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Year 2 Foundation in Clinical Practice 2 > Introduction to Haematology > Flashcards

Introduction to Haematology Flashcards

1
Q

components of the blood

A

plasma (55%)
RBCs
WBCs
Platelets

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2
Q

the densest blood component

A

the RBCs, least dense is the plasma

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3
Q

when blood is centrifuged, the “buffy coat” is composed of

A

the WBCs and platelets

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4
Q

Haemopoiesis

A

refers to the production of blood cells

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5
Q

platelet cells are referred to as

A

thrombocytes

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6
Q

the average lifespan for the various blood cells

A

120days for RBCs
4 hours to 10 yeas for WBCs
10-14 days for platelets

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7
Q

name some of the main causes of cell loss

A

ageing
physical injury to tissues or the cells themselves
Ischemia
Autoimmune Diseases
Apoptosis

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8
Q

the first site of blood production in humans

A

the yolk sac

after 2-7 months of development, the part of the developping baby that takes over blood production is the spleen and the liver. After nine months, the bone marrow takes over.

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9
Q

do all the bones in an infant/adult produce blood?

A

they do

in adults, some of the bones cease to produce blood as we grow, so only a selected few do(Vertebrae, ribs, sternum, skull, sacrum, pelvis, proximal ends of femur)

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10
Q

progenitor cells

A

a type of undifferentiated cell with the capacity to differentiate into specific types of cells but with a more restricted potential compared to stem cells

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11
Q

where can you find immature cells in the body

A

the bone marrow

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12
Q

normal peripheral blood cells

A

these are mature blood cells that circulate around the body

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13
Q

name the four main normal peripheral cells circulating the body

A

ERYTHROCYTES(RBCs)
LEUCOCYTES(WBCs)
PLATELETS

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14
Q

Granulocytes are a component of leucocytes, true or false

A

true

granulocytes are a type of white blood cell (leukocyte) characterized by the presence of granules in their cytoplasm, which contain various enzymes and substances involved in immune responses.

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15
Q

the types of granulocytes

A

neutrophils
basophils
Eosinophils

the most abundant types of granulocytes ae neutrophils

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16
Q

basophil functions

A

plays a role in inflammatory responses and allergic reactions. They release histamine and heparin from their granules, which contribute to inflammation and help regulate blood clotting.

https://www.google.com/search?sca_esv=9f50a84c28a88f83&rlz=1C1GCEA_enGB1

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17
Q

neutrophils

A

They engulf and destroy bacteria and other pathogens through phagocytosis and release enzymes to help kill bacteria.

it is multi-lobed( 3 to 5 lobes)

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18
Q

other types of WBCs apart from granulocytes are

A

monocytes
lymphocytes

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19
Q

which wbcs develop into macrophages

A

monocytes

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20
Q

anaemia

A

A reduction in oxygen-carrying of the blood capacity due to a
lower haemoglobin concentration than is usual for
that individual

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21
Q

the three classifications of anaemia

A

Microcytic hypochromic(Small-sized red blood cells (microcytic) with reduced hemoglobin content, making them appear pale (hypochromic).)

Normocytic normochromic(Normal-sized red blood cells (normocytic) with normal hemoglobin content (normochromic).)

Macrocytic(Larger-than-normal red blood cells (macrocytic), which may or may not have normal hemoglobin content.)

note that different types of anaemia fall under different classifications

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22
Q

some clinical features or symptoms of anaemia

A

shortness of breath
lethargy
retinal harmorrhages
confusion
tachycardia

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23
Q

causes of IDA(iron deficiency anaemia)

A

depletion of iron levels due to;
Reduced absorption due to dietry deficiency or malabsorption

Blood loss

increased demand for growth in pregnancy

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24
Q

can the size of the RBCs decrease in case of IDA

A

yes it can, this is known as microcytosis, and is common in IDA

this is due to the lack of haemoglobin

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25
Q

what is meant by the term Hypochromic in IDA

A

this is used to describe when the RBCs become PALE due to the scarcity of haemoglobin

remember haemoglobin gives the cells their red colour

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26
Q

state three treatments for the treatment of IDA

A

oral iron supplements (Like ferrous fumerate…)

dietary changes(incroporating iron rich foods into one’s diet)

intravenous iron therapy for extreme cases of IDA, and patients that need more iron than supplements or diet can provide, at a quicker rate

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27
Q

which nutrient helps with the absorption of iron and how does it do it

A

vitamin c
it does this by reducing ferric iron to ferrous iron or preventing the conversion of iron to ferric iron

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28
Q

methods of diagnosing IDA

A

POCT( point of care testing)

Laboratory based tests

point of care testing is used for the initial doagnosis, where a quick assessmment of the blood might be required, but for a more accurate diagnosis, laboratory tests are used

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29
Q

some examples of POCT

A

Hemoglobin testing
hematocrit
POC ferritin or transferrin saturation tests.

