Haematological Cancers Physiology

Question 1

lifespan of a neutrophil

Answer 1

7-8 hours

Question 2

what is a blast?

Answer 2

nucleated precursor cells (erythroblasts and myeloblasts)

Question 3

platelet precursor

Answer 3

megakaryocyte

Question 4

what regulates platelet production?

Answer 4

thrombopoietin, a glycoprotein produced by the liver and kidney

Question 5

what is a reticulocyte?

Answer 5

immediate red cell precursor (polychromasia)

Question 6

what is a myelocyte?

Answer 6

nucleated precursor between neutrophils and blasts

Question 7

development events in haemopoiesis

Answer 7

self-renewal
proliferation
differentiation
maturation
apoptosis

Question 8

define pluripotency

Answer 8

ability to differentiate into a specific type of lineage of blood cell

Question 9

which layer of the embryo do HSC originate?

Answer 9

mesoderm

Question 10

sites of haematopoiesis in the embryo

Answer 10

yolk sac
liver starts at week 6
bone marrow at week 16

Question 11

when is the cellularity of bone marrow highest?

Answer 11

when born and decreases with age

Question 12

IgM

Answer 12

recent infection

Question 13

IgG

Answer 13

past infection

Question 14

what are immunoglobulins?

Answer 14

antibodies produced by B cells from plasma cells

Question 15

what are immunoglobulins made up of?

Answer 15

2 heavy (μ, α, δ, γ, ε) 
2 light chains (κ or λ)

Question 16

role of immunoglobulins

Answer 16

each recognises a specific antigen due to the presence of their variable region

Question 17

immunoglobulins that are monomers

Answer 17

IgD
IgE
IgG

Question 18

immunoglobulins that are dimer

Answer 18

IgA

Question 19

immunoglobulins that are pentamer

Answer 19

IgM

Question 20

where do B cells go once out of the bone marrow?

Answer 20

germinal centre of the lymph node where it enters and improves the fit by somatic mutations or it is deleted (self)

Question 21

where does the B cell go after the germinal centre?

Answer 21

may go to the marrow as a plasma cell or circulate as memory B cell

Question 22

what do plasma cells produce?

Answer 22

antibodies

Question 23

what do plasma cells look like on blood film?

Answer 23

clock face nucleus
plentiful blue cytoplasm
pale perinuclear area (golgi apparatus)

Question 24

what causes a polyclonal increase in immunoglobulins?

Answer 24

infection
AI
malignancy
liver disease

Question 25

what does monoclonal increase in immunoglobulins indicate?

Answer 25

underlying problems

Question 26

what is monoclonal immunoglobulins called?

Answer 26

paraprotein (used as a marker for underlying disease)

Question 27

causes of paraproteinaemia

Answer 27

``` myeloma MGUS amyloidosis lymphoma plasmacytoma CLL Waldenstrom's ```

Question 28

methods used to detect immunoglobulins

Answer 28

1. serum electrophoresis | 2. serum immunofixation

Question 29

what is serum electrophoresis

Answer 29

separates proteins based on size and charge which appear as bands

Question 30

what is serum immunofixation?

Answer 30

classified abnormal protein bands seen on electrophoresis

Question 31

what is the Bence Jones Protein (BJP)?

Answer 31

immunoglobulin light chains detected by urine electrophoresis

Question 32

how is the BJP detected?

Answer 32

urine electrophoresis

Question 33

what causes BJP?

Answer 33

excess light chain production cause it to leak into the urine and precipitate into the BJP