Intro to Haematology Flashcards by Martin Beattie

What is covered by the clinical speciality of heamtology?

1 - Investigation of blood and bone marrow

2 - Management of disorders of blood and bone marrow

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What are the 3 major constituents of blood?

1 - Plasma

2 - Buffy coat

3 - Red blood cells

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What are the components of plasma?

1 - Clotting/coagulation factors

2 - Albumin

3 - Antibodies

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What are the components of the buffy coat?

1 - Platelets

2 - White cells or Leucocytes

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What are the 3 main functions of blood?

1 - Transport

2 - Maintenance of vascular integrity

3 - Protection against pathogens

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What does blood transport?

1 - Gases (O2, CO2)

2 - Nutrients

3 - Waste

4 - Messages

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What component of blood carries gases?

Red cells

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What component of blood carries the nutrients, waste and messages?

Plasma

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In what ways does blood maintain vascular integrity?

1 - Prevention of leaks

2 - Prevention of blocakges

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Which components of blood are responsible for preventing leaks?

1 - Platelets

2 - Clotting factors

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Which component of blood is responsible for preventing blockages?

1 - Anticoagulants

2 - Fibrinolytics

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In what ways does blood provide protection from pathogens?

1 - Phagocytosis and killing

2 - Antigen recognition and antibody formation

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Which components of blood are responsible for phagocytosis and killing?

Macrophages

Neutrophils

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Which components of blood are responsible for anitgen recognition and antibody formation?

Lymphocytes

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What are the main categories of haematological abnormalities?

1 - High levels of blood

2 - Low levels of blood

3 - Altered function

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What is haematopoiesis?

The differentiation of stem cells into red blood cells and lymphoid cells

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What are erythrocytes?

Red blood cells (erythros = red)

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What are the myeloid cells?

Erythrocytes

Platelets

Neutrophils

Monocytes

Basophils

Eosinophils

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What are the lymphoid cells?

Natural Killer cells

T and B cells

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What is meant by totipotency?

The ability of a single cell to divide and produce all of the differntiated cells of an organism

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Can stem cells self-renew?

Yes

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What type of marrow do stem cells contain?

Marrow niche - CXCR4

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What are the processes involved in stem cell differentiation?

Binary Fission

Flux

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What regulates the process of flux?

Hormones

Growth factors

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Where is bone marrow found in children?

In most bones

Where is bone marrow found in the elderly?

Axial bones

What does bone marrow look like?

Stroma and sinusoids

What are the stages in Erythroid differentiation?

1) Erythro**blast** 2) Reticulocyte 3) Erythro**cyte**

What is erythropoietin?

Glycoprotein cytokine

What does erythropoietin do?

Stimulates the production of RBC's in bone marrow

Where is erythropoietin made?

Kidney

In response to what conditions is erythropoietin made?

Hypoxia

Why is the reticulocyte count useful?

It can be used as a measure of red cell production

What is polycythaemia?

An abnormally high **concentration** of haemoglobin in the blood

What are the causes of polycythaemia?

Reduction in plasma volume Increased in number of red blood cells

What is the general consequence of anaemia?

Poor gas transfer

What are the _specific_ problems caused by anaemia?

Dyspnoea Fatigue

What are the general causes of anaemia?

1 - Decreased production 2 - Increased loss

In general, what is anaemia?

Decrease in amount of **RBC's** or **Haemaglobin**

What can be the reason for anaemia caused by deficiency in haematinics?

- Iron - Folate - Vitamin B12

What is meant by the term 'haematinics'?

The vitamins and minerals required for the proper creation of RBC's

What are the congential causes of anaemia?

Thalassaemias

What is Thalassaemias?

**Genetic** problem resulting in production of **not enough haemaglobin**

What can be the reasons for anaemia resulting from 'increased loss' of blood?

Bleeding Haemolysis

What is haemolysis?

The break down of RBC's

What are some common diseases of RBC's?

Microcytes Macrocytes Sickle cell

What are microcytes and with what condition are they associated?

Very small RBC's associated with anaemia (e.g. iron deficiency)

What are macrocytes and with what condition are they associated?

Large RBC's associated Folate deficiency

What are Burr cells and with what condition are they associated?