Hematocrit (Hct) is a blood test that measures the percentage of your blood volume that is made up of red blood cells (RBCs)

Transferrin is a glycoprotein produced in the liver that binds to iron(III) to help transfer it throughout the body.

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30
Q

examples of lab based diagnosis for IDA

A

comprehensive diagnosis
peripheral blood smear
Serum Soluble Transferrin Receptor (sTfR)
Reticulocyte Hemoglobin Content

note that the comprehensive diagnosis entails a combination of tests to identify IDA

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31
Q

ferritin

A

a protein that stores iron in the body and releases it when needed

it is used as an indicator of the body’s iron reserves

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32
Q

what is normally used to collect venous blood from the antecubital vein

A

a vacutainer

33
Q

venepuncture

A

a medical procedure used to access a vein, typically for drawing blood or administering medications

34
Q

define serum and plasma in terms of blood

A

serum is the liquid part of the blood after clotting has occurred and the blood cells have been removed.

plasma is the liquid component of anticoagulated blood(blood that has not clotted)

Both serum and plasma are different parts oft he blood, crucial for diagnosing different aspects of Iron Deficiency Anemia (IDA), with serum mainly for iron studies and plasma for blood cell analysis.

35
Q

does serum have coagulation factors

A

no, because the blood has already undergone clotting, so they have been used up

36
Q

does plasma have coagulation factors

A

yes, because it is composed of anticoagulated blood, so the coafulation factors have not been used up yet.

37
Q

are there any blood cells left in the serum

A

No, there are no red blood cells left in serum. When blood clots, the red blood cells, white blood cells, and platelets become trapped in the clot, leaving behind only the serum. Serum is the clear, yellowish liquid that remains after the clotting process and contains electrolytes, proteins (like antibodies), hormones……

note that plasma has all the blood cells

38
Q

the commonly used anticoagulant for blood cell counting and other associated tests

A

EDTA

39
Q

what are the key contents of the blood that are analysed in the full blood count

A

haemoglobin level
RBC count
WBC count
Platelet count
Red cell parameters

Red blood cell (RBC) parameters are a set of measurements that evaluate the size, shape, and quality of red blood cells

40
Q

tests that might require the collection of serum

A

Serum Ferritin
Serum Iron
Transferrin Saturation
Total Iron-Binding Capacity (TIBC)

41
Q

tests that require the collection of plasma

A

Complete Blood Count (CBC)
Reticulocyte Hemoglobin Content
Peripheral Blood Smear
Hematocrit

42
Q

the first line test in haematology

A

full blood count

43
Q

name the main types of lymphocytes

A

B and T lymphocytes

44
Q

white blood cells are classified into two broad groups, named?

A

phagocytes and immunocytes

Phagocytes are the granulocytes and monocytes.

Immunocytes are the lymphocytes and plasma
cells.

45
Q

monocytes enter most tissues and mature into?

A

macrophages

note that monocytes may specialise into different cells in different tissues

46
Q

bone marrow samples are usually taken for what purpose

A

to examine cellular morphology
usually for lymphoproliferative disorders and haematological disease

47
Q

how are bone marrow samples collected( the two main stages )

A

bone marrow aspiration: involves the insertion of a needle into the bone marrow to withdraw a portion of it’s liquid part

bone marrow biopsy : involves the use of a larger needle to remove a small core of solid bone marrow tissue

both procedures are usually carried out under local anaesthesia, and biospsy follows aspiration

48
Q

cell mobilisation and migration

chemotaxis

A

the movement of cells or organisms in response to a chemical stimulus.

usually happens during infection or injury, with the WBC moving towards the site of injury or infection

49
Q

the main functions of neutrophils

A

chemotaxis
phagocytosis
cytokine production…etc

50
Q

main functions of monoctyes

A

chemotaxis
phagocytosis
antigen presentation (macrophages)
cytokine production

51
Q

note these steps are more advanced that previously learnt

the five main steps involved in phagocytosis and bacterial destruction

A

Engulfment: A pathogen is engulfed by a phagocyte (like a neutrophil or macrophage), forming a phagosome.

Respiratory Burst: The phagocyte undergoes a respiratory burst, producing hydrogen peroxide (H₂O₂) and other reactive oxygen species (ROS) inside the phagosome to help destroy the pathogen.

Primary Granules (Azurophilic Granules): These granules fuse with the phagosome and release enzymes like myeloperoxidase (MPO), which uses hydrogen peroxide to produce hypochlorous acid (a potent bactericidal agent).

