocytosis or another myeloproliferative disorder

Question 45

secondary thrombocytosis

Answer 45

infection/inflammation/surgery post-splenectomy iron deficiency malignancy

Question 46

thrombocytopaenia

Answer 46

too few platelets

Question 47

symptoms of thrombocytopaenia

Answer 47

bruising gum bleeding nose bleeds petechiae prolonged bleeding from cuts

Question 48

TCP - increased destruction/consumption of platelets

Answer 48

immune - immune thrombocytopenia pupura, drugs (e.g. heparin), autoimmune, infection non-immune - hyperplenism, MAHA

Question 49

TCP - decreased production of platelets

Answer 49

bone marrow failure b12/folate deficiency drugs/alcohol infection liver disease

Question 50

pancytopenia

Answer 50

severe infection hypersplenism megaloblastic anaemia myelosuppressive drugs bone marrow failure