Part I: Development, Structure and Function 1
Preface 3
1.Overview of the Immune, Blood and Lymphatic Systems 3
The players-an overview of the cell lines 3
Acknowledgements 5
2.Organization of the Lymphoid System 7
Primary Iymphoid organs 7
Dedication 8
Secondary Iymphoid organs 9
3.Concepts of Immunity 15
Innate and adaptive immunity 15
The innate immune system 16
Recognition molecules:The B cell 22
Recognition molecules:The T cell 26
Generation of antigen receptor diversity 30
Humoral immunity 33
Cell-mediated immunity 35
The complemnt system 38
4.The Immune System in disease 43
Response to tissue damage 43
Hypersensitivity mechanisms 49
Immune response to pathogens 51
Autoimmunity and immune disease 53
Immunization 55
Transplantation 58
Structure and function of erythrocytes 61
5.Red Blood Cells and haemoglobin 61
Erythropoiesis 63
Iron and haem metabolism 65
Haemoglobin 68
The red cell cytoskeleton 72
Metabolism of red cells 73
6.Haemostasis 77
Platelets and blood coagulation 77
The coagulation cascade 80
Normal serum proteins 85
7.Serum Proteins 85
Acute phase proteins 87
8.Serology and Blood Transfusion 89
Red cell antigens 89
Blood transfusion 91
Part II: clinical Assessment 93
9.Taking a History 95
Structure of a history 95
Common presenting complaints 97
10.Clinical Examination 101
11.Further Investigations 105
Haematological investigations 105
Investigation of immune Function 110
Part III: Basic Pathology 119
12.Disorders of Immunity 121
Autoimmune disease 121
Diseases of immune deficiency 124
Amyloidosis 130
Leukopenia 133
13.Disorders of White Cells, Lymph Nodes and the Spleen 133
Reactive proliferation of white cells 134
Neoplastic proliferation of white cells 134
Disorders of the spleen 143
14.Disorders of Red Cells 145
Anaemia due to blood loss 145
Anaemia due to red cell destruction (haemolytic anaemias) 146
Anaemia due to impaired red cell production 152
Bleeding disorders:platelets 155
15.Disorders of Red Cells 155
Bleeding disorders:clotting factor abnormalities 158
Thrombosis 159
Part IV: Self-assessment 161
Multipe-choice questions 163
Short-answer questions 168
Essay questions 169
MCQ answers 170
SAQ answers 171
Index 175