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Year 3 > Intro to Haematology > Flashcards

Intro to Haematology Flashcards

1
Q

components of blood

A

plasma
buffy coat
RBC

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2
Q

components of plasma

A

clotting or coagulation factors
albumin
antibodies

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3
Q

components of buffy coat

A

platelets

white cells or leuocytes

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4
Q

functions of blood

A

transport
maintenance of vascular integrity
protection from pathogens

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5
Q

what do red cells transport?

A

gases - oxygen and CO2

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6
Q

what does plasma transport?

A

nutrients
waste
messages

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7
Q

what maintains vascular integrity?

A

platelets and clotting factors

anticoagulants and fibrinolytics

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8
Q

in the blood what protects from pathogens?

A

granulocytes/monocytes

lymphocyte

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9
Q

what are the fucntions of granulocytes?

A

phagocytosis and killing

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10
Q

what are the funcitons of lymphocytes?

A

antigen recognition

antibody formation

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11
Q

pathogenesis of haematological abnormalities: high levels

A

increased rate of production

decreased rate of loss

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12
Q

pathogenesis of haematological abnormalities: low levels

A

decreased rate of production

increased rate of loss

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13
Q

using a diagram show haematopoeisis

A

see notes

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14
Q

stem cells are capable of what type of differentiation?

A

totipotent

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15
Q

discuss stem cells

A

self-renewal

home to marrow niche

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16
Q

what is marrow niche?

A

CXCR4 - antagonist plerixafor

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17
Q

how do stem cells increase numbers?

A

binary fission and flux through differentiation pathways

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18
Q

how is stem cells flux regulated?

A

hormones/growth factors

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19
Q

what hormones are used therapeutically to regulate flux?

A

erythropoietin
G-CSF
thrombopoeitin agonists

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20
Q

at what age is most bone marrow found?

A

children

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21
Q

in the elderly where is marrow found?

A

axial bones

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22
Q

what does marrow consist of?

A

stroma

sinusoids

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23
Q

describe the erythroid differentiation pathway

A

erythroblast
reticulocyte
erythrocyte

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24
Q

where is erythropoietin made in why?

A

kidney in response to hypoxia

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25
Q

what is reticulocyte used for?

A

measure of red cell production

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26
Q

when may you get polycythaemia?

A

myeloid malignancies

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27
Q

consequences of anaemia?

A

poor gas transfer
dyspnoea
fatigue

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28
Q

anaemia results in decreased production of?

A

haematinics - iron, folate, vit B12

thalassaemia

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29
Q

anaemias causes increased loss through

A

bleeding

haemolysis

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30
Q

how many red cells are made per day?

A

10g/l/day

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31
Q

function of platelets

A

haemostasis and immune

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32
Q

how is platelet production regulated?

A

thrombopoietin

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33
Q

discuss thrombopoietin

A

produced in liver

regulation by platelet mass feedback

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34
Q

agonists of thrombopoietin

A

romiplostim

eltrobopag

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35
Q

life span of platelets

A

7 days

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36
Q

when may you get thrombocytosis?

A

myeloid malignancies

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37
Q

when may you get thrombocytopenia?

A

marrow failure

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38
Q

what causes thrombocytosis?

A

reactive

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39
Q

what causes thrombocytopenia?

A

immune distruction

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40
Q

what drugs alter platelet function?

A

aspirin
clopidogrel
abciximab

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41
Q

function of neutrophils

A

ingest and destroy pathogens esp bacteria and fungi

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42
Q

neutrophils carry>

A 
interleukins
CSFs (colony stimulating factors)
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43
Q

what is G-CSF?

A

granulocyte colony stimulating factor

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44
Q

what regulates neutrophils?

A

immune responses - macrophages, IL-17

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45
Q

life span of neutrophils

A

1-2 days

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46
Q

how quickly to neutrophils respond?

A

few hours

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47
Q

what may cause neutrophilia?

A

infection

inflammation

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48
Q

neutrophilia in infection

A

G-CSF used therapeutically
left shift
toxic granulation

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49
Q

causes of neutrophilia in inflammation

A

MI
Post op
RA

50
Q

what causes neutropenia through decreased production?

A

drugs

marrow failure

51
Q

what causes neutropenia through increased consumption

A

sepsis

autoimmune

52
Q

what causes neutropenia through altered function

A

chronic granulomatous disease

53
Q

what are monocytes involved in?

A

reticuloendothelial system

54
Q

what do monocytes do?

A

ingest and destroy pathogens, esp bacteria and fungi

55
Q

some monocytes migrate into tissues becoming what?

A

macrophages

56
Q

lifespan of macrophages?

A

many months

57
Q

dendritic cells lifespan?

A

weeks

58
Q

causes of monocytosis

A

myocbacterial infection

59
Q

what is monocytosis usually associated with

A

usually associated with neutrophilia (GM-CSF)

60
Q

causes of monocytopenia

A

mycobacteria in hairy cell leukaemia

61
Q

what are eosinophils involved in?

A

parasites

allergy

62
Q

function of lymphocytes

A

immunological memory

63
Q

surface antigens on lymphocytes

A

CD markers

64
Q

causes of lymphocytosis

A

infectious mononucleosis

pertussis

65
Q

causes of lymphopenia

A

usually post iral

lymphoma

66
Q

subtypes of lymphocytes

A

B cells
T cells
NK cells

67
Q

types of T-cells

A

helper
cytotoxic
regulatory

68
Q

where are lymphocytes produced?

