PBL 7 - abnormaltiies of haematopoiesis and blood disorders

Question 1

what is red cell quantity reflected by?

Answer 1

measured Hb

Question 2

how is WBC measured?

Answer 2

measured in numbers automatically with subtype differentiation

Question 3

too low red cell count can be due to what and what is the collective name?

Answer 3

ANAEMIA

• decreased production
• increased consumption

Question 4

what is too high red cell number due to and what is the name?

Answer 4

POLYCYTHAEMIA

• increased production

Question 5

what are symptoms and signs of anaemia?

Answer 5

> fatigue 
> pallor
> tachycardia 
> heart murmur 
> heart failure 
> jaundice (yellow eyes)

Question 6

what are causes of anaemia?

Answer 6

> blood loss
haemolysis
increased consumption
decreased red cell lifespan (haemoglobinopathies)
lack of essential nutritional components for haematopoiesis (eg. iron, vitamins)
bone marrow problems (… including renal — lack of renal stimulus)
BM failure, displacement of normal haematopoiesis

Question 7

what is haemolysis?

Answer 7

the destruction of RBCs prior to their 120 day lifespan

Question 8

why is blood given?

Answer 8

to increase the oxygen carrying potential of the blood

Question 9

what is MCV? what is a low MCV a sign of?

Answer 9

= mean corpuscular volume

- a low MCV is an indication of a loss of iron eg. through bleeding, heavy periods of women

Question 10

what does a high WBC count indicate?

Answer 10

stress, infection

Question 11

what is a large MCV a sign of?

Answer 11

dysfunction in bone marrow

Question 12

what is polycythaemia?

Answer 12

having a high concentration of RBCs in your blood

Question 13

what are signs and symptoms of polycythaemia?

Answer 13

• red/bluish skin

- complex eg. twins — one normal, one small and ill — one receives blood and one gives blood (TTT)

Question 14

what are causes of polycythaemia?

Answer 14

• iatrogenic
• twin to twin transfusion (TTT)
• relative for increased O2 demand (small increase for smokers)
• bone marrow driven

Question 15

what is leukopenia?

Answer 15

a decrease in the number of leucocytes

Question 16

what are causes of leukopenia?

Answer 16

• increased consumption
• infection
• decreased production
• bone marrow problems

Question 17

what is leucocytosis?

Answer 17

too many WBCs

Question 18

what are causes of leucocytosis?

Answer 18

• increased production/mobilisation
• reactive: infection/stress
• primary bone marrow disease eg. leukaemia

Question 19

what is a sign of leucocytosis (only in extreme cases)?

Answer 19

hyper viscosity

Question 20

what is thrombocytosis?

Answer 20

too many platelets

Question 21

signs and symptoms of thrombocytosis

Answer 21

• only in extreme cases (hyper viscosity)

- normally no action needed

Question 22

causes of thrombocytosis

Answer 22

• increased production/mobilisation
  > reactive: infection, stress
  > primary bone marrow problems

Question 23

what is thrombocytopenia?

Answer 23

too little platelets

Question 24

signs and symptoms of thrombocytopenia?

Answer 24

• bleeding

- gums, GI, skin

Question 25

causes of thrombocytopenia

Answer 25

> increased consumption
infection
autoimmune
decreased production — failure of bone marrow, displacement of normal haematopoiesis

Question 26

in leukaemia, where has something gone wrong?

Answer 26

multipotent haematopoietic stem cell, common myeloid/lymphoid progenitor cells

Question 27

what is normal bone marrow replaced by in abnormal bone marrow?

Answer 27

fat or other cells

Question 28

ALL vs AML leukaemia

Answer 28

ALL = acute lymphoidblastic leukaemia —85% of children cured
AML = acute myeloid leukaemia — 70% of children cured

Question 29

what are 4 different leukaemia types?

Answer 29

Question 30

how do you distinguish ALL from AML?

Answer 30

• light microscopy
• morphology
  - AML: Auer rods, cytoplasmic granules
  - ALL: no Auer rods or granules
• flow cytometry (surface markers)
• cytochemistry
• cytogenetics