Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

ESA2 > MEH - Spleen White Cells Cytopenia > Flashcards

MEH - Spleen White Cells Cytopenia Flashcards

1
Q

What is red pulp vs white pulp in the spleen?

A

Red pulp contains RBC, granulocytes, platelets, plasma - sinuses (engorged with blood) lined by endothelial macrophages and cords (connective tissue)

White pulp - similar structure to lymphoid follicles with especially T and B lymphocytes

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

What organ does a large spleen put pressure on?

A

Stomach so have to have small meals

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

Where do white cells and plasma pass through in the spleen?

A

Preferentially white pulp

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

Where do RBC pass through?

A

Red pulp

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

What are 4 major roles of the spleen?

A

Sequestration and phagocytosis of old/damaged RBCs - splenic macrophages

Blood pool - release RBC and platelets during bleeding

Extramedullary haemopoiesis - pluripotent stem cells prolif during haem stress or bone marrow failure e.g. myelfibrosis

Immune function - 25% T cells and 15% B cells present in spleen (more in infection)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

What is the broad role of red pulp and white pulp?

A

Red - RBC sequestration and phagocytosis

White - Immune response - cell mediated and humeral

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

Is it ever normal to be able to palpate spleen?

A

No

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

6 reasons for splenomegaly?

A
  • Back pressure - portal hypertension
  • Overworking red pulp e.g. haemolytic anaemia
  • Overworking white pulp
  • Extramedullary haemopoiesis
  • Infiltrated cancer - leukaemia etc
  • Infiltrated other - gaucheries disease, sarcoidosis
  • Malaria
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

Via what vessel does blood enter the spleen?

A

Splenic artery

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

What would you see typically on a blood film of someone with hyposplenism?

A

Howell - Jolly bodies

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

What are Howell - Jolly bodies and why are they present?

A

Basophilic nucelar remnants (clusters of DNA) in circling erythrocytes. Normally during erythropoiesis erythroblasts expel their nuclei but in some cases a small portion of DNA remains. Such cells would normally be removed by the spleen but presence of these bodies is a good indicator of reduced spleen function

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

What is leucopenia?

A

Low WBC count

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

What is low neutrophil blood count?

A

Neutropenia

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

What is pancytopenia?

A

Low red cells, white cells and platelets

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

What is leucocytosis?

A

High WBC count

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

What is high lymphocyte count?

A

Lymphocytosis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

What is hyposplenism? What are some causes?

A

Lack of functional spleen

E.g. splenectomy, coeliac, sickle cell

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

How will Howell Jolly- Bodies look on blood film?

A

Purple dots

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

Which are the encapsulated bacteria that hyposplenic patients are particularly at risk of infection from?

A

Neisseria meningitidis
Haemophilus influenzae
Step pneumoniae

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

What are some causes of massive splenomegaly (4)?

A

CML, myelofibrosis, chronic malaria, schistosomiasis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

What are some causes of moderate splenomegaly?

A

As above plus lymphoproliferative disorders, myeloproliferative disorders, liver cirrhosis with portal hypertension, infections such as glandular fever caused by EBV

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

What are some causes of mild splenomegaly?

A

Infection hepatitis, endocarditis, infiltrative disorders such as sarcoidosis, autoimmune diseases such as AIHA

23
Q

How can hypersplenism cause pancytopenia or thrombocytopenia?

A

Because it can pool blood/platelets so removing it from normal circulation

24
Q

What is the risk with playing contact sports with splenomegaly?

A

Risk of rupture if below rib cage

25
Q

What are some complications of splenomegaly?

A

Infarction - e.g. sickle cell

Haematoma - can cause anaemia and hypertension in spleen

26
Q

What is increased lobes on neutrophil indicative of (e.g. 3-5 lobes)?

A

Vit B12 deficiency

27
Q

How long do neutrophils live for?

A

1-4 days

28
Q

What hormone controls neutrophil maturation/production? What 4 roles does the hormone have?

