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Metabolism, Endocrinology and Haematology > Session 3 - Haemapoiesis + Blood Counts > Flashcards

Session 3 - Haemapoiesis + Blood Counts Flashcards

1
Q

What is haemopoiesis?

A

Production of BL,old cells

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2
Q

What is the function of erythropoietin?

A

Stimulate red blood cell production

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3
Q

Where is erythropoietin secreted?

A

Kidney

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4
Q

What are the 2 organs that secretes thrombopoietin?

A

Liver and kidney

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5
Q

What is the function of thrombopoietin?

A

Regulate production of platelets

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6
Q

What are the 2 parts of the spleen?

A

Red and white pulp

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7
Q

What is the structure of red pulp of the spleen?

A

Sinuses lined by endothelial macrophages and cords

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8
Q

What is the structure of the white pulp of the spleen?

A

Similar structure to lymphoid nodules

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9
Q

What are 4 functions of the spleen?

A

Phagocytosis of abnormal red cells
Rapidly mobilize blood pooling platelets and red cells during bleeding
Extramedullary haemopoiesis during haematological stress or failure of bone marrow
Immunological function

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10
Q

How does blood enter the spleen?

A

Splenic artery

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11
Q

What are 5 causes of splenomegaly?

A 
Portal hypertension in liver disease
Overwork 
Extramedullary haemopoiesis
Infiltration by cells 
Infiltration by other materials
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12
Q

What is hypersplenism?

A

Low blood counts due to overactive spleen and pooling of blood in enlarged spleen

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13
Q

What is a clinical consequence of splenomegaly?

A

Risk of rupture as spleen is no longer protected by rib cage

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14
Q

What should a patient with splenomegaly avoid?

A

Contact sports and vigorous activity

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15
Q

What is hyposplenism?

A

Lack of functioning splenic tissue

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16
Q

What are 4 causes of hyposplenism?

A

Splenectomy
Sickle cell disease
Gastrointestinal diseases
Autoimmune disorders

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17
Q

What does blood film of a patient with hyposplenism show?

A

Howell Jolly inclusion bodies

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18
Q

What are Howell Jolly bodies?

A

Red cells with DNA remnants

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19
Q

Why are Howell Jolly inclusion bodies present?

A

Normally be removed by fully functioning spleen

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20
Q

What are patients with hyposplenism at risk of?

A

Sepsis from encapsulated bacteria

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21
Q

What are 3 encapsulated bacteria?

A

Streptococcus pneumonia
Haemophilus influenzae
Meningococcus

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22
Q

How to treat hyposplenism patients at risk of sepsis?

A

Immunization and lifelong antibiotic prophylaxis

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23
Q

What is the lifespan of RBCs?

A

120 days

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24
Q

What is the function of RBCs?

A

Deliver oxygen to tissues by carrying haemoglobin

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25
Q

What is the structure of haemoglobin?

A

Tetramer of 2 pairs of glob in chains with its own haem group

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26
Q

How can RBC shape be compromised?

A

Changes in components of cell membrane

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27
Q

What is the consequence of red cell membrane structure being compromised?

A

Cells become more fragile, spleen recognize cells as abnormal and removes them, resulting in haemolytic anaemia

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28
Q

What are the 4 main proteins involved in structure of cell membrane cytoskeleton?

A

Spectrin
Ankyrin
Band 3
Protein 4.2

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29
Q

What does spectrin do in the cytoskeleton?

A

Links plasma membrane to actin cytoskeleton

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30
Q

What does ankyrin do?

A

Links integral membrane proteins to the underlying spectrin-actin skeleton

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31
Q

What does band 3 do?

A

Integral protein that binds with ankyrin and protein 4.2 to link membrane to cytoskeleton

32
Q

What does protein 4.2 do?

A

ATP-binding protein which regulates the association of band 3 with ankyrin

33
Q

What are 3 sources of haemopoietic stem cells?

A

Bone marrow aspiration
Peripheral blood stem cells collected by leucopharesis
Umbilical cord stem cells

34
Q

How do u examine the spleen?

A

Palpate in right iliac fossa, feel for spleen edge and feel for splenic notch, spleen should not be palpable below costal margin

35
Q

What happens to iron when haem is degraded?

A

Recycled

36
Q

How is jaundice caused?

A

Haem is degraded to bilirubin, unconjugated bilirubin is transported in blood bound to albumin, if in excess can cause jaundice

37
Q

Why is faeces brown?

