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A Haematology and Immunology > Introduction > Flashcards

Introduction Flashcards

1
Q

What are the components and products of blood?

A

Plasma

  • Clotting or coagulation factors
  • Albumin
  • Antibodies

Buffy coat

  • Platelets
  • White cells or leucocytes

Red blood cells

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2
Q

What function of blood is are the RBC’s responsible?

A

Gas exchange: oxygen and carbon dioxide

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3
Q

What function of the blood is the plasma responsible for?

A
  • Nutrient transport
  • Waste transport
  • Message transport
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4
Q

What are the functions of the blood?

A
  • Transport
  • Maintenance of vascular integrity
  • Protection from pathogens
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5
Q

What function of blood are the platelets and clotting factors responsible for?

A

Prevention of leaks

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6
Q

What function of blood are the anticoagulants and fibrinolytics responseible for?

A

Prevention of blockages

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7
Q

What function of blood are the granulocytes and monocytes responsible for?

A

Antigen recognition and antibody formation

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8
Q

What are the mechanisms of pathogenesis of haematological abnormalities?

A

High levels

  • Increased rate of production
  • Decreased rate of loss

Low levels

  • Decreased rate of production
  • Increased rate of loss

Altered function

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9
Q

What are stem cells?

A
  • Totipotent cells which self-renew
  • Home to marrow niche
  • The undergo binary fission and flux through differentiation pathways to amplify numbers. This is regulated by hormones and growth factors
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10
Q

Where is bone marrow located?

A

In most bones in children or in the axial skeleton of adults/elderly

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11
Q

What does bone marrow look like?

A

Stroma and sinusoids

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12
Q

What differentiation doe RBC undergo?

A
  • Erythroblast
  • Reticulocyte
  • Erythrocyte
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13
Q

What is the reticulocyte count?

A

A measure of red blood cell production

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14
Q

Where is erythropoietin made and what trigger it?

A

Made in the kidney in response to hypoxia

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15
Q

What are the consequences of anaemia?

A

Poor gas transfer and as a result dyspnoea and fatigue

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16
Q

What can cause anaemia?

A

Decreased production

  • Deficiency in haematinics such as iron, folate or vit B12
  • Congenital: thalassaemia

Increased loss
-Bleeding, haemolysis

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17
Q

What is the function of platelets?

A

Haemostasis and immunity

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18
Q

What regulates platelet production?

A

Thrombopoietin

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19
Q

Where is thrombopoiten produced?

A

Liver

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20
Q

What is thrombopoietin production regulated by?

A

Platelet mass feedback

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21
Q

What is the lifespan of platelets?

A

7 days

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22
Q

What platelet agonists are used therapeutically?

A
  • Romiplostim

- Eltrombopag

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23
Q

What pathologies are linked to platelets?

A

Thrombocytosis

  • Myeloid malignancies
  • Reactive

Thrombocytopenia

  • Marrow failure
  • Immune destruction

Altered function
-Aspirin, clopidogrel, abciximab

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24
Q

What is the function of neutrophils?

A

To ingest and destroy pathogens, especially bacteria and fungi

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25
Q

What is the lifespan of neutrophils?

A

1-2 days

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26
Q

What is the speed of response of neutrophils?

A

Few hours

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27
Q

How are neutrophils regulated?

A

Regulated by immune responses including macrophages and IL-17

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28
Q

What stimulates production of neutrophils?

A

Granulocytes colony stimulating factor and interleukins

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29
Q

What are the stages in neutrophil differentiation?

A
  • Blast
  • Promyelocyte
  • Myleocyte
  • Metamyelocyte
  • Neutrophil
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30
Q

What is neutrophilia?

A

High number of neutrophils in the blood

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31
Q

What can cause neutrophilia?

A

Infection
-Left shift, toxic granulation

Inflammation
-Eg. MI, postoperative, rheumatoid arthritis

When G-CSF is used therapeutically

  • Neutropenia
  • Mobilisation of stem cells
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32
Q

What is neutropenia?

A

Low number of neutrophils in the blood

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33
Q

What can cause neutropenia?

A

Decreased production

  • Drugs
  • Marrow failure

Increased consumption

  • Sepsis
  • Autoimmune

Altered function
-Chronic granulomatous disease

Some individuals from Sub-Saharan Africa have natural neutropenia

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34
Q

What system do monocytes belong to?

A

The Reticuloendothelial System

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35
Q

What is the function of monocytes?

A

To ingest and destroy pathogens, especially bacteria ad fungi

36
Q

What can monocytes differentiate into?

A
  • Macrophages

- Dendritic cells

37
Q

What is the lifespan of macrophages?

A
  • Lifespan of many months

- Some populations of macrophages self-maintaining

38
Q

What is the lifespan of dendritic cells?

A

Weeks

39
Q

Name the myeloid cells.

A
  • Monocytes
  • Macrophages
  • Neutrophils
  • Basophils
  • Eosinophils
  • Erythrocytes
  • Megakaryocytes
40
Q

What are eosinophils involved in?

A
  • Parasitic infection

- Allergies

41
Q

What type of markers do lymphocytes possess?

A

CD markers

42
Q

What is lymphocytosis?

A

Increase in the number of lymphocytes in the blood

43
Q

Give examples of causes of lymphocytosis.

A
  • Infectious mononucleosis

- Pertussis

44
Q

What is lymphopenia?

A

Decrease in the number of lymphocytes in the blood

45
Q

Give examples of causes of lymphopenia.

