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Diseases of the Blood Flashcards

(80 cards)

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1
Q

what are the 4 diseases of the blood plasma?

A
  1. bleeding
  2. thrombosis
  3. hereditary angioedema
  4. complement deficiency
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2
Q

what are the 7 main diseases of the blood cells?

A
  1. haematological malignancies
  2. sickle cell anaemia
  3. thalassaemia
  4. haemoglobinopathies
  5. leukopenia
  6. thrombocytopenia
  7. infectious mononucleosis
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3
Q

What is leukopenia?

A

A reduction in the number of white blood cells

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4
Q

What is thrombocytopenia?

A

a reduction in the number of platelets, which leads to bleeding

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5
Q

what is infectious mononucleosis?

A

an infection, usually caused by Epstein-Barr virus, that causes atypical mononuclear cells

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6
Q

What is thrombosis?

A

The formation of a blood clot inside a blood vessel

This obstructs the flow of blood through the circulatory system

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7
Q

What is a venous thrombosis?

A

A blood clot that forms within a vein

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8
Q

What is the most common type of venous thrombosis?

Why does this occur?

A

Deep vein thrombosis which occurs in the deep veins of the leg

It usually occurs when something slows or changes the flow of the blood

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9
Q

How many deaths per year in the UK are attributable to venous thrombosis?

A

25,000

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10
Q

What are the 4 most common triggers for venous thrombosis?

A
  1. surgery
  2. cancer
  3. immobilisation
  4. hospitalisation
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11
Q

What is an arterial thrombus?

A

A blood clot that develops in an artery

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12
Q

Why is an arterial thrombus dangerous?

How many deaths does it cause per year in the UK?

A

It can obstruct or stop the blood flow to major organs, such as the brain and heart

It causes 200,000 deaths per year

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13
Q

What are the majority of cases of arterial thrombosis caused by?

A

Artery damage due to atherosclerosis

This is fatty deposits that build up on the walls of the arteries and cause them to harden and narrow

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14
Q

What are the 7 causes of thrombosis?

A
  1. atherosclerosis
  2. cancer
  3. immobilisation
  4. surgery
  5. hyper-coagulability due to inhibitor deficiencies
  6. thrombocytopenia
  7. factor V Leiden
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15
Q

What is a haematological malignancy?

A

A form of cancer that begins in the cells of blood-forming tissue

e.g. bone marrow or cells of the immune system

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16
Q

How can cancer affect blood cells and what are the consequences?

A

cancer can affect any blood cell

the consequences depend on the cell it affects and whether it is myeloid and lymphoid

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17
Q

In which 3 ways are haematological malignancies categorised?

A
  1. according to blood cell lineage
  2. according to lineage
  3. how long it lasts
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18
Q

How are haematological malignancies classified according to blood cell lineage?

A

It is either a myeloid lineage or a lymphoid lineage

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19
Q

How are haematological malignancies classified according to location?

A

Leukaemia is found in the blood

Lymphoma is found in the lymph nodes

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20
Q

How are haematological malignancies classified according to how long they last?

A

Acute affects the blast cells (progenitors) and lasts for weeks

Chronic affects mature cells and lasts for years

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21
Q

What is neoplasia?

A

Neoplasia is the presence or formation of a new, abnormal growth of tissue

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22
Q

What is a neoplasm?

A

An abnormal mass of tissue that results from excessive cell division, or lack of cell death

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23
Q

What are the 2 types of neoplasms?

A

they may be benign (not cancerous) or malignant (cancerous)

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24
Q

What are oncogenes and how can they lead to cancer formation?

