Lab Tests and Diagnostics: Haematology Basics
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Questions and Answers

What is the main role of Red Blood Cells?

  • To respond to mediators released from mast cells
  • To migrate to sites of inflammation
  • To remove foreign material from the body
  • To deliver oxygen to tissues and remove carbon dioxide (correct)

    • What is the function of Neutrophils?

  • To migrate to sites of inflammation and remove foreign material (correct)
  • To respond to mediators released from mast cells
  • To remove foreign material from the body
  • To synthesize haemoglobin

    • What is MCV?

  • The average haemoglobin level in the blood
  • The ratio of the volume occupied by RBCs to the total volume of blood
  • The average volume of a single RBC (correct)
  • The average concentration of haemoglobin per unit weight of RBCs

    • What is the term for a reduction in the quantity of haemoglobin in the blood?

    <p>Anaemia</p> Signup and view all the answers

    What is the term for an increased number of cells?

    <p>-cytosis</p> Signup and view all the answers

    What is the composition of haemoglobin?

    <p>Four polypeptide chains (2 alpha &amp; 2 beta)</p> Signup and view all the answers

    What is the main function of phosphate in the body?

    <p>Energy metabolism</p> Signup and view all the answers

    What is the normal range for adjusted calcium levels?

    <p>2.2-2.6 mmol/L</p> Signup and view all the answers

    What is the most common cause of microcytic anaemia?

    <p>Iron deficiency</p> Signup and view all the answers

    What is the function of haem in polypeptide chains?

    <p>To bind to oxygen</p> Signup and view all the answers

    What is the normal range for magnesium levels?

    <p>0.7-1.0 mmol/L</p> Signup and view all the answers

    What is the effect of hyperkalaemia on the heart?

    <p>Cardiac arrhythmias and cardiac arrest</p> Signup and view all the answers

    What is the function of creatinine in the body?

    <p>To indicate renal function</p> Signup and view all the answers

    What is the normal range for albumin levels?

    <p>34-50 g/L</p> Signup and view all the answers

    What is the effect of hypocalcaemia on the body?

    <p>Muscle weakness and fatigue</p> Signup and view all the answers

    What is the main cause of iron deficiency anaemia?

    <p>All of the above</p> Signup and view all the answers

    What is the primary function of albumin in the body?

    <p>Binding to and carrying endogenous compounds and medicines</p> Signup and view all the answers

    What is the likely cause of a decrease in albumin levels in a patient with cirrhosis?

    <p>Volume of distribution increases due to ascites</p> Signup and view all the answers

    What is the normal range of bilirubin in the blood?

    <p>Greater than 19 micromoles/L</p> Signup and view all the answers

    What is the primary function of C-reactive protein (CRP) in the body?

    <p>To measure inflammation in the body</p> Signup and view all the answers

    What is the normal range of ESR in the blood?

    <p>Variable and dependent on the individual</p> Signup and view all the answers

    What is the primary mechanism to maintain optimal pH in the body?

    <p>All of the above</p> Signup and view all the answers

    What is the primary cause of respiratory acidosis?

    <p>Increased concentration of carbon dioxide in the blood</p> Signup and view all the answers

    What is the primary function of troponin in the body?

    <p>To regulate muscle contraction</p> Signup and view all the answers

    What is the normal range of troponin in the blood?

    <p>Variable and dependent on the individual</p> Signup and view all the answers

    What is the primary use of troponin in clinical practice?

    <p>To diagnose acute coronary syndrome</p> Signup and view all the answers

    What is the average lifespan of a Red Blood Cell?

    <p>3 months</p> Signup and view all the answers

    What type of White Blood Cell migrates to sites of inflammation and removes foreign material?

    <p>Neutrophils</p> Signup and view all the answers

    What is the term for a reduction in the number of a type of blood cell?

    <p>-penia</p> Signup and view all the answers

    What is the ratio of the volume occupied by Red Blood Cells to the total volume of blood?