A

Stercobilin is brown

38
Q

How does haem become stercobilin?

A

Haem is degraded into bilirubin, bilirubin taken up by liver and conjugated with glucuronic acid forms bilirubin diglucoronide, secreted in bile into duodenum and glucoronic acid is removed by bacteria, converting bilirubin diglucoronide to urobilinogen which is oxidized to stercobilin

39
Q

Why is urine yellow?

A

Urobilin

40
Q

How does haem form urobilin?

A

Haem is degraded into bilirubin, bilirubin is transported to liver and conjugated with glucuronic acid to form bilirubin diglucoronide, secreted in bile into duodenum, glucoronic acid is removed by bacteria, bilirubin diglucoronide becomes urobilinogen, some absorbed into blood and transported to kidney, oxidized to urobilin

41
Q

What is cytopenia?

A

Reduction of number of blood cells

42
Q

What can cytosis or philia mean?

A

Increase in number of blood cells

43
Q

What are neutrophils?

A

First responder phagocyte

44
Q

What are maturation of neutrophils controlled by?

A

G-CSF

45
Q

What are the 4 functions of G-CSF?

A

Increase neutrophils production
Speed up release of mature cells from bone marrow
Enhance chemotaxis
Enhance phagocytosis and killing of pathogens

46
Q

When is G-CSF administered?

A

Severe neutropenia and sepsis after chemotherapy

47
Q

What is neutrophilia?

A

Increase in absolute number of circulating neutrophils?

48
Q

What are 3 possible causes of neutrophilia?

A

Infection
Cancer
Cytokines

49
Q

What is neutropenia?

A

Reduction of neutrophils number

50
Q

What are 3 consequences of neutropenia?

A

Severe life threatening bacterial infection
Severe life threatening fungal infection
Mucosal ulceration

51
Q

What has to be done during neutropenic sepsis?

A

Give intravenous antibiotics

52
Q

What are 2 main causes of neutropenia?

A

Reduced production or increased removal

53
Q

What are 3 possible causes of reduced production of neutrophils?

A

B12 deficiency
Aplastic anaemia
Viral infection

54
Q

What are 3 possible causes of increased removal of neutrophils?

A

Immune destruction
Sepsis
Splenic pooling

55
Q

What are monocytes?

A

Macrophages in blood

56
Q

What are 3 functions of monocytes?

A

Phagocytose
Antigen presenting
Defense against chronic bacterial infections

57
Q

What is monocytosis?

A

Increase number of monocytes circulating in blood

58
Q

What are 3 causes of monocytosis?

A

Bacterial infection
Inflammatory conditions
Carcinoma

59
Q

What are 4 functions of eosinophils?

A

Immune response against multicellular parasites
Mediator of allergy responses
Granules contain cytotoxic proteins
Phagocytose antigen antibody complexes

60
Q

What are 3 common causes of eosinophilia?

A

Allergic diseases
Drug hypersensitivity
Parasitic infection

61
Q

What are 2 functions of basophils?

A

Allergy reactions and inflammatory conditions

Release granules containing histamine, heparin, hyaluronic acid, serotonin

62
Q

What are 3 types of lymphocytes?

A

B cells
T cells
Natural killer cells

63
Q

What is the function of B cells?

A

Antibody forming cells

64
Q

What is the function of T cells?

A

CD4+ and CD8+ helper cells

65
Q

What is the function of natural killer cells?

A

Cell mediated cytotoxicity

66
Q

What does packed cell volume show?

A

Proportion of blood made up of RBC - if too much = polycythemia, if too little = anaemia

67
Q

What does red cell count show?

A

Number of RBC in blood - if too much = erythrocytosis, if too little = anaemia

68
Q

What does mean cell volume show?

A

Mean size of RBC = show cause of anaemia

69
Q

What does mean cell haemoglobin show?

A

Average measure of amount of Hb in each RBC, assesses cause of anaemia

70
Q

What does mean cell haemoglobin concentration show?

A

Concentration of haemoglobin in RBC

71
Q

What does red cell distribution width show?

A

Variation in size of RBC - assess cause of anaemia

72
Q

What does reticulocyte count show?

A

Measure number of young erythrocytes

73
Q

What does microcytic mean?

A

Small red cell size

74
Q

What does macrocytic mean?

A

Large RBC

75
Q

What does hypochromic mean?

A

Pale, less Hb per cell

76
Q

What does hyperchromic mean?

A

Dense, more Hb in given volume

Metabolism, Endocrinology and Haematology (8 decks)

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