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haematology Flashcards

1
Q

what is haematology

A

the study of normal and pathological aspects of blood

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2
Q

what do haematologists do

A

they diagnose, treat and care for people with blood disorders

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3
Q

what are examples of blood disorders

A

bleeding disorders, haemoglobinopathies, haematological malignancies

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4
Q

what is the volume of blood in the body

A

5 1/2 litres in a 70kg man (8% of body weight)
females lave 4-5 L whereas males have 5-6 L (due to body size)

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5
Q

what can blood be classed as

A

connective tissue

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6
Q

what are the physical characteristics of blood

A

sticky, metaillic taste, high O2 levels blood colour is scarlet but if have low O2 levels colour is dark red (not good), pH is 7.35-7.45

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7
Q

is bright red blood in the arteries or veins

A

arteries

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8
Q

why does the arteries (instead of veins) have bright red blood

A

because higher levels of oxygen are found there

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9
Q

what are the functions of blood

A

protection, transportation, regulation

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10
Q

describe transport as a function of the blood

A

-it transports O2 and nutrients to body cells.
-transports metabolic waste to lungs and kidneys to eliminate
transports hormones from endocrine organs to target organs

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11
Q

describe regulation as a function of the blood

A
  • maintains temperature by absorbing and distributing heat (by vasoconstriction and dilation)
  • maintains pH by using buffers (acid and base) such as bicarbonate
  • maintain normal fluid volume (done by plasma proteins which produce colloid osmotic pressure)
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12
Q

describe protection as a function of the blood

A

-prevents excessive blood loss after injury
- prevents infection as have white bc, antibodies and complement proteins

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13
Q

how and what is the composition of blood

A

-when take blood out put it in centrifuge
-55% of plasma (least dense)
-1% buffy coat (has leukocytes and platelets)
-45% erythrocytes (most dense)

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14
Q

what type of cells are the most abundant in blood

A

-red blood cells (erythrocytes)
-males have more RBC than females

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15
Q

what is haematocrit

A

the % of erythrocytes (RBC) in blood

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16
Q

what’s the volume of leukocytes in blood

A

1%

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16
Q

what is the function of leukocytes

A

-defense against disease
-they can leave capillaries by diapedesis which is when you move through tissue spaces by ameboid motion and positive chemotaxis

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17
Q

what is leukocytosis

A

this is when the white BC count is over 11 x10*9 (means you have an infection so response is normal)

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18
Q

what are the types of leukocytes (phagocytes)

A

-neutrophils, basophils, eosinophils, monocytes

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19
Q

starting from the most to least dense put the leukocytes in order

A

-neutrophils
-lymphocytes
-monocytes
-eosinophils
-basophils
(never let monkeys eat bananas)

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20
Q

what is the function of RBC (erythrocytes)

A

-gas transport such as O2 and CO2
-contributes to blood viscosity
-has a 120 life span

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21
Q

what are the structural characteristics of RBC (erythrocytes)

A

-biconcave shape (high surface area which allows O2 and CO2 to diffuse quicker)
-anucleate (no nucleus)
-no mitochondria/ ribosomes (no organelles)

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22
Q

how do erythrocytes produce energy

A

By the embden meyerhof glycolytic pathway which convers glucose into lactate. And anaerobically produces ATP

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23
Q

why do erythrocytes need energy

A
  • to maintain shape
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24
Q

how and why do erythrocytes need to be flexible

A

it has a red cell membrane which has spectrin (provides flexibility)

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25
Q

why do RBC need flexibility (provided by spectrin)

A

to change shape

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26
Q

what are RBC filled with

A

97% of haemoglobin (for gas transport)

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27
Q

what is the structure of haemoglobin

A

-binds and carries O2
-globin is a large protein made of 4 polypeptide chains (2 alpha and 2 beta chains)
-RBC has 200-300 million hae (males have more than females)

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28
Q

haemoglobin structure

A

-haem binds to a globin chain (gives red colour)
-haem is made of protoporphyrin ring that’s made up of 4 pyrrole rings
- there’s iron (gives colour) in the middle which binds to 1 O2
-each hae transports 4 O2

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29
Q

what’s oxyhaemoglobin

A

produces ruby red substance

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30
Q

what happens when O2 is loading in lungs

A

-oxyhaemoglobin is produced
-O2 is abundant (lots) in lungs
-hae picks up 4 O2 molecules

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31
Q

what happens when O2 is unloading in tissues

A

-hae releases O2 into tissues
-deoxyhaemoglobin is produced (dark red)

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32
Q

what happens to oxygen’s affinity when O2 binds to one haem grp

A

affinity increases

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33
Q

what is co-operativity

A

causes sigmoidal s shape when oxygen binds to haemoglobin. the change in shape makes it easier for next O2 to bind (that’s why affinity increases)

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34
Q

what type of structure does haemoglobin have

A

quaternary structure

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35
Q

where is iron located

A

in the middle of each globin subunit (2 beta and 2 alpha)