    <p>PCV</p> Signup and view all the answers

    What is the term for a type of anaemia caused by a lack of nutrients or bone marrow failure?

    <p>Reduced haemoglobin synthesis</p> Signup and view all the answers

    What is the composition of haemoglobin?

    <p>Two alpha and two beta polypeptide chains</p> Signup and view all the answers

    What is the primary role of albumin in the body?

    <p>to regulate blood pressure and bind to endogenous compounds</p> Signup and view all the answers

    What is the normal range of pH in the blood?

    <p>7.35-7.45</p> Signup and view all the answers

    What is the primary function of CRP in the body?

    <p>to detect inflammation in the body</p> Signup and view all the answers

    What is the effect of a decrease in albumin levels in a patient with cirrhosis?

    <p>a shift of albumin from the serum to interstitial fluid</p> Signup and view all the answers

    What is the primary use of troponin in clinical practice?

    <p>to detect cardiac muscle damage</p> Signup and view all the answers

    What is the normal range of ALT in the blood?

    <p>&lt; 45 U/L</p> Signup and view all the answers

    What is the effect of an increase in bilirubin levels in the blood?

    <p>jaundice</p> Signup and view all the answers

    What is the primary mechanism to maintain optimal pH in the body?

    <p>respiratory and metabolic mechanisms</p> Signup and view all the answers

    What is the effect of a decrease in albumin levels in a patient with ascites?

    <p>a shift of albumin from the serum to interstitial fluid</p> Signup and view all the answers

    What is the primary cause of an increase in ESR in the blood?

    <p>all of the above</p> Signup and view all the answers

    What is the primary function of haemoglobin in the body?

    <p>To carry oxygen to the muscles</p> Signup and view all the answers

    What is the primary cause of anaemia of chronic disease?

    <p>Renal disease</p> Signup and view all the answers

    What is the effect of hyperkalaemia on the muscles?

    <p>Muscle weakness</p> Signup and view all the answers

    What is the primary function of phosphate in energy metabolism?

    <p>To generate ATP</p> Signup and view all the answers

    What is the primary cause of hypomagnesaemia in critically ill patients?

    <p>All of the above</p> Signup and view all the answers

    What is the primary function of creatinine in the body?

    <p>To monitor renal function</p> Signup and view all the answers

    What is the primary cause of macrocytic anaemia?

    <p>B12 deficiency</p> Signup and view all the answers

    What is the effect of hypocalcaemia on the nervous system?

    <p>Numbness and tingling</p> Signup and view all the answers

    What is the primary function of albumin in the body?

    <p>To transport nutrients and waste</p> Signup and view all the answers

    What is the primary cause of iron deficiency anaemia?

    <p>All of the above</p> Signup and view all the answers

    What is the primary role of Red Blood Cells?

    <p>To deliver oxygen to tissues and remove carbon dioxide</p> Signup and view all the answers

    What is the term for a reduction in the quantity of haemoglobin in the blood?

    <p>Anaemia</p> Signup and view all the answers

    What is the function of Eosinophils?

    <p>To appear in response to mediators released from mast cells</p> Signup and view all the answers

    What is the ratio of the volume occupied by Red Blood Cells to the total volume of blood?

    <p>PCV</p> Signup and view all the answers

    What is the composition of haemoglobin?

    <p>Four polypeptide chains (2 alpha &amp; 2 beta)</p> Signup and view all the answers

    What is the average lifespan of a Red Blood Cell?

    <p>Approx. 3 months</p> Signup and view all the answers

    What is the primary function of albumin in the body?

    <p>To maintain blood pressure and bind to endogenous compounds</p> Signup and view all the answers

    What is bilirubin?

    <p>A breakdown product of red blood cells</p> Signup and view all the answers

    What is a normal range for pH in the blood?

    <p>7.35-7.45</p> Signup and view all the answers

    What is the primary function of C-reactive protein (CRP)?

