Cells of the Blood

Question 1

How is Bone Marrow Sampled?

Answer 1

Aspiration - cytology
Trephine Biopsy - histology
Usually from Iliac Crest

Question 2

What is the function of White Blood Cells?

What is the Life Expectancy of a White Blood Cell?

Answer 2

Combat Pathogens and other foreign substances that enter the body.

Live for a few hours to a few days

Question 3

How are Red Blood Cells removed from the Circulation?

What is the Life Expectancy of a Red Blood Cell?

Answer 3

Phagocytic Macrophages in the Liver and the Spleen

120 days - wear and tear from squeezing through capillaries

Question 4

What are the two arms of Haematopoeisis?

Answer 4

Myeloid and Lymphoid

Question 5

What is the function of Neutrophils?

Answer 5

Phagocytosis
First on the scene
60-70% of WBCs

Question 6

What is the function of Basophils?

Answer 6

Intensify inflammatory response in allergic reactions

Question 7

What is the function of Eosinophils?

Answer 7

Combat effects of histamine in allergic reactions

Destroy certain parasitic worms

Question 8

What is the function of Monocytes?

Answer 8

Convert to macrophages

Then phagocytosis

Question 9

What is the function of lymphocytes?

Answer 9

B cells develop into plasma cells
Plasma cells sector antibodies

T cells attach invading viruses and cancer cells
NK cells attack a variety of infectious microbes

Question 10

How are phagocytes attracted to microbes and inflamed tissues?

Answer 10

Chemotaxis

Chemoattractants and Chemorepellants

Question 11

What is a Platelet?

Answer 11

Fragments of megakaryoctes, enclosed by a piece of plasma membrane

No nucleus

Megakaryocytes are huge cells in the red bone marrow which split into 2000-3000 fragments

Platelets stick together and to endothelium

Question 12

What is the normal range for Haemoglobin concentration?

Answer 12

Male: 13.0-18.0 g/dL
Female: 11.4-16.5 g/dL

Question 13

What is Mean Cell Volume?

What is the normal range for Mean Cell Volume?

Answer 13

A representation of how big the RBCs are

77-96 fL

Question 14

What is the normal range for platelets?

Answer 14

150-400 x10^9/L

Question 15

What is the normal range for White Blood Cells?

Answer 15

4-11 x10^9/L

Question 16

What is the normal range for Neutrophils?

Answer 16

2.0-7.5 x10^9/L

Question 17

What is the normal range for Lymphocytes?

Answer 17

1.3-4 x10^9/L

Question 18

What would raised neutrophils indicate?

Answer 18

Bacterial Infection

Question 19

What would a raised White Blood Cell count suggest in absence of infection?

Answer 19

Haematological Malignancy

Question 20

What what raised lymphocytes suggest?

Answer 20

Viral Infection

Question 21

What what raised eosinophils suggest?

Answer 21

Parasitic Infection

Question 22

Hoe are Red Blood Cells made?

Answer 22

ERYTHROPOIESIS
In Red Bone Marrow
Proerythroblast -> ejects nucleus -> Reticulocyte

Stimulated by Erythropoietin
Released by the kidneys in response to reduced oxygen supply to the kidneys and other organs

Question 23

Where is Red Bone Marrow found?

Answer 23

Axial Skeleton

Head, trunk, epiphyses of femur and humerus, pectoral and pelvic girdles

Question 24

What is Anaemia?

Answer 24

Absolute reduction in Haemoglobin

<13.5g/dL in men
<11.5g/dL in women

Question 25

What is Microcytic anaemia and what are the causes?

Answer 25

Anaemia with Low MCV (<77) Iron Deficiency excessive loss, dietary inadequacy, failure of absorption, excessive demands

Question 26

What is Normocytic anaemia and what are the causes?

Answer 26

Anaemia with normal MCV (77-95) Recent Bleeding Chronic disease (kidneys-EPO) Preganancy

Question 27

What is Macrocytic anaemia and what are the causes?

Answer 27

Anaemia with high MCV (>95) B12 deficiency Pernicious anaemia (intrinsic factor antibodies, unable to absorb B12) Folate Deficiency Alcohol Excess

Question 28

What fluid is given to known alcoholics in A&E?

Answer 28

Pabrinex | Multivitamins, B12, folate

Question 29

Where is Vitamin B12 obtained from? How is Vitamin B12 absorbed?

Answer 29

Meat, eggs and dairy Binds to intrinsic factor in the stomach then absorbed in the terminal ileum

Question 30

Where is Folate obtained from?

Answer 30

Green leafy vegetables, nuts and liver

Question 31

What is Acute Lymphoid Leukaemia? Who is it seen in most commonly?

Answer 31

B or T cell Malignancy Good Prognosis - goes down as age goes up Commonest childhood cancer

Question 32

What is Acute Myeloid Leukaemia? How is it treated? Who is it seen in most commonly?

Answer 32

High neutrophils, basophils and eosinophils Intensive Chemotherapy Most common leukaemia in adults

Question 33

What is Chronic Lymphoid Leukaemia? How is it treated? Who is it seen in most commonly?

Answer 33

B and T cell malignancy Asymptomatic in 90% at presentation (seen in routine FBC) Non-curative management Disease of the elderly, especially males

Question 34

What is Chronic Myeloid Leukaemia? How is it treated? Who is it seen in most commonly?

Answer 34

Insidious presentation - splenomegaly Philadelphia chromosome in >80% Treated with imatinib (monoclonal antibody to suppress bone marrow) Typically 40-60 year olds

Question 35

What is lymphoma? What are the two types?

Answer 35

Malignant tumour of the lymphatic system Hodgkin's and Non-Hodgkin's

Question 36

How is Hodgkin's lymphoma characterised?

Answer 36

Histologically - multinucleate giant cells - Reed-Sternberg cells Present with an enlarged lymph node, typically lower neck or supraclavicular B Symptoms - drenching night sweats, fever and weight loss

Question 37

What is the prognosis of Non'Hodgkin's Lymphoma?

Answer 37

Low Grade - good prognosis but not usually curable High Grade - More aggressive but usually curative

Question 38

What is Myeloma? Who does it affect most commonly? How does it present? What tests are done? How is the diagnosis confirmed?

Answer 38

Malignant proliferation of plasma cells Increased osteoclastic activity - bone marrow destruction and bone marrow failure Incurable, relapsing/remitting disease Generally effect older people Bone Pain (back ache) Hypercalcaemia (breakdown of bone) Anaemia Renal Impairment Urine Protein Electrophoresis looking for Bence-Jones protein Bone marrow sample and skeletal survey

Question 39

Hypercalcaemia Symptoms

Answer 39

Bones - bone pain Groans - constipation, abdominal pain Stones - renal stones Moans - depression