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Adult Patient 1 > Cells of the Blood > Flashcards

Flashcards in Cells of the Blood Deck (39):
1

How is Bone Marrow Sampled?

Aspiration - cytology
Trephine Biopsy - histology
Usually from Iliac Crest

2

What is the function of White Blood Cells?

What is the Life Expectancy of a White Blood Cell?

Combat Pathogens and other foreign substances that enter the body.

Live for a few hours to a few days

3

How are Red Blood Cells removed from the Circulation?

What is the Life Expectancy of a Red Blood Cell?

Phagocytic Macrophages in the Liver and the Spleen

120 days - wear and tear from squeezing through capillaries

4

What are the two arms of Haematopoeisis?

Myeloid and Lymphoid

5

What is the function of Neutrophils?

Phagocytosis
First on the scene
60-70% of WBCs

6

What is the function of Basophils?

Intensify inflammatory response in allergic reactions

7

What is the function of Eosinophils?

Combat effects of histamine in allergic reactions
Destroy certain parasitic worms

8

What is the function of Monocytes?

Convert to macrophages
Then phagocytosis

9

What is the function of lymphocytes?

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

10

How are phagocytes attracted to microbes and inflamed tissues?

Chemotaxis

Chemoattractants and Chemorepellants

11

What is a Platelet?

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

12

What is the normal range for Haemoglobin concentration?

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

13

What is Mean Cell Volume?

What is the normal range for Mean Cell Volume?

A representation of how big the RBCs are

77-96 fL

14

What is the normal range for platelets?

150-400 x10^9/L

15

What is the normal range for White Blood Cells?

4-11 x10^9/L

16

What is the normal range for Neutrophils?

2.0-7.5 x10^9/L

17

What is the normal range for Lymphocytes?

1.3-4 x10^9/L

18

What would raised neutrophils indicate?

Bacterial Infection

19

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

Haematological Malignancy

20

What what raised lymphocytes suggest?

Viral Infection

21

What what raised eosinophils suggest?

Parasitic Infection

22

Hoe are Red Blood Cells made?

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

23

Where is Red Bone Marrow found?

Axial Skeleton

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

24

What is Anaemia?

Absolute reduction in Haemoglobin

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

25

What is Microcytic anaemia and what are the causes?

Anaemia with Low MCV (<77)

Iron Deficiency
excessive loss, dietary inadequacy, failure of absorption, excessive demands

26

What is Normocytic anaemia and what are the causes?

Anaemia with normal MCV
(77-95)

Recent Bleeding
Chronic disease (kidneys-EPO)
Preganancy

27

What is Macrocytic anaemia and what are the causes?

Anaemia with high MCV (>95)

B12 deficiency
Pernicious anaemia (intrinsic factor antibodies, unable to absorb B12)
Folate Deficiency
Alcohol Excess

28

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

Pabrinex
Multivitamins, B12, folate

29

Where is Vitamin B12 obtained from?

How is Vitamin B12 absorbed?

Meat, eggs and dairy

Binds to intrinsic factor in the stomach then absorbed in the terminal ileum

30

Where is Folate obtained from?

Green leafy vegetables, nuts and liver

31

What is Acute Lymphoid Leukaemia?

Who is it seen in most commonly?

B or T cell Malignancy

Good Prognosis - goes down as age goes up

Commonest childhood cancer

32

What is Acute Myeloid Leukaemia?

How is it treated?

Who is it seen in most commonly?

High neutrophils, basophils and eosinophils

Intensive Chemotherapy

Most common leukaemia in adults

33

What is Chronic Lymphoid Leukaemia?

How is it treated?

Who is it seen in most commonly?

B and T cell malignancy
Asymptomatic in 90% at presentation (seen in routine FBC)

Non-curative management

Disease of the elderly, especially males

34

What is Chronic Myeloid Leukaemia?

How is it treated?

Who is it seen in most commonly?

Insidious presentation - splenomegaly
Philadelphia chromosome in >80%

Treated with imatinib (monoclonal antibody to suppress bone marrow)

Typically 40-60 year olds

35

What is lymphoma?

What are the two types?

Malignant tumour of the lymphatic system

Hodgkin's and Non-Hodgkin's

36

How is Hodgkin's lymphoma characterised?

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

37

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

Low Grade - good prognosis but not usually curable

High Grade - More aggressive but usually curative

38

What is Myeloma?

Who does it affect most commonly?

How does it present?

What tests are done?

How is the diagnosis confirmed?

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

39

Hypercalcaemia Symptoms

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