Haemotology Flashcards by Maddie Sharpe

Name the different types of blood types and what they are ? how common are they? (%s)

0= A+B antibodies 43%
A= A antigens B antibodies 45%
B= B antigens A antibodies 9% 
AB= A + B antigens 3%

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Which blood type is the universal donor and which is the universal recipient

o = donor
ab = recipient

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Describe rhesus D pregnancy problem

Mum Rh -ve baby rh+-e. When born babies rbcs get into maternal blood and mum makes Anti D IgG against the Rh +ve. If the mum then has another baby that is Rh +ve. IgG crosses placenta and attacks babies RBCs

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How do we prevent rh D pregnancy problem

give mum Anti D Anti bodies against the RBCs after pregnancy so she doesnt make them herself (antinatal prophylaxis)

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What do you do when testing between patient serum and donor cells prior to blood issue

select blood type to match on basis of ABO/ Rh group

mix serum and cells first to test if reaction

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Name some risks of a blood transfusion

reactions - febrile and allergic
infection -bac virus protazon prion
iron overload -cant excrete
anaphylaxis
viral transmission- HIV, HEP  B
RBC antibodies - alloimmunisation 
fluid overload
TRALI

hypocalaemia + dilution of clotting factors on a massive transfusion

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How much blood in the body?

Composition of blood?

5L.

45% RBC, 55% PLASMA, 1% WBC+ PLATELET

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Name the stuff in the blood that helps with immunity

WBC, antibodies, acute phase proteins

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difference between serum and plasma and blood

plasma is centrifuged blood

serum is without clotting factors

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functions of a RBC

acts as a buffer, gas exchange

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normal Hb levels

male 13.5-18

female 11.5-13.5 - less because of menstruation and decreased circulating vol

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what is the haematocrit

% of blood that is red cells (often proportional to haemoglobin)

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How many platelets in the blood and how long do they last

7-14 days .

150

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Descrive the 3 granulocytes

eosinophils
neutrophils
basophils

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eosinophils

vital or antiparasite immunity and important in allergic responce
linked to 1gE
biloben nucleus

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basophils

function not clear, may be important against parasites and anaphalaxis 
dark blue granules

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neutrophils

phagocytose bacteria and kill (H2o2 and free radicals)
multi lobed nucleus
lifespan 8 hours
2-7%

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what are monocytes

macrophages
phagocytose dead or dying cells or foreign material
may contain phagocytic vacuoles

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whats the difference between MCV and MCH

and name some disease in each

MCV = mean corpuscular volume - cell size
small in microcytic anaemia
large in macrocytic anaemia

MCH is how red they are
pale in hypochromic anaemia

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what is polycythaemia

RBC overproduction in the marrow

or decrease plasma (pseudopolycythameia) - caused by alcohol

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name 3 general causes of anaemia

decreased RBC production
increased RBC destruction
increased RBC loss

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Name 4 causes of microcytic anaemia

Thalassaemia (a+b globin chains )
Iron deficience
Chronic disease - body tries to decrease amount in inflammation
Sideroblastic anaemia (congenital)

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what is a reticulocyte

an immature RBC

around for one day before becomes a RBC

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whats the most common cause of microcytic anaemia

blood loss via parasites

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descrive 3 causes of macrocytic anaemia

- bone marrow trying to compensate for blood loss (haemorrhage and haemolysis) - marrow dysfunction 2y to renal liver and thyroid dysfunction or chemo or leukaemia - megaloblastic anaemia

what is megaloblastic anaemia

caused by b12 or folate deficiency , abnormal maturation of RBC

what is a marker for macrocytic anaemia

reticulocyte counts

what is thrombocytosis

platelet overproduction - normally a reaction ro inflammatory/infection

what is thrombocytopenia

decreased platelets. consumption by clots, infection, liver disease

philia penia cytosis | mean what?

philia - increased penia - decreased cytosis - increased

common causes of ? 1) neutrophilia 2) neutropenia 3) monocytosis 4) eosinophilia

1) reaction to infection 2) under production and over consumption 3) chronic inflammation 4) parasites, fungi, allergies

