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Clinical Pathology > Introduction to haematology > Flashcards

Introduction to haematology Flashcards

1
Q

What is haematopoiesis?

A
  • The physiological developmental process that gives rise to the cellular components of blood
  • A single multipotent haemopoietic stem cell can divide and differentiate to form different cell lineages that will populate the blood
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2
Q

What is a haemopoietic stem cell?

A
  • Differentiation potential for all lineages
  • High proliferative potential
  • Long term activity throughout the lifespan of the individual
  • Self renewal
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3
Q

What is symmetric self-renewal?

A

Increase stem cell pool – NO generation of differentiated progeny

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4
Q

What is asymmetric self-renewal?

A

Maintain stem cell pool – generation of differentiate progeny.

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5
Q

What is lack of self-renewal?

A

Deplete stem cell pool – generation of ONLY differentiated progeny

OR

Maintain stem cell pool – NO differentiated progeny

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6
Q

What are the two haemopoietic lineages?

A
  • Myeloid

- Lymphoid

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7
Q

At what point in human development does heamopoiesis start?

A

Day 27

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8
Q

Where does heamopoiesis start?

A

In the aorta-gonado-mesonephros region,

expands rapidly at day 35, then disappear at day 40.

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9
Q

Why does the aorta-gonado-mesonephros region disappear?

A

This disappearance correlates with the migration of these hematopoietic stem cells to the foetal liver, which becomes the subsequent site of haemopoiesis.

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10
Q

What are the features of erythrocytes?

A

Bi-concave discs, 7.5 µM diameter

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11
Q

What is the lifespan of an erythrocyte?

A

120 days

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12
Q

What is anaemia?

A

Reduced erythrocytes

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13
Q

What is polycythaemia?

A

Abnormally raised erythrocytes

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14
Q

What is relative polycythaemia?

A

Plasma volume is reduced so erythrocytes appear raised

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15
Q

What are granulocytes?

A

Have cytoplasmic granules (neutrophils, eosinophils, basophils)

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16
Q

What is the function of neutrophils?

A

Phagocytes

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17
Q

What is neutrophilia?

A

Increased numbers of neutrophils

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18
Q

Why might neutrophil levels be increased?

A

Bacterial infection and inflammation

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19
Q

What is the lifespan of neutrophils?

A

A few hours

20
Q

What is neutropenia?

A

Decreased numbers of neutrophils

21
Q

Why would eosinophil levels be increased?

A
  • Parasitic infection

- Allergies

22
Q

Why might basophil levels be increased?

A

CML

23
Q

What are monocytes?

A
  • Phagocytic & antigen-presenting cells
  • Migrate to tissues & are then identified as “macrophages” or “histiocytes”
    e. g. Kupffer cells in liver
    e. g. Langerhans cells in skin
24
Q

What is monocytosis and why might it occur?

A

Increased numbers of monocytes. Can happen in TB.

25
Q

What is the function of NK cells?

A
  • Recognise “non-self”
    e. g. Cells, viruses
  • Large granular lymphocytes
26
Q

What are B-lymphocytes?

A
  • Adaptive immune system
  • rearrange the immunoglobulin genes to enable antigen specific antibody production
  • humoral immunity
27
Q

What are T-lymphocytes?

A
  • Adaptive immune system
  • rearrange the T-cell antigen receptor
  • cell-mediated immunity
  • target specific cytotoxicity
  • Interact with B cells, macrophages
  • Regulate immune responses
28
Q

What is lymphocytosis and why might it occur?

A

Increased numbers of lymphocytes.

e. g. atypical lymphocytes of glandular fever (infectious mononucleosis)
e. g. Chronic lymphocytic leukaemia

29
Q

What is lymphopenia and why might it occur?

A

Decreased numbers of lymphocytes.

e.g. post bone marrow transplant

30
Q

What is plasmocytosis and why might it occur?

A

Increased numbers of plasma cells

e.g. infection, myeloma

31
Q

What are platelets derived from?

A

Bone marrow megakaryocytes

32
Q

What measures are included in a full blood count?

A
  • Haemoglobin concentration
  • Red cell parameters
  • MCV (mean cell volume)
  • MCH (mean cell Hb)
  • White Cell Count (WCC)
  • Platelet Count
33
Q

What measures are included in a coagulation test?

A
  • Prothrombin Time
  • Activated Partial Thromboplastin Time
  • Thrombin Time
34
Q

How is a bone marrow aspirate & trephine performed?

A

Under local anaesthetic, liquid marrow is aspirated from the posterior iliac crest of the pelvis and a trephine core biopsy is then taken with a hollow needle.

35
Q

How is a reference range established?

A
  • Define the reference population
  • Reference population should be relevant to the test population
  • Consider if separate ranges are required for adults versus children, men versus women, and so forth.
  • Determine the expected range of interindividual variation
36
Q

What is a reference range?

A

The set of values for a given test that incorporates 95% of the normal population

37
Q

What percentage of results fall within the reference range?

A

95%

38
Q

What is sensitivity?

A
  • The proportion of abnormal results correctly classified by the test.
  • Expresses the ability to detect a true abnormality
39
Q

What is specificity?

A
  • The proportion of normal results correctly classified by the test
  • Expresses the ability to exclude an abnormal result in a healthy person
40
Q

In what situation might an abnormal lymphocyte count be expected?

A
  • Post-splenectomy, mild lymphocytosis

- 3 months post-bone marrow transplant lymphopenia

41
Q

What is microcytic anaemia?

A

MCV

42
Q

What are the causes of microcytic anaemia?

A
  • Iron deficiency
  • Thalassaemia
  • Anaemia of chronic disease (some)
  • Lead poisonng
  • Sideroblastic anaemia (some cases)
43
Q

What is normocytic anaemia?

A

MCV 80-95 fl & MCH ≥ 27 pg

44
Q

What are the causes of normocytic anaemia?

A
  • Many haemolytic anaemias
  • Anaemia of chronic disease (some cases)
  • After acute blood loss
  • Renal disease
  • Mixed deficiencies
  • Bone marrow failure (e.g. post-chemotherapy, infitration by carcinoma etc)
45
Q

What is macrocytic anaemia?

A

MCV >95 fl

46
Q

What are the causes of macrocytic anaemia?

A

Megaloblastic: Vitamin B12 or folate deficiency

Non-megaloblastic: alcohol, liver disease, myelodysplasia, aplastic anaemia etc

Clinical Pathology (65 decks)

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