First year cards Flashcards
(69 cards)
1
Q
What can a myeloblast become?
A
Basophil
Promyeloblast -> neutrophils
Eosinophil
Promonocyte -> monocyte -> macrophage
2
Q
Thalassaemia
A
- Decrease in Hb chain
- Abnormal tetramers that causes premature destruction
- Microcytic, hypochromic anaemia
3
Q
What are pappenheimer bodies?
A
Abnormal granules of iron found inside RBCs on routine blood stain
4
Q
What conditions are pappenheimer bodies observed?
A
Sideroblastic anemia
Hemolytic anemia
Sickle cell disease.
5
Q
Features of iron deficiency anaemia
A
- Hypochromic, microcytic
- Anisocytosis
- Pokilocytosis
- Serum ferritin reduced
- Serum iron low
- Raised transferrin
- Raised unsaturated iron binding capacity
6
Q
NOAC
A
New/novel oral anticoagulants
7
Q
Pernicious anaemia
A
Autoimmune gastritis -> reduced gastric secretion of intrinsic factor
8
Q
WAIHA
A
Warm antibody autoimmune haemolytic anaemia
- happens at body temperature
- IgG
- antibody attaches to RBC -> monocytes and macrophages in the spleen ‘take a bite’ -> spherocytes -> destroyed
SLE, rheumatoid arthritis, CLL
9
Q
Jaundice sclera
A
Icterus
10
Q
Fibrolytic agents
A
- tPA (tissue plasminogen activator) binds fibrin and converts plasmingen to plasmin
- Plasmin (fibrin -> FDPs)
- Protein C stimulates tPA
11
Q
Pica
A
Desire for non nutrient rich food
12
Q
Thrombocytopenia
A
Deficiency of platelets
13
Q
HbA
A
α2β2 98%
14
Q
Cold agglutin disease
A
- high levels of IgM
- direct against RBC
- only bind at low temperatures 28-31°C
- haemolytic anaemia
15
Q
Shift binding curve to right
A
- Carbon dioxide
- Increase H+ concentration
- Increase temp
- Increase 2,3 bisphosphoglycerate
16
Q
Virchow’s triad
A
Causes of thrombi
- Endothelial damage
- Abnormal blood flow
- Hypercoagulability
17
Q
Factors involved in haemophilia A, B, C
A
A VIII
B IX
C XI
18
Q
Erythropoiesis in the foetus
A
Up to around 6 weeks Yolk sac
6 weeks- 6 months Liver and spleen
From 7 months bone marrow
19
Q
What’s it called when erythropoiesis occurs not in the bone marrow?
A
Extramedullary erythropoiesis
20
Q
Lab features of B12 and folate deficiency
A
- Macrocytic
- Hypersegmented neutrophils
- Slightly reduced leukocyte and platelet counts
- Raised bilirubin
- BM hypercellular
- Megaloblastic
21
Q
HbA1c
A
α2β2glucose
<5%
Glycated hemoglobin- measures 3 month average plasma glucose
22
Q
Cause of increase APTT
A
(activated partial prothrombin time)
- Heparin treatment
- Haemophilia
- DIC
- Liver disease
23
Q
Biochemical tests for blood
A
- bilirubin
- LDH
- haptoglobin
24
Q
Mechanical haemolytic anaemias
A
- microangiopathic haemolytic anaemia (red cells travel through damaged vessels and are cut by thrombin)
- valve prosthesis
- march haemoglobinuria
25
HbA2
α2δ2
| <3.5%
26
MCV
Mean corpuscular volume
Normal 80-96 fL
27
Reticulocytes
- young non-nucleated RBCs
- retain RNA
- nucleus condenses on maturation of cell and is extruded prior to release in circulation
28
EPO
- erythropoietin
- released from kidney when oxygen low
- inhibit RBC apoptosis
29
Mechanism of factor V Leiden
Patients have a mutated factor V so protein C can't cleave it. Coagulation continues unchecked.