    <p>To indicate inflammation in the body</p> Signup and view all the answers

    What is the primary use of troponin in clinical practice?

    <p>To diagnose cardiac damage</p> Signup and view all the answers

    What is the term for a decrease in the number of a type of blood cell?

    <p>Cytopenia</p> Signup and view all the answers

    What is the primary mechanism to maintain optimal pH in the body?

    <p>Respiratory and metabolic mechanisms</p> Signup and view all the answers

    What is alkalosis?

    <p>A condition where the blood pH is too high</p> Signup and view all the answers

    What is the primary cause of a decrease in albumin levels in a patient with cirrhosis?

    <p>All of the above</p> Signup and view all the answers

    What is gamma-glutamyl transpeptidase (GGT)?

    <p>A liver enzyme involved in metabolism</p> Signup and view all the answers

    What is the function of haem in the polypeptide chains?

    <p>To bind to oxygen</p> Signup and view all the answers

    What is the primary cause of microcytic anaemia?

    <p>Iron deficiency</p> Signup and view all the answers

    What is the normal range for magnesium levels?

    <p>0.7-1.0 mmol/L</p> Signup and view all the answers

    What is the primary function of phosphate in energy metabolism?

    <p>To synthesize ATP</p> Signup and view all the answers

    What is the normal range for adjusted calcium levels?

    <p>2.2-2.6 mmol/L</p> Signup and view all the answers

    What is the primary cause of hyperphosphataemia?

    <p>All of the above</p> Signup and view all the answers

    What is the function of creatinine in the body?

    <p>To monitor renal function</p> Signup and view all the answers

    What is the primary cause of hypomagnesaemia in critically ill patients?

    <p>All of the above</p> Signup and view all the answers

    What is the function of albumin in the body?

    <p>To maintain oncotic pressure</p> Signup and view all the answers

    What is the primary cause of anaemia of chronic disease?

    <p>Renal disease</p> Signup and view all the answers

    Study Notes

    Haematology Basics

    • Red Blood Cells (RBCs):
      • Main role: deliver oxygen to tissues and remove carbon dioxide
      • Lifespan: approximately 3 months
      • Main component: haemoglobin
    • White Blood Cells (WBCs):
      • Neutrophils: migrate to sites of inflammation and remove foreign material (most abundant WBC)
      • Eosinophils: appear in response to mediators released from mast cells, raised in allergic conditions
      • Basophils, lymphocytes, and monocytes
    • Platelets:
      • Damage caused to vascular endothelium is plugged by platelet aggregation

    Definitions

    • MCV (Mean Cell Volume): average volume of a single RBC
    • PCV (Packed Cell Volume)/Haematocrit: ratio of the volume occupied by RBCs to the total volume of blood
    • MCHC (Mean Cell Haemoglobin Concentration): average concentration of haemoglobin per unit weight of RBCs
    • Macrocytic: large cells
    • Microcytic: small cells
    • -penia: reduced number of ...
    • -cytosis: increased number of ...

    Anaemia

    • Definition: reduction from normal of the quantity of haemoglobin in the blood
    • Causes:
      • Haemoglobin loss: haemorrhage (RBC loss) or haemolysis (RBC destruction)
      • Reduced haemoglobin synthesis: lack of nutrients, bone marrow failure, etc.
    • Symptoms:
      • Hair loss
      • Eye yellowing
      • Chest pain
      • Irregular heartbeats
      • Pale skin
      • Spleen enlargement
      • Changes in stool odour
      • Shortness of breath
      • Muscle weakness
      • Fatigue
      • Dizziness
      • Memory problems

    Classification of Anaemia

    • Microcytic (MCV < 80fL): iron deficiency, thalassaemia
    • Normocytic (MCV 80-100fL): anaemia of chronic disease (renal), sickle cell anaemia
    • Macrocytic (MCV > 100fL): B12 deficiency, folate deficiency

