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Medicine > Blood > Flashcards

Blood Flashcards

1
Q

what are the stages of apoptosis

A

step 1 apoptotic membrane blebbing
2. formation of apoptotic membrane protrusions
step 3. cell fragmentation

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2
Q

summary of haemopesis

A

formation of blood cells from precursor stem cells
stem cells derive from the bone marrow
regulated by hormonal growth factors
and transcription factors

blood cells have a finite lifespan controlled via apoptossis

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3
Q

describe RBC

A

simple cell
- no nucleus , no mitochondria

membrane encloses glycolysis
- enzymes and hameoglboin
have 5 l blood
4x 10 ^12 / L (F)
5x 10 V 12 /L M
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4
Q

describe the structure of haemoglobin

A

tetrameric protein
2 alpha chains
2 beta chains

allows oxygen to reversibly combine with iron fe2+ in aqueous environement

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5
Q

what is anaemia

A

deficiency of Hb

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6
Q

what are the signs and symptoms of anaemia

A

signs
Pallor (e.g. pale mucous membranes or nail beds)

Angular stomatitis

Glossitis

Signs related to underlying cause

symptoms
Tiredness / lethargy / malaise

Shortness of breath on exertion / reduced exercise tolerance

Angina & claudication
(in older individuals)

Symptoms related to underlying cause

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7
Q

what is acute anaemia

A

blood loss realists in loss of RBC and plans

low hb but haematrocrit remains at 45%

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8
Q

what is chronic anemai

A

los of RBC due to inflammatory disorders or malignancy

low hb and reduced hameatrocrit (20%)

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9
Q

iron deficiency anaemia is caused by:

A

Poor diet, malabsorption, chronic bleeding

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10
Q

what are its effects?

A

Iron necessary for Hb production

Reduction in mean corpuscular Hb (MCH)

Reduction in mean corpuscular volume (MCV)

Low Hb

Haematocrit remains at ~45%

MCV <80 fL
(normal range 82-96 fL)

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11
Q

what is megaloblastic anaemia

A

Incorrect production of RBC (macrocytosis)

Abnormally large RBC (MCV >100 fL) observed in plasma

Reduced production of normal RBC resulting in low Hb

Macrocytosis caused by liver disease, alcohol abuse & hypothyroidism can cause macrocytosis

Megaloblastic anaemia caused by vitamin B12 or (primarily) folate deficiency

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12
Q

what can cause megaolgastic

A

liver disease, alcohol abuse and hpothydroism

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13
Q

Why are b12 and folate required

A

Required for DNA synthesis

Affects all dividing cells

Manifests first in bone marrow as this is the most active source of dividing cells

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14
Q

where can folate be found ?

A

folate found in fruit/. veg and food supplements

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15
Q

what are the causes of folate deficiency

A

poor diet, malabsorption or increased turnover (psoriasis, haemolysis)

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16
Q

b12 deficiency - is caused by

A

lack of gastric parietal cells

lack of terminal ideal function

17
Q

haemolytic anaemia

A

Cells have a lifespan <30 days
(normal 120 days)

Normal or increased RBC production

Increases haem turnover leading to jaundice and anaemia

18
Q

what are the different types of white blood cells

A

Neutrophils
(6-10 hours)

monocytes (20-40 hours)

lymphocytes ( weeks to years)

basophiles ( days)

eosinophils ( days)

19
Q

what is the lifespan of Neutrophils

A

(6-10 hours)

20
Q

what is the lifespan of monocytes

A

(20-40 hours)

21
Q

what is the lifespan of lymphocytes

A

( weeks to years)

22
Q

what is the lifespan of basophiles

A

( days)

23
Q

what is the lifespan of eosinophils

A

( days)

24
Q

describe neutrophils

A

Most numerous type of white cell
(1.8-7.5 x 109 / L)

Phagocytose bacteria & foreign material

Release chemotaxins & cytokines
important in the inflammatory response

Lack of number or function results in recurrent bacterial infections

25
Q

describe basophils

A

Relatively rare in peripheral blood
(0.01-0.1 x 109 / L)

Migrate to tissues becoming mast cells

Mast cells filled with histamine containing granules & express surface IgE

Important role in immunity & allergic response

26
Q

describe Eosinophils

A

Also rare in peripheral blood
(0.04-0.4 x 109 / L)

Important role in inflammation & allergic response

Special role in protection against parasites

27
Q

what are the two types of lymphocytes

A

B lymphocytes
Mature in the bone marrow

Generate antibodies when stimulated by foreign antigens

T lymphocytes
(80% of total)

Mature in the thymus

Aid B cells & also generate cellular or cell-mediated immunity

28
Q

what are the two types of T lymphocytes

A

Helper cells (CD4+)

Suppress / regulate the immune response

Natural killer cells (CD8

Target damaged / infected cells for death

29
Q

describe acute leukaemia

A

Haemopoietic stem cells proliferate without differentiation

Normal bone marrow precursor cells replaced

Causes:
Anaemia, neutropenia & thrombocytopenia

30
Q

what are the two types of acute leukaemia

A

Acute myeloblastic leukaemia (AML)

-Proliferation of myeloblasts (neutrophil precursor)

Primarily of adults:
50% survive 5 years

Treatment:
Cyclical high dose chemo
Bone marrow transplant

Acute lymphocytic leukaemia (ALL)
Proliferation of lymphoblasts (lymphocyte precursor)

Primarily of childhood:
>80% cured

Treatment:
Cyclical chemo over 2-3 yr
Transplantation (if relapse)

31
Q

what is high grade lymphoma

A

malignant tumour developing from lymphocytes
classified as Hodgkin lymphoma or non Hodgkin lymphoma
usually affects lymph nodes but can spread
treat with aggressive chemo or with radiotherapy (if localised)

32
Q

Name platelet bleeding disorders

A

Bernard-Soulier syndrome

, Glanzmann’s thrombasthenia, Hermansky-Pudlak syndrome

33
Q

What are the causes and impacts of Hermansky-Pudlak syndrome

A

Defect in dense storage granules

Platelet activation & aggregation

34
Q

What are the causes and impacts of Glanzmann’s thrombasthenia

A

Defect or deficiency of GPIIb/IIIa receptor

Platelet cross-linking & aggregation

35
Q

What are the causes and impacts of Bernard-Soulier syndrome

A

Deficiency of GPIb receptor

Platelet adhesion

36
Q

Disseminated intravascular coagulation (DIC)

A

Breakdown of haemostatic balance

Simultaneous bleeding & microvascular thrombosis (life threatening)

Cause can be sepsis, obstetric or malignancy

Administering plasma & platelets can be considered (if required)

37
Q

what does aspirin and clopidogrel affect

A

Aspirin & clopidogrel affect platelet function

38
Q

what does heparin and warfarin affect

A

Heparin & warfarin affect the coagulation cascade

39
Q

what does steroids do

A

Steroids make tissues thin causing

bruising & bleeding

Medicine (2 decks)

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