Haematology: introduction to blood cells Flashcards Preview

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Flashcards in Haematology: introduction to blood cells Deck (61)
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1

Composition of blood


Blood which is composed of plasma (-55%) and the cellular elements which are:
1. The erythrocytes (RBC’s)-45%
2. The Leukocytes (WBC’s) and platelets (thrombocytes) – 1%

2

Erythrocytes contain and function

Contain haemoglobin
Function in the transport of O2 and CO2

3

Centrifuged whole blood the sample

Anti-coagulated sample e.g. EDTA to chelate Ca2+

4

Normal blood cell production –


• Fetal: yolk sac
• Post natal – long bones (femur and humerus)
• Adult – axial skeleton

5

Bone Marrow

• 75% of marrow for WBC
• 25% of BM for Red cells
Erythroid/Granuocyte Ratio 1:3 (increased in consumption or loss of RBC)

6

How are cells produced?

Multi-potential hematopoietic stem cells
• Common myeloid progenitor
• Common lymphoid progenitor

7

Common myeloid progenitor produces

Thrombocytes
Erythrocytes
Mast cells
Myleblasts:
• Basophil
• Neutrophils
• Eosinphils
• Monocyte → macrophage

8

Common lymphoid progenitor produces

Natural killer cells
T lymphocytes (cell mediated immunity and also “help” B cells)
B lymphocytes ( humoralimmunity)

9

Lymphoid tissue found in


1. Bone marrow
2. Thymus
3. Tonsils and adenoids
4. Spleen
5. Lymph nodes
6. Gut associated lymphoid tissue (GALT) e.g. tonsils, appendix, payers patches
7. Lymphatic channels
8. Blood – 2% of total body lymphocytes
9. Thyroid, parotid etc.

10

Lymph node function

Act as a filter to remove bacteria, wiruses, and foreign particles

11

Problems with blood cells list

1. Myeloid or lymphoid
2. Too many cells (cythaemia, cytosis – “reactive or neoplastic/clonal)
3. Lymphadenopathy – “reactive or neoplastic”
4. Hepatosplenomegaly
5. Clonal plasma cells (Myeloma, MGUS, plasmacytoma)
6. Too many cells (cytopenia)
7. Dysfunction

12

What does the full blood count measure:

Red cells
Platelets
White cell count
WCC: differential e.g. neutrophils

13

Red cells looking at

Concentratino of haemoglobin: Hb
Red cell to plasma ratio: Hct or PCV (pack cell volume)
Cell numbers (RBC)
Cell size (MCV)
Amount of Hb/RBC (MCH, MCHC)

14

Platelet normal range

150-4000 x 109/l

15

WCC normal range

4-11 x 109/l (4-11)

16

Neutrophils range

2-7.5 x 109/l

17

Lymphocytes range

1.0-4.0 x 109/l

18

Haemoglbin

Male: 130-180 g/L
Female: 115-165 g/L

19

Haematocrit

Male: 42%-54%
Female: 38%-46%

20

RBC count

Male: 4.7-6.1 million cells/mcL
Female: 4.2-5.4 million cells/mcL

21

Haematocrit definition

Ratio of red cells to haemoglobin
Contents:
• 57% plasma
• 1% buffy coat – WBC
• 42% Hct (PCV)

22

MCV indicates and good starting point for

Mean cell volume (MCV)
Indicates the Red cell volume (size)
Normal range 80-100 fl
Good starting point for the evaluation of anaemia

23

MCV can be

Microcytic (100 fl)

24

Microcytic anaemia differentials

Iron defiency IDA
(Chronic bleeding)
Chronic disease
Thalassemias
Hemoglobinopathies
Sideroblastic anaemia

25

Normocytic anaemia differentials

Chronic disease
Acute blood loss
Hemoglobinopathies
Primary marrow disorders
Combined defiencies
Haemolysis
Renal failure

26

Macrocytic anaemia

Megaloblastic anaemia
Liver disease/ alchohol
Metabolic disorders
Marrow disorders
Reticulocytosis
Drugs

27

Mean cell haemoglobin (MCH) and Mean cell haemoglobin concentration (MCHC) reflect

• Both the MCH and MCHC reflect Hb content of RBC
• MCH – 27.0-32.0 pg. Increased on macrocytosis (Large RBC)
• MCHC – 32.0-36.0 g/dL. Increased in spehrocytosis
• Both are reduced in iron defiency and thalassaemia

28

Reticulocyte count use for

• Investigation of anaemia

29

Reticulocytes increased indicates

• RBC production appropriately increased
• Reduced survival (Haemoloysis or bleeding)
• LDH, Bili, blood film, haptoglobins can help distinguish

30

If reticulocytes reduced

• Problem with production

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