The Full Blood Count

Question 1

How is the blood counted?

Answer 1

analyser assess cells by firing laser at them. The forward and side scatter gives detail about size and granules

Question 2

What is in the full blood count?

Answer 2

Haemoglobin

• Haematocrit
• Red blood count
• Mean cell volume
• MCH
• MCHC

Reticulocyte count
White blood count (+ differential)
Platelet count

Question 3

What is anisocytosis?

What is poikilocytosis?

Answer 3

• all different sizes

- all different shapes

Question 4

What are ancanthocytes?

Answer 4

Irregularly shaped cells, sometimes spikey

Question 5

What are target cells?

What are tear drop cells?

Answer 5

XS membrane, appear as a target, coming in liver disease and Hbopathy
Bone marrow problem,

Question 6

How do hypo chromic red blood cells appear?

Answer 6

darker ring of red is thinner

Question 7

What are the two main types of polycythaemia?

How can one of these be further classified?

Answer 7

Relative
Absolute
- primary (symptoms/signs, complications, treatments)
- secondary (appropriate/innapropriate)

Question 8

What’s in white cell differential count?

Answer 8

Granulocytes (polymorphonuclear cells)
- neutrophiles
- eosinophils
- basophils
Mononuclear cells
- lymphocytes
- monocytes

Question 9

Function: neutrophil

Answer 9

phagocytose and destroy (mostly bacteria)

Question 10

Function: eosinophil

Answer 10

phagocytose and destroy (also parasites)

Question 11

Function: basophil

Answer 11

Immediate hypersensitvity (IgE bind and release histamine and leukotrienes)
Modulate inflammatory response

Question 12

Function: lymphocyte

Answer 12

T cells (CD4/8) regulate B cells, kill virus/fungi/mycobacterial-infected cells, delayed hypersensitivity
B cells produce antibody and produce antigen
NK cells lyse ab-coated cells, kill tumour and virus-infected cells w/out abs

Question 13

Function: monocyte

Answer 13

Phagocytose and destroy

Antigen presenters

Question 14

What are the causes of neutrophilia?

Answer 14

Reaction - infective/non-infective
Tissue infarction
Demargination
Malignant i.e. chronic myeloid leukaemia
Physiological e.g. pregnancy

Question 15

What are the causes of neutropenia?

Answer 15

Ethnic neutropenia
Congenital neutropenia
Cyclical neutropenia
Reactive, especially viral
Bone marrow infiltration 
B12/folate deficiency
Immune
Drugs

Question 16

List the ways in which lymphocyte numbers are changed?

Answer 16

• gene rearrangements
• clonal deletion in the thymus
• selection clonal expansion in secondary in secondary lymphoid tissue
• cell death by apoptosis (active/passive)

Question 17

List some lymphoproliferative disorders

Answer 17

lymphoma or lymphocytic leakaemia
chronic lymphocytic leukaemia 
- most common
- frequency increases with age
- often asymptomatic
- can be controlled with chemo
- associated with B symptims and lymphadenopathy

Question 18

List the things that can lead to too many/few lymphocytes

Answer 18

Too many
- smoking
- splenectomy
- infection
- lymphoproliferative disorders 
Too few
- reactive
- drugs
- congenital immunodeficiency
- HIV

Question 19

What can cause thrombocytopenia?

Answer 19

immune thrombocytopenic purpura
consumption of DIC, TTP, HELLP
splenomegaly
alcohol
liver diseaase
bone marrow infiltration
drugs 
familial
von Willebrands disease type 2B

Question 20

What can cause XS platelets?

Answer 20

reactive: infection/inflammation/infarction
splenectomy
iron deficiency
bleeding
myeloproliferative disorders e.g. essential thromocythemia