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Y2 Haematology > Haematopoiesis > Flashcards

Haematopoiesis Flashcards

1
Q

What is haematopoiesis?

A

the production and development of blood cells

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2
Q

Describe the haematopoiesis differentiation pathway?

A

pluripotent blood stem cell –> myeloid stem cell – RBCs, platelets, myeloblast. Myeloblast –> granulocytes (eosinophil, basophil, neutrophil)

pluripotent blood stem cell –> Lymphoid SC –> Lymphoblast –> B and T lymphocyte and NK cell.

granulocytes, B, T and NK = WBCs

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3
Q

Where does adult haematopoiesis occur?

A

axial skeleton (sternum, vertebra, ribs, pelvis, proximal long bones, skull)

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4
Q

Where does foetal haematopoiesis occur?

A

yolk sac, liver, spleen, lymph nodes

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5
Q

Where does babies and children haematopoiesis occur?

A

all bone marrow

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6
Q

What are platlets?

A

small particles of cytoplasm budded off megakaryocyte cell. Megakaryocyte stays in bone marrow (not circulation)

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7
Q

How long does it take from pluripotent stem cell to blood element?

A

2-3 weeks

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8
Q

Difference between symmetric and asymmetric division?

A

symmetric - x1 multipotent adult stem cell, x2 mature somatic cell differentiated

asymmetric - x2 multipotent adult stem cell, x1 mature somatic cell

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9
Q

What is the average blood volume?

A

5L

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10
Q

What hormone stimulates RBC proudction?

A

Erythropoetin (epo) in kidneys

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11
Q

What hormone increases platelet count?

A

Thrombopoetin (tpo) from liver and kidney, acts on megakaryocytes

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12
Q

What factor increases neutrophils?

A

GCSF (granulocyte colony stimulating factor) by endothelium. initiates myeloid cells into granulocytes into neutrophils

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13
Q

What increases WBCs?

A

ILs and cytokines

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14
Q

Describe feedback loop of RBC production and Epo?

A

Low O2 = liver and kidney ↑ epo = ↑ RBC = ↑ O2 carrying capacity = ↓ epo

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15
Q

Two reasons for high blood counts?

A

Primary = abnormal bone marrow (malignancy), overproduction

Secondary = normal bone marrow with external factor causing overproduction

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16
Q

Primary and secondary causes of leucocytosis?

A

P = leukaemia/lymphoma/myeloproliferative disorders

S = infection/inflammation/infarction/tumour

17
Q

Primary and secondary causes of thrombocytosis?

A

P = thrombocythemia (treat bone marrow)

S=infection/inflammation/infarction/tumour

18
Q

What is haematocrit?

A

ratio of RBCs to total blood volume

19
Q

Primary and secondary causes of erythrocytosis?

A

P = polycythaemia vera
S = raised epo levels (low O2, tumours, doping, high affinity Hb)

20
Q

What the common treatment for a primary cause of increased blood cell number?

A

P = malignancy = hydroxycarbamide plus aspirin

21
Q

Two main reasons for low blood count?

A

underproduction or reduced survival in circulation

22
Q

Reasons for reduced white cells?

A

Underproduction = drugs affecting stem cell/part of pancytopenia due to marrow failure

Reduced survival = autoimmune/drugs/viruses

23
Q

Reasons for reduced platlets?

A

Underproduction = drugs affecting stem cell/ liver failure (tpo underproduction)/part of pancytopenia due to marrow failure

Reduced survival = autoimmune (ITP)/drugs/hyperslenism/infectoin/inflammation/sepsis

24
Q

Name 3 drugs that can cause reduced platelets?

A

penicillin, NSAIDs and furosemide

25
Q

8 causes of low blood counts by reduced production? (3M,2L,A,H)

A

Myeloma
Myelodysplasia
Metastatic malignancy
Myelofibrosis
Leukaemia
Lymphoma
Aplastic anaemia
Haematinic deficiency

26
Q

Name the myeloid white cell malginancies?

A

Immature cells = acute myeloid leukaemia (AML)

mature cells = myelodysplasia and the myeloproliferative disorders (polycythaemia vera/ chronic myeloid leukaemia/ essential thrombocythemia/myelofibrosis)

27
Q

Name the lymphoid white cell malignancies?

A

immature cell = acute lymphoblastic leukaemia (ALL)

mature = chronic lymphocytic leukaemia/
myeloma/ lymphoma.

28
Q

Describe myelodysplasia (MDS)

A

abnormal maturation and proliferation of cells in bone marrow (don’t get into blood)

affects red cells, granulocytes and platelets

20% evolve into AML

29
Q

what is aplastic anaemia?

A

bone marrow is empty, damage to multi or pluripotent stem cells

reduced erythropoiesis, granulopoiesis and thrombopoiesis

drugs (chemo) / viruses (Hep, EBV, CMV, parvovirus, HIV)/ radiation/ autoimmune

30
Q

Describe myelofibrosis

A

malignant reticulin fibre proliferation in bone marrow

anaemia/a leucoerythroblastic blood film/splenomegaly

can develop from MPN
can transform to AML

31
Q
A

Y2 Haematology (23 decks)

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