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Pathology 2220 > Week 4: Haematology > Flashcards

Week 4: Haematology Flashcards

1
Q

What is a full blood count?

A

A set of data that tells you information about the RBC, WBC, platelets and other blood components?

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2
Q

What are some important pieces of information to do with RBC?

A

Haemoglobin levels
Cell size (MCV: Mean Corpuscular Volume)
Number of cells
Haematocrit (% of blood that is cellular)

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3
Q

Why are bone marrow examinations performed?

A

To investigate blood count

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4
Q

What is Haematopoeisis?

A

The process of blood cell formation

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5
Q

__________ stem cells are the primitive precursor cells that differentiate under control of ___________ and ___________ to form blood cells

A

Pluripotent Stem cells

Growth Factors and Cytokines

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6
Q

What are the 3 components of coagulation (aka Virchow’s Triad)?

A

Clotting factors - circulating proteins
Platelets - derived from megakaryocytes
Endothelium - blood vessel lining

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7
Q

What is Haemostasis?

A

The process of stopping bleeding

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8
Q

Primary Haemostasis disorders are associated with _______________________.

A

Platelet malfunction

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9
Q

Secondary Haemostasis disorders are associated with _______________________.

A

Clotting factor malfunction

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10
Q

What are the primary Haemostasis disorders?

A

vWF Deficiency
Haemophillia
Platelet Dysfunction

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11
Q

What are the secondary Haemostasis disorders?

A 
DIC
Anticoagulation
Vitamin K Deficiency
Hepatic Failure
Renal Failure
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12
Q

What is Haemophilia A?

A

An inherited X-linked deficiency in Factor VIII that causes spontaneous or after trauma bleeding and bleeding into the joints (Haemarthroses)

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13
Q

How do we diagnose Haemophilia A?

A 
Family history (Females are carriers)
Factor VIII levels
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14
Q

How do we treat Haemophilia A?

A

Prophylaxis

Factor VIII replacement

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15
Q

What is Thrombocytopenia?

A

Low thrombocyte levels

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16
Q

What is Thrombocytosis?

A

Elevated thrombocyte levels, it has an increased risk of clotting

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17
Q

What is platelet dysfunction?

A

A disorder where you can’t aggregate your platelets

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18
Q

What is Thrombosis?

A

The formation of a blood clot that obstructs blood flow in a vessel

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19
Q

What are some causes of thrombosis

A 
Obesity
Oral contraceptives/Pregnancy
Prolonged immobility
Surgery
Malignancy
Inheritance
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20
Q

If you have type A blood you have __ antigens and __ antibodies

A

A

B

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21
Q

If you have type B blood you have __ antigens and __ antibodies

A

B

A

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22
Q

If you have type AB blood you have __ antigens and __ antibodies

A

A+B

No A or B

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23
Q

If you have type O blood you have __ antigens and __ antibodies

A

No A or B

A + B

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24
Q

Haemoglobin is made in the ____________

A

Mitochondria

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25
Q

___________ regulates RBC production. __% is made in the ________. It’s release is stimulated by __________.

A

Erythropoetin
90% made in the kidney
Low blood O2

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26
Q

What are the requirements for Erythropoeisis?

A

Iron, cobalt
Vitamin B12, folate, thiamine
Amino acids
Other cytokines

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27
Q

RBC are removed in the ________. Iron is stored as _______ and Globin is ________________. Haem is broken down to ________ which is excreted by the ________.

A

Spleen
Ferritin
Degraded to AAs
Billibrubin, excreted by the liver

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28
Q

Define Anaemia:

A

Reduction in haemoglobin, Also reduced red cell count & haematocrit:
Males:

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29
Q

What causes anaemia?

A

Reduced bone marrow production
Increased loss of RBC
Premature destruction (haemolysis)

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30
Q

What are the symptoms of anaemia?

A 
Shortness of breath
Fatigue 
Tachycardia / chest pain  
Generalised weakness
Pale:  mouth mucosa (Hb
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31
Q

Anisocytosis is?

A

Variation in red cell size

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32
Q

Poikilocytosis is?

A

Variation in RB cell shape

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33
Q

Hypochromasia is?

A

RBC are Pale (reduced colour)

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34
Q

Polychromasia is?

A

RBC have Many colours

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35
Q

Microcytic is?

A

Small red cells

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36
Q

Macrocytic is?

A

Large red cells

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37
Q

Schistocyte is?

A

Fragmented red cell

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38
Q

Spherocytes is?

A

Spherical red cell

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39
Q

Acanthocyte is?

A

Spiculated RBC membrane

40
Q

State the primary causes of anaemia related to reduced bone marrow production:

A

Bone marrow failure - erythropoeisis fails to occur

Red cell aplasia - erythropoeisis fails to occur properly

41
Q

State the secondary causes of anaemia related to reduced bone marrow production:

A 
Infection
Drugs
Infiltration 
Absence of “ingredients”
BM hypoxia
42
Q

How do we classify anaemia based on cell size?