A

bone marrow

69
Q

where do B cells mature?

A

bone marrow

70
Q

where do T cells mature?

A

thymus

71
Q

where do lymphocytes circulate?

A

blood
lymph
lymph nodes

72
Q

where do lymphocytes differentiate into effector cells?

A

secondary lymphoid organs

73
Q

antibodies are also know as?

A

immunoglobulins

74
Q

what are antibodies involved in?

A

pathogen clearance
opsonisation
fix complement
block binding

75
Q

how does combinatorial diversity occur?

A

within each chain

any V region combined with any J or D region then C region

76
Q

how does junctional diversity occur?

A

at any join

additional nucleotides added by enzyme (terminal deoxynucleotydyl transferase (TdT)

77
Q

how does combinational diversity occur?

A

between chains
each alpha chain pairs with a beta chain
each light chain pairs with a heavy chain

78
Q

mistakes in the diversity process can cause lymphoid malignancies. name common ones

A

IgH heavy locus on chromosome 14

t(14,18), t(8,14), t(11,14)

79
Q

it is theoretically possible to create how many B cell receptors?

A

5x10^13

80
Q

it is theoretically possible to create how many T cell receptors?

A

1x10^18

81
Q

what type of maturation do B cells have?

A

Affinity

82
Q

what is positive selection?

A

if gene rearrangement results in a functional receptor the cell is selected to survive

83
Q

what is negative selection?

A

if the receptor recognises self antigens the cell is triggered to die

84
Q

B cells that survive the processes of selection are exported to where?

A

periphery

85
Q

where in lymph nodes are B cells found?

A

follicles

86
Q

where in lymph nodes are T cells found?

A

paracortex

87
Q

where in lymph nodes are plasma cells found?

A

in the medulla

88
Q

within the B cell areas there are different popultions. name these

A

cells undergoing expansion and selection in the GCs

naive cells in the mantle zone

89
Q

what is HLA?

A

human leucocyte antigen

90
Q

what does class I HLA display?

A

internal antigens on all nucleated cells

91
Q

what does class II HLA display?

A

antigens eaten by professional antigen presenting cells

92
Q

how does HLA vary?

A

constant within

varies between individuals

93
Q

how does RA affect the blood?

A
  • Anaemia of chronic disease
  • Iron deficiency
  • Folate deficiency
  • Immune haemolysis
  • Neutrophilia
  • Immune thrombocytopenia
  • Cytopenias secondary to medication
  • Felty syndrome
94
Q

how does hepatic disease affect the blood?

A

anaemia

deficient clotting factors

95
Q

how does renal disease affect the blood?

A

anaemia

HUS

96
Q

how does CV disease affect the blood?

A

anaemia

97
Q

how does resp disease affect the blood?

A

polycythaemia

98
Q

how does GI disease affect the blood?

A

anaemia

99
Q

to much plasma results in

A

paraproteins

100
Q

to little plasma causes

A

clotting factors: haemophilia

101
Q

abnormal plasma

A

clotting factors

haemophillia

102
Q

normal Hb male

A

135-170 g/g

103
Q

normal Hb female

A

120-160 g/l

104
Q

normal RBC

A

4-5 x 10^12/l

105
Q

normal platelets

A

150-400 x 10^9/;

106
Q

normal WBC

A

4-10 x10^9/l

107
Q

normal neutrophils

A

1.5-7 x10^9/l

108
Q

normal lymphocytes

A

1.5-4 x10^9/l

109
Q

normal monocytes

A

0.2-0.8 x10^9/l

110
Q

normal eosinophils

A

0.1-0.5 x10^9/l

111
Q

what diagnostic tools can you use for blood disease?

A 
FBC
clotting times for clotting factors
bleeding time for platelets
(platelet and leucocyte function tests)
chemical assays - iron (ferritin), B12, folate
marrow aspirate and trephine biopsy
lymph node biopsy
imaging
112
Q

haematological treatment

A

replacement
transplantation
drugs

113
Q

haematological treatment: replacement

A

blood
haematinics
coagulation factors
plasma exchange

114
Q

haematological treatment: drugs

A

cytotoxics
monoclonal antibodies
inhibitors of cellular pro

115
Q

what does hypersplenism cause?

A

pancytopenia

116
Q

what does hyposplenism cause?

A

infections with encapsulated bacteria

red cell changes

117
Q

what can cause splenomegaly?

A 
infectious
haematological malignant
portal hypertension
Haemolytic disorders
connective tissue disorders
storage pool disorders
sarcoid
malignant
amyloid
118
Q

causes of splenomegaly: infectious

A

acute - EBV, CMV
chronic bacterial - TB, Brucella, SBE
chronic parasitic - malaria, leishmaniasis, schistosomiasis

119
Q

causes of splenomegaly: haematological malignant

A

various leukaemias and lymphomas

myeloproliferative disroders

120
Q

causes of splenomegaly: haemolytic disorders

A 
hereditary spherocytosis
thalassaemia
haemoglobinopathies
megaloblastic anaemia
autoimmune
121
Q

causes of splenomegaly: connective tissue disorders

A

SLE

Felty syndrome

122
Q

causes of splenomegaly: storage pool disordeers

A

Gauchers

Niemann-Pick

Year 3 (164 decks)

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