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36
Q

what type of haemoglobin do foetus’s have

A

2 alpha and 2 gamma chains which have higher affinity

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37
Q

how much red blood cells do adults produce every second

A

2.3 million

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38
Q

how much red blood cells do adults produce every minute

A

138 million

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39
Q

what type of stem cells does every cell in the blood come from

A

haematopoietic stem cell

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40
Q

where are haematopoietic stem cells located

A

in the bone marrow

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41
Q

what do you call the formation of red cells

A

erythropoiesis

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42
Q

what is the name for the formation of granulocytes and monocytes

A

myelopoiesis

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43
Q

what is the name for the formation of platelets

A

thrombopoiesis

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44
Q

what is bone marrow

A

bone marrow is the active site, it has great blood supply (important for transportation)

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45
Q

what can multipotential haematopoietic stem cells (hemocytoblast) be split into

A

common lymphoid progenitor and common myeloid progenitor

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46
Q

what are examples of common myeloid progenitors

A

megakaryocyte, erythrocyte, mast cell and myeloblast

47
Q

what is a type of megakaryocyte

A

thrombocyte

48
Q

how many RBC do we make per day

A

10 to power of 12

49
Q

where are RBC made (erythropoiesis)

A

in the bone marrow

50
Q

describe erythropoiesis as a process of making RBC in bone marrow

A

haematopoietic stem cells turns into multipotent progenitor cell which turns into common myeloid progenitors. this then develops into a normoblast which turns into a reticulocyte (leaves the bone marrow and goes into blood stream). the reticulocyte is an immature blood cell and still has organelles. finally it turns into an erythrocyte

51
Q

describe normoblasts

A
  • a large cell with a dark blue cytoplasm
  • has a central nucleus with nucleoli
  • when the normoblast develops into an erythrocyte it goes through divisions such as getting smaller, increased haemoglobin and loses RNA and protein synthesis apparatus
52
Q

characteristics of a normoblast

A
  • has DNA, RNA and is found in bone marrow and blood
53
Q

what can happen if we have too many RBC

A

can lead to tissue hypoxia

54
Q

what does too many RBC increase

A

blood viscosity

55
Q

what balances RBC production and destruction

A
  • hormonal controls
  • enough iron, amino acids, vitamin B
56
Q

what can blood viscosity lead to

A

blood clots

57
Q

what does the hormone erythropoietin (EPO) act on

A

early progenitor cells

58
Q

what is erythropoietin

A

a 30.4kD glycoprotein hormone

59
Q

what does erythropoietin (hormone) do

A
  • stimulates erythropoiesis (production of RBC)
  • they are produced in the kidneys (sometimes liver)
  • there is always a small amount in the blood to maintain basal rate
60
Q

what are the effects of erythropoietin (hormone)

A
  • it leads to the rapid maturation of marrow cells
  • also increases circulating reticulocyte count in 1-2 days
61
Q

what type of people would abuse the use of EPO

A

athletes but it could have dangerous consequences

62
Q

why do males have higher RBC count

A

because testosterone stimulates EPO production

63
Q

what stimulates the kidneys to produce erythropoietin

A

low levels of O2 (hypoxia) in blood

64
Q

what are the causes of hypoxia

A
  • low RBC numbers because of haemorrhage (bleeding)
  • not enough haemoglobin per RBC
  • low availability of O2 (in the mountains)
65
Q

what are the dietary needs for erythropoiesis

A
  • nutrients such as amino acids, lipids and carbohydrates
  • iron which can be available from your diet and 65% of it is in haemoglobin and rest is in spleen, liver, bone marrow
  • vitamin B12 and folic acid
66
Q

what is the daily iron cycle

A
  • the same amount of iron that’s consumed/absorbed is lost
  • iron absorbed and transferrin transports iron around the body
  • iron is lost through urine, skin, faeces
67
Q

what is the life span of erythrocytes

A

100-120 days

68
Q

what happens to the old RBC

A

they become fragile and the haemoglobin starts to degenerate (breakdown)

69
Q

where are erythrocytes recycled

A

in the spleen

70
Q

name erythrocyte disorders

A
  • anaemia
  • haemorrhagic anaemia
  • iron deficiency anaemia
71
Q

what is anaemia

A

this is when the blood has abnormally low O2 carrying capacity. this means the blood O2 can’t support normal metabolism.

72
Q

what is anaemia accompanied by

A

fatigue, shortness of breath and chills

73
Q

what are the causes of anaemia

A

blood loss, low RBC production and high RBC destruction

74
Q

what is haemorrhagic anaemia

A

this is excessive blood loss.

