Introduction to Haematology

Question 1

The physiological development process that gives rise to the cellular components of the blood.

Answer 1

Haemopoiesis

Question 2

What are the 4 forms of self-renewal that a haematopoietic stem cell can undergo

Answer 2

Symetrical self-renewal
Asymetrical self renewal
Lack of self-renewal (2xP)
Lack of self-renewal

Question 3

What type of self renewal increases the stem cell pool?

Answer 3

Symetrical self renewal

Question 4

What type of self renewal maintains the stem cell pool and generates differentiated progeny?

Answer 4

Asymetrical self-renewal

Question 5

What type of self-renewal depletes the stem cell pool and only generates differentiated progeny

Answer 5

Lack of self renewal

Question 6

What are the 2 haematopoietic lineages

Answer 6

Myeloid

Lymphoid

Question 7

At day 27, haemopoiesis starts where?

Answer 7

Aortagonad mesonephros region

Question 8

At day 40, haematopoietic stem cells migrate where?

Answer 8

Foetal liver

Question 9

Life span of erythrocytees

Answer 9

120 days

Question 10

low RBCs

Answer 10

Anaemia

Question 11

high RBCs

Answer 11

Polycythaemia

Question 12

When plasma vol. is low and high conc of RBCs

Answer 12

Relative polycythaemia

Question 13

What are the 2 major groups of leukocytes

Answer 13

Granulocytes (myeloid)

Lymphocytes (lymphoid)

Question 14

Most common WBC

Answer 14

Neutrophils

Question 15

Lifespan of neutrophils

Answer 15

A few hours

Question 16

Increased numbers of neutrophils, when might this happen?

Answer 16

Neutrophilia e.g. infection, inflammation

Question 17

Decreased numbers of neutrophils, when might this happen?

Answer 17

Neutropenia e.g. side effect of a drug

Question 18

A rare WBC, part of the primative immune system

Answer 18

Basophils

Question 19

Describe the differentiation of monocytes

Answer 19

Migrate to tissues and are then identified as macrophages. (histiocytes e.g. kupffer cells in liver, langerhans cells in skin)

Question 20

Increased numbers of monocytes, when might this happen

Answer 20

Monocytosis e.g. TB

Question 21

3 types of lymphocytes

Answer 21

Natural killers
B Lymphocytes
T lymphocytes

Question 22

Innate immune system, large granular lymphocytes that recognise ‘non self’

Answer 22

Natural killers

Question 23

Lymphocytes associated with humoral immunity

Answer 23

B cells

Question 24

Lymphocytes associated with cell-mediated immunity

Answer 24

T cells

Question 25

Examples of when you might get lymphocytosis

Answer 25

Glandular fever, chronic lymphocytic leukaemia

Question 26

Examples of when you might get lymphopenia

Answer 26

Post bone marrow transplant

Question 27

Platelets are derived from what cell?

Answer 27

Megakaryocytes

Question 28

Normal Hb concentration

Answer 28

115-175g/L

Question 29

Normal RBC concentration

Answer 29

4-6.5x1012/L

Question 30

Normal WBC concentration

Answer 30

4-11x109/L

Question 31

Normal MCV

Answer 31

80-100

Question 32

Normal MCH

Answer 32

27-33

Question 33

What does the FBC test

Answer 33

Concentration of Hb MCV, MCH White cell count Platelet count

Question 34

3 examples of coagulation screens

Answer 34

Prothrombin time Activated partial thromboplastin time Thrombin time

Question 35

Liquid marrow is aspirated from posterior iliac crest of pelvis. Trephine core biopsy

Answer 35

Bone marrow aspirate and trephine

Question 36

The set of values for a given test that incorporates 95% of the population

Answer 36

Reference range

Question 37

MCV

Answer 37

Microcytic hypochromic anaemia

Question 38

Causes of microcytic hypochromic anaemia

Answer 38

Iron deficiency Thalassaemia Anaemia of chronic disease lead poisoning

Question 39

MCV 80-95 MCH > 27 low serum iron

Answer 39

Normocytic normochromic anaemia

Question 40

Causes of normocytic normochromic anaemia

Answer 40

``` Haemolytic anaemias Anaemia of chronic disease After acute blood loss Renal disease Mixed deficiencies Bone marrow failure ```

Question 41

MCV>95 | Can be megaloblastic or non megaloblastic

Answer 41

Macrocytic anaemia

Question 42

Abnormally large, immature, and dysfunctional red blood cell, sometimes seen in macrocytic anaemia

Answer 42

Megaloblastic

Question 43

Causes of macrocytic megaloblastic anaemia

Answer 43

Vit B12 or folate deficiency

Question 44

Causes of non megaloblastic macrocytic anaemia

Answer 44

Alcohol, liver disease, myelodysplasia, aplastic anaemia etc

Question 45

Haematological findings of iron deficiency

Answer 45

Low MCV and MHC. Small pate RBCs, variable size and shape. Lon, thin 'pencil' cells

Question 46

Haematological findings of vit B12 deficiency

Answer 46

RBCs much bigger. Hypersegmented neutrophils and oval macrocytes

Question 47

Reduced levels of serum iron, MCV and MCH are within the normal ranges

Answer 47

Norcocytic, normochromic anaemia

Question 48

Describe the pathology of megaloblastic macrocytic anaemia

Answer 48

B12/folate deficiency- RBCs can't synthesise DNA quick enough to divide at the right point in their growth, so cells are abnormally large and MCV and MCH are low