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Introduction to Haematology > Introduction to Haematology > Flashcards

Introduction to Haematology Flashcards

1
Q

what is haematology the study of?

A

red cell disorders
white cell disorders
haemostasis/coagulation

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2
Q

what is the approx blood volume?

A

5L

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3
Q

what are the 3 components of blood?

A

plasma
buffy coat
erythrocytes

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4
Q

what are the properties of plasma

A

~55% of total blood volume
least dense component
contains - electrolytes e.g. Na+, K+, Ca2+, Cl-, HCO3
proteins e.g. haemostatic proteins, immunoglobulins, transport proteins
small organic molecules e.g. glucose

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5
Q

what cells are in the buffy coat

A

leukocytes and platelets

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6
Q

what are the properties of erythrocytes?

A

~45% of total blood volume
most dense component
haematocrit: the ratio of the volume of RBCs to the total volume of blood

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7
Q

what are the most abundant cells in the blood?

A

red cells

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8
Q

what does the blood haemtocrit represent?

A

the ratio of the volume of RBCs to the total vol of blood

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9
Q

adult male RBC reference ranges

A

4.5-6.5x10^12/L

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10
Q

adult female RBC references ranges

A

3.8-5.8x10^12/L

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11
Q

male haematocrit reference range

A

0.47 +/- 0.05

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12
Q

female haematocrit reference range

A

0.42 +/- 0.05

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13
Q

leukocytes reference range

A

4-11 x 10^9 cell/L

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14
Q

most requested test in haematology

A

FBC

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15
Q

Blood cell counting is used in the differential diagnosis of

A

anaemia
leukaemia
thrombocytopenia

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16
Q

Haemoglobin Hb parameter

A

conc in blood in g/L

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17
Q

RBC parameter

A

number of cells expressed x10^12/L

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18
Q

WBC parameter

A

number of cells expressed x10^9/L

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19
Q

Platelet count (PLT) parameter

A

number of cells expressed x10^9/L

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20
Q

mean cell volume MCV parameter

A

average size of red cell size in fl (10^-15L)

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21
Q

Mean cell hb (MCH) parameter

A

average amount of Hb per cell in pg (10^-12g)

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22
Q

Packed cell volume/haematocrit (PCV/HCT) parameter

A

proportion of the blood that is red cells

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23
Q

reticulocyte count parameter

A

% of new immature red cells

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24
Q

what does RDW stand for

A

red cell distribution width

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25
Q

differential white count parameter

A

% of neutrophils, lymphocytes, monocytes, eosinophils and basophils

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26
Q

reference range of Hb g/L

A

M = 135-180, F=115-160

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27
Q

reference range platelets

A

150-400x10^9/L

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28
Q

MCV (fL) ref range

A

78-100

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29
Q

PCV/haematocrit ref range

A

M=0.40-0.52, F=0.37-0.47

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30
Q

MCH (pg) ref range

A

27-32

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31
Q

MCHC g/L ref reange

A

310-370

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32
Q

RDW ref range

A

11.5-15

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33
Q

neutrophils ref range

A

2.0-7.5

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34
Q

lymphocytes ref range

A

1.0-4.5

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35
Q

monocytes ref range

A

0.2-0.8e

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36
Q

eosinophils ref range

A

0.04-0.40

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37
Q

basophils ref range

A

<0.1

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38
Q

what is the ‘coulter’ principles FBC analyser

A

method of sizing and counting particles

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39
Q

what is the FBC analyser prinicple

A

the ‘coulter’ principle: method of sizing and counting particles
whole blood is passed between 2 electrodes through an aperture
the impedance changes as a cell passes through
the change in impedance is proportional to cell volume
cell identification based on measurable changes in electrical impedance

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40
Q

how are RBCs removed for a WBC automated differential?

A

RBCs are removed using a lysis solution

41
Q

principles of a WBC automated differential

A

RBCs removed using a lysis solution
WBCs stabilised to prevent alteration
hydronamically focussed flow cell
laminar flow- single file

42
Q

what is measured simultaneously in a WBC automated differential?

A

cell size
internal composition (chemical composition, nuclear volume)
cell shape/surface - granularity, nuclear lobularity, cell surface structure

43
Q

how is the cell size measured using WBC automated differential

A

Volume: direct current impedance to measure the volume that the entire cell displaces in an isotonic solution

44
Q

how is cell internal composition measured using WBC automated differential

A

conductivity: alternating current in the radio frequency (RF) range allow energy to penetrate the cell

45
Q

how is the cell shape/surface measured using WBC automated differential

A

scatter: cell struck by the coherent light of a leaser beam, the scattered light spreads out in all directions.

46
Q

FBC flow what does volume indicate

A

cell size

47
Q

FBC flow what does conductivity indicate

A

internal composition

48
Q

FBC flow what does scatter indicate

A

cell shape / surface

49
Q

what does a WBC automated differential do

A

allows the direct measurement of cell populations

50
Q

why are red blood cell indices helpful

A

help classify the RBCs- size and Hb content

51
Q

what parameters are used to calculate red cell indices

A

HB, Hct and RBC

52
Q

what are the red cell indices

A

MCV - mean cell volume
MCH- mean cell haemoglobin
MCHC- ean cell haemoglobin concentration

53
Q

what are RBCs with a normal size / volume called?

