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1.2 POM Haematology > Red Blood Cell Diseases > Flashcards

Red Blood Cell Diseases Flashcards

1
Q

What are the 8 parts with units of a full blood count?

A
  1. WBC - white blood cell count (x10^9/L)
  2. RBC - red blood cell count (x10^12/L)
  3. Hb - haemoglobin concentration (g/L)
  4. Hct - haematocrit = % of blood that is rbcs (%)
  5. MCV - mean cell volume (fL —> 10^-15)
  6. MCH - mean cell haemoglobin (pg —> 10^-12)
  7. MCHC - mean cell haemoglobin concentration (g/L)
  8. Platelet count (x10^9/L)
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2
Q

How do you calculate MCV?

A

MCV = Hct/RBC x 1000
- think about units 10^-9L = 10^-12L x 1000

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3
Q

How do you calculate MCH?

A

MCH = Hb/RBC
∵ Hb per RBC = total Hb / no. RBCs
g/L = g/L / no.

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4
Q

How do you calculate MCHC?

A

MCHC = Hb/Hct
∵ Hb conc per RBC = total Hb / proportion of RBCs
g/L = g/L / % no.

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5
Q

How are blood cell counts performed now?

A

Automated instruments
- cell flows between light source and sensor/through electric field —> electronic impulses

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6
Q

What are the 2 indicators of anaemia on a FBC?

A
  1. Low Hb
  2. Low MCV
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7
Q

Which 4 features of erythrocytes distinguish the type of anaemia on a blood film?

A
  1. Size (microcytic, normocytic, macrocytic)
  2. Shape
  3. Colour (pale, polychromasia)
  4. Poikilocytes - abnormal shapes
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8
Q

How is iron deficiency anaemia indicated on a FBC? (4)

A
  1. Low Hb
  2. Low MCV
  3. Low MCH
  4. Low MCHC
    (5. High transferrin)
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9
Q

How is iron deficiency anaemia indicated on a blood film?

A

Microcytic erythrocytes (small and pale)

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10
Q

How is thalassaemia trait identified on a blood film?

A

Microcytic erythrocytes (small and pale)

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11
Q

What is anaemia?

A

Low Hb

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12
Q

What is thalassaemia?

A

Abnormal Hb production leading to anaemia

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13
Q

Which 2 lab techniques can be performed to see the presence of different Hbs in blood?

A

Hb electrophoresis
HPLC (high performance liquid chromatography)

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14
Q

What is the electrophoresis pattern of Hb?

A

HbA
HbF
(HbS)
HbA2

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15
Q

How is anaemia of chronic disease indicated on a FBC with transferrin and protein measures?

A
  1. Low Hb
  2. Low MCV
  3. Low transferrin
  4. High C-reactive protein
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16
Q

How is thalassaemia trait indicated on a FBC?

A
  1. Low Hb
  2. Low MCV
  3. Low MCH
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17
Q

What are the 4 common causes of microcytic anaemia and why?

A
  1. Iron deficiency anaemia
  2. Anaemia of chronic disease
  3. α-Thalassaemia
  4. β-Thalassaemia
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18
Q

How is megaloblastic anaemia indicated on a blood film?

A

Macrocytic erythrocytes

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19
Q

What are the 4 common causes of macrocytic anaemia?

A
  1. Megaloblastic anaemia (B12/folic acid deficiency)
  2. Drugs interfering with DNA synthesis
  3. Liver disease/ethanol toxicity
  4. Haemolytic anaemia
20
Q

What are the 3 causes of haemolytic anaemia

A
  1. Hereditary Spherocytosis
  2. SCD
  3. G6PD deficiency
21
Q

What is microcytic anaemia?

A
  • Low Hb
  • Smaller erythrocytes
22
Q

What is macrocytic anaemia?

A
  • Low Hb
  • Larger erythrocytes
23
Q

What is haemolytic anaemia?

