Cases affecting BM

Question 1

a) Convert ng/mL into SI units (ug/L)
b) Convert 1mm^3 into SI units (1 x10^9/L)

Answer 1

a) ng/mL = ug/L
b) mm^3 = uL then x by 10^6 to get 10^9/L

Question 2

What’s the general term for activated macrophages engulfing RBC/WBC/MK. & specific term for WBC & RBC

Answer 2

Haemophagocytosis
- Leukophagocytosis
- Erythrophagocytosis

Question 3

a) What is haemophagocytic syndrome &
b) what causes it

• aka haemophagocytic lymphohistiocytosis OR macrophage activation syndrome)

Answer 3

• haemophagocytosis & is the endpoint of disorders (inherited, Acquired (&non-) neoplastic) e.g. parvovirus B19 infection & HbS disease
• caused by excessive cytokine stimulation

Question 4

Why/How might a patient w/ a yeast infection get pancytopenia?

Answer 4

When immune system is suppressed = affect BM => pancytopenia

Question 5

What can a granuloma contain?

Answer 5

• epitheliod macrophage
• Langerhans (giant cells)
• fibrosis
• lymphocyte cuffing
• caseation

Question 6

What is disseminated histoplasmosis (DHP) & its effects on body

Answer 6

• disseminated: spread across body
• histoplasmosis: infection w/ Histoplasma sp.
  => granuloma & pancytopenia

Question 7

what’s the significance of finding monoclonal protein in serum protein electrophorhesis

Answer 7

monoclonal protein usually assoc. with multiple myeloma

Question 8

What would you expect in FBC & PB in a patient that’s been infected by a parasiste?

Answer 8

eosinophilia

Question 9

What is posttransplant lymphoproliferative disorder (PTLD)

Answer 9

• heterogenous lymphoid disorder
• Range from not painful polyclonal proliferations to aggressive lymphomas that complicate solid organ or haematopoetic transplantation

Question 10

Which Mycobacterium sp. are a) rapid-growing (7-10days) and
b) slow-growing (14+ days)

Answer 10

a) Rapid: M. abscessus & M. fortuitum
b) Slow: M. avium & M. intracellularae

Question 11

What is Coxiella burnetii?

Answer 11

• obligate intracellular bacteria
• causes Q fever

Question 12

what reasons might explain the FBC findings:
• Hb: 66 g/L
•Reticulocyte count: 0.2% (LLimit of range)
• Epo: 750mIU/ML (N: 3-19mIU/mL)

Answer 12

• Anaemia
• Retic. not inc. even though EPO is high
  => marrow not responding to EPO

Question 13

What further testing is used to confirm the origin of cells (if Erythroid)

Answer 13

• Glycophorin
• E-cadherin

Question 14

What is the effect of Parvovirus B19?

Answer 14

=> red cell aplasia
- erythroid maturation arrest
- BM: giant proerythroblast (viral transformation, (& neoplasm))
• Erythroid hypoplasia
• Intranuclear viral inclusions
• Dysplastic changes
- PB: anaemia, Pancytopenia, neutropenia

Question 15

What’s the effect of steroid therapy?

Answer 15

immunosuppression => susceptibilty of infection w/ organisms

Question 16

a) what is Leishmania
b) How it’s transmitted

Answer 16

a) parasite
b) bite from sandfly

Question 17

a) define osteomyelitis
b) what makes ppl susceptible to this

Answer 17

a) Inflammation of bone marrow
b) ppl w/ trilineage hypoplasia & immuno-compromised

Question 18

What is filgrastim?

Answer 18

Filgrastim is granulocyte colony-stimulating factor (G-CSF)

Question 19

what might you dx a cond that showed in BM:
• megaloblastic changes in erythroid precursors
• bi/multinucleated normoblast (nRBC)

Answer 19

Congenital dyserythropoetic anaemia

Question 20

a) What does the Alcian blue stain (on BM) stain
b) what could it indicate if found in BM

Answer 20

a) acidic polysaccharides e.g. glycoaminoglycans
b) Gelatinous transformation of BM (GTBM)

Question 21

What features might you see in Gelatinous transformation of BM (GTBM)

Answer 21

•adipocyte atrophy (dec size)
• haematopoetic tiss. hyoplasia
• extracellular deposition of gelatinous substance

Question 22

What is cystinosis

Answer 22

• defect in cyctine transport (bc cystinosin) & accumulates in lysosome esp in kidneys => progress. kidney failure
• mutation in CTNS gene

Question 23

significance of these crystals:
• Cystine
• Haematoidin
•Charcot-Leyden (CL)

Answer 23

• C: cystinosis
• H: from breakdown of RBC after necrosis/haemorrhage
• CL: by-product of eosinophils (infection, allergy)

Question 24

What’s Mixed Connective Tissue Disease

Answer 24

• Autoimmune disorder
• its features commonly seen in systemic lupus erythematosus, scleroderma, and polymyositis

Question 25

macrophage iron accumulation occurs in waht 3 condition states

Answer 25

• anaemia of inflammation/chronic disease
• Iron overload (esp after transfus. w/ Fe in severe Thalass)
• Hereditary haemochromatosis