Haematology Flashcards
(94 cards)
1
Q
How are RBCs measured?
A
10^12/l
2
Q
How are WBCs measured?
A
10^9/l
3
Q
What is an FBC?
A
Rapid screening test
Automatically performed by an analyser
4
Q
-cytosis is put on the end of?
A
Agranulocyte WBCs
5
Q
-philia is put ont he end of?
A
Granulocyte WBCs
6
Q
What are the granulocytes?
A
Eosinophils, basophils, neutrophils, mast cells
7
Q
Hb, red cell parameters, and WBC count can vary with?
A
Age
8
Q
What affects Hb?
A
Age
Sex
Physiological status
9
Q
Hb range - women?
A
115-155g/l
10
Q
Hb range - men?
A
130-170g/l
11
Q
MCV range?
A
80-99fL
12
Q
WBC count - normal?
A
4-11 x 10^9/l
13
Q
Platelet count - normal?
A
2.0-7.5 x 10^9/l
14
Q
Neutrophil count?
A
2.0x7.5 x 10^9/l
15
Q
Lymphocyte count?
A
1.5-4.0 x 10^9/l
16
Q
Monocyte count?
A
0.2-0.8 x 10^9/l
17
Q
Eosinophil count?
A
0.0-0.4 x 10^9/l
18
Q
Basophil count?
A
0-0.1 x 10^9/l
19
Q
What to do if FBC abnormalities are found?
A
Blood film
20
Q
What do blood films show?
A
Morphology
Cell count
Cells that shouldn’t be there
21
Q
What is anaemia?
A
Reduced [Hb] in the peripheral below
22
Q
How is anaemia classified?
A
Microcytic - small RBCs
Normocytic
Macrocytic - large RBCs
23
Q
What are RBCs like in iron deficiency anaemia?
A
Microcytic
Poikilocytosis
Hypochromic
24
Q
What is poikilocytosis?
A
Different shapes
25
What is hypochromia?
Paler than normal
26
What is leukocytosis?
Increased total number of circulating WBCs
Neutrophilia can lead to leucocytosis
27
What causes leukocytosis?
Infection
Inflammation
Malignancy
28
Does leukocytosis always happen in leukaemia?
No, can have normal or low WBC count
29
What is commonly seen in blood films of patients with CLL?
Smear cells
30
What components are given in a transfusion?
Cellular (RBC, platelets)
Plasma (FFP, fibrinogen) and fractionated products
31
Why are transfusion components given?
Correct anaemia or thrombocytopaenia
Replace coagulation factors
32
How to safely give transfusion?
Appropriate transfusion
Transfuse only when indicate
Compatibility
Storage and handling
33
How many RBCs in a unit?
280ml
34
How much do packed cells increase with 1 unit?
>10g/l Hb/unit of packed cells?
35
What temperature are RBCs stored at for how long?
4 degrees
Up to 35 days
36
What is platelet transfusion made of?
1 pool from 4 donors - standard adult dose
or
1 donor by apheresis
37
What is apheresis?
Cell separator machine
38
How are platelets stored?
22 degrees - constantly agitated
39
What is the shelf life of platelets?
7 days
Due to risk of bacterial infection
40
What is FFP stored at for how long?
-30
1 year
41
What is a typical dose of FFP?
12-15ml/kg
42
Do you need to know blood group for FFP?
Yes
No cross match, just choose same group
43
What is FFP made of?
1 unit from 1 donor
~300ml
Can get small packs for children
44
What is cryoprecipitate?
Plasma-derived blood product for transfusion
Contains fibrinogen, factor 8, factor 13, VwF, fibrinectin
45
How is cryoprecipitate stored?
-30 degrees
1 year
46
What is a standard dose?
10 donors - 5 in a pack
47
What are indications for cryoprecipitate?
If massive bleeding and fibrinogen very low
Rarely, hypofibrinogenaemia
48
What are the 2 most important blood group systems clinically?
ABO
Rh
49
Antigen on RBCs and antibodies in plasma: group O?
Antigen - none
Antibodies - anti-A and anti-B
50
Antigen on RBCs and antibodies in plasma: group B?
Antigen - B
Antibodies - anti-A
51
Antigen on RBCs and antibodies in plasma: group A?
Antigen - A
Antibodies - anti-B
52
Antigen on RBCs and antibodies in plasma: group AB?
Antigen - A, B
Antibodies - none
53
What does RhD+ mean?
Presence of D antigen
54
What does RhD- mean?