A

G-CSF

Increased production of neutrophils

Decreased time to release of mature cells from BM

Enhances chemotaxis

Enhances phagocytosis and killing of pathogens

29
Q

What are two reasons for immature release of neutrophils e.g. meyeloblast/promyelocyte/myelocyte/metamyelocyte

A

Haem cancer

Sepsis

30
Q

What treatment can you give to enhance a patients neutrophils e.g. post chemo neutropenia

A

Recombinant CSF

31
Q

What are 10 important causes of neutrophilia

A

1) Drugs e.g. steroids
2) Acute haemorrhage
3) Myeloproliferative diseases
4) Tissue damage
5) Smoking
6) Infection
7) Cancer
8) Cytokines G-CSF
9) Metabolic/endocrine disorders
10) Acute inflammation

32
Q

What is the diagnostic level of neutrophils for neutropenia?

A

<1.5 x 10^9/L

<0.5 is servere

33
Q

What causes neutropenia?

A

Decreased production

Increased breakdown or use

34
Q

What reasons for decreased production of WBC are there?

A

1) B12/folate deficiency
2) Infiltration by malignancy or fibrosis
3) Aplastic anaemia
4) Radiation
5) Drugs - chemo etc
6) Viral infection - v common
7) Congenital disorders

35
Q

What are three causes of increased neutrophil removal or use?

A

Immune destruction
Sepsis
Splenic pooling

36
Q

What are two others causes of neutropenia?

A

Benign ethnic neutropenia in afro carribbevn

Cyclic neutropenia

37
Q

What are 3 complications of neutropenia?

A

Severe life threatening bacterial infection

Severe life threatening fungal infection

Mucosal ulceration - painful mouth ulcers

38
Q

What do monocyte lysosomes contain?

A

Lysozyme, complement, interleukins, arachidonic acid (conditionally essential fatty acid), CSF

39
Q

What is increased monocytes called?

A

Monocytosis

40
Q

When might you see monocytosis (4)?

A

Chronic inflam conditions - Rheumatoid, SLE, Crohns, Ulcerative colitis

Chronic infection e.g. TB

Carcinoma

Myeloproliferative disorders/leukaemias

41
Q

How long are eosinophils in circulation? What is their life span

A

3-5 hours

Lifespan 8-10 days

42
Q

What do their granules contain?

A

Arginine
Phospholipid
Enzymes

43
Q

What can eosinophils phagocytose?

A

Antigen-antibody complex

44
Q

When might you see eosinophilia?

A

Allergic diseases - hay fever, asthma, eczema, aspergillosis

Drug hypersensitivity

Parasitic infections

Hodgkins lymphoma, acute myeloid leukaemia, acute lymphoblastic leukaemia, myeloproliferative conditions, eosinophilic leukaemia, idiopathic hypereosinophilic syndrome

45
Q

How common are basophils?

A

Least common

46
Q

What are they active for?

A

Allergic reactions and inflammatory conditions

47
Q

What do their granules contain?

A

Histamine
Heparin
Hyaluronic acid
Serotonin

48
Q

When might you see basophilia?

A

Reactive -
Immediate hypersensitivity reactions
UC
RA

Myeloproliferative disorders
CML etc

49
Q

When might you see lymphocytosis?

A 
Viral infections
Bacterial infections
Post splenectomy 
MI/Cardiac arrest (stress related)
Smoking

Lymphoproliferative e.g. CLL (B cells), other lymphomas/leukaemias

50
Q

What can cause pancytopenia?

A

Most common is reduced production

Also splenic pooling

51
Q

How can reduced production of all blood cells occur?

A 
B12 folate deficiency - if advanced 
Malignancy in bone marrow
Marrow fibrosis
Idiopathic immune aplastic anaemia
Radiation
Drugs - chemo
Viruses - EBC, viral hepatitis, HIV, CMV
Congenital bone marrow failure Fanconi's Anaemia, Dyskeratosis congenita
52
Q

What non haem malignancy can cause pancytopenia?

A

Prostate
Breast
Lung

53
Q

What are symptoms of pancytopenia?

A

Anaemia symptoms
Thrombocytopenia symptoms (bleeding bruising)
Neutropenia symptoms - fever infection ulcers
Symptoms of underlying cause

54
Q

What can you do to increase all cells?

A

GCSF mobilised stem cells from donor - stem cell transplant

ESA2 (37 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions