Hematology

Question 1

Describe the process of Erythropoiesis.

Answer 1

Myeloid stem cell in bone marrow differentiates and proliferates into Proerythroblast

Division of cells

Multi-stage maturation into reticulocytes

Filling of Hb

Migration into blood capillaries via diapedesis

Maturation into RBCs

Question 2

What is required for RBC maturation DNA synthesis?

Answer 2

Folate and B12

Question 3

What is required for filling of reticulocytes with Hb?

Answer 3

Fe

Question 4

Name 2 characteristics of reticulocytes.

Answer 4

Reabsorbed nucleus
Organelle remnants eg endoplasmic reticulum

Question 5

How does insufficient Hb synthesis affect RBCs?

Answer 5

Decreased RBC size due to insufficient Hb squeezed into them

Question 6

Name 3 characteristics of mature RBCs.

Answer 6

Flexible membrane
Lasts 120 days
Destroyed in spleen

Question 7

What is the growth factor for differentiation and proliferation of proerythroblasts?

Answer 7

Erythropoietin

Question 7

What is the regulation process of erythropoiesis?

Answer 7

Decrease in PaO2

HIF-1a production and release into circulation

Transcription factor for EPO production and release by kidney

Increase mature RBC and O2 carrying capacity

Increases PaO2 causing negative feedback loop

Question 8

What are some RBC loss factors?

Answer 8

Clearance
Blood loss
Immune destruction

Question 8

What drives erythropoiesis?

Answer 8

Decrease in PaO2

Question 9

What composes the RBC indices?

Answer 9

Hematocrit
MCV
MCH
MCHC

Question 9

What are some erythropoiesis factors?

Answer 9

Hypoxia
Nutrients availability
EPO/blood doping
Neoplasia

Question 9

What are the primary components of a full blood count?

Answer 9

Hb count which determines anaemia
RBC indices determine type/cause of anaemia

Question 10

What is normocytic anemia?

Answer 10

RBC loss eg acute blood loss
Decreased RBC production eg renal disease

Question 10

What is MCV?

Answer 10

Mean corpuscular volume
Size of each RBC

Question 11

What is MCHC?

Answer 11

Mean corpuscular Hb conc
Amount of Hb per volume per RBC

Question 11

What is the definition of anaemia?

Answer 11

Decreased Hb or RBC

Question 12

What does microcytic or hypochromic anemia entail?

Answer 12

Insufficient or abnormal Hb synthesis eg Fe deficiency or Haemoglobinopathies

Question 13

What does normochromic anemia mean?

Answer 13

Anemia is less likely due to Hb production issues

Question 13

What does macrocytic anemia mean?

Answer 13

Impaired DNA synthesis and cell division eg B12 & folate deficiency

Question 14

What does hyperchromic anemia mean?

Answer 14

Presence of spherocytes

Question 15

What are the different modes of diagnostic test for blood?

Answer 15

Full blood count
Reticulocyte count
Peripheral blood film

Question 16

What can peripheral blood film assess?

Answer 16

Size, Shape, Appearance, Maturity of RBCs

Question 17

What is anisocytosis?

Answer 17

Varying sizes of RBCs

Question 18

What does poikilocytosis mean?

Answer 18

Varying shapes of RBCs

Question 18

What does presence of target cells and inclusion bodies mean?

Answer 18

Signs of haemoglobinopathy

Question 19

What does presence of RBC fragments mean?

Answer 19

Haemolytic anemia

Question 20

What does presence of erythroblasts and megaloblast mean?

Answer 20

chronic and severe anemia eg megaloblastic anemia