Intro to haematology Flashcards
what is the 6 step protocol for breaking bad news?
SPIKES setting and listening skills patients perception invitation or indication knowledge empathise and sympathise strategy and summary
what is polychromasia?
an abnormally high reticulocyte count in the blood stream (premature RBC) due to premature release from the bone marrow during formation
what hormone drives RBC formation?
erythropoietin
where is erythropoietin formed?
kidney
what drives the kidney to produce erythropoietin?
hypoxia
what is polycythaemia?
a disorder in which there is too much RBC found in the blood stream
what are the myeloid cells?
all cells except lymphoid cell s
what are the white blood cells?
all cells except platelets and erythrocytes
what are the haematinics and what results if there is a deficiency in one of them?
iron
folate
vitamin B12
= anaemia
what hormone regulates the production of platelets?
thrombopoietin
where is thrombopoietin produced and what is its function?
produced from the liver
drives production of platelets
if someones platelet count is too low what can be given therapeutically to correct this?
platelet agonists;
romiplostim
eltrombopag
platelet transfusion
if immune cause - give corticosteroids
what features are characteristic of thrombocytopenia?
platelet type bleeding;
- petechial rash
- mucosal bleeding
- ecchymosis (bruising)
- epistaxis
- GI bleed
- menorrhagia
what is the function of neutrophils?
ingest and destroys pathogens particularly bacteria and fungi (rather than viruses)
what is responsible for regulating the production of neutrophils?
granulocyte-colony stimulating factor (G-CSF)
what change in neutrophil count would you observe on FBC if there was an infection?
left shift
what is G-CSF used for therapeutically?
neutropenia
what drugs can cause a low neutrophil count / neutropenia?
furosemide NSAIDS penicillin quinine ranitidine (H2 recetor blocker)
what is the function of monocytes?
to ingest and destroy pathogens particularly bacteria and fungi
what is the function of eosinophils?
ingest and destroy parasites
also involved in allergies
what are causes of lymphocytosis?
viral infection (HIV, Hepatitis, CMV…)
lymphoma
lymphoid malignancies
what are causes of lymphocytopenia?
autoimmune i.e. SLE, RA, myaesthenia gravis
lymphoma
HIV/AIDS
chemo & radiatiotherapy
AKI / CKD
drugs i.e. dimethyl fumarate, azathioprine
where does B and T lymphocytes mature?
T cells mature in thymus
B cells mature in bone marrow
what are the 3 types of T lymphocytes?
cytotoxic
helper
regulatory
what’s the difference between class I and class II HLA?
class I display internal antigens on all nucleated cells
class II displays antigens rated by antigen presenting cells
what diseases is felty’s syndrome associated with?
RA
lymphoma
what are the main features of felty’s syndrome?
severe disease defined by the presence of 3 conditions; - rheumatoid arthritis - neutropenia - splenomegaly causes repeated infections
features; Splenomegaly Arthrits (RA) Neutropenia Thrombocytopenia Anaemia
what is the normal range of haemoglobin in a male and female?
male: 135-170 g/L
female: 120-160 g/L
what is the normal range of platelets?
150-400 X 10 (9)/L
what is the normal range of WCC?
4-10 X 10/L
what is the normal range of RBC?
4-5 X 10(9) /L
with regards to blood count what does splenomagely indicate?
pancytopenia
what are the antigen presenting cells?
dendritic cells
macrophages
B-cells
what diagnostic test can you perform to investigate platelet function?
bleeding time
what diagnostic test can you perform to investigate clotting factors?
clotting time tests
prothrombin (PT) measures extrinsic factors
activated partial thromboplastin time (APTT)
what are causes of splenomegaly?
leukaemia's and lymphoma's myeloproliferative disorders thalassaemia megablastic anaemia autoimmune haemolytic disease felty's syndrome SLE portal hypertension sarcoidosis amyloidosis malignancy acute infection i.e. EBV, CMV chronic bacterial infection i.e. TB, brucella chronic parasitic infection i.e. malaria, schistosomiasis, leishmaniasis storage pool disorders; - gauchers - neimann pick
what can cause neutropenia?
drugs i.e furosemide sepsis autoimmune chronic granulomatous disease bone marrow failure
what can cause neutrophillia?
bacterial infections tissue inflammation i.e. rheumatoid arthritis tissue infarct i.e. MI post-op drugs i.e. steroids malignancy i.e. lymphoma
