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Haematology > Haematopoiesis, stem cells + bone marrow > Flashcards

Haematopoiesis, stem cells + bone marrow Flashcards

1
Q

Define haematopoiesis

A

making blood

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2
Q

Define stem cells

A

undifferentiated cells that have the capacity to differentiate and multiply into all human cell types

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3
Q

Define pluripotent stem cell

A

completely undifferentiated
can form any tissue

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4
Q

Define haematopoietic stem cell

A

in bone marrow
multipotent
can differentiate into blood cells

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5
Q

Where does haematopoiesis occur in the foetus?

A

yolk sac
liver
spleen
lymph nodes

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6
Q

Where does haematopoiesis occur in babies and children?

A

made my all bone marrow (mainly red bone marrow)

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7
Q

What happens to bone marrow as you age?

A

red marrow turns into yellow marrow

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8
Q

Where does haematopoiesis occur in adults?

A

bone marrow of axial skeleton, proximal long bones + skull

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9
Q

What happens with haematopoiesis in bone marrow disease?

A

yellow marrow can be recruited to produce blood cells again in an adult
as can liver and spleen (extramedullary haematopoiesis)
can cause hepatosplenomegaly

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10
Q

Define myelofibrosis

A

bone marrow space occupied by fibrotic tissue
no space for blood cell production
body tries to compensate by producing cells elsewhere

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11
Q

Define erythropoiesis

A

production + development of RBCs

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12
Q

Define granulopoiesis

A

production + development of granulocytes

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13
Q

Define thrombopoiesis

A

production + development of platelets

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14
Q

Are platelets cells?

A

no

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15
Q

How long does it take a stem cell to become a formed blood element?

A

2-3 weeks

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16
Q

2 properties of stem cells

A

differentiation
self-renewal

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17
Q

What is the average blood volume in women and men?

A

women = 4-5L
men = 5-6L

18
Q

What are the layers when blood is centrifuged?

A

Plasma
Buffy coat (leukocytes + platelets)
Erythrocytes

19
Q

When would haematopoiesis increase?

A

bleeding
infection

20
Q

Which haematopoietic growth factors stimulate increased production of blood cells?

A

EPO (erythropoietin)
TPO (thyroperoxidase)
G-CSF (granulocyte colony stimulating factor)
interleukins (cytokines)

21
Q

2 causes for high blood counts

A

primary = abnormal bone marrow

secondary = normal bone marrow (being stimulated by environment to produce extra cells)

22
Q

Define leucocytosis and list some primary and secondary causes

A

high WBCs

primary = clonal stem cell disorder:
leukaemia/lymphoma/myeloproliferative disorders

secondary = response to environmental factors:
- infection
- inflammation
- infarction (eg. MI)
- tumour

23
Q

Define thrombocytosis and list some primary and secondary causes

A

high platelets

primary = clonal stem cell disorder:
- essential thrombocythaemia

secondary = reactive thrombocytosis:
- infection
- inflammation
- infarction
- tumour

24
Q

Define erythrocytosis and list some primary and secondary causes

A

high RBCs

primary = clonal stem cell disorder:
- polycythaemia vera

secondary = increased EPO levels:
- less oxygen (eg. COPD)
- tumours
- doping
- high affinity Hb

25
Q

Describe the difference between true erythrocytosis (polycythaemia) and apparent polycythaemia

A

polycythaemia:
- increased number of RBCs, decreased amount of plasma

apparent polycythaemia:
- same number of RBCs (higher % so haematocrit increases), decreased amount of plasma
- reduced plasma volume (eg. dehydration)

26
Q

2 general causes of low blood counts

A

underproduction
reduced survival in circulation

27
Q

What can cause underproduction of WBCs?

A

drugs affecting stem cell
part of pancytopenia due to marrow failure (all cell lines low)

28
Q

What can cause decreased survival of WBCs?

A

autoimmune
drugs
consumption (flu)
combination (eg. viral hepatitis)

29
Q

What can cause underproduction of platelets?

A

drugs affecting stem cell
liver failure (TPO underproduction)
part of pancytopenia due to marrow failure

30
Q

What can cause peripheral destruction of platelets?

A

autoimmune (ITP)
hypersplenism
drugs (eg. penicillin, NSAIDs, furosemide)
infection/inflammation/sepsis

31
Q

7.5 causes of low blood counts caused by decreased production (MMMMLLAh)

A

Myeloma
Myelodysplasia
Metastatic malignancy
Myelofibrosis
Leukaemia
Lymphoma
Aplastic anaemia
[haematinic deficiency]

32
Q

Do platelet counts vary with age/sex?

A

no

33
Q

Describe myelodysplasia

A

haematopoietic stem cell malignancies
related to myeloproliferative disorders
abnormal maturation + proliferation
proliferation of cells in bone marrow, but as cells deformed (dysplastic) they don’t get into blood
active, cellular marrow but low blood counts
20% progress to AML

34
Q

Describe aplastic anaemia

A

damage to pluripotent stem cell by drugs, viruses, radiation
reduced erythropoiesis, granulopoiesis, thrombopoiesis
pancytopenia
‘empty’ bone marrow

35
Q

Define myelofibrosis

A

malignant proliferation of reticulin fibres in bone marrow causing anaemia, leucoerythroblastic blood film + splenomegaly
can be primary of develop from myeloproliferative neoplasms (MPN)
can progress to AML

36
Q

What can cause decreased cell survival with a normal bone marrow?

A

immune cellular destruction (eg. ITP, AIHA)
drugs
haemorrhage
hypersplenism

37
Q

Causes of hyposplenism

A

splenectomy
auto-infarction (eg. sickle cell disease)
infiltration (eg. metastatic malignancy)
under-functioning (eg. coeliac disease)

38
Q

Neutrophilia causes

A

bacterial infection
inflammatory conditions
burns
cigarette smoking
steroids (glucocorticoids)
G-CSF
solid tumours
myeloproliferative disorders (eg. CML)

39
Q

Lymphocytosis causes

A

viral infection
hyposplenism
TB
Brucellosis
CLL
Lymphoma with ‘spillover’

40
Q

What mutation causes polycythaemia vera?

A

JAK2 mutation

Haematology (16 decks)

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