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Haematology and Immunology > Intro to Haemotology > Flashcards

Intro to Haemotology Flashcards

1
Q

What are the 3 blood components?

A

Plasma
Buffy coat
RBCs

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2
Q

What is found in plasma?

A

Clotting or coagulation factors
Albumin
Antibodies

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3
Q

What is found in the buffy coat?

A

Platelets

White cells or leucocytes

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4
Q

Functions of the blood

A

Transport (RBCs and plasma)
Maintenance of vascular integrity
Protection from pathogens

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5
Q

What is transported in red cells?

A

Gases - CO2 and O2 (haem binding to these)

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6
Q

How is vascular integrity maintained by the blood?

A

Prevention of leaks
- platelets and clotting factors
Prevention of blockages
- anticoagulants and fibrinolytics

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7
Q

How does the blood protect from pathogens?

A

Phagocytosis and killing
- granulocytes/monocytes
Antigen recognition and antibody formation
- lymphocytes

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8
Q

Abnormally high levels in the blood is due to either…

A

Increased rate of production

Decreased rate of loss

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9
Q

Abnormally low levels in the blood is due to either…

A

Decreased rate of production

Increased rate of loss

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10
Q

Where do all cells in the blood come from?

A

Uncommitted stem cells

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11
Q

Haematopoiesis definition

A

the commitment and differentiation processes that lead to the formation of all blood cells from haematopoietic stem cells

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12
Q

Another name for RBCs

A

Erythrocytes

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13
Q

Another name for WBCs

A

Leucocytes

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14
Q

What are myeloid cells?

A

Everything apart from lymphocytes

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15
Q

What type of stem cells form other types of cells outwith the blood?

A

Mesenchymal stem cells

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16
Q

Features of stem cells

A

Totipotent
Self renewal
Home to marrow niche (CXCR4)
properties can now be induced

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17
Q

How are stem cell numbers amplified?

A

Binary fission and flux through differentiation pathways

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18
Q

What is the flux of stem cells regulated by?

A

Hormones/growth factors

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19
Q

Where is bone marrow found?

A

Bone marrow

  • mostly in children
  • axial in elderly
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20
Q

Examples of RBCs pathologies

A

Polychromasia

Polycythaemia

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21
Q

Polychromasia definition

A

Abonormally high number of immature RBCs

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22
Q

Polycythaemia definition

A

Abnormally high number of haemoglobin in the blood

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23
Q

Differentiation stages of RBCs

A

Erythroblast - > reticulocyte - > erythrocyte

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24
Q

When is erythropoietin made and where?

A

Made in the liver in response to hypoxia

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25
Q

What does the reticulocyte count measure?

A

A measure of Red cell production

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26
Q

Consequences of anaemia

A

Poor gas transfer
Dyspnoea
fatigue

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27
Q

Causes of anaemia

A

Decreased production

  • deficiency in haematinics (iron, folate, vitamin B12)
  • congenital (thalassaemias)

Increased loss

  • bleeding
  • haemolysis
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28
Q

What make up the most common haematinics?

A

Iron
Folate
Vitamin B12

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29
Q

What are platelets produced by?

A

Marykaryocytes

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30
Q

Function of platelets

A

Haemostasis

Immune

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31
Q

What is the production of platelets regulated by?

A

Thrombopoietin

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32
Q

Regulation of platelet production

A

Thrombopoietin regulates it
Produced in liver
Regulation by platelet mass feedback (agonists - romiplostim can be used therapeutically)

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33
Q

Lifespan of platelets

A

7 days

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34
Q

Pathologies of platelets

A 
Thrombocytosis 
Thrombocytopenia
Altered function
- aspirin 
- clopidogrel etc
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35
Q

Features of thrombocytosis

A

Reactive - goes away when underlying disease resolves

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36
Q

Thrombocytosis definition

A

Excessive number of platelets in the blood

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37
Q

Thrombocytopenia definition

A

Abnormally low level of platelets in the blood

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38
Q

Thrombocytopenia causes

A

Marrow failure

Immune destruction

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39
Q

Function of neutrophils

A

To ingest and destroy pathogens, especially bacteria and fungi

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40
Q

Function of neutrophils is controlled by what?