30
Inhibitor of IIa (thrombin)
Dabigatran
| Idarucizumab for reversal
31
Increase in D-dimers
- DIC
- DVT
- PE
32
Characteristic of platelet defects
- bleeding but lack of joint swelling/pain
- superficial bleeding
- nose bleeds
- takes a whle to stop but does stop
- enlarged spleen
- petechia
33
TIBC
total iron binding capacity
34
Normal platelet count
150-450 x 10^9/L
35
Intermittent claudication
Obstruction of arteries during exercise -> leg cramps
36
Causes of normocytic anaemias
```
Acute blood loss
Anaemia of chronic disease
Bone marrow failure
Haemolysis
(Hypothyroidism)
Renal failure
Pregnancy
```
37
Mechanism of LMWH
Inactivates Xa
38
B12
- stored in liver
- 2-4 years
- intrinsic factor (gastric parietal cells)
- B12/IF bind transcobalamin II to be taken into the cells
- absorbed in the terminal ileum
39
DNA bodies
Howell Jolly bodies
40
Signs of factor bleeding
- subtle
- delayed
- into joints
- no splenomegaly
- presents early in life
41
Sickle cell anaemia
- abnormal Hb shape
| - releases oxygen and aggregates -> burst in small blood vessels
42
Sickle cell anaemia inheritance pattern
autosomal recessive
gene on chromosome 11
43
Coombs test
Detects antibody or complement bound to surface of RBCs
44
Mutations in EPO cascade that leads to increase RBC production
Polycythaemia rubavera
45
Action of heparin
Glyccosaminoglycan which binds antithrombin and makes it a better inhibitor of thrombin, Xa and IXa
46
Causes of increased INR (normalised prothrombin time)
International normalised ratio
Extrinsic
- warfarin
- vitamin k deficiency
- liver disease
- DIC
47
DIC
Disseminated intravascular coagulation
48
Proteins that control coagulation cascade
- TFPI tissue factor pathway inhibitor (inhibits VIIIa)
- Antithrombin III
- Protein C (protease targets Va and VIIIa)
- Protein S is a cofactor that helps C
49
Inhibitors of Xa
Betrixaban
Edoxaban
Apixaban *
Rivaroxaban *
50
Signs of anaemia
- pallor
- jaundice
- gallstones or splenomegaly
- koilonychia (spoon shaped nails)
51
MCHC
Mean corpuscular haemogloin concentration
| - measure of Hb in a given volume of RBC
52
Causes of increased thrombin time
- heparin treatment
- DIC
- dysfibrinogenaemia
53
Abnormal shape of RBC
Poikilocytosis
54
Causes of macrocytic anaemia
```
Hypothyroidism
Myelodysplastic syndrome
Marrow infiltration
Alcohol excess/liver disease
Cytotoxics
Reticulocytosis
Antifolate drugs
B12/folate deficiency
```
55
Signs of Von Willelbrand disease
- increase APTT
- increase bleeding time
- decrease factor VIIIc
- INR and platelets normalish
56
Thrombin activities
+ 5, 7, 8, 11, 13
| - plasmin, antithrombin (targets thrombin, X, 7, 9, 11)
57
Clinical features of B12 or folate deficiency
- glossitis
| - angular cheilitis
58
Infectious agents at risk of if had splenectomy
Neisseria meningitidis
Haemophilus influenza type B (Hib)
Streptococcus pneumoniae
59
HBF
α2γ2
< 2%
switch to adult up to months
60
Formation of a clot
- collagen exposed
- vWF binds
- vWF binds GP1b receptor on platelet
- platelet integrin α2β1 and GPVI to collagen
- increase intracellular calcium
- pseudopodia and TXA2
- platelet dense granules released
61
Intravascular haemolysis
- decrease haptoglobins
- haemoglobinuria
- urine haemosiderin
62
Causes of microcytic anaemia
Sideroblastic
Iron deficiency
Thalassaemia
63
Exit of bilirubin through gut
- bilirubin
- urobininogen -> urobilin -> urine
- stercobilin -> feces
64
Lysed RBCs
Schistocytes
65
RBCs different size
Anisocytosis
66
PCV/haematocrit
Packed cell volume
Most cells in blood are RBC so reflects RBC
Normal
M 0.45 +/- 0.05 Abnormal >0.52
M 0.41 +/- 0.05 Abnormal >0.48
67
Normal white cell count
4-11 x 10^9/L
68
Flat broad nails
Plantonychia
69
Erythropoiesis in adults
Central skeleton and proximal ends of long bones
