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CLS > Haemotology > Flashcards

Haemotology Flashcards

1
Q

Name the different types of blood types and what they are ? how common are they? (%s)

A 
0= A+B antibodies 43%
A= A antigens B antibodies 45%
B= B antigens A antibodies 9% 
AB= A + B antigens 3%
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2
Q

Which blood type is the universal donor and which is the universal recipient

A 
o = donor
ab = recipient
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3
Q

Describe rhesus D pregnancy problem

A

Mum Rh -ve baby rh+-e. When born babies rbcs get into maternal blood and mum makes Anti D IgG against the Rh +ve. If the mum then has another baby that is Rh +ve. IgG crosses placenta and attacks babies RBCs

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4
Q

How do we prevent rh D pregnancy problem

A

give mum Anti D Anti bodies against the RBCs after pregnancy so she doesnt make them herself (antinatal prophylaxis)

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5
Q

What do you do when testing between patient serum and donor cells prior to blood issue

A

select blood type to match on basis of ABO/ Rh group

mix serum and cells first to test if reaction

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6
Q

Name some risks of a blood transfusion

A 
reactions - febrile and allergic
infection -bac virus protazon prion
iron overload -cant excrete
anaphylaxis
viral transmission- HIV, HEP  B
RBC antibodies - alloimmunisation 
fluid overload
TRALI

hypocalaemia + dilution of clotting factors on a massive transfusion

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7
Q

How much blood in the body?

Composition of blood?

A

5L.

45% RBC, 55% PLASMA, 1% WBC+ PLATELET

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8
Q

Name the stuff in the blood that helps with immunity

A

WBC, antibodies, acute phase proteins

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9
Q

difference between serum and plasma and blood

A

plasma is centrifuged blood

serum is without clotting factors

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10
Q

functions of a RBC

A

acts as a buffer, gas exchange

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11
Q

normal Hb levels

A

male 13.5-18

female 11.5-13.5 - less because of menstruation and decreased circulating vol

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12
Q

what is the haematocrit

A

% of blood that is red cells (often proportional to haemoglobin)

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13
Q

How many platelets in the blood and how long do they last

A

7-14 days .

150

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14
Q

Descrive the 3 granulocytes

A

eosinophils
neutrophils
basophils

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15
Q

eosinophils

A

vital or antiparasite immunity and important in allergic responce
linked to 1gE
biloben nucleus

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16
Q

basophils

A 
function not clear, may be important against parasites and anaphalaxis 
dark blue granules
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17
Q

neutrophils

A

phagocytose bacteria and kill (H2o2 and free radicals)
multi lobed nucleus
lifespan 8 hours
2-7%

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18
Q

what are monocytes

A

macrophages
phagocytose dead or dying cells or foreign material
may contain phagocytic vacuoles

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19
Q

whats the difference between MCV and MCH

and name some disease in each

A

MCV = mean corpuscular volume - cell size
small in microcytic anaemia
large in macrocytic anaemia

MCH is how red they are
pale in hypochromic anaemia

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20
Q

what is polycythaemia

A

RBC overproduction in the marrow

or decrease plasma (pseudopolycythameia) - caused by alcohol

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21
Q

name 3 general causes of anaemia

A

decreased RBC production
increased RBC destruction
increased RBC loss

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22
Q

Name 4 causes of microcytic anaemia

A

Thalassaemia (a+b globin chains )
Iron deficience
Chronic disease - body tries to decrease amount in inflammation
Sideroblastic anaemia (congenital)

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23
Q

what is a reticulocyte

A

an immature RBC

around for one day before becomes a RBC

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24
Q

whats the most common cause of microcytic anaemia

A

blood loss via parasites

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25
Q

descrive 3 causes of macrocytic anaemia

A
  • bone marrow trying to compensate for blood loss (haemorrhage and haemolysis)
  • marrow dysfunction 2y to renal liver and thyroid dysfunction or chemo or leukaemia
  • megaloblastic anaemia
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26
Q

what is megaloblastic anaemia

A

caused by b12 or folate deficiency , abnormal maturation of RBC

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27
Q

what is a marker for macrocytic anaemia

A

reticulocyte counts

28
Q

what is thrombocytosis

A

platelet overproduction - normally a reaction ro inflammatory/infection

29
Q

what is thrombocytopenia

A

decreased platelets. consumption by clots, infection, liver disease

30
Q

philia penia cytosis

mean what?

A

philia - increased
penia - decreased
cytosis - increased

31
Q

common causes of ?