Secondary Granules (Specific Granules): These granules release additional antimicrobial substances like lactoferrin and lysozyme, which attack the pathogen’s cell wall and restrict its iron supply, further aiding in its destruction.

Pathogen Destruction: The combination of ROS from hydrogen peroxide and enzymes from primary and secondary granules leads to the breakdown and death of the pathogen.

52
Q

function of myeloperoxidase

A

an enzyme that reacts with hydrogen peroxide to produce hypochlorous acid (HOCl), a powerful antimicrobial agent

53
Q

function of hydrogen peroxide in bacterial destruction

A

is key in generating reactive oxygen species that help phagocytes destroy pathogens during phagocytosis

54
Q

neutropenia

A

a condition characterized by an abnormally low number of neutrophils

Most commonly associated with infections of
mouth and throat.

55
Q

causes of neutropenia

A

Can be caused by drugs

infections

autoimmune disease.

bone marrow disorders

Chemotherapy or radiation therapy, which suppresses bone marrow.

56
Q

septicaemia

A

a serious, life-threatening bloodstream infection that occurs when bacteria or their toxins enter the bloodstream, leading to widespread inflammation and potential organ failure.

57
Q

lymphocytosis

A

a condition characterized by an abnormally high number of lymphocytes, a type of white blood cell, in the blood

58
Q

symptoms of lymphocytosis

A

fever, sore throat,
lympadenopathy and atypical lymphocytes in
blood film

Lymphadenopathy is a term that refers to the swelling of lymph nodes

59
Q

causes of lymphocytosis

A

infection like HIV, Epstein-Barr virus

autoimmune disorders

blood cancers

60
Q

Infectious Mononucleosis(IM) caused by

A

Epstein-Barr virus

aka glandular fever, and occurs in people aged 15-25

61
Q

some symptoms of IM

A

sore throat, lymphadenopathy and
fever, swollen lymph nodes, swollen spleen, headache…etc

62
Q

mode of transmission of IM

A

Spread through saliva, which is why it is sometimes referred to as the “kissing disease.”

It can also spread through sharing drinks, utensils, or contact with other bodily fluids.

63
Q

haemostasis

A

the process by which the body stops bleeding and maintains blood within the damaged blood vessel following an injury.

it is the balance between procoagulant systems and anticoagulant systems

64
Q

components of the process of haemostasis

A

Platelets.
Coagulation factors.
Coagulation inhibitors.
Fibrinolysis.
Blood vessels.

65
Q

where are platelets produced and how are they produced

A

produced in the bone marrow by
fragmentation of the cytoplasm of
megakaryocytes

66
Q

megakaryocytes

A

large precursor cells that produce platelets

found in the bone marrow. each one produces about 4000 platelets

67
Q

megakaryocytes mature by

A

endomitotic
synchronous nuclear replication.

68
Q

endomitotic
synchronous nuclear replication.

A

a process in which DNA replication occurs without nuclear or cytoplasmic division, and is involved in the maturation of megakaryocytes, which produce platelets.

69
Q

thrombopoietin

A

hormone primarily produced by the liver and kidneys, stimulates the development of megakaryocytes and promotes platelet production.

70
Q

factor IX and X are axctivated by

A

factor VII

thrombin is produced by factor X

71
Q

vitamin K function in coagulation

A

essential for the activation of specific clotting factors in the blood

72
Q

coagulation factor II aka

A

prothrombin

73
Q

thrombocytopenia

A

condition characterized by an abnormally low number of platelets (thrombocytes) in the blood. causes are autoimmune

can cause skin purpura and prolonged bleeding.
can be caused by decreased platelet production, increased platelet destruction, etc

74
Q

skin purpura

A

refers to the appearance of purple or red spots on the skin caused by bleeding underneath the skin, due to the rupture of small blood vessels

75
Q

the most common heriditary coagulation disorder or blood clotting disorder

A

haemophilia A

76
Q

what are some clinical features of haemophilia

A

Can be discovered from excessive bleeding in infants post circumcision.

Bruising in joints once start to be active.

Can lead to joint deformity

77
Q

haemophilia A

A

A genetic disorder where the body lacks certain clotting factors (usually Factor VIII) leading to difficulty forming clots. This results in prolonged bleeding, even with normal platelet levels.

sometimes factor IX absence can also lead to haemophilia(B)

78
Q

the clinical severity of hameophilia is dependant on

A

the extent of factor VIII deficiency

79
Q

haemophilia treatment

A

Gene Therapy:

desmopressin

Antifibrinolytic Medications( like tranexamic acid or aminocaproic acid)

Replacement Therapy: Factor VIII infused for haemophilia A and IX for haemophilia B

Year 2 Foundation in Clinical Practice 2 (4 decks)

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