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[Y1] Pathology > Blood disorders > Flashcards

Blood disorders Flashcards

1
Q

why under the microscope do RBCs have a paler centre?

A

due to the donut shape

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2
Q

are RBCs or platelets smaller?

A

platelets

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3
Q

what is the function of RBCs?

A

provide the tissue with oxygen and remove carbon dioxide

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4
Q

what is the function of WBCs?

A

fight infection

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5
Q

what is the function of plasma and platelets?

A

clotting factors
prevent vascular leakage

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6
Q

what stain is used on blood smears to look at RBCs?

A

Romanowsky stain:
-Methylene blue stains nuclei purple
-No nucleus
- Eosin (counterstain) stains cytoplasmic proteins pink
-Full of haemoglobin
-No mitochondria

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7
Q

how many RBCs are there per litre of blood?

A

4-6 x 10^12

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8
Q

what is the shape of RBCs referred to as?

A

biconcave discs

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9
Q

what is the diameter of a RBC?

A

7-12 µm

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10
Q

what does Eosin stain?

A

Basic things (such as basic groups of amino acids pink)

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11
Q

what does Methylene blue stain?

A

acidic things like nucleic acids purple

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12
Q

what is the physiology of RBCs?

A

Transport of oxygen (bound to haemoglobin) and carbon dioxide around the body

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13
Q

how many Hb molecules are in each RBC?

A

~250 million

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14
Q

how many Fe atoms does each Hb contain?

A

4

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15
Q

How many molecules of O2 can each Fe bind to?

A

1

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16
Q

what is the definition of anaemia?

A

Reduced haemoglobin concentration in the blood which reduces the oxygen carrying capacity of blood

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17
Q

what percentage of woman does anaemia affect?

A

10%

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18
Q

what percentage of men does anaemia affect?

A

2-5%

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19
Q

what are the 5 common causes of anaemia?

A
  • acute bleeding (trauma, surgery)
  • chronic bleeding (GI, heavy menstraution)
  • iron deficiency (dietry, malabsorption, pregnancy- affects 24%)
  • folate/ vitamin B12 deficiency
  • premature distruction of RBCs
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20
Q

Name 5 symptoms of anaemia

A
  • tiredness and lack of energy
  • shortness of breath
  • noticeable heartbeats (heart palpitations)
  • paler than usual skin
  • headaches
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21
Q

what test is done to diagnose anaemia?

A

FBC (full blood count)

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22
Q

what is the concentration of Hb where you are diagnosed with anaemia?

A

<120g/L

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23
Q

what are the 3 things concidered when finding the cause/class of anaemia?

A
  • RBC count
  • size of RBCs
  • colour of RBCs
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24
Q

what would the 3 things show is the cause of anaemia was acute bleeding?

A

RBC count - low
size of RBCs - normal
colour of RBCs - normal

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25
Q

what would the 3 things show is the cause of anaemia was iron deficiency?

A

RBC count - normal
size of RBCs - small
colour of RBCs - pale

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26
Q

what would the 3 things show is the cause of anaemia was folate/ B12 deficiency?

A

RBC count - normal/low
size of RBCs - small
colour of RBCs - pale

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27
Q

what would the 3 things show is the cause of anaemia was haemolysis?

A

RBC count - low
size of RBCs - normal
colour of RBCs - normal

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28
Q

what is the treatment of anaemia?

A
  • Depends on cause
  • Stop / address any bleeding
  • Iron rich foods, iron supplements, iron injections
  • Folate / B12 rich foods, supplements, B12 injections
  • Blood transfusions
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29
Q

how many types of WBCs are there?

A

5 types

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30
Q

what are the 5 types of WBCs?

A
  • neutrophils
  • lymphocytes
  • monocytes
  • eosinophils
  • basophils
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31
Q

what is the diameter of WBCs?

A

~24 µm

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32
Q

what does the Romanowsky stain show for WBCs?

