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IMS- Strand 4 > The Full blood count > Flashcards

The Full blood count Flashcards

1
Q

What is Anaemia?

A

Low Haemoglobin (Hb)

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2
Q

What is Polycythaemia/ Erythrocytosis?

A

High Hb & haematocrit

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3
Q

What is Leukopenia?

A

Low white cell count (WCC)

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4
Q

What is Leucocytosis?

A

High WCC

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5
Q

What is Thrombocytopenia?

A

low platelets (plts)

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6
Q

What is Thrombocytosis/ thrombocythaemia?

A

High plts

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7
Q

Generally we see low values of a cell if…

A
  • Increased destruction (e.g. splenomegaly)
  • Decreased production (e.g. cancer in bone marrow)
  • Relative loss affecting concentration (e.g. post IV fluids)
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7
Q

What is Pancytopenia?

A

Low Hb & WCC & plts

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8
Q

Generally we see high values of a cell if…

A
  • Reactive to inflammatory/ infective process (e.g. sepsis)
  • Increased production by a cancer (lymphoma/ leukemia/ myeloma/ polycythemia vera/ essential throbocythemia)
  • Relative increase if fluid loss (e.g. if dehydrated)
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9
Q

What are the 7 symptoms of anaemia?

A

Fatigue
Weakness
Pallor
Dizziness
Fainting
Shortness of breath (SOB)
Chest pain

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10
Q

What are the 3 main types of anaemia?

A

Microcytic
Normocytic
Macrocytic

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11
Q

What is Microcytic anaemia?

A

MCV= low
red blood cell is small

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12
Q

What is Normocytic anaemia?

A

MCV normal, normal RBC size
- Reticulocytes present
- Reticulocytes absent

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13
Q

What are reticulocytes?

A
  • Immature RBCs
  • Presence show the bone marrow is physically able to make red cells and has had the time to make red cells
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14
Q

What is Macrocytic anaemia?

A

MCV= high, large RBC
Megaloblasts present
Megaloblasts absent

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15
Q

What are megaloblasts?

A

Large RBCs
Haven’t been able to complete cell division

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16
Q

What is Microcytic anaemia caused by?

A
  • Iron deficiency (often due to chronic bleeding)
  • Thalassemia
  • May have cancer or problem with menstrual cycle
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17
Q

What is the cause of Normocytic anaemia when reticulocytes absent?

A

Aplastic anaemia (affects the bone marrow= not working properly)
Acute bleeding (sometimes retics increased)
Anaemia of chronic disease (sometimes microcytic)

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18
Q

What is the cause of Normocytic anaemia when reticulocytes present?

A

Haemolysis (heart valves, spherocytosis)
Sickle cell
G6PD deficiency

19
Q

What is G6PD?

A

enzyme you need to make glutathione which makes strong RBCs
Deficiency means you have weak RBCs

20
Q

What is the cause of Macrocytic anaemia when Megaloblasts are present?

A
  • B12 deficiency (can’t complete cell division)
  • Folate (B9) deficiency (both of which can be caused by alcohol)
21
Q

What is the cause of Macrocytic anaemia when Megaloblasts are absent?

A
  • Myelodysplastic syndrome
  • Liver disease (inc caused by alcohol- excess cell membrane due to defective cholesterol esterification)
22
Q

What is the treatment for anaemia?

A

FIX THE CAUSE
- Diet
- Vitamin replacement (Fe/B12/folate)
- EPO injection
- Blood transfusion

23
Q

What are the causes of Polycythaemia?

A

-Relative
- Absolute
Primary
Polycythemia Vera (JAK2 gene)= blood cancer
Secondary
Renal cell carcinoma
Exogenous EPO (EPO made in kidneys, could be caused by kidney cancer)

24
Q

What are the causes of Leukopenia? (5)

A
  • Cancer (esp those affecting bone marrow)
  • Cancer treatment (chem/ radiotherapy)
  • Other drugs (antipsychotics, carbimazole)
  • Viral infection (HIV)
  • Autoimmune conditions
25
Q

What are the 4 causes of Leukocytosis?

A

Raised neutrophils
Raised eosinophils
Raised lymphocytes
Very Raised lymphocytes

25
Q

In what cases should you be worried about Leukopenia?

A

Neutropenia (neutrophils very low)
Agranulocytosis (neutrophils very very low)

26
Q

What do raised neutrophils indicate?

A

Think bacterial infection

27
Q

What do raised eosinophils indicate?

A

Think allergy

28
Q

What do raised lymphocytes indicate?

A

Think viral infection

29
Q

What do very raised lymphocytes indicate?

A

Think malignancy

30
Q

What are the 3 cancers of white cells?

A

Leukemias
Lymphomas
Myeloma

31
Q

What are Leukemias?

A
  • Commonly present with raised WBC
  • Acute (AML, ALL)
  • Chronic (CML, CLL)
32
Q

What are Lymphomas?

A
  • Commonly presents with raised WBC
  • Hodgkin’s (presence of cells down microscope)
  • Non-Hodgkins
33
Q

What are Myelomas?

A

Solid tumour in the bone marrow

34
Q

What are the 4 causes of Thrombocytopenia?

A
  • Decreased production by marrow
  • Increased platelet sequestration
  • Dilutional
  • Increased platelet destruction
35
Q

What is decreased production by marrow caused by?

A

Malignancy
Myelofibrosis/ myelodysplasia
Nutritional deficiency

36
Q

What is increased platelet sequestration caused by?

A

Splenomegaly (portal hypertension due to cirrhosis)

37
Q

What is dilutional caused by?

A

Post blood transfusion
Pregnancy

38
Q

What is increased platelet destruction caused by?

A

Immune thrombocytopenic purpura (ITP)
Disseminated intravascular coagulation (DIC)
Thrombotic thrombocytopenic purpura (TTP) (ADAMTS13 gene)
Drug related (Chemo, quinine, NSAIDS, penicillin & anticonvulsants)

39
Q

What is Thrombocytosis/ thrombocythemia?

A

Raised platelets

40
Q

What are the causes of thrombocytosis?

A

Primary
- Essential thrombocythaemia (cancer)
Secondary/ reactive (>80%)
- Inflammation (autoimmune or infection)
- Drugs
- Surgery/ other trauma
- Haemolysis
- Iron deficiency

41
Q

What are the 3 key causes of Pancytopenia?

A

Reduced production
Increased destruction
Sequestration

42
Q

Why does reduced production cause Pancytopenia?

A
  • Replacement of marrow by fibrosis (myelofibrosis)
  • Replacement of marrow by tumour
  • Aplastic anaemia (often non cause found)
43
Q

Why does increased destruction cause Pancytopenia?

A

Sepsis

44
Q

Why does sequestration cause Pancytopenia?

A

Splenomegaly

IMS- Strand 4 (4 decks)

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