Lecture 9: Haematology Flashcards
What might cause a high WBC?
Infection, post-op, leukaemia
What might cause a low WBC?
Chemotherapy, drugs, severe infection, immune disorders
What type of cell is raised during bacterial infection?
Neutrophils
What type of cell is raised during viral infection?
Lymphocytes
What type of cell is raised during parasitic infection?
Eosinophil
What is the definition of anaemia?
Low concentration of haemoglobin
What are platelets?
Fragments of cells that help form clots to stop bleeding
What is the coulter principle?
Principle of cell counting
Blood cells are poor conductors of electricity - cells in conducting medium - increase in electrical impedance as each cell passes through aperture
What is the equation of normal ESR for men and women?
Men: age/2
Women: age+10/2
What structure on the RBC binds acute phase proteins?
Sialic acid
What are the causes of normocytic anaemia?
Acute blood loss
Anaemia of chronic disease
Bone marrow issues
Renal failure (decreased EPO production)
What are the causes of microcytic anaemia?
Iron deficiency
Thalassaemia
What are the clinical symptoms of iron deficiency?
Pallor
SOB
TATT
Glossitis
Spoon nails
What causes microcytic anaemia?
Non-megaloblastic (large RBC with no DNA involvement):
Alcohol or liver disease
Megaloblastic (large RBC with DNA affected):
B12 and folate def, chemotherapy, HIV treatment
What are the clinical symptoms of B12 and folate deficiency?
Weight loss
Fatigue
Glossitis
Jaundice
Dementia
Paraesthesiae
Neuropathy
What does poikilocytosis mean?
Variation in shape
What does anisocytosis mean?
Variation in size
What may cause dimorphic RBCs?
Responding anaemia or post-transfusion
What may cause decreased production of platelets (thrombocytopenia)?
Congenital - rare
Acquired - BM damage, alcohol, haem malignancy
What may cause increased destruction of platelets (thrombocytopenia)?
Congenital - maternal antibodies
Acquired - ITP, infections (bacterial/viral/parasitic), drug induced
What may cause thrombocythaemia?
High platelet count
Primary - malignant proliferative disorder (pre-leukaemia)
Secondary (reactive) - infection, inflammation, haemorrhage
What may cause neutrophillia (high neutrophils)?
Acute and chronic bacterial infections
Some viral, fungal, parasitic infections
Tissue damage
Inflammation
Etc…
What may cause neutropenia (low neutrophils)?
Drugs (anti-cancer)
Bacterial infections
Some viral, fungal, parasitic infections
Irradiation
Aplastic anaemia
What can happen to neutrophils in disease?
Left shifted (immature) - infection, leukaemia
Toxic granulation - infection
Myelocytes (very immature neuts) - severe infection, leukaemia
Hypersegmented (right shifted) - megaloblastic conditions e.g. B12 folate def
What may cause lymphocytosis?
Viral infection (measles, chicken pox)
Some bacterial infections
Stress related (post MI)
Vigorous exercise
Smoking
Lymphoproliferative disorders (CLL)
What may cause lymphocytopenia?
AIDs/HIV
Acute stress (surgery/trauma)
Carcinoma
Cytotoxic therapy
What is leukaemia?
Disease resulting from neoplastic proliferation of haemopoietic or lymphoid cells (myeloid or lymphoid)
Acute: Primitive cells affected, complete block in maturation, can have normal WBC count but bc they are not normal they get symptoms (death in weeks if untreated)
Chronic: Divide out of control and are able to mature, many white cells, most are mature (death in months/years if untreated)
Which drug affects PT?
Warfarin
Which drug affects HPTT?
Heparin