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ESA2 - Metabolism, Endocrinology and Haematology > The Spleen, White Cells, Cytopenia > Flashcards

The Spleen, White Cells, Cytopenia Flashcards

1
Q

What does the spleen consist of?

A

Red pulp - sinuses lined by endothelial macrophages and cords

White pulp - similar structure to lymphoid follicles

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2
Q

How does blood enter the spleen?

A

Via the splenic artery

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3
Q

When blood enters the spleen, what do red cells preferentially pass through?

A

Red pulp

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4
Q

When blood enters the spleen, what do white cells preferentially pass through?

A

White pulp

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5
Q

What are the functions of the spleen in adults?

A

1) Sequestration and phagocytosis - old/abnormal red cells removed by macrophages
2) Blood pooling - platelets and red cells can be rapidly mobilised during bleeding
3) Extramedullary haemopoiesis
4) Immunological function - 25% of T cells and 15% of B cells present in the spleen

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6
Q

Why would the spleen grow?

A 
Overworking red/white pulp
Back pressure - portal hypertension in liver disease
Extramedullary haemopoiesis
Infiltrated by cancer cells
Sarcoidosis
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7
Q

What are some causes of hyposplenism?

A

Splenectomy, sickle cell disease, coeliac disease

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8
Q

What does the blood film of a patient with hyposplenism show?

A

Howell Jolly bodies (DNA remnants) - purple dots

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9
Q

What are patients with hyposplenism at risk of?

A

Overwhelming sepsis, particularly from encapsulated organisms (eg pnemococcus, haemophilus influenzae, meningococcus)

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10
Q

What is cytopenia?

A

Reduction in the number of blood cells

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11
Q

What is leucopenia?

A

Low white cell count

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12
Q

What is neutropenia?

A

Low neutrophil count

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13
Q

What is thrombocytopenia?

A

Low platelet count

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14
Q

What is the term for low red cells, white cells and platelets?

A

Pancytopenia

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15
Q

What is the term for a high red cell count?

A

Erythrocytosis

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16
Q

What is the term for a high white cell count?

A

Leucocytosis

17
Q

What is the term for a high neutrophil count?

A

Neutrophilia

18
Q

What is the term for a high lymphocyte count?

A

Lymphocytosis

19
Q

What is the term for a high platelet count?

A

Thrombocytosis

20
Q

What is the commonest white cell?

A

Neutrophil

21
Q

What hormone controls the production of neutrophils?

A

G-CSF

22
Q

What could be used to treat severe neutropenia?

A

Recombinant G-CSF

23
Q

What defines neutropenia?

A

<1.5x10^9/L

Severe if <0.5

24
Q

Broadly speaking, what could cause neutropenia?

A

Reduced production, increased removal or use (eg immune destruction, sepsis, splenic pooling)

25
Q

What things could cause reduced production of neutrophils?

A

B12/folate deficiency, bone marrow malignancy, aplastic anaemia, radiation, drugs (eg chemotherapy), viral infection, congenital disorders

26
Q

What do lysosomes in monocytes/macrophages contain?

A

Lysozyme, complement, interleukins, arachidonic acid,

27
Q

What things could cause monocytosis?

A

Chornic inflammatory conditions, chronic infection, carcinoma, leukaemias

28
Q

What do granules in eosinophils contain?

A

Arginine, phospholipid, enzymes

29
Q

What could cause eosinophilia?

A

Allergic diseases, parasitic infection, skin diseases, hodgkin lymphoma, acute lymphoblastic leukaemia, eosinophilic leukaemia etc

30
Q

What are the least common, but largest white cells?

A

Basophils

31
Q

What are basophils active in?

A

Allergic reactions and inflammatory conditions

32
Q

What do the granules in basophils contain?

A

Histamine, heparin, hyaluronic acid, serotonin

33
Q

What things could cause basophilia?

A

Hypersensitivity, UC, RA, CML, mastocytosis

34
Q

What could cause lymphocytosis?

A

Viral infections, bacterial infections (especially whooping cough), post splenectomy, smoking, CLL, lymphoma

35
Q

What is aplastic anaemia?

A

Pancytopenia with hypocellular bone marrow in the absence of an adnormal infiltrate and with no increase in reticulin (fibrosis)

ESA2 - Metabolism, Endocrinology and Haematology (19 decks)

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