Introduction To Haematology Flashcards
Where do all blood cells come from
Bone marrow
What cells are blood cells derived from
Haemopoietic stem cells
What are the site of haemopoiesis during embryogenesis
Yolk sac
At birth what is the site for haemopoeisis
Bone marrow
In certain condition what is the major site for haemopoiesis
Liver
When can you have too few red blood cells
Hereditory haemoglobinopathies
Acquired secondary anaemia e.g iron, vitamin b12 or folate deficiency, autoimmune hameolytic anaemia, aplastic anaemia
When can you have too many/dysfunctional
Hereditory haemochomatosis due to iron overload
When can you have too few/dysfunctional white cells
Rare congenital anaemias
Acquired seconday deficiency- vitamin b12 or folate deficiency, autoimmune neutropenia, aplastic anaemia, drug or viral suppression
When can you have too many white blood cells
Myeloproliferative disorders
Acute leukemia
When can you have too few platelets
Bone marrow failure syndromes
Acquired secondary deficiency: vitamin b12, folate deficiency, immune thrombocytopenia, drug induce thrombocytopenia
When can you have too many platelets
Infection
Trauma
Iron deficiency
Essential thrombocythaemia
When can you have dysfunctional platelets
Inherited platelet dysfunction: bernard soulier, glanzmanss
Acquired platelet dysfunction: aspirin, heparin, uraemia
What is contained in plasma
Water Plasma proteins Electrolyte e.g sodium and chloride Nutrients: glucose and amino acids Hormone Waste: ureea and creatinne Gases: oxygen and carbon dioxide
What is the difference between plasma and serum
Plasma: liquid part of the blood with no cells that has been treated with anti-coagulants to allow appropiate testing
Serum: liquid part of blood that is coagulated therefore removes fibrinogen (serum=plasma-fibrinogen)
How is a bone marrow examination carried out
- Patient will lie in a lateral position
- Expose the iliac crest
- Use a needle to go into the bone marrow cavity
- Take a sample of the liquid bone marrrow
- Send for an analysis
- Then take sample of the periosteum itself called the trephine
What is an aspirate
Removal of the liquid bone marrow
What is a trephine
Solid histology section and allows study of marrow cellularity
What are exmaples of inherited haemoglobinopathies
Thalassemia
Sickle cell disease
What are the 2 types of thalassemia
Alpha
Beta
What is beta thalassemia
Abnormality of the beta chain
What is a feature of the bone marrow compensation of RBC
Nucleated red blood cells - the bone marrow is trying to compensate for the anaemia which is pushing out nucleated RBC
What is the treatment for beta thalassemia
Transfusion
Genetic counselling if they have a child
What is alpha thalassemia
Abnormality in the alpha gene
What are the classification of anaemia by
Size of the red blood cell:
Microcytic
Normocytic
Macrocytic
What are the causes for microcytic anaemia
Iron deficiency anaemia
Thalassemia
What are the causes for normocytic anaemia
Bone marrow failure
Aplastic anaemia
Chronic disorders
Renal disease
What are the causes of macrocytic anaemia
B12 and folate deficiency
Alcoholism
What are the causes of iron deficiency anaemia
Chronic blood loss: GI bleed or menstruation
Poor diet
Malabsorption: parasitic infection or GI disease
What is the treatment of iron deficiency anaemia
Treating the underlying disease Ferrous sulphate (iron tablets)
What are the causes of macrocytic anaemia
Alcohol
Pernicious anaemia: cant absorb vitamin b12 or folate
What are the features of macrocytic anaemia
Pallor
Macroglossia (beef tongue)
What are the complicatiomns of macrocytic anaemia
Folate deficiency- spina bifida Hypersegmented neutrophils (you can get 5 nuclei of neutrophils)
What is haemolytic anaemia
This is when the RBC are brocken down rapidly so anaemia occur
What is a clinical feature of haemolytic anaemia
Jaundice as RBC breakdown leads to increase in bilirubin
What are the causes of haemolytic anaemia
Inherited: membrane, haemoglobin, enzyme
Acquired: immune and non immune
How does blood clotting occur
- Endothelium on the blood vessel is damaged
- VWF binds to the injured vessel wall
- VWF changes configuration
- Platelets stick to the VWF
- GP1B and GP2B/3A will then stick to more platelets can bind
What can the pattern on bleedin tell us
Mucosal or skin bleed- vascular or platelet abnormality
Coagulation disorders- bleeding into joints and muscles
What can the causes of thrombosis be
Inherited: factor 5 leids, antithrombin, protein c or s abnormality
Acquired: vessel damage, stasis, change in blood composition
What are the 4 major sets of leukemia
Acute myeloid leukemia
Chronic myeloid leukemia
Acute lymphoid leukemia
Chornic lymphoid leukemia
What are lymphomas
Tumours of lymphocytes- commonly in b than t
Give examples of lymphoma
Non hodgkin lymphoma
Hodgkin lymphome
What does hodgkin lymphoma in histology show
Owl eye
What is myeloma
Maligancy of the plasma cells that produce a monoclonal immunoglobulin called paraprotein
What is myeloma likely to present with
Renal failure
Bone pain
Anaemia
Infection
In transfusion what can we give
Packed red blood cells Platelets Fresh frozen plasma and cryoprecipitate Fresh frozen plasma Cyroprecipitate
What is in the packed red blood cells
Platelts and plasma are removed just the RBC
What does fresh frozen plasma contain
Coagulation factors
What does cyroprecipitate contain
Factor 8,13,vwf and fibrinogen
