Haemotology

Question 1

Define thrombocytopenia and list the more common causes of this condition.

Answer 1

• Low blood levels of platelets

One common definition of thrombocytopenia requiring emergency treatment is a platelet count below 50,000 per microliter.

Can be caused by
Dehydration, Vitamin B12 or folic acid deficiency

Leukemia or myelodysplastic syndrome or aplastic anemia

Decreased production of thrombopoietin by the liver in liver failure
Sepsis, systemic viral or bacterial infection

Question 2

Other causes of Thromobocytopenia?

Answer 2

Immune related
Hypersplenism
Dengue fever
Gaucher's disease
Zika virus

Other causes[edit]
Snakebite[13]
Niacin toxicity[14]
Lyme disease[15]

And also some medications

Question 3

What is Idiopathic Thrombocytopenic Purpura (ITP?

Answer 3

Same but, caused by the immune system

Question 4

Consequences of low platelet count?

Answer 4

LAck of blood clotting, bleeding, bruising, bleeding gums etc

Question 5

What drugs have been associated with the development of thrombocytopenia?

Answer 5

Medication-induced[edit]
The following medications can induce thrombocytopenia through direct myelosuppression.[12]

Valproic acid
Carboplatin
Interferon
H2 blockers and proton-pump inhibitors

Question 6

How is thrombocytopenia treated in individuals diagnosed with the condition?

Answer 6

plasmapheresis. this treatment works by removing antibodies against the von Willebrand factor-cleaving protease ADAMTS-13.

The plasmapheresis procedure also adds active ADAMTS-13 protease proteins to the patient, restoring a normal level of von Willebrand factor multimers.

Question 7

Explain the genetic basis behind the basic blood groups. What happens if blood gets mixed during a transfusion?

Answer 7

There are four main blood groups (types of blood) – A, B, AB and O. Your blood group is determined by the genes you inherit from your parents. Each group can be either RhD positive or RhD negative, which means in total there are eight main blood groups.

An ABO incompatibility reaction can occur if you receive the wrong type of blood during a blood transfusion. It’s a rare but serious and potentially fatal response to incompatible blood by your immune system

Question 8

How does the universal recipient differ from the universal donor

Answer 8

Universal donors are Type O-negative people; because they have no antigens with which anybody else’s immune system would be unfamiliar, their blood can be donated to any patient

Universal recipients are Type AB-positive; that is, they already carry the A antigen, the B antigen, and the Rh antigen

Question 9

What does being Rhesus negative or positive mean?

Answer 9

Your rhesus factor is fixed by your genes. If you’re rhesus positive (RhD positive), it means that a protein (D antigen) is found on the surface of your red blood cells.

Question 10

What is haemolytic disease of the newborn (HDN)?

Answer 10

Hemolytic disease of the newborn, also known as hemolytic disease of the fetus and newborn, HDN, HDFN, or erythroblastosis fetalis, is an alloimmune condition that develops in a fetus, when the IgG molecules (one of the five main types of antibodies) produced by the mother pass through the placenta.

Question 11

What is jaundice and what can happy to a newborn if it is left untreated?

Answer 11

a medical condition with yellowing of the skin or whites of the eyes, arising from excess of the pigment bilirubin and typically caused by obstruction of the bile duct, by liver disease, or by excessive breakdown of red blood cells

If bilirubin levels in babies are very high for too long, a type of brain damage, known as kernicterus, may occur.[6

Question 12

What are the possible causes of haemolysis in an adult, and how common are they?

Answer 12

Hemolysis inside the body can be caused by a large number of medical conditions, including many Gram-positive bacteria (e.g., Streptococcus, Enterococcus, and Staphylococcus),

some parasites (e.g., Plasmodium),

some autoimmune disorders (e.g., drug-induced hemolytic anemia),

some genetic disorders (e.g., Sickle-cell disease or G6PD deficiency),

blood with too low a solute concentration (hypotonic to cells).

Question 13

How is iron stored and transported in the body?

Answer 13

A protein called transferrin attaches to the iron and helps transport it throughout your body. Iron later passes to your bone marrow, where it is used to make hemoglobin and red blood cells, which circulate in your body and help supply oxygen to your organs and tissues.

Question 14

What is Iron Deficiency Anemia (IDA) and how frequently does it occur?

Answer 14

Iron deficiency anemia occurs when your body doesn’t have enough iron to produce hemoglobin.

When onset is slow, symptoms are often vague, including feeling tired, weakness, shortness of breath, or poor ability to exercise.[1]

Anemia that comes on quickly often has greater symptoms, including: confusion, feeling like one is going to pass out, and increased thirst.[

Question 15

What are the red blood cell indices, and what tests are diagnostic for IDA?