    Iron Deficiency Anaemia

    • Most common cause of microcytic anaemia
    • Lack of iron, essential component of haemoglobin
    • RBCs are smaller in size
    • Causes:
      • Chronic blood loss
      • Poor dietary intake
      • Malabsorption
      • Increased requirements (pregnancy)

    Electrolytes and Minerals

    • Magnesium:
      • Normal range: 0.7-1.0 mmol/L
      • Essential ion for enzymatic processes, ATP, and metabolic processes
      • Decrease in magnesium: critically ill patients, symptoms include muscle tremor, arrhythmias, loss of appetite, and fatigue
    • Calcium:
      • Adjusted calcium: 2.2-2.6 mmol/L
      • Essential ion for skeletal structure, nerve conduction, and muscle contraction
      • Causes of hypercalcaemia: primary hyperparathyroidism, malignancy, thiazide diuretics, lithium, and calcium supplements
    • Phosphate:
      • Normal range: 0.8-1.5 mmol/L
      • Essential for energy metabolism
      • Causes of hypophosphataemia: inadequate dietary intake, chronic renal failure, rhabdomyolysis, and tumour lysis
    • Creatinine:
      • Produced at a fairly constant rate from muscles
      • Complete glomerular filtration with little reabsorption by renal tubules
      • Raised creatinine suggests poor renal function

    Liver Function Tests (LFTs)

    • Routine LFTs: give information about activity or concentrations of enzymes and compounds in the blood
    • Need to be interpreted in the context of patient's baseline function, patterns of abnormalities, and clinical manifestations
    • Useful in confirming or excluding a diagnosis of liver disease and monitoring its course### Anaemia
    • A reduction from normal of the quantity of haemoglobin in the blood
    • Caused by haemoglobin loss (haemorrhage or haemolysis) or reduced haemoglobin synthesis (lack of nutrients, bone marrow failure, etc.)

    Symptoms of Anaemia

    • Hair loss
    • Eye yellowing
    • Chest pain
    • Irregular heartbeats
    • Pale skin
    • Spleen enlargement
    • Changes in stool odour
    • Shortness of breath
    • Muscle weakness
    • Fatigue
    • Dizziness
    • Memory problems

    Classification of Anaemia

    • Microcytic (MCV < 80fL): Iron Deficiency, Thalassaemia
    • Normocytic (MCV 80-100fL): Anaemia Of Chronic Disease (Renal), Sickle Cell Anaemia
    • Macrocytic (MCV > 100fL): B12 Deficiency, Folate Deficiency

    Iron Deficiency Anaemia

    • The most common cause of microcytic anaemia
    • Lack of iron, an essential component of haemoglobin
    • RBCs are smaller in size
    • Caused by chronic blood loss, poor dietary intake, malabsorption, or increased requirements (pregnancy)

    Differential Diagnosis

    • Decreased MCV (5mmol/L)
    • Hyperkalaemia: asymptomatic but fatal
    • Elevated potassium: effects on the heart, leading to cardiac arrhythmias and cardiac arrest
    • Causes: excessive intake, decreased elimination (renal failure), shift of potassium from cells to the plasma, and medicines (ACEI, ARBs, and potassium sparing diuretics)

    Magnesium

    • Normal range: 0.7-1.0 mmol/L
    • Essential ion for enzymatic processes, ATP, and metabolic processes
    • Decrease in magnesium: frequently seen in critically ill patients
    • Symptoms: muscle tremor, arrhythmias, loss of appetite, and fatigue
    • Causes: GI losses, increased renal excretion, surgery, trauma, infection, and malnutrition
    • Medicines associated with hypomagnesaemia: cisplatin, ciclosporin, and laxatives

    Calcium

    • Adjusted calcium: 2.2-2.6mmol/L
    • Best measure of calcium, taking into account albumin concentration
    • Calcium is essential for maintaining skeletal structure and involved in nerve conduction and muscle contraction
    • Causes of hypercalcaemia: primary hyperparathyroidism, malignancy, thiazide diuretics, lithium, and calcium supplements
    • Causes of hypocalcaemia: severe malnutrition, hypoalbuminaemia, vitamin D deficiency, renal and liver disease, bisphosphonates, chemotherapy, and furosemide