A

Microcytic
Normocytic
Macrocytic

43
Q

What are some causes of microcytic anaemia?

A

Iron deficiency
Thalassaemia
Haemoglobinopathies
Anaemia of chronic disease

44
Q

What are some causes of normocytic anaemia?

A 
Blood loss
Haemolytic 
- RBC membrane
- Enzyme defects
- Extrinsic
Stem cell defects
45
Q

What are some causes of macrocytic anaemia?

A 
Megaloblastic
 Excess alcohol
 Liver disease
 Reticulocytosis
 Drug therapy
 Marrow failure
46
Q

What does a low reticulocyte count suggest?

A

Failure of Erythropoeisis

47
Q

What does a high reticulocyte count suggest?

A

Appropriate Bone marrow erythroid response

48
Q

What are the causes of Iron Deficiency Anaemia?

A

Poor iron intake
Poor iron absorption
Chronic blood loss (Gut, uterine bleeding (menorrhagia) )
Increased iron utilisation (Neonates; puberty; pregnancy)

49
Q

What is the Pathology of Iron Deficiency Anaemia?

A

Hypochromic and microcytic RBC with low MCV

50
Q

How do we treat iron deficiency?

A

Iron Supplementation or Intravenous/Muscular if severe continuing until levels normalise

51
Q

What are Haemoglobinopathies?

A

Genetic disorders of Hb synthesis that causes reduced or abnormal globin chains
i.e. Thalassaemia, Structural Haemaglobinopathies

52
Q

What is Thalassaemia?

A

Reduced production of α or β globin chains

53
Q

What are Structural Haemaglobinopathies?

A

Abnormal globin chain structure

i.e. HbS (Sickle Cell Anaemia)

54
Q

What is β-Thalassaemia?

A

Mutations in the β-globin gene which causes reduced β-globin chain production .’. reduced haemoglobin

55
Q

What are the 2 types of β-Thalassaemia?

A

Homozygous (thalassaemia major)

Heterozygous (thalassaemia minor)

56
Q

What is thalassaemia major?

A

Homozygous form of β-Thalassaemia:
– Inherited defective gene from both parents
– Present at 3-6 months with severe anaemia
– Transfusion dependent; bone marrow transplant

57
Q

What is thalassaemia minor?

A

Heterozygous form of β-Thalassaemia:

– Asymptomatic

58
Q

There are __ genes involved in making the α-globin chains.

A

4 genes

59
Q

What are the possible outcomes for α-Thalassaemia?

A

– α / αα and – α / – α = Τhalassaemia minor
– – / αα = Τhalassaemia minor
– – / – α = Haemoglobin H disease
– – / – – = Hb Barts hydrops fetalis

60
Q

Structural Haemaglobinopathies are ussually caused by _______________ that cause a __________________. They are most common in the __ chain.

A

Point Mutations
Structural Abnormality
β

61
Q

List the 3 most common types of Structural Haemaglobinopathies:

A

HbS: Occurs in Negro race;
βS gene
- Homozygous: HbS forms crystals: sickle shaped
RBC resulting in sickling crises (painful)

HbE: Thailand;
βE gene; target cells; common

HbC: West Africa;
βC gene; target cells

62
Q

Megaloblastic Anaemia is a type of _________ anaemia that is caused by _______________________________.

A

Macrocytic

Deficiency of Vitamin B12 or folate

63
Q

List some possible causes of Megaloblastic Anaemia other that B12/Folate deficiency:

A

– Liver disease
– Excess alcohol consumption
– Hypothyroidism
– Drug effects (e.g. chemotherapy drugs)

64
Q

What is the pathology of Megaloblastic Anaemia?

A

• high MCV
• Hypersegmented neutrophils
• Hypercellular bone marrow
• Reduced serum vitamin B12 or RBC folate
• Intrinsic factor or Parietal cell antibodies (auto-
antibodies)

65
Q

What is Normocytic Anaemia and what causes it?

A

Anaemia where the MCV is normal 80fL

66
Q

Hereditary Haemolytic Anaemia can be caused by:

A

Red cell membrane defect

Biochemical (enzyme) defect

67
Q

Acquired Haemolytic Anaemia can be caused by:

A 
Immune haemolytic anaemia (antibodies) 
Drugs
“Hole in the heart” fracturing red cells
Multi-organ failure: kidney, liver 
Infections: malaria, Clostridial sepsis
68
Q

RBC in Haemolytic anaemia are _________ they are ______ and have ____________.

A

Spherocytes

Small and have lost their central palour

69
Q

Leukocytes can be classed as __________ or ________ and have an absolute count of ________.

