introduction to haematology

Question 1

what is the haematocrit

Answer 1

red cell volume % ( of blood sample )

Question 2

what is plasma

Answer 2

contains proteins of blood

Question 3

what is serum

Answer 3

plasma minus the clotting factors

Question 4

what does the Buffy coat contain

Answer 4

WBC

Question 5

What are pluripotent stem cells

Answer 5

under the influence of different growth factors, they differentiate into different cell linesr

Question 6

where are pluripotent stem cells found

Answer 6

in red bone marrow

Question 7

what are reticulocytes

Answer 7

immature erythrocytes

Question 8

what are the 6 steps of RBC genesis

Answer 8

-proethryblast
-basophil eythroblast
-polychromaatophil erthroblast
-orthochromatic erythroblast
-reticulocyte
-erythrocyte

Question 9

reticulocytes are immature erythrocytes which can be found in higher numbers in the blood if the bone marrow increases RBC production

Question 10

what is haematopoeisis

Answer 10

the process of creating a wide variety of blood and bone marrow cells, namely erythrocytes, platelets, granulocytes, lymphocytes, and monocytes

Question 11

What does EPO stand for and what is it

Answer 11

erythropoietin
Erythropoietin is a hormone that your kidneys naturally make to stimulate the production of red blood cells.

Question 12

what does EPO do in response to hypoxia (lack of oxygen in tissue)

Answer 12

EPO stimulates haematopoeisis in response to hypoxia

Question 13

EPO can be given to patients with renal disease

Question 14

how can an athete increase athletic performance without using synthetic EPO

Answer 14

train at altitudes to increase their endogenous EPO production

Question 15

what is the haeme group

Answer 15

molecule that allows binding of oxygen

Question 16

what is haemoglobin role

Answer 16

carry oxygen
(but can buffer substances e.g co2)

Question 17

what position in haemoglobin is the iron ion situatioed

Answer 17

at the centre of our haeme rings

Question 18

describe how the shape of the red blood cell is advatageous

Answer 18

• red cell can fold to a fraction of its size inside capillary
• biconcave shape increase SA for exchange of gases

Question 19

defects in red cell membrane can lead to early destruction of the RBC

Question 20

what organ removes damage red blood cells and recycles constituents

Answer 20

spleen sometimes liver (breakdown by macrophages in spleen/liver)

Question 21

what products of haemoglobin are recycled

Answer 21

• globin (protein)
• heame ( contains iron and bile pigments)

Question 22

what can be some issues of RBC

Answer 22

• failure to absorb/retain iron
• defects in globin synthesis (sickle cell)
• defects in cell membrane
• defects in cell metabolism
• red cell infections
• autoimmunity

Question 23

what is haemoglobin broken down into and what can happen if this product cannot be removed

Answer 23

bilirubin
- if biliary system cant remove it then you will get jaundiced

Question 24

where is bilirubin excreted

Answer 24

in bile

Question 25

how can you identify iron deficiency anemia in elderly ppl

Answer 25

- can be due to cancer and a 'top and tail' OGD and colonoscopy is recommended - might not be possible for elderly so CT Colonoscopy - patients have bowel prep and colon inflated - gastrograffin contrast swallowed to reduce motion artefact

Question 26

what is a capsule endoscopy

Answer 26

small camera is swallowed and passed thru GI tract (may form part of pre-MRI checklist)

Question 27

what is sickle cell

Answer 27

The term "sickle cell disease" applies to all patients who have two abnormal beta chains. The resultant haemoglobin molecules tend to clump together into long polymers, making the red blood cell (RBC) elongated (sickle-shaped), rigid and unable to deform appropriately when passing through small vessels, resulting in vascular occlusion (blockage)

Question 28

what is osteocrenosis and what can cause this

Answer 28

occurs when part of the bone does not get blood flow and dies sickle cell disease

Question 29

what is rhesus incompatibility

Answer 29

refers to the discordant pairing of maternal and fetal Rh types (RBC protein)

Question 30

what is ABO incompatibility

Answer 30

different blood types cannot be exchanged as immune system will react

Question 31

what happens to donated red blood cells

Answer 31

they get washed of plasma and dont have antibodies in them

Question 32

typically patients will only make antibodies against antigens they dont have unless they are SENSITISED

Question 33

what is one way to avoid sensitisation of mother to their foeus

Answer 33

to give negative blood ( O negative blood)

Question 34

what is sensitisation in blood of pregnant mother

Answer 34

when a woman with RhD negative blood is exposed to RhD positive blood, usually during a previous pregnancy with an RhD positive baby. The woman's body responds to the RhD positive blood by producing antibodies (infection-fighting molecules) that recognise the foreign blood cells and destroy them.

Question 35

what is haemostasis

Answer 35

blood clotting in response to injury

Question 36

what are the 3 phases of haemostasis

Answer 36

1. primary haemostasis (platelet plus and vasoconstriction) 2. secondary haemostasis (fibrin cross-meshing) 3. clot resolution (resumption of blood flow)

Question 37

exposure of what protein can activate platelets and cause platelet plug in haemostasis

Answer 37

collagen

Question 38

what 2 things are needed for thrombosis (blood clots)

Answer 38

platelets and clotting factors

Question 39

where are the platelets and clotting factors formed

Answer 39

platelets in bone marrow clotting factor in liver

Question 40

how are clots broken down

Answer 40

- endogenously produced plasminogen (when activated) converted into plasmin - plasmin breast down fibrin mesh and makes ' fibrin degradation products '

Question 41

what is virchows triad

Answer 41

describes factors that make thrombosis

Question 42

what are the 3 components of virchows triad

Answer 42

stasis of blood flow endothelial injury hyper coagulability

Question 43

how are bleeding problems pharmacologically induced

Answer 43

- anti platelet agents e.g aspirin stop primary haematostasis - anticoagulants e.g warfarin stop secondary haematostasis - clot resolution (resuming of blood flow) enhanced with tissue plasminogen activator

Question 44

what can be given as a clot busting drug in emergencies

Answer 44

tissue plasminogen activator

Question 45

why is tissue plasminogen activator only used in emergencies

Answer 45

risk of bleeding is high with these drugs

Question 46

what is the lifespan of platelets

Answer 46

7-10 days

Question 47

what can warfarin (anticoagulation drug) be reversed with

Answer 47

vitamin K

Question 48

what are 3 reasons to stop anticoagulation/antiplatelet medication dependant one

Answer 48

1. expected bleeding 2. reason for anticoagulation 3. if procedure can be delayed