1) neutrophilia
2) neutropenia
3) monocytosis
4) eosinophilia

A

1) reaction to infection
2) under production and over consumption
3) chronic inflammation
4) parasites, fungi, allergies

32
Q

What is virchows triad

A

clots occur due to :

  • stasis of blood
  • changes in blood composition
  • disturbed vessel - vascular wall injury
33
Q

type of bloot clot in aa and vv and what you give to treat them

A

aa - platelet ASPRIN

vv - fibrin WARFRIN

34
Q

1 What does prothrombin time measure
2 how long is normal
3 what do we use it for

A

1 activity of extrinsic pathway
2 usually 9-12 s
3 use this to monitor the effect of warfarin

35
Q

name 2 diseases the prothrombin time will be longer

A

liver disease and DIC

36
Q

1 what does the APPT measure
2 how long is normal
3 what do we use it for

A

1 activity of intrinsic pathway
2 22-32s
3 unfractioned heparin ad hirudin

37
Q

name some diseases the APPT is prolonged in

A

haemophilia A&B, liver disease, lupus anticoagulant, von willebrands disease, DIC

38
Q

1 what does the thromin time measure

2 how long is normal

A

1 final common pathway

2 13-20

39
Q

name 1 treatment and 3 pathological diseases that can increased thrombin time

A

heparin
liver disease
DIC
dysfibrinogenaemia

40
Q

1 what is the template bleeding time

2 how long is normal

A

1 measures in vivo. razor cute 5mm cuts in skin
excess blood removed gently
time from cut to bleeding stopped is measured
2 normally 2-8 minute

41
Q

Name a limitations of the clotting cascade model

A

1 explains how it clots in a test tube not in mammal

42
Q

which model is more accurate representation of blood clotting

A

cell based model

43
Q

describe the final common clotting pathway

A

prothrombin(2) to thrombin triggers fibrinogen(1) to fibrin . FXIII cross links fibrin to form strong clot

44
Q

1 What are D dimers
2 what are they used for
3 Normal amounts

A

1) fragment of fibrinogen created when its chopped into pieces.
2) thery’re increased if a clot is present so can be used to rule out clots in the worried well
3) normally 250 if

45
Q

What causes haemophilia A and haemophilia B

A

A- reduced CF 8

B - reduced CF 9

46
Q

who gets haemophilia and why

A

both genes on the X chromosome so sex linked so only present in males

47
Q

how does haemophilia present

A

arthritis - bleeding into joins as baby boy starts to walk

causes prolonges APTT (180 seconds)

48
Q

how do you treat haemophilia

A

factor replacement intravenously either to treat current bleeding or prophylactically to prevent bleeding

49
Q

What is Disseminated Intravascular Coagulation

A

microscopic clots form in the circulation, when platelets and clotting factors run out bleed horrendously

50
Q

what can trigger DIC

A

infection, malignancy, pregnancy complications, massive bleeding

51
Q

how do you treat DIC

A

identify the cause and remove it, can use plasma and platelet transfusions to buy time whilst treating the cause

52
Q

what is transfusion coagulopathy

A

occurs when a massive transfusion
platelets and clotting factors depleted.
circulation becomes acidotic and hypothermic
the temp and ph changes further from norm therefor CFs and platelets dont work

53
Q

2 things that can case dysfunctional platelets

A

drugs . asprin clopidogrel abcizimab

2y to liver disease

54
Q

1 what can dysfunctional platelets lead to?

2 how do you treat it

A

1 bleeding from mucosal surfaces e.g nosebleeds gum bleeds GI bleeds
2 remove cause

55
Q

causes of low platelets

A

liver disease or marrow failure or ITP

56
Q

1 what can low platelets lead to?

2 how do you treat it

A

1 mucosal bleeding problems

2 platelet transfusion + procoagulant drugs to prevent bleed

57
Q

name 2 causes of aa clot and 3 of vv clot

A

stroke and MI

DVT PE and AF/cardio-embolism

58
Q

thrombolysis of aa clots?

A

tPA - activated plasmin

heparin

59
Q

prevention of aa clots?

A

platelet inhibition - eg asprin, clopidogrel, abciximab

reduce atheroma - statins to lower cholesterol, treat diabetes, bp, smoking

60
Q

thrombolysis of vv clots?

A

immediately using HEPARIN high dose

medium term use warfarin

61
Q

prevention of vv clots?

A

keep patients mobile - elastic stockings to maintain venous return. prophylactic heparin

62
Q

what is warfarin

A

vit K antag for vit k dependent clotting factors, 2, 7,9,10

63
Q

how long does warfarin take to work

A

49-72 hours

64
Q

how does heparin work

A

inactivates factor 10 and 2(prothrombin)

65
Q

difference between LMWH and UFH and one positive of both

A

LMWH fomed by cleavage of unfractioned heparines
LMWH - consistent
UFH - easily reversible

66
Q

how do you administer heparin and warfarin

A

heparin iv

wafarin oral

67
Q

what is INR used for

A

warfarin use and acute liver damage

CLS (17 decks)

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