Intro to Haematology Flashcards
(122 cards)
1
Q
components of blood
A
plasma
buffy coat
RBC
2
Q
components of plasma
A
clotting or coagulation factors
albumin
antibodies
3
Q
components of buffy coat
A
platelets
white cells or leuocytes
4
Q
functions of blood
A
transport
maintenance of vascular integrity
protection from pathogens
5
Q
what do red cells transport?
A
gases - oxygen and CO2
6
Q
what does plasma transport?
A
nutrients
waste
messages
7
Q
what maintains vascular integrity?
A
platelets and clotting factors
anticoagulants and fibrinolytics
8
Q
in the blood what protects from pathogens?
A
granulocytes/monocytes
lymphocyte
9
Q
what are the fucntions of granulocytes?
A
phagocytosis and killing
10
Q
what are the funcitons of lymphocytes?
A
antigen recognition
antibody formation
11
Q
pathogenesis of haematological abnormalities: high levels
A
increased rate of production
decreased rate of loss
12
Q
pathogenesis of haematological abnormalities: low levels
A
decreased rate of production
increased rate of loss
13
Q
using a diagram show haematopoeisis
A
see notes
14
Q
stem cells are capable of what type of differentiation?
A
totipotent
15
Q
discuss stem cells
A
self-renewal
home to marrow niche
16
Q
what is marrow niche?
A
CXCR4 - antagonist plerixafor
17
Q
how do stem cells increase numbers?
A
binary fission and flux through differentiation pathways
18
Q
how is stem cells flux regulated?
A
hormones/growth factors
19
Q
what hormones are used therapeutically to regulate flux?
A
erythropoietin
G-CSF
thrombopoeitin agonists
20
Q
at what age is most bone marrow found?
A
children
21
Q
in the elderly where is marrow found?
A
axial bones
22
Q
what does marrow consist of?
A
stroma
sinusoids
23
Q
describe the erythroid differentiation pathway
A
erythroblast
reticulocyte
erythrocyte
24
Q
where is erythropoietin made in why?
A
kidney in response to hypoxia
25
what is reticulocyte used for?
measure of red cell production
26
when may you get polycythaemia?
myeloid malignancies
27
consequences of anaemia?
poor gas transfer
dyspnoea
fatigue
28
anaemia results in decreased production of?
haematinics - iron, folate, vit B12
| thalassaemia
29
anaemias causes increased loss through
bleeding
| haemolysis
30
how many red cells are made per day?
10g/l/day
31
function of platelets
haemostasis and immune
32
how is platelet production regulated?
thrombopoietin
33
discuss thrombopoietin
produced in liver
| regulation by platelet mass feedback
34
agonists of thrombopoietin
romiplostim
| eltrobopag
35
life span of platelets
7 days
36
when may you get thrombocytosis?
myeloid malignancies
37
when may you get thrombocytopenia?
marrow failure
38
what causes thrombocytosis?
reactive
39
what causes thrombocytopenia?
immune distruction
40
what drugs alter platelet function?
aspirin
clopidogrel
abciximab
41
function of neutrophils
ingest and destroy pathogens esp bacteria and fungi
42
neutrophils carry>
```
interleukins
CSFs (colony stimulating factors)
```
43
what is G-CSF?
granulocyte colony stimulating factor
44
what regulates neutrophils?
immune responses - macrophages, IL-17
45
life span of neutrophils
1-2 days
46
how quickly to neutrophils respond?
few hours
47
what may cause neutrophilia?
infection
| inflammation
48
neutrophilia in infection
G-CSF used therapeutically
left shift
toxic granulation
49
causes of neutrophilia in inflammation
MI
Post op
RA
50
what causes neutropenia through decreased production?
drugs
| marrow failure
51
what causes neutropenia through increased consumption
sepsis
| autoimmune
52
what causes neutropenia through altered function
chronic granulomatous disease
53
what are monocytes involved in?
reticuloendothelial system
54
what do monocytes do?
ingest and destroy pathogens, esp bacteria and fungi
55
some monocytes migrate into tissues becoming what?
macrophages
56
lifespan of macrophages?
many months
57
dendritic cells lifespan?
weeks
58
causes of monocytosis
myocbacterial infection
59
what is monocytosis usually associated with
usually associated with neutrophilia (GM-CSF)
60
causes of monocytopenia
mycobacteria in hairy cell leukaemia
61
what are eosinophils involved in?
parasites
| allergy
62
function of lymphocytes
immunological memory
63
surface antigens on lymphocytes
CD markers
64
causes of lymphocytosis
infectious mononucleosis
| pertussis
65
causes of lymphopenia
usually post iral
| lymphoma
66
subtypes of lymphocytes
B cells
T cells
NK cells
67
types of T-cells
helper
cytotoxic
regulatory
68
where are lymphocytes produced?