A

normocytic

54
Q

When MCV is high RBCs are called

A

macrocytic

55
Q

when MCV is low RBCs are called

A

microcytic

56
Q

RBCs with normal about of MCHC are called

A

normochromic

57
Q

RBCs with low MCHC

A

Hypochromic

58
Q

RBCs with high MCHC

A

hyperchromic

59
Q

normal RBC morphology

A

roughly uniform in size
small area of pallor in centre
should have a diameter equal to the nucleus of a small lymphocyte

60
Q

what is anisocytosis

A

RBCs of unequal sizes

61
Q

what is poikilocytosis

A

abnormally shaped RBCs

62
Q

what is the ESR

A

erythrocyte sedimentation rate - the rate at which blood settles in 1 hour

63
Q

what is the principle of ESR

A

the specific weight of RBCs is higher than that of plasma
in stabilised blood, RBCs slowly sink towards bottom of the tube = sedimentation

64
Q

what is an ESR test used for?

A

it is a non-specific test
indicator of disease
monitoring of treatment
monitoring of disease

65
Q

what factors may increase ESR

A

low hct, low blood viscosity
high conc of fibrinogen (e.g. during pregnancy, vascular diseases, heart diseases)
high haptoglobin
high lipoproteins
high immunoglobulins
macrocytic RBCs
extreme elevation of WBC (leaukaemia)

66
Q

what factors may decrease the ESR

A

high hct
change in RBC shape (e.g. sickle cell anaemia, poikilocytosis)
high albumin concentration

67
Q

what increases sedimentation rate?

A

inflammation/cell damage can cause RBCs to aggregate, making them ‘heavier’, thus increasing their sedimentation rate

68
Q

properties of leukocytes

A

make up <1% total blood volume
4-11x10^9/L of blood
function in defence against disease- can leave capillaries via leukocyte extravasation/diapedesis
leukocytosis - WBC count over 11 x 10^9 /L (this can be normal in response to infection)

69
Q

what cells are myeloid granulocytes

A

neutrophil
eosinophil
basophil

70
Q

properties of neutrophils

A

12-15um diameter
nucleus has 2-5 distinct lobes separated by narrow filament
condensed chromatin pattern
cytoplasm has fine, evenly distributed granlues

71
Q

properties of eosinophils

A

12-17 um diameter
bi-lobed nucleus
large, spherical granules that are red/orange in colour
granules more coarse and larger than those of neutrophils

72
Q

properties of basophils

A

10-14um diameter
nucleus observed by blue/black granules
rarely found in the peripheral blood circulation

73
Q

properties of monocyte

A

myeloid agranulocyte
12-20um diameter
largest peripheral blood cell
large amount of grey-blue cytoplasm; often vacuolated
large indented/folded nucleus
irregular cytoplasm outline

74
Q

properties of a lymphocyte

A

B cells, T cells, NK cells
10-16um in diameter
scanty cytoplasm/high nuclear to cytoplasmic ratio
usually have a round or slightly indented nucleus

75
Q

leukocyte order of prevalence

A

Neutrophils
Lymphocytes
Monocytes
Eosinophils
Basophils
Never let monkeys eat bananas

76
Q

what is leukopenia?

A

low white cell count, usually low neutrophils (neutropenia)

77
Q

what is the term for low neutrophils?

A

neutropenia

78
Q

what is leukocytosis

A

increased white cell count, may be reactive to infection or inflammation

79
Q

what are leukaemias?

A

malignant (neoplastic) proliferation of white cells or their precursors

80
Q

what are lymphomas

A

lymphoid neoplasms

81
Q

what is multiple myeloma

A

a plasma cell neoplasm

82
Q

what are haematopoietic malignancies

A

clonal diseases that derive from a single cell in the marrow or peripheral lymphoid tissue that has undergone genetic alteration

83
Q

classification of leukaemia

A

Acute:
- myeloid - > AML acute myeloid leukaemia
- lymphoid -> ALL acute lymphoid leukaemia
Chronic:
- myeloid-> CML chronic myeloid leukaemia
- lymphoid -> CLL chronic lymphoid leukaemia

84
Q

classification of acute leukaemia

A

all ages
clinical onset - sudden
course of disease (untreated) weeks - months
predominant cell - blasts
WBC - variable

85
Q

classification of chronic leukaemia

A

typically adults
clinical onset - insidious
course of disease (untreated)- months - years
predominant cells - mature forms
WBC- increased

86
Q

acute leukaemia is usually an…

A

aggressive disease

87
Q

what is acute leukaemia defined as

A

the presence of ≥20% blasts in the bone or bone marrow on clinical presentation or <20% blasts plus leukaemia-associated cytogenetic or molecular genetic abnormalities5trfgtv

87
Q

how does acute leukaemia develop?

A

leukaemic mutation(s) transform a normal haematopoietic precursor cell to a cancer-initiating cell. if the mutation(s) result in a block to terminal differentiation- the resulting malignancy will be an acute leukaemia.

88
Q

where does malignant transformation occur in acute leukemia

A

in the haemopoietic stem cells or early progenitors

88
Q

in acute leukaemia a series of genetic alterations occur that have an impact on

A

cell proliferation
apoptosis
differentiation

these genetic events cause accumulation of early bone marrow haematopoietic cells known as blast cells

89
Q

what cells are you likely to see in AML

A

myeloblast

90
Q

what cells are you likely to see in ALL

A

lymphoblast

91
Q

what cells are you likely to see in CML?

A

Granulocytes - neutrophils, eosinophils, basophils

92
Q

what cells are you likely to see in CLL?

A

B lymphocytes / T lymphocytes

93
Q

what are plasma cells

A

a plasma cell is a mature B lymphocyte that secretes a single type of antibody (monoclonal)

94
Q

what is multiple myeloma?

A

a neoplastic proliferation characterised by plasma cell accumulation in the bone marrow

95
Q

where does lymphoma begin?

A

in the cells of the lymph system

96
Q

who does lymphoma occur in?

A

children and adults

97
Q

what are the 2 main types of lymphoma

A

hodgkin’s lymphoma (Reed-Sternberg cells)
non-hodgkin lymphoma (NHL)

Introduction to Haematology (10 decks)

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