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Haematopoietic stem cell (HSM) |
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Definition
Common precursor from which all blood cells are derived |
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Proportion of whole blood made up by RBC |
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- Increased Destruction - Decreased Production |
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Reduction in RBC's can be due to |
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Reduced/ ineffective bone marrow Defects of clotting factors |
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Definition
Types Decreased Productivity = Reduction in RBCS |
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Autoimmune destruction Hyperslenism |
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Definition
Types Increased destruction = Reduction in RBCS |
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Generate erthyrocytes, thrombocytes hranular leukocytes |
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Generates T + B lymphocytes |
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Type of immunity neutrophils involved in |
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Usual response to infection which involves increase of neutrophils in blood |
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Granulocyte important in allegry for recruiting mast cells, destroying parasites |
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Involves in specific immmunity |
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antigen stimulation by infection |
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Lymph nodes enlarge and become reactive in response to |
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Part of the spleen full of lymphocytes |
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Red pulp of the spleen consists of RBCs and Macrophages allowing for |
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Thrombocytopenia Haemolytic anaemia |
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Removal of the spleen can be useful treatment for immune |
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an abnormality of the circulatory system that results in inadequate organ perfusion + tissue oxygenation |
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Shock due to blood loss following trauma, surgery, |
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Shock due to pump failure - blunt/penetrating chest trauma - Air embolus - MI |
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Tension Pneumothorax (surgical emergency) |
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Shock due to lung collapse and mediastinal shift impairing venous return to the heart |
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Immediate treatment for Tension pneumothorax |
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Shock due to loss of sympathetic tone = systemic vasodilation Hypotension Bradycardia Or spinal cord injury |
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Shock caused by bacterial release endotoxin |
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Anaphylactic (vasogenic) shock |
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Shock due to abnormally exaggerated allergic reaction to drug or other antigen |
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Skin pallor Tachycardia Tachypnoea Hypotension Confusion Reduced urine output |
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Signs and symptoms of shock |
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Constant replacement of RBCs |
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Globular Haemoglobin proteins borken down to |
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Haem groups minus the iron converted to _ then secreted as _ |
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Iron bind to _ and is recycled |
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Erythropoiesis is hormonally regulated by |
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Name of Percentage of RBCs in whole blood. |
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Normal haematocrit - in males - in females |
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When reduced it combats oxidative stress. maintaining normal reduced state in cell |
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Reduction in haemoglobin concentration |
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Increased Reticulocytes Work hypertrophy - eg splenomegaly |
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Indication of increased RBC destruction |
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Approx 90% of Chronic anaemias result of |
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The presence of abnormal large RBCs in the blood |
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Causes of megoblastic anaemia |
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A failure to become SMALLER, not and increase in size |
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Definition
The larger cell size in megablastic anaemia is due to |
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Cannot be absorbed directly, Binds to intrinsic factors in stomach then is absorbed in ileum |
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Animals Body store = 2-4years |
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Definition
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Inadequate intake Pernicious anaemias Gastrectomy |
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leafy veg Yeast Body store = 4months |
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Inadequater intake Malabsorption - Coeliac disease, Crohns disease Haemolysis Pregnancy Drugs |
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ALcohol Liver disease Hypothyroidism Marrow failure |
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Definition
Causes of non-megaloblastic macrocytosis |
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Form of anaemia resulting from B12 def, autoimmune condition |
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Hypersegmented neutrophils |
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Definition
In Pernicous anaemia blood films usually show |
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Absorption of iron is regulated by |
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Absorprtion of iron is limited |
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Exhaustion of iron stores Falling red cell MCV Microcytic anaemia Thin curved nails |
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Definition
Consequences of negative iron balance |
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Long term excess iron absorption with parenchymal iron loading and eventual organ damage |
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Weakness Joint pains Arthiris Diabetes/cardiomyopathy |
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Clinical features of primary iron overload |
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Iron overload damages which gland |
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anaemia - decreased hb iron Reduced iron storage - low serum ferritin |
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Definition
Iron defs can be confirmed by a combo of |
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Deoxyhaem -> Oxyhaem reaction driven to the right by |
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_ PO2 Favours oxygen binding |
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Mutations of Beta globin genes only manifiest... |
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Inherited disorders of either structure or rate of synthesis of one or more globin chains |
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high percentage of haemoglobinopathy trait in people of which origin |
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Haemoglobinopathies are common in areas of the world where _ is |
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Sicle cell disorder inheritance |
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test for insoluble deoxygenated Hb |
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Sickle test for sickle cell disorder |
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Redduced rate of globin chain synthese |
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Needs to be checked before prescribing iron in suspected thalassaemia |
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Excess Alpha chains in erythroblasts due to the fact Beta is absent |
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Ineffective erythropoiesis - massive erythroid expansion to produce Fcells - bone marrow expansion - skeletal changes + iron overload |
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Result of B thalassaemia Major |
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Red cell transfusion splenectomy |
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Treatment of B thalassaemia major |
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First few months of life when gamma-beta globin production switches |
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B thalassaemia major is not clinicaly expressed until |
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Alpha Thalassaemia is more severe because |
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Excess gamma chains in foetus and beta chains in adults |
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In alpha thalassaemia there is high affintity for o2 but poor delivery therefore precipitate in RBCs leading to |
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Disease seen in all generations 50% likelihood of child infected if parent is infected Same chance in females and males |
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Deletion of 2 alpha genes on one chromosome 16 |
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Definition
a thalassaemia trait is indictated by |
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B thalassaemia inheritance is |
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sickle cell disease caused by a specific point mutation in codon 6 that changes |
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The destriction of red blood cells |
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Increased rate of red cell destruction exceeding bone marrow capacity for red cell production |
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Erythroid hyperplasia (increased bone marrow red cell production) Excess red cell breakdown products eg billirubin (clinical features differ by aetiology and site of red cell breakdown) |
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Definition
Consequences of haemolysis |
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EXTRAVASCULAR RED CELL DESTRUCTION |
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Definition
More common classificatiion of RBC destruction. Hyperplasia at site of destruction. |
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ABO incompatible blood transfusion |
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Intracellular red cell destruction is incompatible with which blood transfusion |
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In general inherited disorders are _ to the red cell |
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Normochromatic mormocytuc |
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Definition
Red cells in most cases of anaemia are |
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Reticulocytes a a characteristic _ tinge |
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Most common cause of inherited haemolytic disease in Northern Europe. Red cells are Speroidal with reduced diameter and more intense staining |
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Jaundice Splenomegaly Anaemia |
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Definition
Symptoms of hereditary spherocytosis |
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nuclear maturation defects; |
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Definition
macrocytic anaemias likely to be due to |
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cytoplasmic maturation defects |
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Definition
microcytic anaemias likely to be due to |
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Spherocytes can be seen in |
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Necessary enzyme in the generation of reduced glutathion which protects the red cell from oxidant stress |
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