A
  • Low Hb
  • Shortened erythrocyte lifespan
24
Q

How is haemolytic anaemia indicated on a blood film? (3)

A
  1. Poikilocytes
  2. Polychromasia
  3. Reticulocytes high
25
Q

What are the 3 causes of normocytic anaemia?

A
  1. Blood loss
    (haemorrhage, trauma)
  2. Failure to produce erythrocytes
    (bone marrow issues, anaemia of chronic disease)
  3. Erythrocytes pooling in spleen
    (hypersplenism-liver cirrhosis, splenic sequestration-SCD in infants)
26
Q

What are poikilocytes?

A

Abnormally shaped red blood cells
- not biconcave disc

27
Q

What are the 6 types of poikilocytes?

A
  1. Target cells —> dark centre ∵ accumulated Hb
  2. Sickle cells
  3. Red cell fragments (Schizocytes)
  4. Spherocytes
  5. Elliptocytes
  6. Irregularly contracted cells eg. blister cells
28
Q

How is sickle cell anaemia indicated on a FBC?

A
  1. High RBC
  2. Low MCV
  3. Low MCH
29
Q

What are 6 important types of anaemia and their causes?

A
  1. Iron deficiency anaemia
  2. Megaloblastic anaemia —> B12/folate deficiency
  3. Anaemia of chronic disease
  4. Sickle cell anaemia —> autosomal recessive
  5. Thalassaemia —> autosomal dominant
  6. Haemolytic anaemia
30
Q

How is SCD indicated on a blood film? (5)

A
  1. Sickle cells
  2. Boat cells
  3. Target cells
  4. Howell Jolly bodies - erythrocyte nuclei (should be removed by spleen)
  5. Platelets high
31
Q

When and why do erythrocytes become sickled in SCD?

A

Hypoxia
- Polymerisation forming insoluble HbS

32
Q

What are the 4 causes of target cells in a blood film?

A
  1. Obstructive jaundice
  2. Liver disease
  3. Haemoglobinopathies
  4. Hyposplenism
33
Q

How is SCD indicated via Hb electrophoresis?

A
  • No HbA
  • High HbF (only α + γ —> no mutated β)
  • High HbS
34
Q

What mutation causes SCD?

A
  • Glutamic acid —> Valine
  • Position 6
  • β-globin gene
35
Q

What is the difference between SCT and SCD?

A
  1. Trait —> heterozygous (HbA + HbS)
  2. Disease —> homozygous (HbS + HbS) —> symptoms
36
Q

What 3 effects do sickle cells have regarding the circulatory system?

A
  1. Haemolysis
  2. Shortened erythrocyte lifespan (20 days)
  3. Vaso-occlusion
37
Q

What are the 6 symptoms of SCD?

A
  1. Anaemia
  2. Jaundice (bilirubin)
  3. Gallstones
  4. Crises
  5. Dactylitis
  6. Splenomegaly
38
Q

What are the 6 sites of vaso-occlusion in SCD?

A
  1. Bone
  2. Kidney
  3. Cerebral
  4. Retina
  5. Lung
  6. Spleen
39
Q

How is the difference between Hb affinity of HbA and HbS?

A

HbS lower affinity for Hb

40
Q

How does SCD affect the spleen and what are the consequences of this?

A
  • Vaco-occlusion —> hyposplenism
  • Functional hyposplenism by age 5 - spleen stops working
  • Inc susceptibility to encapsulated bacteria —> give immunisations and prophylactic antibiotics
41
Q

How is polycythaemia indicated on a FBC? (3)

A
  1. High Hb
  2. High Hct
  3. High RBC
42
Q

What might high Hb and an abdominal mass indicate?

A

Kidney carcinoma

43
Q

What might high Hb, breathlessness and cyanosis indicate?

A

Hypoxia —> polycythaemia

44
Q

What might high Hb and splenomegaly indicate?

A

Polycythaemia vera

45
Q

What might high Hb in a healthy athlete indicate?

A

Blood doping/erythropoietin use —> polycythaemia

1.2 POM Haematology (7 decks)

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