**RBC** with **spiky** outer membrane associated with **Renal failure**

What are schistocytes and with what condition are they associated?

**Fragments** of RBC's associated with **haemolytic uraemic syndrome**

What are sickle cells and with what condition are they associated?

They have a sickle shape, have problems carrying haemoglobin and are associated with sickle-cell disease

What is the function of platelets?

To 'clump' together during bleeding in order to form a clot

Which hormone is responsible for the production of platelets?

Thrombopoietin

Where is thrombopoietin produced?

Liver

What is the lifespan of a platelet?

7 days

In what diseases are problems with platelets a feature?

Thrombocytosis (too many platelets) Thrombocytopenia (not enough platelets)

What medication can affect the functioning of platelets?

Aspirin (fever, pain or inflammation medication) Clopidogrel (antiplatelet medication)

What is the function of neutrophils?

To ingest and destroy pathogens Especially bacteria and fungi

What are the different white cell types?

Neutrophil Eosinophil Basophil Monocytes Lymphocytes

From which cells are macrophages derived?

Monocytes

How do neutrophils compare to macrophages?

**Neutrophils** - granulocytes which work only in the **circulation** **Macrophages** - agranulocytes which work **within tissue**

How long do neutrophils take to respond to them being required?

A few hours

What are the steps of differentiation of neutrophils?

1 - Blast 2 - Promyelocyte 3 - Myelocyte 4 - Metamyelocyte 5 - Neutrophil

What hormone stimulates bone marrow to produce neutrophils?

Granulocyte - colon stimulating factor (G-CSF)

What do neutrophils mostly fight against?

Infection Inflammation

In what conditions can G-CSF be used therapeutically?

Neutropenia (not enough neutrophils)

What can cause neutropenia by decreased production of neutrophils?

1 - Drugs 2 - Marrow failure

What can cause neutropenia by increased consumption of neutrophils?

1 - Sepsis 2 - Autoimmune

What is the function of monocytes?

To ingest and destroy pathogens

What is the function of eosinophils?

Fight off: 1 - Parasites 2 - Allergies

What is the function of lymphocytes?

Cells of the immune system

What is lymphocytosis and with what conditions is it associated?

An increased number of lymphocytes Associated with: - Infectious mononucleosis - Pertussis

What is lymphopenia and with what conditions is it associated?

Not enough lymphocytes: - Usually post-viral - Lymphoma

What are the subtypes of lymphocytes?

B cells T cells NK cells

What is the function of B cells?

Make antibodies

What is the function of T cells?

Helpers - Help other WBC's with immunity Cytotoxic - Destroy virus infected cells Regulatory - Maintain immunity

Where are B cells produced?

Bone marrow

Where are T cells produced?

Thymus

What antigen is responsible for regulating the immune system?

Human Leukocyte Antigen

How does Human leukocyte antigen work?

It identifies whether cells are infected or not - if they are infected then an immune response is triggered

What blood disorders are associated with disease of the liver?

Anaemia Deficient clotting factors

What blood disorders are associated with kidney disease?

Haemolytic uraemic syndrome Anaemia

What blood disorder is associated with the GI system?

Anaemia

What blood disorder is associasted with the respiratory system?

Polycythaemia

What is the most common inherited bleeding disorder?

Von Willebrand disease

What is the most common congenital coagulation factor deficiency?

Haemophilia A

What are the normal haemoglobin values for a male \< 70 y.o.?

135-170

What are the normal haemoglobin values for a female \< 70 y.o.?

120-160

What is the normal range for platelet count?

**150-400** 10^9/L

What is the normal range for white blood cells on a full blood count?

**4-10** 10^9/L

What are the diagnostic tools used in blood disorders?

1 - Full blood count 2 - Clotting times 3 - Check Iron, B12 and Folate levels 4 - Bone marrow aspirate 5 - Lymph node biopsy 6 - Imaging

What are the main categories of treatment for blood disorders?

1) Replacement 2) Transplantation 3) Drugs

What are the major causes of splenomegaly?

1 - Infectious (e.g. Epstein-Barr virus, TB) 2 - Haematological Malignancy (e.g. leukemias) 3 - Portal hypertension 4 - Haemolytic disorders (e.g. spherocytosis) 5 - Connective tissue disorders (e.g. SLE)