T3 - Clinical haematology Flashcards

1
Q

what is the only blood cell that has a nucleus?

A

white blood cells

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2
Q

what are the five types of WBCs?

A

neutrophils, basophils, eosinophils, lymphocytes and monocytes

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3
Q

what three things may cause leucocytosis (high WBCs)

A

infection, post operative and leukaemia

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4
Q

what four things may cause leucopenia (low WBCs)?

A

chemo, drugs, severe infection or immune disorders

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5
Q

what proportion of WBCs do neutrophils make up?

A

70%

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6
Q

what % of WBC to lymphocytes make up?

A

20%

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7
Q

what two ways can coagulation be assessed by?

A

FBC to measure plats then coagulation screen to measure clotting factors

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8
Q

what happens to RBCs after 100 days?

A

they are broken down to HB and iron then the iron is transported back to the BM to be recycled

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9
Q

what can affect the recycling of iron?

A

chronic bleeding - iron is lost and cant be recycled

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10
Q

what does the erythrocyte sedimentation test show and how does it work?

A

if there are increased levels of plasma protein in the blood

  • works as usually RBCs repel each other as they are negatively charged but increased plasma protein levels cancel out the negative charge (as they are positive) so the RBCs stack up
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11
Q

compared to adults - what different proportions of blood cells do children have?

A
  • less Hb

- more lymphocytes than neutrophils as they are still building memory

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12
Q

what are the characteristics of babies blood cells that are different to adults?

A

high Hb, RBCs, PCV and WBC levels

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13
Q

what are three causes of normocytic anaemia?

A

acute blood loss, anaemia of chronic disease and renal failure

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14
Q

what are the clinical symptoms of microcytic anaemia?

A
  • pallor
  • dyspnoea
  • lethargy
  • glossitis
  • pale conjunctiva
  • kolinychia
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15
Q

what the the appearance of RBC in microcytic anaemia?

A

low MCV and hypo chromic

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16
Q

what cause are two causes of microcytic anaemia?

A

iron deficiency and thalassemia

17
Q

how can thalassemia be characterised on a blood film?

A

nucleated ‘target’ cells

18
Q

how is microcytic anaemia treated?

A

with transfusions

19
Q

what causes macrocytic anaemia?

A

B12/folate deficiency or alcoholic liver disease

20
Q

what is seen in megaloblastic anaemia and what causes it?

A

large cells with a large nucleus (DNA is affected) caused by B12/folate deficiency

21
Q

what is seen in non megaloblastic anaemia and what causes it?

A

large cells with a normal sized nucleus - cells are filled with lipid and is caused by alcoholic liver disease

22
Q

what are the clinical symptoms of B12/folate deficiency?

A
  • weight loss
  • fatigue
  • dementia
  • glossitis
  • jaundice
  • neurological symptoms
23
Q

what is the problem in anaemia that causes lack of production of red cells?

A

BM problem

24
Q

what is seen in anaemia that causes increased destruction of red cells?

A

high reticulocyte levels

25
Q

what can thrombocytopenia caused by decreased production of plats be caused by and how is it treated?

A

caused by BM damage, alcohol or haematological malignancy and treated with plat transfusions

26
Q

what can thrombocytopenia caused by increased destruction of plats be caused by

A

autoantibodies - can be congenital

27
Q

what happens in primary thrombocythaemia?

A

too many plats are produced - pre leukaemia state where precursors proliferate out of control

28
Q

what happens in secondary thrombocythaemia?

A

reactive due to infection, inflammation or haemorrhage

29
Q

name five things that can cause lymphocytosis (high lymphocyte numbers)

A
  • viral infections eg mono, chickenpox and measles
  • stress eg post MI
  • vigorous exercise
  • smoking
  • CLL
30
Q

name five things that can cause lymphocytopenia (low lymphocytes)

A
  • acute stress eg post op or trauma
  • acute or chronic renal failure
  • carcinoma
  • HIV/AIDS
  • cytotoxic therapy
31
Q

how is acute leukaemia characterised?

A
  • death in weeks if untreated
  • affects primitive cells
  • complete inhibition of maturation but lots of proliferation therefore patients lack normal cells
  • high WBC count but immature and non functional
32
Q

how is chronic leukaemia characterised?

A
  • death if untreated in months or years
  • lots of proliferation but maturation isn’t inhibited
  • lots of mature myeloid and lymphoid cells
33
Q

what type of cells does CML affect?

A

premature neutrophils

34
Q

what type of cells does ALL affect

A

lymphoid stem cells

35
Q

what type of cells does CLL affect

A

mature lymphocytes

36
Q

what type of cells does AML affect

A

myeloid stem cells