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Haematology SB > Haemopoiesis and The Lymphoid System > Flashcards

Haemopoiesis and The Lymphoid System Flashcards

1
Q

what is the name for when there is too many blood cells

A

Myeloproliferative disorders

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2
Q

what is the progression from premature cell to neutrophil

A

myeloblast&raquo_space; promyelocyte&raquo_space; myelocyte&raquo_space; metamyelocyte&raquo_space; neutrophil

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3
Q

what is the precursor cell of platelets

A

megakayocyte

- polyploid [can undergo division w/out cytoplasm dividing]

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4
Q

what is meant by “blasts”

A

primitive nucleated precursor cell

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5
Q

what are haemopoietic cells derived from

A

mesoderm

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6
Q

where is the first site of erythroid activity

A

yolk sac

- stops by week 10

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7
Q

where are the other sites of erythroid activity

A

Liver starts by week 6

Spleen by week 12 (small contribution in humans)

Bone marrow by week 16

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8
Q

after age 20, where are the main sites of haemopoiesis

A

axial skeleton

- skull, ribs, sternum, vertebra

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9
Q

what are the bone forming cells and what are the bone break down cells

A

bone forming = osteoblasts

bone break down = osteoclasts

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10
Q

how does blood enter the bone

A

arteries feed into sinusoids

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11
Q

what are sinusoids

A

flatten capillaries with holes between epithelial cells which all regulation of which cells get in and out the blood vessels

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12
Q

why are sinusoids important

A

Formed blood cells can pass through gaps in endothelial cells to enter circulation

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13
Q

what is the relationship between megakaryocytes and sinusoids

A

extend long branching processes called proplatelets into the sinusoidal blood vessels
- blood sheers off platelets and they enter the blood stream

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14
Q

what is red and yellow marrow

A

red = haemopoietically active

yellow = fatty inactive

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15
Q

what is the composition in marrow as we get older

A

red marrow replaced by yellow marrow

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16
Q

what is meant by the myeloid:erythroid ratio

A

relationship of neutrophils and precursors to proportion of nucleated red cell precursors

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17
Q

what is neutrophil maturation regulated by

A

G-CSF (granulocyte-colony stimulating factor)

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18
Q

what regulates growth and development of megakaryocytes from precursors

A

Thrombopoietin

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19
Q

what is important for cytokine growth

A

stem cell factor

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20
Q

what is important for stem cell development

A

CXCL12

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21
Q

what investigation is the study of antigen expression using specific antibodies

A

immunophenotyping

[using flow-cytometry]

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22
Q

what is the functions of the lymphatic system

A

Return lymph to the circulation

Filter lymph before return to the circulation

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23
Q

what is lymph nodes ensures unidirectional flow

A

valves

24
Q

what cells are seen in lymph nodes

A

Lymphocytes
- B cells, T cells [helper or cytotoxic] and NK cells

Mononuclear phagocytes (macrophages), APC, and dendritic cells.

Endothelial cells

25
Q

what is a marker for a B-cell

A

CD20

26
Q

what is a T-cell marker

A

CD3

27
Q

what are causes of lymphadenopathy

A

local inflammation
systemic inflammation [infection, autoimmune, CTD]
malignancy

28
Q

what could a lymphadenopathy of predominant B-cells mean

A

autoimmune conditions

infections

29
Q

what could a lymphadenopathy of predominant phagocytic response mean

A

draining a tumour site

30
Q

what could a lymphadenopathy of predominant T cell mean

A

Viral infections

Drugs e.g. Phenytoin

31
Q

what is a malignant lymphadenopathy called

A

lymphoma

32
Q

what is the blood supply of the spleen

A

splenic artery

- branch of coeliac axis

33
Q

what is the venous drainage of the spleen

A

splenic vein

- w/ SMV forms portal vein

34
Q

what does the parenchyma of the spleen include

A

red pulp and white pulp

35
Q

what does the red pulp in the spleen contain

A

sinusoids
- lined by endothelial cells with gaps

and cords
- contain macrophages, some fibroblasts

36
Q

what does the white pulp do in the spleen

A

comprises the peri-arteriolar lymphoid sheath (PALS).

- CD4+ lymphoid cells

37
Q

how does PALS work

A

Antigen reaches white pulp via the blood.

APCs in the white pulp present antigen to immune reactive cells

When stimulated by antigen, T and B cell responses may occur

38
Q

what is features of splenic enlargement

A

Dragging sensation in LUQ
Discomfort with eating
Pain if infarction
Hypersplenism

39
Q

what is the triad of hypersplenism

A
  1. splenomegaly
  2. fall in one or more cellular components of blood
  3. correction of cytopenias by splenectomy
40
Q

what can cause hyposplenism

A

splenectomy
coeliac disease
sickle cell disease
sarcoidosis

41
Q

what are features of hyposplenism

A

Howell-Jolly bodies

42
Q

what do people need to be immunised against if the spleen is taken out

A

pneumococcal s

43
Q

what is lymphoma

A

malignant lymphocytes that accumulate in the lymph node

44
Q

what are the subdivisions of lymphomas

A

Hodgkin Lymphoma

Non-Hodgkin Lymphoma

45
Q

what are symptoms of a lymphoma

A

painless, non-tender, rubbery/soft, asymmetrical lump - NOT TETHERED

fever
night sweats
weight loss
itch w/out rash
alcohol induced pain 
fatigue
46
Q

how would a viral lymphadenopathy present

A

tender, hard and smooth lymph node

47
Q

how would a bacterial lymphadenopathy present

A

tender, hard, and smooth lymph node

skin inflammed

48
Q

how would a metastatic lymphadenopathy present

A

non-tender, hard lymph node with a irregular surface

TETHERED

49
Q

how is a lymphadenopathy investigated

A

FNA or core biopsy

50
Q

after a lymphoma has been confirmed, what Ix can be done to help subclassify

A

immunohistochemistry

51
Q

what are the 4 subtypes of Hodgkin’s disease that can be differentiated from histology

A

Nodular Sclerosis

Lymphocyte rich

Mixed cellularity

Lymphocyte depleted

52
Q

what cell type is associated with Hodgkin’s disease

A

Reed Sternberg cells

53
Q

what immunomarker is positive in follicular Non-Hodgkin’s lymphoma

A

CD20

54
Q

what immunomarkers are positive in Reed Sternberg cells

A

CD30 and CD15

55
Q

what are the two types of NHL

A

T cell NHL (10%)

B cell NHL (90%)

56
Q

what is a B cell NHL furthered divided into

A

Low grade B cell

High grade B cell

57
Q

how is lymphoma staged

A

1 = one group of glands above diaphragm

2 = more than one group of glands EITHER above OR below diaphragm

3 = both above and below diaphragm

4 = extra nodal disease

Haematology SB (19 decks)

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