week 1 (anaemia, transfusion etc)

Question 1

if in anaemia there is raised reticulocyte response what does this mean?

Answer 1

its haemolysis or blood loss

Question 2

what size of blood cells are the hypoproliferative ones

Answer 2

normocytic

Question 3

if there is abnormal maturation, what are the sizes of the RBCs

Answer 3

microcytic or macrocytic

Question 4

causes of macrocytosis

Answer 4

-alcohol
-liver disease
-hypothyroidism
-pregnancy
-neonatal
-reticulocytosis
-megaloblastic erythropoiesis (B12 or folate deficiency)
-myelodysplasia (stem cell mutation)

Question 5

if the MCV is over 120 what is usually the cause?

Answer 5

B12 or folate deficiency

Question 6

if the platelets or neutrophils are low in macrocytosis what is usually the cause

Answer 6

myelodysplasia or megaloblastic

Question 7

macrocytosis cause if hypersegmented neutrophils and oval macrocytes

Answer 7

megaloblastic

Question 8

macrocytosis cause if dysplastic neutrophils

Answer 8

myelodysplasia

Question 9

is macrocytosis always associated with anaemia

Answer 9

no

Question 10

causes of microcytic anaemias

Answer 10

defects of globin synthesis
-thalassaemia disorders

defects of haem synthesis
-iron deficiency
-defective prophyrin synthesis (sideroblastic anaemias)

Question 11

how do you measure functional iron

Answer 11

Hb concentration

Question 12

how do you measure storage iron

Answer 12

-serum ferritin
-bone marrow biopsy with Perls’ stain

Question 13

how do you measure transport iron

Answer 13

serum transferrin (% saturation with iron)

Question 14

which is used up first in low red cell conditions, the storage iron or transport iron

Answer 14

storage iron is exhausted before transport iron is affected and only then is red cell production reduced

Question 15

causes of iron deficiency

Answer 15

-reduced dietary iron
-increased physiological requirements
-blood loss
-malabsorption- jejunum, need gastric acid

Question 16

what does reticulocytosis occur in response to

Answer 16

increased erythropoietin production

Question 17

how soon does reticulocytosis occur after a bleed

Answer 17

1-2 days

Question 18

how much should reticulocyte count increase by in response to marked anaemia

Answer 18

should increase by 6-8 fold

Question 19

signs of shock

Answer 19

-tachycardia
-hypotension
-peripheral vasoconstriction (pallor)

Question 20

types of reactions of incompatible transfusions

Answer 20

-febrile non-haemolytic due to white cell antibodies or hypersensitiviy to donor plasma proteins
-immediate or delayed haemolytic reactions
-infection transmission
-fluid overload (short term)
-iron overload (long term)

Question 21

what are the 3 elements to cross matching blood

Answer 21

-ABO
-RhD antigen
-alloantibodies

Question 22

what are alloantibodies

Answer 22

antibodies in the patient to antigens that might be on the donor red cells

Question 23

what should be done if an alloantibody is identified in a patient

Answer 23

check donor unit is negative for that antigen

Question 24

what is the final check in blood crossmatch

Answer 24

mix donor cells and recipient plasma