Concepts in haematology

Question 1

what are causes of low blood count

Answer 1

increased destruction/loss: haemorrhage, haemolysis
reduced production: chemo, parovirus B19
redistribution: liver disease, portal hypertension, splenomegaly

Question 2

what are causes of high blood count

Answer 2

increased production with stimulus: infection, hypoxia, high altitude, COPD
increased production with no stimulus: malignancy
redistribution: steroids

Question 3

-cytosis / -philia = high/low count

Answer 3

high

Question 4

-paenia = high/low count

Answer 4

low

Question 5

what is the difference between thrombocytosis and thrombophilia

Answer 5

thrombocytosis = increased platelets 
thrombophilia = excess clotting

Question 6

what underlying malignancies may be present with an isolated thrombocytosis

Answer 6

LEGO C
lung 
endometrial 
gastric 
oesoophageal 
colorectal

Question 7

define hyperplasia

Answer 7

increased production

Question 8

define dysplasia

Answer 8

disordered production

Question 9

define hypoplasia

Answer 9

decreased production

Question 10

define aplasia

Answer 10

no production

Question 11

what is the erythron

Answer 11

intact cellular mechanism generating RBCs

Question 12

what are reticulocytes

Answer 12

immature RBC just released into the bloodstream from bone marrow

Question 13

what is the function of B12 and folate

Answer 13

cell division: DNA synthesis and nuclear maturation

Question 14

what is the function of iron

Answer 14

to make haem

Question 15

which organ detects hypoxia

Answer 15

kidneys

release EPO in response

Question 16

what is erythroid hyperplasia

Answer 16

increased production in RBCs

Question 17

thrombocytosis is common with microcytic anaemia, true or false

Answer 17

true

Question 18

what is low serum ferritin suggestive of

Answer 18

iron deficiency

Question 19

what is serum ferritin

Answer 19

an indirect reflection of tissue ferritin which stores Fe3+

ferritin is also an acute phase protein

Question 20

causes of high serum ferritin

Answer 20

high iron levels

inflammation, infection

Question 21

how can you assess response to iron replacement therapy in iron deficiency anaemia

Answer 21

reticulocyte count should increase

Hb levels

Question 22

what is extramedullary haematopoeisis

Answer 22

blood cell production outside the bone marrow

Question 23

what is a complication of regular blood transfusions

Answer 23

iron overload

Question 24

what are spherocytes

Answer 24

circular RBCs, not biconcave in shape

Question 25

what is hereditary spherocytosis

Answer 25

genetic condition with abnormal proteins in RBC membrane resulting in spherical shape jaundice and fatigue following a cold

Question 26

what investigations can be done for haemolysis

Answer 26

``` FBC bilirubin - high LDH - marker of cell turnover Haptoglobin - binds free Hb reticulocytes - high antibodies by DAT ```

Question 27

Haptoglobin is low/high in haemolysis, and why

Answer 27

low haptoglobin binds free iron, if there is a lot of iron from haemolysis then a lot of haptoglobin is used up meaning FREE haptoglobin is low

Question 28

what is IAT testing

Answer 28

indirect anti-globulin test | - used for crossmatching

Question 29

what is DAT

Answer 29

direct anti-globulin test | - autoimmune haemolytic anaemia

Question 30

spherocytes have a shorter lifespan, true or false

Answer 30

true

Question 31

splenectomy increases/decreases RBC lifespan

Answer 31

increases | the spleen is where RBC are destroyed, if it is not there, they hang around for longer

Question 32

risks of splenectomy/hyposplenism

Answer 32

infection and immunosuppresion risks of clots big operation need vaccinations before

Question 33

What is meant by reactive changes on the blood count

Answer 33

from underlying inflammatory changes or iron deficiency you can get neutrophilia, leucocytosis, thrombocytosis

Question 34

What can cause a high Hb/Hct

Answer 34

dehydration (rule out hypovolaemia, DKA, diuretics) cigarette smoking high altitude COPD

Question 35

what is anisocytosis

Answer 35

how large red cell distribution width is (RDW)

Question 36

causes of neutrophilia

Answer 36

``` steroids smoking trauma infection malignancy ```

Question 37

what is rouleaux

Answer 37

stacked/clumped RBCs due to presence of acute phase proteins in inflammatory conditions eg autoimmune

Question 38

what is pancytopaenia

Answer 38

reduced blood cells all over

Question 39

what is anisopoikilocytosis and in which condition is it seen

Answer 39

red blood cells are of different sizes and shapes aniso = size poikilo = shape B thalassaemia major

Question 40

what are crenated red cells (echinocytes)

Answer 40

abnormally contracted cells - look shrivelled (eg when placed in a hypertonic solution) PK deficiency drugs

Question 41

why do you get splenomegaly

Answer 41

presence of defective cells causes them to be destroyed which is done in the spleen - hyperplasia at site of destruction extravascular haemolysis thalamssaemia