A

-Methylene blue stains nuclei purple
- Different shaped nuclei
- Eosin stains cytoplasm pink
- Granulocytes contain differently staining granules

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33
Q

what is the roles of neutrophils?

A
  • migrate out of blood into tissues where needed
  • elevated in bacterial infections, stress, exercise
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34
Q

what is the role of lymphocytes?

A
  • sit in the lymph nodes to screen lymph
  • elevated in viral infections
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35
Q

what is the role of monocytes?

A
  • clear cell debris
  • elevated in infection, inflamation, tissue damage
36
Q

what is the role of eosinophils?

A

-role in allergy and intestinal parasites

37
Q

what is the role of basophils?

A

-role in allergy

38
Q

what is the name of monocytes in tissues?

A

macrophages

39
Q

define leukaemia

A

Uncontrolled growth of one WBC type in the bone marrow

40
Q

what are 2 things that leukemia causes?

A
  • Increase in affected WBC type
  • Bone marrow failure (over crowding)
41
Q

what are the 4 main classes of leukemia?

A
  • AML: acute myeloid leukaemia
  • ALL: acute lymphoblastic leukaemia
  • CLL: chronic lymphoid leukaemia
  • CML: chronic myeloid leukaemia
42
Q

what symptoms come from the overcrowding of the bone marrow?

A
  • anaemia
  • Leukopenia (recurrent infections)
  • Thrombocytopenia (bleeding)
43
Q

what are the 3 tests to diagnose leukemia?

A
  • full blood count
  • bone marrow biopsy
  • histology of WBCs
44
Q

what does a full blood count show in someone with leukemia?

A
  • Increased number of affected WBC type
  • Decrease in other WBCs
  • Decrease in RBC
  • Decrease in platelets
45
Q

what does a bone marrow biopsy show in someone with leukemia?

A

increase in immature WBCs

46
Q

what does the histology of WBCs show in someone with leukemia?

A

possible enlarged nuclei (immature blast cells)

47
Q

what are the 2 main treatments for leukemia?

A
  • chemotherapy
  • bone marrow transplant
48
Q

how do platelets appear in blood films?

A

as dark-staining granules

49
Q

what is the diameter of a platelet?

A

2-4µm

50
Q

when do platelets change shape?

A

when they have been activated

51
Q

how many platelets are in the blood/L

A

150-400 x10^9 / L

52
Q

what are platelets role in homeostasis?

A

the cessation of bleeding

53
Q

what is fibrinolysis?

A
  • At some point the clot must be broken down and blood flow re-established
  • Fibrin is broken down by plasmin
54
Q

what is the probable cause of arterial thrombosis?

A

by innapropriate activation of platelets

55
Q

why does arterial thrombosis only occur in the arteries?

A
  • Atherosclerosis only occurs in arteries
  • Rupture of an atherosclerotic plaque exposes lipids which are thrombotic
56
Q

what is the cause of venous thrombosis?

A

Inappropriate activation of coagulation in the veins

57
Q

why does venous thrombosis occur in the veins?

A

Virchow’s Triad
-Stasis (caused by immobility)
-Endothelial damage (vessel wall injury)
-Hypercoagulability (genetic variation)

58
Q

where does venous thrombosis often occur?

A
  • in the deep veins of the leg
  • deep vein thrombosis (DVT)
59
Q

what are the signs and sysmptoms of arterial thrombosis?

A

DEPENDS ON LOCATION
- Ischaemic stroke: Disruption of blood supply to the brain
- Myocardial infarction (MI): Disruption of blood supply to the heart

60
Q

what is the main symptom and venous thrombosis?

A

pain in leg

61
Q

what are the signs of venous thrombosis?

A

Tenderness, swelling, redness, heat (unilateral). Fever, general malaise, elevated WBC and erythrocyte sedimentation rate

62
Q

how is an ischaemic stroke diagnosed?

A

Clinical (from signs / symptoms) but neuroimaging necessary to distinguish haemorrhagic vs ischaemic (CT or MRI)

63
Q

how is a myocardial infraction (MI) diagnosed?