A

They are directly causative of cancer

A mutation in an oncogene will make them more active

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25
How do tumour suppressor genes cause cancer?
A mutation that leads to a loss of suppressor activity can cause cancer
26
What are the 3 mechanisms that may initiate cancer of the blood cells?
1. point mutations due to UV light, radiation, carcinogens 2. chromosome translocation 3. viral genes
27
What retrovirus has been associated with leukaemia?
Human T-lymphotropic virus
28
What is Burkitt's lymphoma?
It is caused by a translocation between the c-MYC gene on chromosome 8 with IgH loci on chromosome 14
29
What are chronic myeloproliferative disorders?
A group of slow-growing blood cancers in which the bone marrow makes too many abnormal red blood cells, white blood cells or platelets, which accumulate in the blood
30
What happens when the body makes too many blood cells?
In a myeloproliferative neoplasm, the overproduction of blood cells leads to problems with blood flow
31
What is myeloid neoplasia caused by?
The proliferation of myeloid cells
32
What is polycythaemia caused by?
An increase in red blood cells makes the blood thicker and less able to travel through vessels and organs
33
What is meant by the haemocrit being elevated in polycythaemia?
The volume percentage of erythrocytes is elevated
34
What is thrombocythemia caused by?
an increase in the number of platelets in the blood too many platelets can lead to abnormal blood clotting which can block the flow of blood in blood vessels
35
What is myelofibrosis caused by?
an increase in megakaryocyte production this leads to scarring in the bone marrow
36
What is chronic myeloid leukaemia caused by?
An increase in granulocytes A translocation leads to an abnormal long chromosome 9 and short chromosome 22 This is Philadelphia syndrome
37
How does chronic myeloid leukaemia affect blood cells?
It is slow to progress and affects white blood cells The bone marrow produces too many myeloid cells There is also a reduction in other blood cells, including RBCs
38
What is leukaemia caused by?
The accumulation of white blood cells in the bone marrow and blood due to bone marrow failure These abnormal white blood cells are blasts
39
How does the number of blood cells change in leukaemia? Is this different in advanced disease?
The number of white blood cells increases The number of red blood cells and platelets decreases In advanced disease, the number of white cells decreases due to bone marrow disease
40
What symptom of leukaemia is caused by an increase in the number of white blood cells?
Blood hyperviscosity leads to neurological and respiratory symptoms
41
What symptoms of leukaemia are caused by a lowered level of white blood cells?
Increased susceptibility to infection
42
What are the other common symptoms of leukaemia?
1. tiredness 2. anaemia 3. bleeding 4. bone pain in children
43
Where in the body does lymphoma affect and how?
It affects the lymph nodes The cancer originates in the lymphocytes and causes them to change and grow out of control
44
What symptoms and characteristics of the lymphocytes are common to both types of lymphoma?
1. B-lymphocytes multiply in an abnormal way and collect in parts of the lymphatic system 2. affected lymphocytes lose infection-fighting properties 3. the most common symptom is a painless swelling in a lymph node usually in the neck, armpit or groin
45
What is Hodgkin lymphoma categorised by?
The presence of Reed-Sternberg cells
46
How is Hodgkin lymphoma treated?
It is a relatively aggressive cancer that can quickly spread throughout the body It is treated with chemotherapy followed by radiotherapy
47
What is non-Hodgkin lymphoma characterised by?
There are no Reed-Sternberg cells visible under a microscope
48
How is non-Hodgkin lymphoma treated?
chemotherapy, radiotherapy or monoclonal antibody therapy
49
What must haemoglobin levels be in order for someone to have anaemia?
< 13.5 g/dL in men < 11.2 g/dL in women
50
What are common symptoms of anaemia? How common is it?
Occurs in 30% of the population 1. tiredness 2. pallor 3. fainting 4. tachycardia 5. shortness of breath
51
In general, what is anaemia caused by?
1. abnormalities in red blood cell destruction | 2. abnormalities in red blood cell or haemoglobin production
52
What are the 3 stages involved in classifying an anaemia?
1. Is it acute (sudden) or chronic (long-standing)? 2. Is is inherited or acquired? 3. Is it primary or secondary?
53
How do growth factors act on the multipotential haematopoietic stem cell?
They direct the transformation of multipotential stem cells into colony-forming units (CFU) and burst-forming units (BFU) These will ultimately form specialised blood cells
54
