Week 3 formative tutorial

Question 1

what crises would require increased production of white cells

Answer 1

infection
surgery/trauma
cancer

Question 2

neutrophils function

Answer 2

innate (non-specific) immune system.
kill bacteria - phagocytose and release lysozymes that break down

Question 3

lymphocytes function

Answer 3

B cells - produce plasma cells releasing antibodies

T cells - cell-mediated immunity. bind to antigen. cytotoxic.

Question 4

monocytes

Answer 4

develop into macrophages that will gobble stuff.
similar function to neutrophils

Question 5

eosinophils role

Answer 5

release granules that destroy parasites.

atopic disease - asthma, dermatitis etc have eosinophilia

Question 6

basophils function

Answer 6

release histamine and inflammatory mediators

histamine vasodilates

Question 7

give examples of leucocytosis that is not reactive

Answer 7

malignancy of the white cells
- e.g. acute lymphoblastic leukaemia
- e.g. chronic lymphocytic leukaemia

Question 8

clonality definition

Answer 8

one single cell becomes malignant and all the cells it produces are the same

Question 9

why is pancytopenia potentially serious?

Answer 9

• neutropenic sepsis
• haemorrhage (because thrombocytopenia) - not worried until pretty low like below 50, 40, 30

Question 10

iatrogenic cause of pancytopenia

Answer 10

cytotoxic chemotherapy

Question 11

how does hypersplenism cause pancytopenia

Answer 11

more blood pools in the spleen because it’s big and the sinusoids are big

so much blood in the spleen that there is not so much circulating

Question 12

commonest cause of pancytopenia

Answer 12

megaloblastic anaemia- B12/folate deficiency

Question 13

malignant cause of pancytopenia

Answer 13

myelodysplastic syndrome - bone marrow not working properly.

Question 14

what does a haematocrit of 0.52 mean

Answer 14

52% of blood volume is red cells and the rest is plasma

Question 15

in true polycythaemia, what would drive the marrow to produce too many red blood cells

Answer 15

primary: myeloproliferative disorders. JAK2 mutation

others:

chronic hypoxia conditions like COPD. High altitude like people living in the Himalayas lol

tumours of the kidney leading to overproduction of erythropoietin

bodybuilders - testosterone abuse. testosterone promotes more red cell production in the bone marrow

Question 16

myeloproliferative disorders clinical presentation

Answer 16

headaches
blood vision
poor concentration
nosebleeds
red face
gout
hepatosplenomegaly

Question 17

why would we be concerned if there are too many red blood cells?

Answer 17

stroke

Question 18

how to reduce haematocrit

Answer 18

regular venesection until reduced below 0.45

can use a gentle chemo drug hydroxycarbamide

Question 19

what can myeloproliferative disorders transform to

Answer 19

myelofibrosis

AML

Question 20

what is the difference between thrombocytosis and thrombocytopenia

Answer 20

thrombocytosis - increase in platelets

thrombocytopenia - reduced number of platelets

Question 21

what are the two broad mechanisms whereby the bone marrow produces too many platelets

Answer 21

reactive (infection, inflammation, trauma, blood loss)

Clonal. (Primary clonal disorder - Myeloproliferative disorders)