Week 4: Disorders of Blood Flashcards
What does MCV mean
Is the actual volume of the average red blood cell
Macrocytic is larger than normal, microcytic is smaller than normal
what does haematocrit mean
Is the ratio of RBC volume to the total blood volume
The actual packed cell volume
what is MCH
volume of the average Haemoglobin
What are the 4 types of defiency anaemia?
Iron defiency
Megaloblastic anaemia
Anaemia of chronic disease
aplastic anaemia
what are the 2 types of increased destruction anaemia?
blood loss anaemia
haemolytic (autoimmune) anaemia
Iron Defiency Anaemia
Comment on RBC, WBC and PLT count.
Comment on MCH and MCV
Comment on the appearance of the RBC
decrease RBC, normal WBC and PLT count
Decreased MCH and decreased MCV
Microcytic and hypochromic

Explain the pathogenesis of iron defiency anaemia
decreased iron –> decreased Hb production –> decreased RBC size –> decrease RBC O2 carrying
what are the clinical features of iron deficient anaemia?
glossitis (inflamation of tongue)
stomatitis (inflammation of lips and stomach)
koilonychia (abnormally thin nails)
what are the causes of iron deficient anaemia
Main cause is bleeding (in developing countries this is caused by worms / infections, in developed countries cancers etc.)
Can also occur through poor nutrition
Megaloblastic anaemia
Comment on RBC, WBC and PLT count.
Comment on MCH and MCV
Comment on the appearance of the RBC
Decrease RBC, WBC and PLT count (pancytopenia)
increase MCH and MCV
Macrocytic and Normochromic
Explain the pathogenesis of megaloblastic anaemia
Is caused by Vitamin B12 and Folate deficiency which diminishes the ability of the blast cell to replicate DNA and divide (thus a deficiency will cause extremely large RBCs, in a diminished amount)
what are the clinical features of megaloblastic anaemia?
Mild jaundice
Glossitis (inflammation of tongue)
Chelitis (inflammation of lips)
Stomatitis (inflammation of mouth and lips)
What are the causes of megaloblastic anaemia?
Lack of an adequate diet
Can also be from GIT disorders and cancer therapies
Aplastic anaemia
Comment on RBC, WBC and PLT count.
Explain the pathogenesis
What are the causes for it
Decrease RBC, WBC and PLT (pancytopenia)
Caused by the stem cell not producing erythroblasts
idiopathic (could be from viral)
Haemloytic Anaemia (autoimmune)
What are the two types of this anaemia? and what causes them?
what are the clinical features of this anaemia
Comment on the MCH and MCV
Comment on the RBC, WBC and PLT count
Acquired
Immune response
Drugs
Infections
Congenital
Membrane abnormality (hereditary spherocytosis [HS])
Haemoglobin abnormality (sickle cell anaemia, thalassemia)
Enzyme abnormality (G6PD deficiency)
All of these affect young children, as foetal haemoglobin turns into adult haemoglobin and show severe anaemia and jaundice, splenomegaly (caused by breakdown of RBCs in spleen)
Clinical features of Haemolytic anaemia include;
Jaundice (which is caused by the breakdown of RBCs, which releases Hb, which breaks down into bilirubin (causing the yellowing of the skin)
Marrow expansion (as a response to RBC loss)
Haemolysis
Decreased MCH and MCV
Pancytopenia
Comment on the appear of the RBC and other morphological features involved in haemolytic aneamia?
Abnormal RBC shape (Spherocytes [no central pallor] in immune, target form in thalassemia, sickle cells etc.)
Reticulocytes (which are immature RBCs. They are large and bluish)
Nucleated RBCs (nucleus within reticulocyte)
Low haptoglobin (Hb carrier protein, so as soon as the RBC break down it grabs onto it and takes it to the urine
define neutrophilia
increased neutrophil count
Explain the pathogenesis of leukemia
This is a cancer of the blast cells within the bone marrow, which results in continuous replication of the blast cells forming excess WBCs
Lymphoid leukaemia: which is caused by a mutation within the lymphoid stem cells
Myeloid Leukaemia: which is caused by a mutation within the myeloid stem cells
cancer cells fill up the bone marrow, causing destruction and impeding production, decreasing all other haemopoiesis

what are the 4 types of leukemia
Acute: is used when the cells are dividing so fast, that they don’t have time to mature generating only blast cells, occur in the younger ages (kill patients fast)
Chronic: leukaemia’s refers to when the blast cells mature and progress slowly, occur in the older ages (kill the patients slowly)
Can have lymphoid or myeloid there we can have these 4 types of anemia:
Acute Lymphocytic Leukaemia (common in the young children)
Acute Myeloid Leukaemia (common in adults)
Chronic lymphocytic Leukaemia (common in the old)
Chronic myeloid leukaemia (common in the old)
what is lymphoma?
Is a type of cancer of the lymphoid tissue, that produces solid tumours (unlike leukaemia’s)
Lymph nodes turn hard, and enlarge significantly
Define anaemia
decrease RBC mass that affects tissue oxygenation
What anaemia has decrease MCV and MCH with a microcytic appearance of RBC
iron deficient anaemia
what anaemia has abnormal RBC shape, increased reticulocytes, nucleated RBCs and low haptoglobin
haemolytic anaemia
what are 2 causes for megaloblastic anaemia
poor diet and GIT disorders
pathogenesis of sickle cell anaemia
abnormality in Hb which distorts RBC shape
list 3 common causes for neutrophilia
actue injury
inflammation
bacterial infeciton
what is the difference between neutrophilia and leukemoid reaction?
neutrophilia is from acute injury, inflammation ofr bacterial infeciton whereas leukmoid reaction is from severe infection resulting in excessive stimulation of bone marrow
what organs does leukemia travel to
Spleen, liver and lymphnodes
causes enlargement of these organs
What is the pathology of thrombocytopenia
decreased platelet count –> leads to easy bleeding
Which factors deficiency does Haemophilia A and B lead to
8 and 9
What are 3 major groups of bleeding disorders?
haemophilia a and b
vWF disease
thrombocytopenia
What are 3 factors which contribute to thrombosis?
- stasis of blood flow
- Hypercoagubility
- Endothelia injury
why are diabetes, hypertension and cardiovascular disease patients prescribed ‘low does asprin’ for life?
decrease risk of cardiovascular disease, decrease fever, aches and headaches
prevents platelets in blood from clumping and blocking arteries