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Haematology > Haematology > Flashcards

Haematology Flashcards

1
Q

What are the components of the blood

A

plasma (clotting factors, albumin, antibodies), red blood cells and a Buffy coat in-between (platelets, white cells, leucocytes)

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2
Q

What are the functions of blood

A

transport of gases, nutrients and hormones
Maintenance of vascular integrity (clots and anticoags)
Protection from pathogens

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3
Q

Describe haematopoiesis

A

Made from pleuripotent stem cells,
erythroblasts develop into reticules and then erythrocytes

production is governed by erythropoietin

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4
Q

what does totipotent mean

A

cells that can differentiate into any cell

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5
Q

where are pleuripotent stem cells found

A

bone marrow- fixed here by CXCR4

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6
Q

how do we measure the production of red cells on a blood test

A

reticulocyte count

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7
Q

where is erythropoietin made?

A

in the kidney in response to hypoxia

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8
Q

function of platelets

A

haemostasis and immune function

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9
Q

what regulates the production of platelets and where is this produced

A

thrombopoietin in the liver and regulated by platelet mass feedback

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10
Q

function of neutrophils and how are they regulated

A

Ingest and destroy pathogens regulated by immune response- macrophages and IL-7. Production is due to G-CSF

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11
Q

when would we see increased neutrophils

A

Infection and inflammation

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12
Q

function of monocytes

A

ingest and destroy pathogens - specialised in presenting antigens to lymphocytes
can become macrophages and dendritic cells

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13
Q

Function of eosinophils

A

play a part in allergy and parasites

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14
Q

Function of lymphocytes

A

huge part in the immune system

have many antigens on their surface

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15
Q

what are HLA and what are the 2 classes

A 
Molecules that take antigens and display them 
class 1: displays internal antigens on all nucleated cells 
class 2: displays antigens eaten by professional antigen presenting cells.
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16
Q

what are the normal haem values for men and women

A

women- 120-160

men- 130-170

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17
Q

normal platelet count

A

150-400

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18
Q

normal white cell count

A

4-10

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19
Q

Explain the ABO blood groups

A

arise from antigens on the surface
O- non- functional allele (recessive) so no antigens
A- transferase enzyme (N-acetly galactosamine)
B- Galactose transferase enzyme
AB- both antigens and therefore no antibodies.

Depending on your blood type you have antibodies against the other antigens
you have IgM natural immune tolerance against antibodies you dont have.

20
Q

What happens when 2 blood groups mix

A

Response where fixed complements are formed and this causes issues

21
Q

what is rhesus blood groups

A

you can be rhesus positive or negative

again these shouldn’t mix

22
Q

what is the process that occurs when you donate blood

A

Have extensive behavioural screening
Tested for blood type
screened for disease
Skin is carefully cleaned and first bit of blood collected is diverted

23
Q

at what temp must red cells be stored at and how are they transfused

A

4 degrees and transfused over 2-4 hours

24
Q

when would we prescribe platelets

A

massive haemorrhage
bone marrow failure
prophylaxis for surgery
bypass (only use if bleeding)

25
Q

when would we prescribe plasma

A

massive haemorrhage
DIC with bleeding
prophylactic

26
Q

what is the Coombes test/ DAT test

A

detects if there is any Ig G on the surface of red cells

can be used to diagnose disease and used indirectly in cross matching

27
Q

how are red cells broken down

A

occurs in the reticuloendothelial system
globing broken down to amino acids that are reused
haem- biliverdin- bilirubin
iron is recycled

28
Q

what are 2 key pathways involving enzymes in the red cells

A

glycolysis pathway

pentose phosphate pathway

29
Q

what is MCH and MCV on a blood test

A

mean cell haemoglobin

mean cell volume

30
Q

what are the various morphological descriptions of red cells and anaemia

A

hypochondriac microcytic
nomochromic normocytic
macrocytic

31
Q

what occurs when a vessel is damaged resulting in the activation of platelets and coag factors

A

abnormal surface- collagen is exposed and acts as a receptor to be bound to
physiological activator is released into circulation which triggers the coag cascade

32
Q

How is a primary clot formed

A

when a vessel Is damaged platelets become activated and adhere to collagen through GP1a and VW factor through GP1b
pathways (ADP and COX) are activated that help aggregation occur

aggregation occurs and scrambalase enzyme is expressed which is needed for coagulation

fibrinogen also binds

33
Q

Explain how fibrin formation occurs from a platelet plus

A

clotting cascade causes fibrinogen to be converted to fibrin

34
Q

Describe key steps in the clotting cascade

A

prothrombin converted to thrombin

thrombin to fibrinogen to fibrin

35
Q

what natural anticoagulants do we have

A

TFP1- binds and inhibit factor 7 and 10 therefore decreased thrombin
activated protein C and cofactor protein S- turns off factor 8 and 5
Anti- thrombin- inactivates many factors particularly 10 and thrombin

36
Q

explain fibrinolysis

A

when a clot forms the endothelial cells release activators of plasminogen
cleave plasminogen- plasmin which breaks down the clot into D dimer

37
Q

What inhibits plasmin

A

inhibitors of plasminogen (PA1 and PA2)

inhibitors of plasmin- antiplasmin, macro globulin

38
Q

what is virchows triad

A

stasis, hypercoagubility, vessel damage

39
Q

What is broadly wrong if you present with with mucosal bleeding and epistaxis, purport, menorrhagia

A

platelet

40
Q

what Is broadly wrong if you present with bleeding is classically into joints and causes spontaneous muscle haemotoma

A

Coagulation factors

41
Q

Why does neutropenia occur during cancer treatment

A

chemo wipes out the cells in the bone marrow therefore causing neutropenia

42
Q

how many days of neutropenia puts you at high risk of infection

A

more than 7 days

43
Q

if neutropenia is less than 0.5 What is the risk of infection

A

significant

44
Q

If neutropenia is less than 0.2 what is the risk of infectino

A

high risk

45
Q

what are the other risks other than neutropenia for infection during cancer treatment

A

distributed skin/mucosa- lines, GHVD
altered flora due to antibiotic prophylaxis
lymphopenia- due to lymphoma, treatment or transplant
monocytopenia- can be associated with certain types of leukaemia or chemo

46
Q

What are the various causes of febrile (bacterial)

A

Gram positive- staphylococci, streptococci

gram negative- E coli, klebsiella, pseudomonas aeruginosa

Haematology (1 decks)

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