Answer 15

Red blood cell (RBC) indices are part of the complete blood count (CBC) test. They are used to help diagnose the cause of anemia, a condition in which there are too few red blood cells.

Question 16

How does IDA differ from sickle cell anaemia? What are the symptoms and aetiology of the latter?

Answer 16

In IDA, the RBC is low (there isn’t enough iron around, so the bone marrow makes fewer cells). In mild thalassemia, however, the RBC tends to be normal or even elevated. The reasons for this are unclear..

Normal RBCs are circular in shape or disc-shaped while sickle cells are shaped like a half moon or crescent shape.
2. Normal hemoglobin will cause smooth flowing of RBCs into the bloodstream while sickled-shape hemoglobin will cause a “traffic jam” into the bloodstream.
3. In normal RBCs, bone marrow will reproduce it every 3 months while in sickle-shaped, it takes 10-20 days only.
4. Sickle-shaped hemoglobin is inherited from both parents who have it.
Sickle cell much more severe

Question 17

Outline the different causes of: a. Microcytic anaemia b. Macrocytic anaemia c. Normocytic anaemia

Answer 17

a-characterized by small red blood cells (called microcytes) In microcytic anaemia, the red blood cells (erythrocytes) are usually also hypochromic, meaning that the red blood cells appear paler than usual

b- red blood cells (erythrocytes) are larger than their normal volume. T

c- the hematocrit and hemoglobin is decreased.[1

Question 18

Define Leukaemia

Diagnosis by?

Answer 18

Leukemia, , is a group of cancers that usually begin in the bone marrow and result in high numbers of abnormal white blood cells.[8]

These white blood cells are not fully developed and are called blasts or leukemia cells.[2] 2]

Diagnosis is typically made by blood tests or bone marrow biopsy.[2]

Question 19

Symptoms of Leukemia?

Answer 19

Symptoms may include bleeding and bruising problems, feeling tired, fever, and an increased risk of infections.[2] These symptoms occur due to a lack of normal blood cells.[

Question 20

Types of Leukaemia?

Answer 20

Acute myeloid leukemia (AML) - occurs more commonly in adults than in children,

Chronic myeloid leukemia (CML) - 55+

Acute lymphocytic leukemia (ALL) - Common in Children

Chronic lymphocytic leukemia (CLL) occurs mainly in adults; a very small number of children also develop this disease

Question 21

Diff between chronic and acute?

Answer 21

Acute leukemia is characterized by a rapid increase in the number of immature blood cells. The crowding that results from such cells makes the bone marrow unable to produce healthy blood cells.

Chronic leukemia is characterized by the excessive buildup of relatively mature, but still abnormal, white blood cells. Typically taking months or years to progress, the cells are produced at a much higher rate than normal, resulting in many abnormal white blood cells

Question 22

What is a lumbar puncture?

Answer 22

Lumbar puncture (LP), also known as a spinal tap, is a medical procedure in which a needle is inserted into the spinal canal, most commonly to collect cerebrospinal fluid (CSF) for diagnostic testing.

Question 23

What is pancytopaenia? What are the main causes of bone marrow failure?

Answer 23

• a reduction in the number of red and white blood cells, as well as platelets.

Iatrogenic causes of pancytopenia include chemotherapy for malignancies if the drug or drugs used cause bone marrow suppression.

Rarely, drugs (antibiotics, blood pressure medication, heart medication) can cause pancytopenia.

The antibiotics Linezolid and Chloramphenicol can cause pancytopenia in some individuals.

Rarely, pancytopenia may have other causes, such as mononucleosis also known as glandular fever, is an infection commonly caused by the Epstein–Barr virus )

, Increasingly, HIV is itself a cause for pancytopenia.

Question 24

What is Polycythemia vera

Answer 24

Polycythemia vera is an uncommon neoplasm in which the bone marrow makes too many red blood cells.

[1] It may also result in the overproduction of white blood cells and platelets.

Question 25

What is multiple myeloma?

Answer 25

Multiple myeloma, also known as plasma cell myeloma, is a cancer of plasma cells, a type of white blood cell normally responsible for producing antibodies.[5]

Often, no symptoms are noticed initially.[1] When advanced, bone pain, bleeding, frequent infections, and anemia may occur.[1]

Complications may include amyloidosis.[2] (deposit in organs from bone marrow)

Question 26

What is serum total protein indicative of?

Answer 26

Concentrations below the reference range usually reflect low albumin concentration, for instance in liver disease or acute infection. Rarely, low total protein may be a sign of immunodeficiency.

Concentrations above the reference range are found in paraproteinaemia, Hodgkin’s lymphoma, leukaemia or any condition causing an increase in immunoglobulins.

Total protein is also commonly elevated in dehydration and C677T gene mutation.