A

Phagocytes or Leukocytes

4 - 11 x 10^9

70
Q

Summarise Neutrophil Specs:

A 
40-75% of WBC (count = 2.5-7.5 x10^9/L)
Develop from primitive myeloblast in BM
– Neutrophil migrates to tissue: Phagocytic function 
– Acquire specific granules
– 2-5 nucleus segments 
– 6-10 hrs in blood
71
Q

Summarise Eosinophil Specs:

A

1-5% of leucocytes (0.1-0.4 x10^9/L)
• 2-lobed nucleus; large orange granules
• Circulation time 3-8 hours
• Involved in allergy, parasitic infection

72
Q

Summarise Basophil Specs:

A
73
Q

Summarise Monocyte Specs:

A
  • 2 - 8% of white cells (0.2-0.8 x10^9/L)
  • Maturation from monoblast
  • 20 -40 hrs in blood
  • Mature to macrophage in tissue (mths-yrs)
  • Grey cytoplasm; horseshoe-shaped nucleus
  • Produce cytokines
74
Q

With respect to leukocytes these mean?

  • cytosis
  • phillia
  • cytopenia
A

Increased numbers
Increased numbers
Decreased numbers

75
Q

List some reactive White Cell disorders

A

– Neutrophilia and neutropenia
– Lymphocytosis
– Monocytosis
– Eosinophilia

76
Q

List some malignant White Cell disorders

A

– Leukaemias: acute and chronic
– Multiple myeloma
– Lymphoma
– Myeloproliferative neoplasms

77
Q

Neutropillia is _______________________. It is usually caused by _________________________________________.

A

Increase in neutrophil count ( >8x10^9 )

Infection, Fever, Inflammation, Steroid therapy and neoplasms

78
Q

Neutrophillia is often accompanied by left shift, which is __________________________________, and toxic granulation, which is _________________.

A

Presence of precursor neutrophils in the blood

Increase in granules

79
Q

What are some causes of Neutropenia?

A

Congenital (rare
Drug-induced: Antibiotics; cytotoxics
Infections: Viral or bacterial
Bone marrow failure (pancytopenia)

80
Q

Neutropenia is associated with an increased risk of __________ and ________________________, especially in the _______ and _______.

A

Severe and recurrent Bacterial Infection
Mouth
Throat

81
Q

Lymphocytosis is commonly secondary to _________________. The morphology of the cells is ________.

A

Viral Infections

Altered

82
Q

Monocytosis is _________ and is caused by ____________________, _________ and _______.

A

Uncommon

Chronic infections, Tuberculosis and Malaria

83
Q

Eoisinophillia is common in ________ and ________ reactions and __________________.

A

Allergic and Drug Reactions

Parasite infection

84
Q

Basophillia is very ________ as it is a manifestation of ________________________.

A

Rare

Chronic myeloid leukaemia

85
Q

What is acute leukaemia?

A

Malignancy of the Precursors in the bone marrow, bone marrow gets replaced by leukaemic cells which causes a reduction in normal cells

86
Q

Leukaemia blast cells ____________ but do not __________.

A

Proliferate

Mature

87
Q

What are the 2 types of acute leukaemia?

A

Lymohoblastic ALL

Myeloblastic AML

88
Q

Acute leukaemia affects ________. Lymphoblastic leukaemia predominately affects ___________.

A

All ages

Children

89
Q

What are the symptoms of acute leukaemia?

A 
Anaemia = Lethargy etc
Leucopenia = Infections, fevers
Thrombocytopenia = Bleeding, bruising
90
Q

How do we treat acute leukaemia?

A

Aggressive Chemotherapy and Bone Marrow Transplant

91
Q

B-Lineage ALL is the commonest in _________ (__% of cases). It is characterised by ______________. It has a poor prognosis for ________ and good prognosis for ________.

A

Children 85% of cases
Small “blast” cells
Adults
Children

92
Q

What is Acute Myeloblastic Leukaemia and how do we treat it?

A

A clonal defect in the myeloblast

Treated with Chemotherapy and Transplantation

93
Q

What is Chronic Leukaemia?

A

Malignant proliferation of mature lymphoid

or myeloid cells

94
Q

What are the 2 types of Chronic Leukaemia?

A

Chronic lymphocytic leukaemia

Chronic myeloid leukaemia

95
Q

Summarise Chronic lymphocytic leukaemia:

A

Disease of the elderly >60yo
Malignant proliferation of mature B lymphocytes
Progressive anaemia, thrombocytopenia & neutropenia
Treated with oral chemotherapy

96
Q

Summarise Chronic myeloid leukaemia:

A

Disease of the middle ages 30-60yo
Characterised by:
• Leucocytosis: neutrophilia and precursors
• Blast cells (

Pathology 2220 (10 decks)

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