A

ECG, elevated troponin levels (protein released by damaged heart muscle), elevated creatine kinase levels (released by damaged heart muscle)

64
Q

how is peripheral arterial disease (PAD) dianosed?

A

Ankle-brachial index (systolic ankle BP/ systolic brachial BP = 0.9-1.3 is normal, <0.9 indicative of PAD), ultrasound, MRI

65
Q

how is a DVT diagnosed?

A

ultrasound, venogram (x-ray with contrast dye), elevated D-dimers (by-product of fibrinolysis)

66
Q

what are 3 types of medications that are used to treat and prevent thrombosis?

A
  • anti-platelet drugs
  • anti-coagulant drugs
  • fibrinolytic drugs
67
Q

what is a drug treatment of thrombosis?

A

Fibrinolytic / clot-busting / thrombolytic drugs (e.g. tPA)
- Helps break down both arterial and venous thrombi

68
Q

what are the 3 surgical treatments of thrombosis?

A
  • PCTA: percutaneous transluminal angioplasty (+/- stent)
  • CABG: coronary artery bypass graft
  • Carotid enterectomy
69
Q

what is PCTA?

A
  • percutaneous transluminal angioplasty (+/- stent)
  • minimally invasive and not classed as a surgical technique, carried out in a cath-lab
  • A tube is inserted through the skin (percutaneous) and into an artery (often the femoral artery at the groin). A balloon is fed all the way up to the heart and the narrowed coronary artery and then inflated to open up the vessel.
  • often leave a stent
70
Q

what is a CABG?

A
  • coronary artery bypass graft
  • Using a vein (often the saphenous vein from the leg) to bypass the blockage
  • The vein graft must be positioned in the reverse direction so that blood can flow from aorta to coronary artery easily (without the valves blocking the flow)
71
Q

what is a carotid enterectomy?

A

Endarectomy is a surgical treatment to remove the atherosclerotic plaque that might rupture and cause thrombosis (occlusion). Endarectomy can be carried out on the carotid arteries, femoral arteries and others.

72
Q

what drugs can prevent arterial thrombosis?

A

anti-platelet drugs

73
Q

what is an example of an anti-platelet drug? give some information about it

A

ASPIRIN
- inhibits platelet aggregation
- Irreversibly acetylates active site of cyclo-oxygenase 1 (COX1)
- Orally administered
- Cheap- out of patent
- A number of clinical studies have demonstrated clinical benefit

74
Q

what drugs can be taken to prevent venous thrombosis?

A

anti-coagulant drugs

75
Q

what are 3 examples of anticoagulant drugs?

A
  • Warfarin (use declining)
  • Rivaroxaban / Apixaban
  • Heparin
76
Q

why is warfarin used as a anti-coagulant?

A
  • Liver synthesises some clotting factors only if vitamin K is present
  • Warfarin inhibits cycling of vitamin K
  • Orally administered
  • Slow action as affects synthesis of clotting factors
  • Dosage monitored as interacts with many drugs and foods
77
Q

what is the proper name for a mini stroke?

A

Transient ischaemic attck (TIA)

78
Q

what percentage of strokes are ischaemic (thrombotic)?

A

> 80%

79
Q

what percentage of strokes are haemorrhagic (bleed)?

A

<20%

80
Q

what are transient ischaemic attacks caused by?

A

temporary clots
-are warning signs or more serious strokes

81
Q

define ischaemia

A

reduced blood flow, and causes hypoxia

82
Q

define hypoxia?

A

reduced (low) oxygen

83
Q

what is a myocardial infarction (MI) caused by?

A

blockage of a coronary artery by a thrombus

84
Q

what is an angina caused by?

A

a temporary narrowing of a coronary artery

85
Q

is peripheral arterial disease more similar to angina or an MI?

A

angina
- a narrowing rather than blockage of the arteries in the legs

86
Q
A

[Y1] Pathology (10 decks)

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