Spleen, WBC and Cytopenia

Question 1

what does the spleen consist of

Answer 1

red pulp and white pulp

Question 2

what is red pulp

Answer 2

sinuses lined by endothelial macrophages where RBC are filtered

Question 3

what is white pulp

Answer 3

lymphoid follicles which give an active immune response due to their large amounts of B and T lymphocytes

Question 4

why can you get weight loss with an enlarged spleen

Answer 4

the spleen pressures of the stomach so it cant expand fully making you feel fuller easier

Question 5

give 4 functions of the spleen in adults

Answer 5

• phagocytosis of old RBC by macrophages
• blood pooling (platelets and RBCs can be mobilised rapidly)
• extramedullary haemopoiesis
• immunological function

Question 6

what causes splenomegaly

Answer 6

• portal hypertension
• overworking red/white pulp
• extramedullary haemopoiesis
• infiltrating cells (cancer or granulomas)

Question 7

what are the causes of massive, moderate and mild splenomegaly

Answer 7

massive = leukaemia, myleofibrosis. malaria 
moderate = portal hypertension, glandular fever 
mild = hepatitis, endocarditis, sarcoidosis

Question 8

what is hypersplenism

Answer 8

where pancytopenia or thrombocytopenia cause pooling of the blood giving an enlarged spleen

Question 9

what are the complications of splenomegaly

Answer 9

• rupture to form a haematoma

- parts of the spleen can be cut off from the blood supply causing areas of infarction

Question 10

what is hyposplenism

Answer 10

lack of functioning splenic tissue

Question 11

what causes hyposplenism

Answer 11

• splenectomy
• sickle cell
• coeliac

Question 12

what is seen histologically in hyposplenism

Answer 12

Howell Jolly Bodies (parts of DNA)

Question 13

what 3 organisms are people with hyposplenism particularly at risk of developing sepsis from

Answer 13

Pnemococcus, Haemophilius influenza and Meningococcus

Question 14

what is cytopenia

Answer 14

reduction in the number of blood cells

Question 15

what is leucopenia

Answer 15

reduction in WBC

Question 16

what is pancytopenia

Answer 16

reduction in RBC, WBC and platelets

Question 17

what gives more than 5 segments of a neutrophils nucleus

Answer 17

B12 deficiency

Question 18

what hormone controls neutrophil maturation

Answer 18

G-CSF which increases neutrophil production

Question 19

what can be administered to patients with neutropenia

Answer 19

recombinant G-CSF

Question 20

what causes neutrophillia

Answer 20

infection, tissue damage, inflammation, cancer, myeloproliferative diseases, drugs

Question 21

what is the neutrophil count in neutropenia

Answer 21

below 1.5x10*9

Question 22

what results in an increased removal of neutrophils

Answer 22

• immune destruction
• sepsis
• splenic pooling

Question 23

what causes a reduced production of neutrophils

Answer 23

• B12/folate deficiency
• infiltration of bone marrow
• empty bone marrow
• radiation
• drugs
• viral infection

Question 24

what is an empty bone marrow called

Answer 24

aplastic anaemia

Question 25

what are the consequences of neutropenia

Answer 25

• life threating bacterial and fungal infections
• mucosal ulceration
• neutropenic sepsis

Question 26

what are monocytes

Answer 26

cells found in the blood which differentiate into macrophages when they reach the tissues
- involved in phagocytosis and pinocytosis in response to inflammation and antigenic stimuli

Question 27

how long do eosinophils live

Answer 27

3-8 hours in circulation

8-12 days in tissues

Question 28

what do eosinophils do

Answer 28

• destroy parasites
• mediator of allergic response
• phagocytosis of antigens

Question 29

what causes eosinophilia

Answer 29

• allergic reactions
• drug hypersensitivity
• parasite infection
• leukaemia
• lymphoma
• myeloproliferative conditions

Question 30

what are basophils

Answer 30

cells active in allergic response and inflammation

Question 31

what do the granules in basophils contain

Answer 31

histamine, heparin, hyaluronic acid and serotonin

Question 32

what causes lymphocytosis

Answer 32

• viral infections
• bacterial infections
• post splenectomy
• leukaemia
  lymphoma

Question 33

what causes an increased removal of cells to give pancytopenia

Answer 33

• immune destruction
• splenic pooling
• haemophagocytosis

Question 34

what are the symptoms of pancytopenia

Answer 34

• RBC = fatigue, dizziness, chest pain, short of breath
• platelets = bruising, bleeding
• neutrophils = infection, ulceration, fevers