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B4W1 > PBL 1 > Flashcards

PBL 1 Flashcards

1
Q

in a blood count, what is Hb?

A

the concentration of haemoglobin in the blood (g/L)

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2
Q

what does it mean when Hb is high?

A

chronic low blood oxygen

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3
Q

what is RBC in a blood count?

A

the number of red blood cells in the blood (x10 to the 12/L)

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4
Q

what is a low RBC called? what is a high RBC called?

A

low= anaemia high= polycythemia

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5
Q

what is MCH in a blood count?

A

mean corpuscular haemoglobin- mean haemoglobin quantity in the blood cells (pg)

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6
Q

what is MCV in a blood count?

A

mean corpuscular volume- average volume of red blood cell. (fL)

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7
Q

what is Hct in a blood count?

A

hematocrit- the ratio of the volume of the RBC to the volume of the blood

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8
Q

what is WCC in a full blood count?

A

the total number of white blood cells in the blood (x10 to the 9/L)

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9
Q

what is a low and high WCC called?

A

low- leukopenia high- leukocytosis

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10
Q

what is a low and high count of neutrophils in the blood called?

A

low- neutropenia

high-neutrophilic

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11
Q

what is a low and high count of lymphocytes in the blood called?

A

low- lymphocytopenia

high- lymphocytosis

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12
Q

what are bands in a full blood count?

A

bands are precursors to neutrophils so an increase in bands show the immune system has been activated and a low count could indicate neutropenia.

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13
Q

what is Plt in a full blood count?

A

the number of platelets in the blood (x10 to the 9/L)

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14
Q

what is a low and a high platelet count called?

A

low- thrombocytopenia

high- thrombocytosis

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15
Q

what is the reticulocyte count for in a full blood count?

A

the number of reticulocytes in the blood. it is used to help determine if the bone marrow is responding adequately to the body’s need for RBCs. it is a given as a percentage over the number of RBCs.

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16
Q

what is ESR in a full blood count?

A

erythrocyte sedimentation rate. the rate at which RBCs sediment in a period of 1 hour. (mm/h)

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17
Q

what would increase and decrease the ESR?

A

increase- anaemia as blood cells are smaller and would more easily fall down the tube/inflammation or infection would make cells heavier
decrease- sickle cell anaemia would as it clumps cells together and interrupts their flow

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18
Q

what is EPO in a full blood count?

A

erythropoietin. a hormone secreted by the kidney that increases the rate of production of RBCs in response to hypoxia.

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19
Q

what are the likely causes of microcytic anaemia?

A

iron deficient anaemia
thalassemia
anaemia of chronic disease
sideroblastic anaemia

20
Q

what are the likely causes of macrocytic anaemia?

A

megaloblastic anaemia (B12 and folate deficiency or pernicious with no/less intrinsic factor)
hypothyroidism
drugs

21
Q

what are likely causes of normocytic anaemia?

A

blood loss
bone marrow failure
haemolytic anaemia

22
Q

describe the structure of haemoglobin?

A

2 alpha and 2 beta globin polypeptide chains. each as a haem group bound to it and at the centre of each haem group is an iron molecule.

23
Q

what are the 3 types of haemoglobin? what is their structure?

A

haemoglobin F- 2 alpha and 2 gamma globin chains
haemoglobin A- 2 alpha and 2 bets chains
haemoglobin A2- 2 alpha and 2 delta chains

24
Q

where does haemoglobin synthesis take place?

A

in the mitochondria and ribsosome

25
Q

describe the haem synthesis?

A

condensation of glycine and succinyl-CoA forms ALA. ALA then leaves the mitochondria and forms porphobilinogin. through a series of reactions this then becomes coproporphyrinogen. this molecule then re-enters the mitochondria and produces protoporphyrin. this is then combined with iron to form haem

26
Q

where is globin synthesised?

A

in the ribosome

27
Q

how should you take an iron supplement?

why?

A

on an empty stomach (1 hour before a meal) with vitamin C. vitamin C increases the stability and solubility of the iron so the body can more readily absorb the iron

28
Q

why can iron deficiency cause microcytic anaemia?

A

as small erythrocytes form due to insufficient haemoglobin

29
Q

why is it sometimes necessary to give iron as an injection rather than orally?

A

as some have an iron deficiency due to malabsorption rather than malnutrition. also some patients may not tolerate oral prescriptions

30
Q

why might a patient have malabsorption?

A

surgical procedures, inflammatory conditions of the GI tract, little/no intrinsic factor

31
Q

what is a common iron supplement?

A

ferrous salts e.g. ferrous sulfate

32
Q

what is the cause of thalassemia? what is its effect?

A

when the body cannot produce enough haemoglobin due to a point mutation that causes partial/complete globin chain deficiency. We result in premature destruction of RBCs leading to Hb spilling out and this can lead to excess bilirubin and therefore jaundice. this can lead to hypoxia which signals the bone marrow to produce more RBCs.

33
Q

what are the different types of beta thalassemia?

A

minor- having 1 mutated gene, intermedia- having 2 mutated genes, major- if no globin chains are produced

34
Q

where can you get vitamin B12 from in the diet?

A

meat, eggs and dairy products

35
Q

describe the absorption of vitamin b12

A

salivary glands secrete R-binder in response to vitamin B12, these then go to the stomach where they combine. in the small intestine, the proteases literate vitamin B12 from the R binder so that it can bind to an intrinsic factor. this complex can then bind to receptors in the terminal ileum and it can enter enterocytes via endocytosis.

36
Q

how does vitamin b12 travel in the blood?

A

bound to transcobalamin

37
Q

what is pernicious anaemia?

A

an autoimmune disorder where antibodies attack parietal cells so we have no/little intrinsic factor being produced and therefore we cannot absorbed vitamin B12.

38
Q

what is vitamin B12 required for?

A

RBC formation, formation of amino acid methionine, entrance of some amino acids into Krebs cycle and manufacture of choline to synthesise Ach and DNA/RNA synthesis.

39
Q

where can we find folic acid in the diet?

A

leafy vegetables, fruit, milk, eggs, nuts, fortified food and yeast

40
Q

where is folate stored and how does it move around the body?

A

stored in the liver. it releases folate into the bile for reabsorption in the jejunum and ileum- enterohepatic circulation to maintain plasma folate levels.

41
Q

how is folate excreted?

A

in the urine

42
Q

what is folic acid required for?

A

normal production of RBCs and WBCs, synthesis of DNA/RNA and amino acids. it is used to increase the metabolism of formic acid (methanol)

43
Q

what is hydroxocobalamin?

A

a dietary supplement for vitamin B12 deficiency. it is a precursor for vitamin B12 and methyl cobalamin. methyl cobalamin is required for the metabolism of folic acid

44
Q

describe the mechanism of action of folic acid once administered into the body?

A

it is converted to tetrahydrofolic acid and methyltetrahydrofolate by dihydrofolate reductase. these products are required for erythropoiesis, synthesising nucleic acids, interconverting amino acids.

45
Q

what type of molecule is the intrinsic factor?

A

a glycoprotein

46
Q

can folic acid be produced by intestinal bacteria?

A

yes!

B4W1 (10 decks)

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