A
  • Usually post-viral

- Lymphoma

46
Q

What are the subtypes of lymphocytes?

A
  • B cells
  • T cells
  • Natural killer cells
47
Q

What do B cells do?

A

Make antibodies

48
Q

What do T cells do?

A

Help, cytotoxic and regulatory cells

49
Q

Where are lymphocytes produced?

A

Bone marrow

-B mature in the bone marrow and T cells In the thymus

50
Q

Where do lymphocytes circulate?

A

In the blood, lymph and lymph nodes

51
Q

What do lymphocytes differentiate into?

A

Differentiate into effector cells in secondary lymphoid organs (lymph nodes or mucosal associated lymphoid tissue)

52
Q

What does each naïve B and T cell have?

A

A unique surface receptor

53
Q

What are antibodies?

A

Produced by B cells, they are adaptors between pathogens and clearance systems. They are also known as immunoglobulins

54
Q

What is the function of antibodies?

A
  • Opsonisation
  • Fix complement
  • Block binding
55
Q

How is antibody diversity created?

A
  • Combinatorial diversity within each chain
  • Junctional diversity
  • Combinatorial diversity between chains
56
Q

What does mistakes in antibody diversity lead to?

A

Lymphoid malignancies

57
Q

Briefly describe the maturation of B cells.

A
  • Immature B cells from in the bone marrow.
  • Naïve B cells can centre of lymph node follicles and undergo somatic hypermutation to become memory B cells or plasma cells
58
Q

What is positive and negative selection that occurs in the bone marrow?

A
  • If gene rearrangement results in a functional receptor the cell is selected to survive – positive selection
  • If the receptor recognises ‘self’ antigens - the cell is triggered to die – negative selection: tolerance
59
Q

What happen to B cells that undergo positive selection?

A

They are exported to the periphery

60
Q

What do class I HLA display?

A

Displays internal antigens on all nucleated cells

61
Q

What do class II HLA display?

A

Displays antigens eaten by professional antigen presenting cells

62
Q

What variation in HLA is there?

A

Constant within, variation between individuals

63
Q

What is the role of HLA?

A

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

64
Q

Give examples of system disease which affect the blood?

A
  • Rheumatoid arthritis
  • Anaemia of chronic disease
  • Iron deficiency
  • Folate deficiency
  • Immune haemolysis
  • Neutrophilia
  • Immune thrombocytopenia
  • Cytopenias secondary to medication
  • Felty syndrome
65
Q

What blood disorders are linked to the hepatic system?

A
  • Anaemia

- Deficient clotting factors

66
Q

What blood disorders are linked to the renal system?

A
  • Anaemia

- Haemolytic uraemic syndrome

67
Q

What blood disorder is linked to the CV system?

A

Anaemia

68
Q

What blood disorder is linked to the respirator system?

A

Polycythaemia

69
Q

What blood disorder is linked to the GI system?

A

Anaemia

70
Q

What pathologies can occur related to plasma?

A

Too much
-Paraproteins

Too little
-Clotting factors: haemophilia

Abnormal function
-Clotting factors: haemophilia

71
Q

What is the normal haemoglobin range for a male?

A

135-170g/L

72
Q

What is the normal haemoglobin range for a female?

A

120-160g/L

73
Q

What is the normal range for platelets?

A

150-400 10^9/L

74
Q

What is the normal range for WBC?

A

4-10 10^9/L

75
Q

What diagnostic tools are used in haematology?

A
  • FBC
  • Clotting times for clotting factors
  • Bleeding time for platelets
  • (Platelet and leucocyte function tests)
  • Chemical assays (iron (ferritin), B12 and folate)
  • Marrow aspirate and trephine biopsy
  • Lymph ode biopsy (other organ biopsy)
  • Imaging
76
Q

What treatments are used in haematology?

A

Replacement

  • Blood
  • Haematinics
  • Coagulation factors
  • Plasma exchange

Transplantation

Drugs

  • Cytotoxics
  • Monoclonal antibodies
  • Inhibitors of cellular proliferation
  • Immunosuppressants
  • Inhibitors of coagulation
  • Inhibitors of fibrinolysis
77
Q

What is the structure of the spleen?

A

Red and white pulp

78
Q

What can cause hypersplenism?

A

Pancytopenia

79
Q

What can cause hyposplenism?

A
  • Infections with encapsulated bacteria

- Red cell changes

80
Q

What are the causes of splenomegaly?

A
  • infection
  • Haematological malignancy
  • Portal hypertension
  • Haemolytic disorders
  • Connective tissue disorders
  • Miscellaneous
  • Storage poor disorders
81
Q

What infectious causes of splenomegaly are there?

A
  • Acute eg EBV, CMV
  • Chronic bacterial eg TB, brucella, SBE
  • Chronic parasitic eg malaria, leishmaniasis, schistosomiasis
82
Q

What haematological malignancies can cause splenomegaly?

A
  • Various leukaemia’s and lymphomas

- Myeloproliferative disorders

83
Q

What haemolytic disorders can cause splenomegaly?

A
  • Hereditary spherocytosis, thalassaemia, haemoglobinopathies
  • Megaloblastic anaemia
  • Autoimmune
84
Q

What connective tissue disorders can cause splenomegaly?

A
  • SLE

- Felty syndrome

85
Q

What miscellaneous causes of splenomegaly are there?

A
  • Sarcoid
  • Malignant
  • Amyloid
86
Q

What storage pool disorders can cause splenomegaly?

A
  • Niemann-Pick

- Gauchers

A Haematology and Immunology (20 decks)

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