Blood cell abnormalities

Question 1

What is anaemia?

Answer 1

Reduction in the amount of haemoglobin in a given volume of blood below normal values for health subject of same age and gender

Question 2

What are the 4 mechanisms of anaemia?

Answer 2

Reduced production of red cells
Blood loss
Reduces serval of red cells
Pooling of red cells in very large spells

Question 3

What is caused by reduced production of globing chains?

Answer 3

Thalassemia

Question 4

How can anaemia be classified?

Answer 4

On the basis of cell size

Question 5

What are causes of microcytic anaemia?

Answer 5

Defect in haem synthesis
-Iron deficiency
-Anaemia of chronic disease
Defect in globing synthesis
-alpha thalassaemia
-beta thalassaemia

Question 6

What causes iron deficiency?

Answer 6

Increased blood loss
Insufficient intake 
Increased requirements (pregnancy and infancy)

Question 7

What are the causes of macrocytic anaemia?

Answer 7

Megaloblastic anaemia 
Abnormal haemopoiesis
Liver disease
Excess alcohol intake 
Increased no. of reticulocytes

Question 8

What is megaloblastic anaemia?

Answer 8

Delay in maturation of the nucleus while the cytoplasm continues to mature and cell grows

Question 9

What is a megaloblast?

Answer 9

Abnormal bone marrow erythroblast

Question 10

What causes megaloblastic anaemia?

Answer 10

Deficiency of B12 or folic acid
Use of drugs interfering with DNA synthesis
Liver diseases increased ethanol toxicity
Recent major blood loss
Haemolytic anaemia

Question 11

What is polycythaemia?

Answer 11

Too many red cells in the circulation

Question 12

What are the two types of polycythaemia?

Answer 12

Pseudo- reduced plasma volume

True- increase in total volume of red cells in circulation

Question 13

What causes polycythaemia?

Answer 13

Excessive transfusion
Response to hypoxia
Changes in levels of erythropoietin
Abnormal function of the bone marrow

Question 14

What can cause increased synthesis of erythropoietin?

Answer 14

High altitude

Question 15

When is an increase in erythropoietin inappropriate?

Answer 15

In sports

In cancer e.g renal tumours secrete it

Question 16

What is polycythaemia vera?

Answer 16

Intrinsic bone marrow disorder

Myeloproliferative neoplasm

Question 17

What does polycythaemia result in?

Answer 17

More viscous blood

Can lead to vascular obstruction

Question 18

What is leukaemia?

Answer 18

Cancer of the blood
Means ‘white blood’
5% of all cancers

Question 19

What causes leukaemia?

Answer 19

Series of mutation in a single lymphoid or myeloid stem cell
The progeny behave abnormally e.g. increased proliferation, failure of differentiation, increased survival
Cells with mutations have a growth advantage

Question 20

What is different about leukaemia?

Answer 20

Stem cells can circulate in blood and enter tissues
Concepts of invasion and metastasis cannot be applied
Therefore terms chronic and acute are uses
Chronic- benign
Acute- malignant

Question 21

How is leukaemia classified?

Answer 21

Acute or Chronic
Lymphoid: (B or T or NK)
Myeloid: (Granulocytic or Monocytic or Erythroid or Megakaryocytic)

Question 22

What does the suffix ‘blastic’ mean?

Answer 22

Acute

Question 23

What does the suffix ‘cytic’ mean?

Answer 23

Chronic

Question 24

Why do people get leukaemia?

Answer 24

Random errors
Oncogenic influences
Loss of function in tumour suppression gene

Question 25

What are the differences between acute and chronic leukaemia?

Answer 25

AML- cells continue to proliferate but no longer mature Build up of immature cells Failure to produce normal functioning end cells Cell behaviour profoundly disturbed CML- leukaemia cells are mature although abnormal

Question 26

How does leukaemia cause diseases characteristics?

Answer 26

Leucocytosis causes bone pain | Enlargement of thymus, spleen etc.

Question 27

What is chronic myeloid leukaemia?

Answer 27

Translocation between chromosome 9 and 22 in haemopoietic stem cell A chimeric gene is formed Gives cell growth and survival advantage gives rise to a leukaemic clone Increase in granulocytes and precursors Anaemia Enlarged spleen

Question 28

What is acute lymphoblastic leukaemia?

Answer 28

``` Leucocytosis Anaemia Neutropenia Thromobocytopenia Replacement of normal bone marrow by lymphoblasts More common in children ```

Question 29

What can molecular genetic analysis do?

Answer 29

Give more information about prognosis | Development on targeted treatment

Question 30

What is the treatment for acute lymphoblastic leukaemia?

Answer 30

``` Red cells for anaemia Platelets for haemorrhages Antibiotics Systemci chemo Intrathecal chemo ```

Question 31

What are the causes of normocytic anaemia?

Answer 31

Iron deficiency Renal failure Recent blood loss Bone marrow failure/ infiltration