A

Interleukins

CSFs (colony stimulating factor)

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41
Q

Lifespan of neutrophils

A

1-2 days

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42
Q

speed of response of neutrophils

A

a few hours

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43
Q

Regulation of neutrophils is by….

A

Immune responses

  • macrophages
  • IL-17
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44
Q

Differentiation of neutrophils

A 
Blast (acute myeloid leukaemia)
Promyelocuye
Myelocyte 
Metamyelocyte
neutrophil
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45
Q

What are neutrophils full of?

A

Enzymes

Granules

46
Q

Definition of neutrophilia

A

Increased number of neutrophils

47
Q

What is production of neutrophilia regulated by?

A

granulocyte colony stimulating factor (G-CSF)

48
Q

Causes of neutrophilia

A 
Infection 
- left shift 
- toxic granulation 
Inflammation 
- E.g. MIR, post op, RA
49
Q

When would G-CSF be used therapeutically?

A

Neutropenia

Mobilisation of stem cells

50
Q

Neutropenia definition

A

Low levels of neutrophils in the blood

51
Q

What does neutropenia vary with?

52
Q

Causes of neutropenia

A 
Decreased production 
- drugs (mainly cytotoxic drugs)
- marrow failure 
Increased consumption 
- sepsis (neutrophils go to septic tissue)
- autoimmune 
Altered function 
- chronic granulomatous disease
53
Q

Function of monocytes

A

To ingest and destroy pathogens especially bacteria and fungi but not as important as neutrophils for this
Migrate to tissues and become macrophages

54
Q

Lifespan of monocytes/macrophages

A

Many months

55
Q

Dendritic cells lifespans

56
Q

Eosinophils are important in the fight against…..

A

Parasites

Allergies

57
Q

Features of lymphocytes

A

Adaptive vs Innate immune system

CD markers as surface antigens

58
Q

Definition of lymphocytosis

A

Increased number of lymphocytes in the blood

59
Q

Causes of lymphocytosis

A

Infectious mononucleosis

Pertussis

60
Q

Definition of lymphopenia

A

Abnormally low levels of lymphocytes in the blood

61
Q

Causes of lymphopenia

A

Usually post viral

Lymphoma

62
Q

Subtypes of lymphocytes

A

B cells
T cells
NK cells

63
Q

What do B cells do?

A

make antibodies or are precursor cells to make antibodies

64
Q

Types of T cells

A

Helper
Cytotoxic
Regulatory

65
Q

What do helper T cells do?

A

Help to regulate the immune system

66
Q

What do cytotoxic T cells do?

A

Kill foreign pathogens that the T cell recognises

67
Q

What do Regulatory T cells do?

A

Help to dampen down the immune system

68
Q

Where are lymphocytes produced?

A

Bone marrow

69
Q

Where do the lymphocytes mature?

A

B cells mature in bone marrow

T cells mature in thymus

70
Q

Where do lymphocytes circulate?

A

Blood
Lymph
Lymph nodes

71
Q

Where do lymphocytes differentiate into effector cells?

A

Secondary lymphoid organs

72
Q

What is a secondary lymphoid organ?

A

Lymph nodes

Mucosal associated lymphoid tissue

73
Q

Regions of Lymphocytes

A

Variable region

Constant region

74
Q

Function of antibodies

A

Adaptors between pathogens and clearance systems

75
Q

Method of antibodies

A

Opsonisation
Fix complement (punching holes in pathogens)
Block binding

76
Q

Types of repertoire diversity

A

Combinatorial (within each chain)

Junctional (at join, additional nucleotides added)

77
Q

Mistakes in repertoire diversity chains can lead to what?

A

Lymphoid malignancies

78
Q

What chains pair in combinatorial diversity?

A

Alpha chain pairs with beta chains

Each light chain pairs with a heavy chain

79
Q

Positive vs negative selection

A

Positive selection = gene rearrangement resulting in a functional receptor so the cell is selected to survive. B cells that survive this are exported to the periphery

Negative selection = if bad gene or if the receptor recognises ‘self-antigens’ then the cells will be triggered to die = TOLERANCE

80
Q

What does HLA stand for?

