35 - Haematology Intro

Question 1

Types of haemopoietic stem cell self-renewal

Answer 1

Symmetric
Asymmetric
Lack of self-renewal x2

Question 2

Symmetric self-renewal

Answer 2

Increases stem cell pool

No differentiated progeny

Question 3

Asymmetric self-renewal

Answer 3

Maintain stem cell pool

Generation of differentiated progeny

Question 4

Lack of self-renewal

Answer 4

No stem cell pool

Either generation of differentiated progeny or nothing at all

Question 5

Haemopoietic lineages

Answer 5

Myeloid - granulocytes (WBC), erythrocytes (RBCs), platelets

Lymphoid - B-lymphocytes, T-lymphocytes

Question 6

Colony-forming unit (CFU-GEMM)

Answer 6

Myeloid lineage

Question 7

Colony-forming unit (CFU-L)

Answer 7

Lymphoid lineage

Question 8

Staging of haemopoiesis

Answer 8

1. Multipotential stem
2. Pluripotential stem
3. Committed stem
4. mature cells

Question 9

Embryology of haemopoiesis

Answer 9

Trophoblast
Starts day 27 in the aorta gonad mesonephros region

Expands rapidly at day 35 and gone by 40

Due to migration to liver

Question 10

Polycythaemia means

Answer 10

Raised RBC count

Question 11

Relative polycythaemia

Answer 11

Raised RBC count when plasma volume reduced

Question 12

Granulocytes - what do they have? who are they?

Answer 12

neutro/eosino/basophils

have cytoplasmic granules

Question 13

Neutrophils - features

Answer 13

Phagocytes
Most common
10x10^9/l
Live for only a few hours

Question 14

Causes of neutrophilia

Answer 14

High #
Bacterial infection
Inflammation

Question 15

Causes of neutropenia

Answer 15

Low #

Side affect of drug

Question 16

Eosinophilia causes

Answer 16

Parasitic infection

Allergies

Question 17

Basophils

Answer 17

Rare cells - part of primitive immune system

Question 18

Causes of basophilia

Answer 18

Chronic myeloid leukaemia

Question 19

Monocyte features

Answer 19

Phagocytic and APCs

Migrate to tissues and are identified as ‘macrophages’ or ‘histiocytes’

Kupffer cells in liver
Langerhans cells in skin

Question 20

High # of monocytes = monocytosis - causes

Answer 20

Tuberculosis

Question 21

Lymphocyte types

Answer 21

NK cells
B-lymphocytes
T-lymphocytes
Plasma cells

Question 22

NK cells

Answer 22

Innate immune system

Large granular lymphocytes which recognise non-self cells

Question 23

B - lymphocytes

Answer 23

Adaptive immune system
Rearrange the immunoglobuin genes to enable antigen specific Ig production

Humoral immunity

Question 24

T-lymphocytes

Answer 24

Adaptive immune system
Rearrange the T-cell antigen receptors

Cell-mediated immunity
Target specific cytotoxicity
Interact with B cells, macrophages
Regulate immune responses

Question 25

Lymphocytosis causes

Answer 25

high #

Atypical lymphocytes of glandular fever (infectious mononucleosis)

Chronic lymphocytic leukaemia

Question 26

Lymphopenia causes

Answer 26

Post bone marrow transplant

Question 27

Plasmacytosis causes

Answer 27

Infection

Myeloma

Question 28

Platelets - features

Answer 28

Derived from bone marrow megakaryocytes

200x10^9/l

W/ soluble plasma clotting factor + endothelial cells form part of clotting system

Question 29

What are haematologists responsible for?

Answer 29

Labs
Patients
Advice

Question 30

What are non-haematologists responsible for?

Answer 30

Blood count + coag tests
Transfusion
Haematological disease can present anywhere…

Question 31

Diagnostic tests:

Answer 31

FBC
Blood film aka smear
Coagulation screen

Question 32

What does FBC test?

Answer 32

[Hb]
Red cell parameters inc. mean cell volume (MCV) and mean cell Hb (MCH)
White cell count
Platelet count

Question 33

Coagulation screen what is it?

Answer 33

Test measure the time taken for a clot to form when plasma is mixed with reactive agents

Question 34

What parts of coagulation cascade can be assayed?

Answer 34

Prothrombin time
Activated partial thromboplastin time
Thrombin time

Question 35

Sensitivity definition

Answer 35

The proportion of abnormal results correctly classified by the test

The ability to detect a true abnormality

Question 36

Specificity defintion

Answer 36

Defined as the proportion of normal results correctly classified by the test

The ability to exclude an abnormal result in a healthy person

Question 37

Equation for sensitivity

Answer 37

TP / (TP + FN)

True positive / (TP + false negative)

Question 38

Equation for specificity

Answer 38

TN / (TN + FP)

Question 39

Types of anaemia

Answer 39

Microcytic hypochromic
Normocytic normochromic
Macrocytic

Question 40

Microcytic hypochromic anaemia test readings

Answer 40

MCV

Question 41

Microcytic hypochromia is a sign of…

Answer 41

Iron deficiency
Thalassaemia 
Anaemia of chronic disease
Lead poisoning
Sideroblastic anaemia

Question 42

Normocytic normochromic test readings

Answer 42

MCV 80-95 fl

MCH ≥ 27 pg

Question 43

Normocytic normochromic is a sign of…

Answer 43

Many haemolytic anaemias
Anaemia of chronic disease
After acute blood loss
Renal disease
Mixed deficiencies
Bone marrow failure (post-chemo or due to cancer)

Question 44

Macrocytic anaemia test readings

Answer 44

MCV >95fl

Question 45

Macrocytic anaemia is a sign of…

Answer 45

Vit B12 or folate deficiency

Non-megaloblastic: alcohol, liver disease, myelodysplasia, aplastic anaemia

Question 46

Description of iron deficiency

Answer 46

Small, pale red cells (low MCV and MCH)

Variable size and shape
Long thin ‘pencil’ cells

Question 47

Description of vit B12

Answer 47

Hypersegment neutrophils and oval macrocytes