Absence of D antigen
55
Are anti-D antibodies naturally occurring?
No
Produced in response to transfusion - e.g. RhD+ cells to RhD- recipient
56
What is prothrombin time and unit?
s
57
What is prothrombin time dependent on?
Extrinsic and common pathway facotrs
58
What is activated partial thromboplastin time dependent on?
Intrinsic and common pathway factors/fibrinogen
59
What are units for fibrinogen levels?
g/l
60
Inappropriate or overactivation of coagulation can lead to...?
Thrombosis
61
Thrombosis definition
Clot inside a blood vessel
62
Thrombosis definition
Clot inside a blood vessel
63
What are the two broad causes of prolonged PT and/or APTT?
- Deficiency in one or more coagulation factors
- Inhibitor causing in vivo prolongation of test
64
What causes prolonged PT, normal APTT?
Extrinsic coagulation factors
65
What causes prolonged APTT, normal PT?
Intrinsic coagulation factors
66
What causes prolonged PT and APTT?
All factors or
common pathway factors or low fibrinogen
E.g. liver disease
67
What conditions could cause prolonged PT?
Congenital deficiencies in extrinsic factors and common pathway
Acquired: liver disease, Vit K deficiency, DIC, massive blood transfusion, warfarin
68
What factors depend on vitamin K?
2, 7, 9, 10
69
What could cause a vitamin K deficiency?
Obstructive jaundice
Haemorrhagic disease of the newborn
70
What conditions could cause prolonged APTT?
Congenital deficiencies in intrinsic factor and common pathway
Liver disease, Vit K deficiency, DIC, massive blood transfusion, warfarin, heparin
71
What could cause low fibrinogen?
Congenital dys/hypofibrinogenaemia
Liver disease - dys/hypofibrinogenaemia
DIC
72
What is VTE?
Blood clots in veins
(DVT or PE)
73
What is the most common site of DVT?
Lower limbs
74
Symptoms of DVT?
Pain, swelling of affected limb, erythema
75
What is a PE?
Presence of blood clot int he pulmonary arteries
Can be fatal
76
VTE mortality in Europe per year?
500k
77
Is VTE preventable?
Yes, with appropriate thromboprophylaxis - i.e. measures to reduce VTE risk
78
What does thromboprophylaxis involve?
Mechanical - e.g. anti-embolism strockings
Drugs - anticoagulant drugs like LMWH
79
Around 20-50% of patients with DVT develop...?
Post-thrombotic syndrome - assoc with ongoing pain and swelling of the affected limb, and other complications like venous ulcers
80
VTE risk assessment on hospital admission underpins VTE prevention - what does this involve assessing?
Absolute VTE risk
Bleeding risk
81
What are risk factors for VTE?
Surgery
Sig. reduced mobility
Abnormal clotting dconditions
Pregnancy
HRT/the pill
VTE history
Cancer (active)
Dehydration
Obesity
Aged > 60
Certain medical conditions
82
What surgeries have the highest incidence of post-operative VTE without prophylaxis?
Knee surgery
Hip fracture surgery
Elective hip surgery
83
What drugs are effective for post-operative VTE prevention?
Heparins
LWMH is as effective and safer than UFH
No mechanical method effective in reducing mortality risk or PE risk
84
What does mechanical thromboprophylaxis involve?
Anti-embolism stockings
Intermittent pneumatic compression - flowtrons
Adjunct to LWMH for surgical patients
85
For whom is mechanical thromboprophylaxis not recommended?
General medical patients
Acute stroke
Vascular surgery patients
Neutropenic patients
86
What are contraindications to stockings?
Suspected/proven peripheral arterial disease
87
What are you supposed to check in all patients?
Presence of dorsalis pedis and posterior tibial pulses
88
What are you supposed to check in all patients?
Presence of dorsalis pedis and posterior tibial pulses
89
What is the definition of hospital acquired VTE (HAT)
VTE occurring >= 24h of admission or <=90 days after last admission
90
What does root cause analysis of HAT show?
Failure to risk assess VTE
Incorrect VTE risk assessment
Failure to prescribe LWMH
Inadequate dose/duration
91
What is the most severe manifestation of VTE, aside from PE?
Pulmonary hypertension
92
What does pancytopaenia mean?
Low Hb
Low WBCs
Low platelets
93
Full blood films can confirm...
Thrombocytopaenia
94
Does vitamin K deficiency present with low fibrinogen?
No
Only prolonged APTT and PT
