Haemopoiesis

Question 1

Compare locations of Haemopoiesis in fetus and adult

What kind of biopsy can be taken and where from? To observe bone marrow

Answer 1

Fetus: Liver, spleen
Adult: Skull, vertebrae, ribs, sternum, spine, pelvis

Trephine biopsy from pelvis

Question 2

What are the 5 major lineage pathways

Outline them

Answer 2

MSC->common myeloid progenitor (CMP) + Common lymphoid progenitor (CLP)

Erythropoiesis: CMP-> Red blood cell
Thrombopoiesis: CMP-> Megakaryocyte-> Platelets

Lymphopoiesis: CLP-> Small lymphocyte-> B + T Lymphocytes

Granulopoiesis: CMP-> Myeloblast-> Basophils+Neutrophils+Eosinophils

Monocytopoiesis: CMP-> Myeloblast-> Monocytes

Question 3

Name 2 important hormones in Haemopoiesis
What do they do?
Where secreted from?

Answer 3

Erythropoietin: Stimulates RBC production, secreted by kidney

Thrombopoitein: Regulates platelet protection, produced in liver and kidney

Question 4

What is the Reticuloendothelial system? What does it do

What is the main cell used

Answer 4

Network of cells throughout body and part of the immune system

Removes dead/ damaged tissue, and identify and destroy foreign antigens

Macrophages and monocytes

Question 5

What are the main organs of the Reticuloendothelial system

Answer 5

Spleen and liver

Question 6

Name 4 functions of the spleen in an adult

Answer 6

• Sequestration and phagocytosis
• Blood pooling (RBCs and platelets can be released when needed)
• Extramedullary haematopoieis
• Immunological function

Question 7

How does blood enter the spleen?

Compare the paths of RBCs and White cells+ Plasma

Answer 7

Splenic artery

RBCs prefer to go through red pulp
WBCs and plasma prefer to go through white pulp

Question 8

Give 4 reasons for splenomegaly

Answer 8

• Overwork
• Infiltration of spleen by cells and other material
• Extramedullary Haemopoiesis
• Portal hypertension in liver

Question 9

What are you at risk of, during splenomegaly when rib cage is not providing protection

Answer 9

Rupture of spleen

Question 10

How can hypersplenism affect blood counts

Answer 10

Reduced, as blood pools in spleen

Question 11

What is hyposplenism

what are 4 causes

Answer 11

Lack/ loss of functioning splenic tissue

Splenectomy
Sickle cell disease
Gastrointestinal disease
Autoimmune diseases

Question 12

Patients with hyposplenism are at risk of what? From who?

How are these patients treated

Answer 12

Sepsis 
Encapsulated bacteria;
- Strep pneumoniae 
- Haemophilus influenzae
- Meningococcus 

Must be immunised and given Antibiotic Prophylaxis for life

Question 13

What is Neutrophilia

Name 4 causes

Answer 13

Increase in no. of circulating neutrophils

Infection, Smoking, Myeloproliferative diseases, G-CSF

Question 14

How does Haemorrhage affect the neutrophil count and why

Answer 14

Haemorrhage brings more cells into Circulating pool from Marginated pool, and only the cells in the circulating pool are measured in a blood count

Question 15

What is Neutropenia, what are 3 consequences

Answer 15

Decrease in no. of circulating neutrophils

• Severe life threatening bacterial infection
• Severe life threatening fungal infection
• Mucosal ulceration

Question 16

Neutropenic Sepsis is an emergency, what is the treatment

What are 2 causes of Neutropenia

Answer 16

IV Antibiotics immediately

Reduced production
Increase usage/ removal

Question 17

Which cells are the largest in blood and are responsible for dealing with bacterial infections

Answer 17

Monocytes

Question 18

Which cells mediate allergic responses

Which cells are the least common

Answer 18

Eosinophils

Basophils

Question 19

Where do lymphocytes originate? What are the 3

Answer 19

In bone marrow

B cells
T cells
Natural Killer cells

Question 20

What are the 2 types of Lymphocytosis

Name 2 causes for each

Answer 20

Reactive- Viral/ bacterial infections, smoking

Lymphoproliferative- Lymphoma, Leukaemia