bone marrow
69
where do B cells mature?
bone marrow
70
where do T cells mature?
thymus
71
where do lymphocytes circulate?
blood
lymph
lymph nodes
72
where do lymphocytes differentiate into effector cells?
secondary lymphoid organs
73
antibodies are also know as?
immunoglobulins
74
what are antibodies involved in?
pathogen clearance
opsonisation
fix complement
block binding
75
how does combinatorial diversity occur?
within each chain
| any V region combined with any J or D region then C region
76
how does junctional diversity occur?
at any join
| additional nucleotides added by enzyme (terminal deoxynucleotydyl transferase (TdT)
77
how does combinational diversity occur?
between chains
each alpha chain pairs with a beta chain
each light chain pairs with a heavy chain
78
mistakes in the diversity process can cause lymphoid malignancies. name common ones
IgH heavy locus on chromosome 14
| t(14,18), t(8,14), t(11,14)
79
it is theoretically possible to create how many B cell receptors?
5x10^13
80
it is theoretically possible to create how many T cell receptors?
1x10^18
81
what type of maturation do B cells have?
Affinity
82
what is positive selection?
if gene rearrangement results in a functional receptor the cell is selected to survive
83
what is negative selection?
if the receptor recognises self antigens the cell is triggered to die
84
B cells that survive the processes of selection are exported to where?
periphery
85
where in lymph nodes are B cells found?
follicles
86
where in lymph nodes are T cells found?
paracortex
87
where in lymph nodes are plasma cells found?
in the medulla
88
within the B cell areas there are different popultions. name these
cells undergoing expansion and selection in the GCs
| naive cells in the mantle zone
89
what is HLA?
human leucocyte antigen
90
what does class I HLA display?
internal antigens on all nucleated cells
91
what does class II HLA display?
antigens eaten by professional antigen presenting cells
92
how does HLA vary?
constant within
| varies between individuals
93
how does RA affect the blood?
* Anaemia of chronic disease
* Iron deficiency
* Folate deficiency
* Immune haemolysis
* Neutrophilia
* Immune thrombocytopenia
* Cytopenias secondary to medication
* Felty syndrome
94
how does hepatic disease affect the blood?
anaemia
| deficient clotting factors
95
how does renal disease affect the blood?
anaemia
| HUS
96
how does CV disease affect the blood?
anaemia
97
how does resp disease affect the blood?
polycythaemia
98
how does GI disease affect the blood?
anaemia
99
to much plasma results in
paraproteins
100
to little plasma causes
clotting factors: haemophilia
101
abnormal plasma
clotting factors
| haemophillia
102
normal Hb male
135-170 g/g
103
normal Hb female
120-160 g/l
104
normal RBC
4-5 x 10^12/l
105
normal platelets
150-400 x 10^9/;
106
normal WBC
4-10 x10^9/l
107
normal neutrophils
1.5-7 x10^9/l
108
normal lymphocytes
1.5-4 x10^9/l
109
normal monocytes
0.2-0.8 x10^9/l
110
normal eosinophils
0.1-0.5 x10^9/l
111
what diagnostic tools can you use for blood disease?
```
FBC
clotting times for clotting factors
bleeding time for platelets
(platelet and leucocyte function tests)
chemical assays - iron (ferritin), B12, folate
marrow aspirate and trephine biopsy
lymph node biopsy
imaging
```
112
haematological treatment
replacement
transplantation
drugs
113
haematological treatment: replacement
blood
haematinics
coagulation factors
plasma exchange
114
haematological treatment: drugs
cytotoxics
monoclonal antibodies
inhibitors of cellular pro
115
what does hypersplenism cause?
pancytopenia
116
what does hyposplenism cause?
infections with encapsulated bacteria
| red cell changes
117
what can cause splenomegaly?
```
infectious
haematological malignant
portal hypertension
Haemolytic disorders
connective tissue disorders
storage pool disorders
sarcoid
malignant
amyloid
```
118
causes of splenomegaly: infectious
acute - EBV, CMV
chronic bacterial - TB, Brucella, SBE
chronic parasitic - malaria, leishmaniasis, schistosomiasis
119
causes of splenomegaly: haematological malignant
various leukaemias and lymphomas
| myeloproliferative disroders
120
causes of splenomegaly: haemolytic disorders
```
hereditary spherocytosis
thalassaemia
haemoglobinopathies
megaloblastic anaemia
autoimmune
```
121
causes of splenomegaly: connective tissue disorders
SLE
| Felty syndrome
122
causes of splenomegaly: storage pool disordeers
Gauchers
| Niemann-Pick