What are colony-forming units involved in?
Haematopoiesis of many cells including: 1. erythrocytes 2. neutrophils, eosinophils, basophils 3. monocytes
55
What are lymphokines involved in?
Haematopoiesis of B and T cells and NK cells
56
What is the role of erythropoietin (Epo)?
It is responsible for red blood cell development
57
What is the role of thrombopoietin (Thpo)?
It is responsible for megakaryocytic cell development
58
Which cells produce Epo? What disease of this organ can lead to anaemia and how is it treated?
Interstitial fibroblasts in the kidney Renal disease can lead to anaemia Recombinant Epo is a treatment for renal disease-induced anaemia
59
Once Epo is released, where does it travel to and what does it signal?
It travels through the blood to the bone marrow Here, it signals whether red blood cell production needs to increase or decrease
60
What type of anaemia results from low levels of Epo and why?
Erythropoietin anaemia Low levels of Epo mean that the body cannot make enough red blood cells
61
What is the name of iron-deficiency anaemia? What do the red blood cells look like?
Hypochromic microcytic anaemia The cells are smaller than normal (microcytic) They have an increased zone of central pallor (paler in colour as there is less Hb)
62
What is meant by increased anisocytosis and poikilocytosis in hypochromic microcytic anaemia?
anisocytosis - variation in size poikilocytosis - variation in shape some cells are elongated to form pencil cells
63
What may iron-deficiency anaemia be caused by? Is it inherited or acquired?
1. diet induced 2. acute or chronic blood loss 3. infection (e.g. hookworm) 4. growth spurts in children 5. pregnancy It is acquired
64
How does hypochromic microcytic anaemia affect haemoglobin?
Iron is an essential element of the haem group Without the haem group, Hb cannot function and carry oxygen
65
What type of anaemia is caused by folate or vitamin B12 deficiency? What are these minerals involved in?
Megaloblastic anaemia Folate and vitamin B12 are involved in DNA replication
66
how does folate/vit B12 deficiency affect red blood cells?
Deficiency causes problems with the proerythroblast This is the earliest of the four stages of development of the normoblast The normoblast is an immature red blood cell
67
What do red blood cells look like in megaloblastic anaemia? What other cells may be affected?
Formation of macroovalocytes These are larger-than-normal, oval-shaped RBCs May lead to formation of hypersegmented neutrophils due to disordered nuclear maturation
68
What is Vitamin B12 deficiency usually caused by?
reduced absorption
69
What is folate deficiency usually caused by?
1. poor nutrition 2. alcoholism 3. malabsorption 4. certain drugs including anti-epileptics, barbiturates and some antibiotics
70
When does anaemia occur through blood loss?
When the amount of blood lost is greater than the capacity of the bone marrow to produce new erythrocytes
71
How does acute and chronic blood loss lead to anaemia?
Acute loss of large amounts of blood leads to anaemia Chronic blood loss causes anaemia when the volume of blood lost exceeds the capability for haematopoiesis of the bone marrow
72
What type of anaemia results from blood loss and why?
Normocytic anaemia There are no abnormalities in red blood cell production or morphology
73
Why does haemolytic anaemia occur? Is it acquired or inherited?
It occurs due to an increase in red blood cell destruction The bone marrow is unable to replace sufficient RBCs It can be acquired or inherited
74
What are the 3 types of acquired haemolytic anaemia which are immune?
1. Haemolytic syndrome of the new-born 2. Autoantibodies 3. Complement system
75
What are autoantibodies?
Antibodies that are directed against the individual's own antigens
76
How does the complement system lead to destruction of red blood cells?
RBCs become coated with antibody (often IgG) Antibodies react with Fc receptors on the macrophages, leading to phagocytosis
77
What is the result of partial phagocytosis in haemolytic anaemia? Why does this happen?
Spherocytes The Fc receptor attaches to the antibody on the RBC but there is no complement receptor
78
Under what conditions will complete phagocytosis occur in haemolytic anaemia?
If there is a complement as well as an antibody on the RBC surface These bind to the Fc receptor and the complement receptor
79
If RBCs are only coated with complement and have no antibody, what happens to them?
They are ineffectively removed and circulate with C3d and C3b on their surface
80
In which 4 ways may acquired haemolytic anaemia be non-immune?
1. drug-induced 2. snake venom 3. mechanical e.g. heart valves 4. infections e.g. malaria/septicaemia

Blood (6 decks)

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