A

Human Leucocyte Antigen

81
Q

Classes of HLA

A

Class I; displays internal antigens on all nucleated cells

Class II; displays antigens eaten by professional antigen presenting cells

82
Q

Which cells is HLA made in?

A

Every single cell apart from Red cells

83
Q

What does HLA do?

A

Immune cells read HLA-barcode on cells to help identify self vs non self cells or uninfected vs infected cells

84
Q

What causes too much plasma?

A

Paraproteins

85
Q

What causes too little plasma?

A

Clotting factors

86
Q

What causes abnormal function of plasma?

A

Haemophilia

87
Q

What can RA cause in the blood?

A 
Anaemia of chronic disease
Iron deficiency 
Folate deficiency 
immune haemolysis 
neutrophilia 
Immune thrombocytopenia
cytopenias secondary to medication 
felty syndrome
88
Q

What can hepatic disease cause in the blood?

A

Anaemia

Deficient clotting factors

89
Q

What can renal disease cause in the blood?

A

Anaemia

Haemolytic uraemia syndrome

90
Q

What can respiratory disease cause in the blood?

A

Polycythaemia

91
Q

Diagnostic tools of the blood

A 
FBC
Clotting times (clotting factors)
Bleeding times (platelets)
Platelet and leucocyte function tests
Chemical assays (iron (ferritin), B12, folate)
Marrow aspirate and trephine biopsy 
Lymph node/other organ biopsy 
Imaging (CT - angiograms)
92
Q

Normal blood values for haemoglobin

A

Male 135-170 g/L

female 120-160 g/L

93
Q

Normal blood vales for platelets

A

150-400 x109/L

94
Q

Normal blood values for WBC

A

4-10 100/L

95
Q

Haematology treatments

A 
Replacement 
- blood
- haematinics
- coagulation factors
- plasma exchange 
Transplantation 
Drugs
- cytotoxic 
- monoclonal antibodies
- inhibitors of cellular proliferation 
- immunosuppressants 
- inhibitors of coagulation 
- inhibitors of fibrinolysis
96
Q

Types of pulp of the spleen

A 
Red = where blood cells go to mature
White = important for immune function
97
Q

Hypersplenism causes

A

Pancytopenia

98
Q

Definition of pancytopenia

A

Deficiency of all 3 cellular components of the blood (RBCs, white cells and platelets)

99
Q

Causes of hyposplenism

A

Infections with encapsulated bacteria

Red cell changes

100
Q

Causes of splenomegaly

A 
Infection 
- acute = EBV, CMV
- chronic bacterial e.g. TB, brucella
- chronic parasitic e.g. malaria 
Haematological malignant 
- leukaemias and lymphomas 
- myeloproliferative disorders 
Portal hypertension 
Haemolytic disorders (autoimmune, megaloblastic anaemia, hereditary spherocytosis)
Connective tissue disorders
-SLE
- Felty syndrome 
Sarcoid
Malignancy 
Amyloid 
Storage pool disorders (Gauchers)
101
Q

When would neutrophils be increased?

A

Acute inflammation
Burns
Malignancy

102
Q

When would neutrophils be decreased?

A

Decreased production e.g. aplastic anaemia

Increased destruction e.g. chemo

103
Q

Causes of lymphocytosis

A

Infection

Lymphoma

104
Q

Causes of lymphopenia

A

HIV

Leukaemia

105
Q

Causes of increased monocytes

A

Infection

  • bacterial
  • chronic infection
  • sarcoid
106
Q

Causes of decreased monocytes

A

Bone marrow failure

Medications e.g. chemo / steriods

107
Q

Causes of increased eosinophils

A

Allergic reaction

Parasitic infection

108
Q

Causes of decreased eosinophils

A

HIV / alcohol

109
Q

Causes of increased basophils

A

Anaphylaxis

Asthma

110
Q

Causes of decreased basophils

A

Bone marrow failure

Haematology and Immunology (18 decks)

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