What is virchows triad

clots occur due to : - stasis of blood - changes in blood composition - disturbed vessel - vascular wall injury

type of bloot clot in aa and vv and what you give to treat them

aa - platelet ASPRIN | vv - fibrin WARFRIN

1 What does prothrombin time measure 2 how long is normal 3 what do we use it for

1 activity of extrinsic pathway 2 usually 9-12 s 3 use this to monitor the effect of warfarin

name 2 diseases the prothrombin time will be longer

liver disease and DIC

1 what does the APPT measure 2 how long is normal 3 what do we use it for

1 activity of intrinsic pathway 2 22-32s 3 unfractioned heparin ad hirudin

name some diseases the APPT is prolonged in

haemophilia A&B, liver disease, lupus anticoagulant, von willebrands disease, DIC

1 what does the thromin time measure | 2 how long is normal

1 final common pathway | 2 13-20

name 1 treatment and 3 pathological diseases that can increased thrombin time

heparin liver disease DIC dysfibrinogenaemia

1 what is the template bleeding time | 2 how long is normal

1 measures in vivo. razor cute 5mm cuts in skin excess blood removed gently time from cut to bleeding stopped is measured 2 normally 2-8 minute

Name a limitations of the clotting cascade model

1 explains how it clots in a test tube not in mammal

which model is more accurate representation of blood clotting

cell based model

describe the final common clotting pathway

prothrombin(2) to thrombin triggers fibrinogen(1) to fibrin . FXIII cross links fibrin to form strong clot

1 What are D dimers 2 what are they used for 3 Normal amounts

1) fragment of fibrinogen created when its chopped into pieces. 2) thery're increased if a clot is present so can be used to rule out clots in the worried well 3) normally 250 if

What causes haemophilia A and haemophilia B

A- reduced CF 8 | B - reduced CF 9

who gets haemophilia and why

both genes on the X chromosome so sex linked so only present in males

how does haemophilia present

arthritis - bleeding into joins as baby boy starts to walk | causes prolonges APTT (180 seconds)

how do you treat haemophilia

factor replacement intravenously either to treat current bleeding or prophylactically to prevent bleeding

What is Disseminated Intravascular Coagulation

microscopic clots form in the circulation, when platelets and clotting factors run out bleed horrendously

what can trigger DIC

infection, malignancy, pregnancy complications, massive bleeding

how do you treat DIC

identify the cause and remove it, can use plasma and platelet transfusions to buy time whilst treating the cause

what is transfusion coagulopathy

occurs when a massive transfusion platelets and clotting factors depleted. circulation becomes acidotic and hypothermic the temp and ph changes further from norm therefor CFs and platelets dont work

2 things that can case dysfunctional platelets

drugs . asprin clopidogrel abcizimab | 2y to liver disease

1 what can dysfunctional platelets lead to? | 2 how do you treat it

1 bleeding from mucosal surfaces e.g nosebleeds gum bleeds GI bleeds 2 remove cause

causes of low platelets

liver disease or marrow failure or ITP

1 what can low platelets lead to? | 2 how do you treat it

1 mucosal bleeding problems | 2 platelet transfusion + procoagulant drugs to prevent bleed

name 2 causes of aa clot and 3 of vv clot

stroke and MI | DVT PE and AF/cardio-embolism

thrombolysis of aa clots?

tPA - activated plasmin | heparin

prevention of aa clots?

platelet inhibition - eg asprin, clopidogrel, abciximab | reduce atheroma - statins to lower cholesterol, treat diabetes, bp, smoking

thrombolysis of vv clots?

immediately using HEPARIN high dose | medium term use warfarin

prevention of vv clots?

keep patients mobile - elastic stockings to maintain venous return. prophylactic heparin

what is warfarin

vit K antag for vit k dependent clotting factors, 2, 7,9,10

how long does warfarin take to work

49-72 hours

how does heparin work

inactivates factor 10 and 2(prothrombin)

difference between LMWH and UFH and one positive of both

LMWH fomed by cleavage of unfractioned heparines LMWH - consistent UFH - easily reversible

how do you administer heparin and warfarin

heparin iv | wafarin oral

what is INR used for

warfarin use and acute liver damage