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Advanced Haematology > Week 8 > Flashcards

Week 8 Flashcards

1
Q

In neonates it is normal to see NRBC before day ____ after that it would suggest haemolysis, hypoxia or infection

A

5

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2
Q

In neonates is the RDW elevated or decreased?

A

Elevated RDW at birth

Anisocytosis on film

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3
Q

Do Neonates have a high or low haematocrit in days after birth?

A

High

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4
Q

In neonates at birth is the WBC elevated or decreased

A

Elevated - Wide reference range

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5
Q

What are the Vit K dependent factors?

A
  • II, VII, IX & X

* Protein C, S & Z

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6
Q

Do elderly people have similar or lower tolerance of anaemia?

A

Lower

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7
Q

At birth, what is extremely cellular?

A

red marrow

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8
Q

At birth what lineages are multiplying and differentiating

A

all

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9
Q

In a full term infant there is little scattered haemopoiesis in ______ which ceases soon after birth

A

liver

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10
Q

Extra-medullary haemopoiesis may be common in ________ liver, spleen, lymph nodes, thymus

A

pre-term babies

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11
Q

What type of Hb predominates at birth

A

Hb F (alpha 2 + Gamma 2)

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12
Q

What type of Hb predominates from 2-adulthood?

A

Hb A1 (Alpha 2 + Beta 2)

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13
Q

Full term =
Premature/Preterm =
Postterm =

A

37 -42 weeks gestation
<37 weeks gestation
>42 weeks gestation

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14
Q

In newborns does the Hb and MCV begin high or low?

A

high

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15
Q

Ranges for pre-term infants depends on what two things?

A

level of prematurity and birth weight

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16
Q

Neonatal (≤ 4weeks) haematological values are affected by:

A 
o Gestational age
o Birth weight
o Age after delivery
o Presence of illness
o Sampling site (Capillary, venous or arterial)
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17
Q

What causes “Polycythaemia of the newborn”

A

• Degree of hypoxia in utero stimulates increased erythropoietin

18
Q

Following birth, oxygenation increases which suppresses what?

A

Suppresses erythropoietin level

19
Q

In newborns erythrocytes are macrocytic until day ___
Orthochromatic normoblasts in film until around day ____ (Persist longer in premature infants)
NRBC after day _____ suggests haemolysis, hypoxia or infection

A

5, 3, 5

20
Q

Capillary samples may have higher _____ and _____than venous

A

Hb, and Hct

21
Q

The more premature the baby the higher the MCV or lower?

A

Higher

22
Q

Is the RDW raised or lowered in newborns?

A

Elevated

23
Q

At birth is the WCC elevated or lowered? Which white cell predominates? Are there increased band forms?

A

Elevated WCC
Predominance of neutrophils
Yes - Increased band forms

24
Q

Would you expect to se a greater left shift with prematurity?

A

Yes • Myelocytes, metamyelocytes, band forms

25
Q

What would indicate an infection in neonates?

A

Neutropenia or neutrophilia, vacuoles, hypergranulation, dohle bodies

26
Q

Describe why neonates should get a vit K injection.

A

Neonates have ~ 30% of adult levels of Vit K dependent factors
• because their intestines have not been colonised by bacteria needed to synthesize Vit K
• Vit K poorly transported across placenta (stores depleted quickly after birth)
• human breast milk contain relatively low conc of vit K
→Risk vit K deficiency bleeding (VKDB)
Reach adult values around 2 to 6 months

27
Q

What is the most common cause of anaemia in children?

A

iron deficiency

28
Q

Most cases of Haemolytic Uraemic Syndrome are associated with what?

A

Shigella dysenteriae or E. coli O157:H7 infection in gut

29
Q

In children Haemolytic Uraemic Syndrome resembles what other condition?

A

Thrombotic Thrombocytopenic Purpura (TTP)

30
Q

What are the 5 main features of HUS and TTP

A
  • fever
  • anaemia (microangiopathic haemolytic anaemia)
  • thrombocytopenia
  • renal problems more in HUS
  • neurological problems more in TTP
31
Q

Which White Blood Cell has decrease in function and which functions are affected?

A

Neutrophil function : chemotaxis, phagocytosis, superoxide generation

32
Q

B cells rely on _____ interaction to produce antibodies.

A

T cell

33
Q

What are the contributing factors of anaemia in the elderly.

A 
Contributing factors: 
• ↓ BM function
• ↓ physical activity
• Nutritional deficiencies
• Cardiovascular Disorders
• Chronic inflamm disorder
34
Q

Anaemia of chronic inflammation depends on severity of underlying disease what can happen to the RBC’s?

A

▪ Proinflammatory cytokines may impair erythropoiesis

▪ ↓ RBC survival

35
Q

Iron deficiency anaemia in the elderly is often associated with what other conditions? (6)

A 
▪ Chronic GI bleed
▪ Long term use of NSAID
▪ Gastritis
▪ Peptic ulcer
▪ Colon cancer
▪ May be asso with poor diet
36
Q

Do plasma concentrations of many coagulation factors increase or decrease with aging?

A

Increase

Incidence of venous thromboembolism (VTE) ↑ with aging.

37
Q

What does HELLP syndrome stand for?

A

(Haemolysis, Elevated Liver enzymes, Low Platelet count)

38
Q

What are some common causes of DIC in obstetrics? (6)

A 
Amniotic fluid embolism
HELLP syndrome
Pre-eclampsia
Placental abruption
Septic abortion
Postpartum haemorrhage
39
Q

What is the most severe form of Haemolytic Disease of the New Born and what is the most common?

A

Rh HDNB is most severe (IgG Ab)

ABO HDNB – more common but less severe (mostly IgM Ab)

40
Q

How does pregnancy affects RBC and WBC?

A

Decreased Hb - no symptoms

Increased WBC, mostly neutrophils, may have hypergranulation & left shift

Advanced Haematology (13 decks)

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