    Phosphate

    • Normal range: 0.8-1.5mmol/L
    • Major function: energy metabolism
    • Causes of hypophosphataemia: inadequate dietary intake, severe malnutrition, chronic renal failure, and hyperparathyroidism
    • Causes of hyperphosphataemia: tumour lysis, rhabdomyolysis, and chronic renal failure

    Creatinine

    • Produced at a fairly constant rate from muscles
    • Undergoes complete glomerular filtration with little reabsorption by the renal tubules
    • Clearance is often a good indicator of renal function
    • Raised creatinine: poor renal function
    • Serum creatinine level: used to calculate CRCL or eGFR to estimate renal function and aid drug dosing

    Liver Function Tests (LFTs)

    • Routine LFTs: give information about the activity or concentrations of enzymes and compounds in the blood
    • Need to be interpreted in the context of the patient's baseline function, patterns of abnormalities, and clinical manifestations
    • Useful in confirming or excluding a diagnosis of liver disease and monitoring its course

    Albumin

    • Normal range: 34-50g/L
    • Protein produced by the liver
    • Roles: maintaining blood pressure, binding to and carrying endogenous compounds, and medicines
    • Decrease in albumin: increased volume of distribution, shift of albumin from the serum to interstitial fluid, increased loss of albumin, and reduced production of albumin

    Bilirubin

    • Normal range: greater than 19 micromoles/L
    • Breakdown product of RBCs
    • Transported to the liver by albumin
    • Conjugated with glucuronic acid and excreted into bile and eventually the faeces
    • Used as a marker of overall liver function and specifically jaundice
    • Increase in bilirubin: increased production, hepatitis, cirrhosis, hepatic tumours, and medicines

    Liver Enzyme

    • Reference ranges: Alanine Transaminase (ALT) < 45 U/L, Aspartate Transaminase (AST) < 35 U/L, Alkaline Phosphatase (ALP) 32-120 U/L, Gamma-Glutamyl Transpeptidase (GGT) < 70 U/L

    Inflammatory Markers

    • C-Reactive Protein (CRP)
    • Protein made by the liver, released into the bloodstream within a few hours of tissue injury, the start of infection, or another source of inflammation
    • Not diagnostic for a specific disease but provides information on whether inflammation is present
    • Causes of increased CRP: acute infection, flare of IBD, RA, post MI, or post-surgery

    Erythrocyte Sedimentation Rate (ESR)

    • Indirect measurement of inflammation in the body
    • Measures the rate of fall (sedimentation) of erythrocytes (RBCs)
    • Normally, red cells fall slowly, leaving little clear plasma
    • Increased blood levels of certain proteins, which are increased in inflammation, cause the red blood cells to fall more rapidly, increasing the ESR
    • Causes of increased ESR: sickle anaemia, acute infection, myeloma, and diseases associated with inflammation

    Blood Gases, pH

    • Normal range: 7.35-7.45
    • Normal physiological pH: needed for many physiological functions, including enzymatic reactions and oxygen release from haemoglobin
    • Mechanisms to maintain optimal pH: respiratory and metabolic
    • Acidosis: pH < 7.35
    • Alkalosis: pH > 7.45

    Troponin

    • Proteins in muscle fibres that help regulate muscle contraction
    • Released into the bloodstream when there is damage to the heart muscle
    • Increase in troponins: indicate damage to cardiac muscle
    • Used alongside an ECG and symptoms of ischaemia to diagnose ACS
    • May also be raised in other cardiac conditions where there is damage to the cardiac muscles

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    Test your knowledge of haematology basics, including red blood cells, white blood cells, and platelets. Learn about their roles, components, and functions in the human body.

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