CSL Flashcards
(39 cards)
What is a common marker used to differentiate lymphoblastic leukaemia from myeloblastic leukemia?
TdT
What is a common marker used to differentiate myeloid leukemia from lymphoblastic leukemia?
Myeloperoxidase and the presence of auer rods
What is a philidephia chromosome and what does it mean for the prognosis of B lymphoblastic leukaemia?
translocation between chromosomes 9 & 22, normally occurs in adults and leads to a poor prognosis :(
What is the difference between a lymphoma and a lymphoblastic leukemia?
Lymphoma= malignant cells form a mass, mainly in lymph nodes Leukemia- malignant cells in blood
A translocation between chromosomes 15 and 17 is associated with what subtype of leukaemia?
acute promyelocytic leukemia
What are the causes of pancytopenia?
- Autoimmunity against blood cells 2. Drugs (chemotherapy) 3. Inability of cells to be made due to physical limitations e.g. leukaemia –> excess blast formation –> not enough room in marrow for other cells to be made, osteopetrosis (bone hardening)
What are the clinical consequences of failure of blood cell production?
Pancytopenia:
Low RBC’s –> anaemia
Low WBC’s –> infection
Low platelets –> inability to clot; easy bruising etc.
Describe the physiology of blood production
What is Imatinib?
To treat BCR-ABL fusion –> tyrosine kinase inhibitor, used to treat CML and some cases of ALL in cases with a philidephia chromosome mutation t(9;22)
Describe the laboratory diagnosis of leukaemia and the significance of the prognostic markers
After taking a bone marrow aspirate, the cells are immunophenotypes (looking for specific cell markers such as CD10, TdT etc) and cytogenetics (chromsome anaylsis). Morphology is also looked at e.g. a blood smear, checking for presence of auer rods to suggest a myeloid blastic lineage.
Who would be a suitable donor for Max? Which represent the genes for the different MHCI and MCHII proteins?
Anna and Lachlan
MCHI= HLA-A, B ,C
MCHII- DP DQ DR
- with aplha and beta chains
Describe what would happen if a patient was given the wrong blood type?
Type 3 delayed immune complex hypersensitivity response within 7+ days (adaptive immune response against foreign antigen)
Describe the normal menstrual cycle and ovulation
What is the main fx of inhibin in the female reproduction cycle?
Inhibition of FSH during the late follicular phae, ovulation and luteal phase to prevent the growth of excess folicle and release of multiple eggs throughout the cycle.
describe normal spermatogenesis
- include LH and FSH targets and effects
- pathway from spermatogonium to spermatozoa
GnRH –> LH –> leydig cells –> testosterone –> sex characteristics, spermatogenesis
GnRH –> FSH –> sertoli cells –> spermatocyte maturation
Spermatogonium –> primary spermatocyte –> secondary spermatocyte –> spermatid –> spermatozoa
describe normal fertilisation
- Sperm capacitation occurs in the vagina
- Day 1- Fertilisation- Sperm and oocyte meet in fallopian tube –> zygote
- Days 2-3- cell division
- Days 4-5 Blastocyst reaches uterus
- Days 5-9 blastocyst implants
Describe normal impantation
Include the formation of the embryo and what cells the baby will grow from.
On days 5-9 post fetilisation, the blastocyst adheres to the endometrial lining. Cords of the trophoblastic cells begin to penetrate the endometrium. As these cells divide and conglomerate together, they for synctiotrophoblasts. Unmerged trophoblasts are referred to as cytiotrophoblasts, and act as a barrier between embryo and maternal blood. These cells will go on to become the placenta.
The embryo develops from the inner cell mass of the blastocyst.
Describe the normal morphology of sperm in a semen analysis for a fertile male; how many sperm would you expect be be normal % wise?
>4% of sperm with normal forms
List 2 sexually transmissible infections that can cause infertility
Chylmydia
Gonnorhea
In which time in pregnancy would teratogenic effects result in major morphological abnormalities?
During the embryonic period; weeks 3-8
Discuss neonatal/transplacental immunity
PASSIVE IMMUNITY
Transplacental- predominately during the third trimester, maternal IgG cross the placenta.
Neonatal- placental IgG stays in the neonate for the first 4-6 months of life. IgA is passed to fetus from breastmilk and protects the immature gut.
What are the differences between superficial, partial-thickness (2nd degree) and full-thickness (3rd-degree) burns in terms of:
- what histological layer of the skin is affected
- appearance
- sensation
- time to heal (scarring?)
- which types blanch?
Blanching: 1st degree, 2nd degree superficial, 2nd degree deep (reduced)
Non-blanching: 3rd degree
describe the systemic features of major burns
- CV
- Resp
- Metabolic
- GI
- Renal
- Coagulability
- Renal
- Electrolyte imbalance
-
CV: dehydration –> hypovolemia –> baroreceptor reflex –>↑ sympathetic activation–> ↑ HR, ↑ vasoconstriction
- TNF-α release –> ↓ heart contractility –> ↓ CO –> ↓ BP
-
Resp: hypoxia, ↑ sympathetic activation & compensation for metabolic acidosis –> ↑ RR
- singed nasal hairs –> burned airways –> inflamm mediators –> oedema and bronchoconstrction –> airway obstruction
- Metabolic: sustained catacholamine release –> catabolic state –> ↑BMR weeks-months following burns
-
GI: vasoconstriction of splanchnic artery –> ischemia of organs
- curling ulcer –> translocation of microbioto –> TSS
- Renal ischaemia –> acute tubular necrosis –> ↓ GFR
- Thermoregulation risk of hypothermia
- DIC increased coagulability due to hypovolemia –> thick, concentrated blood
- Electrolytes hyponatremia and hyperkalemia
Describe the stem cell niches in the skin
- Basal layer of the epidermis
- Bulb of the hair follicle
- In the sebaceous gland
