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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
What is the structure of haemoglobin?
Tetramer of 2 pairs of glob in chains with its own haem group
26
How can RBC shape be compromised?
Changes in components of cell membrane
27
What is the consequence of red cell membrane structure being compromised?
Cells become more fragile, spleen recognize cells as abnormal and removes them, resulting in haemolytic anaemia
28
What are the 4 main proteins involved in structure of cell membrane cytoskeleton?
Spectrin Ankyrin Band 3 Protein 4.2
29
What does spectrin do in the cytoskeleton?
Links plasma membrane to actin cytoskeleton
30
What does ankyrin do?
Links integral membrane proteins to the underlying spectrin-actin skeleton
31
What does band 3 do?
Integral protein that binds with ankyrin and protein 4.2 to link membrane to cytoskeleton
32
What does protein 4.2 do?
ATP-binding protein which regulates the association of band 3 with ankyrin
33
What are 3 sources of haemopoietic stem cells?
Bone marrow aspiration Peripheral blood stem cells collected by leucopharesis Umbilical cord stem cells
34
How do u examine the spleen?
Palpate in right iliac fossa, feel for spleen edge and feel for splenic notch, spleen should not be palpable below costal margin
35
What happens to iron when haem is degraded?
Recycled
36
How is jaundice caused?
Haem is degraded to bilirubin, unconjugated bilirubin is transported in blood bound to albumin, if in excess can cause jaundice
37
Why is faeces brown?
Stercobilin is brown
38
How does haem become stercobilin?
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
Why is urine yellow?
Urobilin
40
How does haem form urobilin?
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
What is cytopenia?
Reduction of number of blood cells
42
What can cytosis or philia mean?
Increase in number of blood cells
43
What are neutrophils?
First responder phagocyte
44
What are maturation of neutrophils controlled by?
G-CSF
45
What are the 4 functions of G-CSF?
Increase neutrophils production Speed up release of mature cells from bone marrow Enhance chemotaxis Enhance phagocytosis and killing of pathogens
46
When is G-CSF administered?
Severe neutropenia and sepsis after chemotherapy
47
What is neutrophilia?
Increase in absolute number of circulating neutrophils?
48
What are 3 possible causes of neutrophilia?
Infection Cancer Cytokines
49
What is neutropenia?
Reduction of neutrophils number
50
What are 3 consequences of neutropenia?
Severe life threatening bacterial infection Severe life threatening fungal infection Mucosal ulceration
51
What has to be done during neutropenic sepsis?
Give intravenous antibiotics
52
What are 2 main causes of neutropenia?
Reduced production or increased removal
53
What are 3 possible causes of reduced production of neutrophils?
B12 deficiency Aplastic anaemia Viral infection
54
What are 3 possible causes of increased removal of neutrophils?
Immune destruction Sepsis Splenic pooling
55
What are monocytes?
Macrophages in blood
56
What are 3 functions of monocytes?
Phagocytose Antigen presenting Defense against chronic bacterial infections
57
What is monocytosis?
Increase number of monocytes circulating in blood
58
What are 3 causes of monocytosis?
Bacterial infection Inflammatory conditions Carcinoma
59
What are 4 functions of eosinophils?
Immune response against multicellular parasites Mediator of allergy responses Granules contain cytotoxic proteins Phagocytose antigen antibody complexes
60
What are 3 common causes of eosinophilia?
Allergic diseases Drug hypersensitivity Parasitic infection
61
What are 2 functions of basophils?
Allergy reactions and inflammatory conditions | Release granules containing histamine, heparin, hyaluronic acid, serotonin
62
What are 3 types of lymphocytes?
B cells T cells Natural killer cells
63
What is the function of B cells?
Antibody forming cells
64
What is the function of T cells?
CD4+ and CD8+ helper cells
65
What is the function of natural killer cells?
Cell mediated cytotoxicity
66
What does packed cell volume show?
Proportion of blood made up of RBC - if too much = polycythemia, if too little = anaemia
67
What does red cell count show?
Number of RBC in blood - if too much = erythrocytosis, if too little = anaemia
68
What does mean cell volume show?
Mean size of RBC = show cause of anaemia
69
What does mean cell haemoglobin show?
Average measure of amount of Hb in each RBC, assesses cause of anaemia
70
What does mean cell haemoglobin concentration show?
Concentration of haemoglobin in RBC
71
What does red cell distribution width show?
Variation in size of RBC - assess cause of anaemia
72
What does reticulocyte count show?
Measure number of young erythrocytes
73
What does microcytic mean?
Small red cell size
74
What does macrocytic mean?
Large RBC
75
What does hypochromic mean?
Pale, less Hb per cell
76
What does hyperchromic mean?
Dense, more Hb in given volume

Metabolism, Endocrinology and Haematology (8 decks)

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