1. Question
1. What is the normal white cell count?
2. What isleukaemia?
3. What are the two classificationsof leukaemia?
4. What happensto make acute leukaemia?
5. What are the featuresof acute leukaemia?
6. What investigationswouldyouuse?
7. What is the managementof leukaemia?
8. What is Chronicmyeloidleukaemia(CML)?
9. How is the oncogene formedinCML?
10. What are the bloodfindings?
11. What is the treatment?
12. What isthe mostcommontype of leukaemia?
13. What are the 3 stagesof CLL?
14. What islymphoma?
15.
Answer
 Total = 4-11x109
/L
Neutrophils=2-7.5 x109
/L
Lymphocytes=1.5-4x109
/L
 Clonal malignantdisorder, accumulation of abnormal
white cellsinbone marrow,bone marrowfailure gives
symptoms
 Acute = quick,symptoms(bleeding/bruising)
Chronic= asymptomatic,detectedwithbloodtest
 derivedfromabnormal stem/progenitorcell,blasts
unable todifferentiatebutable todivide,crowdsbm
 Anaemia(pallor,tired),Neutropenia(infectionsof
mouth,skin,chest),Thrombocytopenia(spontaneous
bruising/bleeding),Organfailure (bone pain,
hepatosplenomegaly)
 Full bloodcount,bone marrow biopsy(see immature
cells),coagulationscreen,chestx-ray
 Treat symptoms:Neutropenia(broadspectrum
antibiotics),Anaemia(bloodtransfusion),
Thrombocytopenia(platelettransfusion)
Treat leukaemia:systemicchemotherapy,bone
marrow transplant(1:4 siblingmatch)
 clonal malignantmyeloproliferativedisorder,
leukaemiccellsdifferentiate intomature forms
 Philadelphiachromosome (9→ 22 translocation)
 ↑ White cell count(30 - 400 x109
/L), granulocytes
shown,↑basophilsandeosinophils,anaemia
 Imatinibblocksproductof Philadelphiachromosome
(BCR-ABL),tyrosine kinase inhibitors
 ChronicLymphocyte Leakaemia(CLL) - accumulation
of lymphocytesinthe blood,nocure,earlydisease >
14 year survival
 Stage A - Hb>10g/dl + Platelets>100x109
/L(1 - 2 lymph
nodes)
Stage B - Hb>10g/dl + Platelets>100x109
/L(3 - 5 lymph
nodes)
Stage C - Hb<10g/dl or Platelets<100x109
/L
 malignantdisordersof lymphoidcells, Hodgkin
lymphoma,low andhighgrade non Hodgkin
lymphoma

Module: CSIM
Lecture: CSIM 14 - White cells and their disorders

2. Question
16. How manyplateletsare withinamegakaryocyte?
17. What 5 organelles are withinaplatelet?
18. What do granulescontain?
19. What do electron-dense granulescontain?
20. What are the 3 plateletsurface glycoproteins?
21. Explainthe 3 stepsof plateletactivation.
22.
Answer
 4000
 Granule,electron-dense granule,microfilaments,
dense tubularsystem, mitochondrion
 platelet-derivedgrowthfactor, βthromboblobulin,
fibrinogen,clottingfactor, vonWilebrandsfactor
 ADP,ATP, serotonin,calcium
 GP Ib, GPIa/IIa,GPIIb/IIIa
 1. Plateletadhesion(vWF- GpIa/IIabindsto collagen)
shape change
2. Release reaction (collogenexposure leadsto
discharge of granulesandelectrondense granules)
fibrogenbinding
3. PlateletAggregation(swellingand+ve feedback
adhesiondue toADPand thromboxane A2