75
Q

what are the types of haemorrhagic anaemia

A

acute- rapid blood loss like a stab wound which can be treated by blood replacement..
chronic- persistent blood loss like bleeding ulcer

76
Q

what is the normal haematocrit

A

47% +or- 5% for males and 42% +or- 5% for females

77
Q

what are the normal haemoglobin levels

A

130-180g for males and 120-160g for females

78
Q

what is pernicious anaemia

A

disorder where body doesn’t use vitamin B12 properly

79
Q

what is the most common cause of anaemia

A

iron deficiency

80
Q

what is the prevalence (commonness) of iron deficiency anaemia on post menopausal women and adult men

A

2-5%

81
Q

what is the cause of iron deficiency anaemia

A

caused by haemorrhagic anaemia and low iron intake or impaired absorption

82
Q

what do the RBC look like when you have iron deficiency anaemia

A

they are small (microcytic) and pale (hypochromic)

83
Q

what is a treatment for iron deficiency anaemia

A

iron supplements

84
Q

what is haemolysis anaemia

A

when the RBC die faster than they’re made

85
Q

what’s haemolysis anaemia and premature RBC lysis caused by

A

infections and haemoglobin abnormalities such as sickle cell anaemia

86
Q

what is sickle cell anaemia

A

this occurs when an amino acid in the beta chain of haemoglobin changes. this leads to a change in the shape of the RBC

87
Q

what’s the mechanism called for dealing with bleeding and clotting

A

haemostasis

88
Q

what is haemostasis

A
  • maintains the fluidity of circulating blood
  • limits and stops bleeding by forming a blood clot whilst at the same time maintaining blood flow
  • after the wound has healed it removes the blood clot
89
Q

what is involved in haemostasis

A

blood vessel wall, platelets, coagulation (stick together) factors

89
Q

describe the platelets in haemostasis

A
  • they have no nucleus (anucleate)
  • normal levels is 150-400 x 10*9
  • if higher than normal levels then thrombocytosis (too many platelets) and if lower than normal levels then thrombocytopenia (too little platelets)
  • 1-3 micro meters
  • they circulate 7-10 days
90
Q

what is the role of platelets

A
  • for blood clotting which is done by firstly detecting the damaged vessel endothelium, then it accumulates at the vessel injury and finally, blood clotting starts to stop the circulatory leak
91
Q

what stages are platelets used in

A

all stages

92
Q

what is the primary haemostatic plug

A

this is platelet to platelet interactions

93
Q

what is the secondary haemostatic plug

A

this is platelet and coagulation factors interactions

94
Q

what produces platelets

A

megakaryocytes

95
Q

how many phases are there in platelet production

A

2 phases

96
Q

what happens in phase 1 of platelet production

A

megakaryocyte maturation:
- endomitosis occurs which is when DNA is replicated without cell division occurring
- then cytoplasm enlargement (including cytoskeletal proteins and platelet granules)

97
Q

what happens in phase 2 of platelet production

A

platelet generation:
- the megakaryocytes extend long branches called proplatelets
- organelles and granules are transported to proplatelets
- they are then driven by cytoskeleton

98
Q

what is platelet production stimulated by

A

thrombopoietin

99
Q

what is released in a healthy blood vessel

A
  • nitric oxide prostacyclin is released which relaxes blood vessels and stops platelet activation
  • antithrombotic is released which reduced blood clots
  • natural anticoagulants are also produced which also reduces blood clot formation
100
Q

what’s released when the blood vessel is damaged

A
  • prothrombotic which promotes blood clotting
  • antithrombotic is inhibited
101
Q

what do the platelets stick to when blood clotting

A

the von willebrand factor and collagen

102
Q

what happens when the platelets stick to vwf and collagen when blood clotting

A

platelets become activated and start to release granules and aggregate (stick on top of each other)

103
Q

what are the three steps of haemostasis

A
  • vasoconstriction of blood vessels
  • platelet plug formation
  • coagulation (blood clotting)
104
Q

describe the first step of haemostasis (vasoconstriction)

A

after the injury (damage to endothelium) chemicals are released from endothelial cells and platelets. then pain reflex (vasoconstriction) occurs.

105
Q

what happens during coagulation

A

fibrin is produced from fibrinogen (to reinforce) as the platelet plug isn’t stable

106
Q

what are the two pathways for haemostasis

A

extrinsic and intrinsic pathway

107
Q

what are the two mechanisms that limit clot size

A

-swift removal and dilution of clotting factors and inhibiting the activation of clotting factors

108
Q

what is fibrinolysis

A

this breaks down clots after healing which starts within 2 days

109
Q

what are the 2 disorders of haemostasis

A
  • thromboembolic disorders (undesirable clot formed)
  • bleeding disorders (abnormalities that stop you from forming clots)
110
Q

what are the types of thromboembolic conditions

A
  • thrombus= when there’s a clot in a healthy blood vessel which may lead to tissue death as circulation is blocked or may lead to pulmonary embolism
  • embolus= when a clot is freely floating in blood
  • embolism= is when the embolus blocks a blood vessel (eg, cerebral emboli)
111
Q

what are the risk factors of thromboembolic conditions

A

atherosclerosis, inflammation

112
Q

give examples of antithrombotic drugs

A

aspirin, warfarin, heparin (look at slides for how they work)

113
Q

what are types of bleeding disorders

A
  • von Willebrand’s disease= most common inherited bleeding D
  • thrombocytopenia= deficient number of platelets in blood
  • haemophillia (a,b,c)

biomedical science (4 decks)

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