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1 Flashcards

1
Q

From the Greek word “haima” (blood) and “logos” (study/science)

A

Hematology

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2
Q

Red liquid circulating in the heart, vein, arteries and capillaries.

A

Blood

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3
Q

Give 6 functions of blood.

A
  • Respiratory
  • Nutritional
  • Excretory
  • Buffering action
  • Maintenance of body temp
  • Transport of hormones
  • Defense mechanism
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4
Q

Also known as respiratory pugments.

A

Hemoglobin

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5
Q

Give 3 waste products of blood.

A

Creatinine, Blood Urea Nitrogen, Blood Uric Acid

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6
Q

What is the normal blood pH?

A

7.35-7.45

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7
Q

What are the liquid portion of blood?

A

Plasma (unclotted)

Serum (clotted)

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8
Q

Give other names of RBC.

A

Erythrocyte
Erythroplastids
Akaryocyte

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9
Q

Give other names of WBC.

A

Leukocyte

Leukoplastids

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10
Q

Give the granular WBC.

A

Basophil
Eosinophil
Neutrophil

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11
Q

Give the agranular WBC.

A

Lynphocyte

Monocyte

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12
Q

Other names of platelets.

A

Thronbocytes

Thromboplastids

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13
Q

What is the specific gravity of blood?

A

1.055

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14
Q

This method is used only when small quantities of blood are required.

A

Skin puncture

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15
Q

What are the effects of squeezing or milking the site of skin puncture?

A

Hemolysis

Excess tissue fluid

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16
Q

What is the recommended depth of skin puncture in small children and infants?

A

< 2mm

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17
Q

What is the recommendes depth of skin puncture in adults?

A

2mm - 2.5mm

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18
Q

Why do we discard the 1st drop of blood in skin puncture?

A

To discard excess tissue fluid

To discard dead epidermal cells

To facilitate free flow of blood

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19
Q

Can warming the puncture site can increase the bloodflow? If so, what is the required temperature of a warm cloth and for how long?

A

Yes, 40 -42 deg celcius for 2 - 5mins

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20
Q

What is the order of draw for skin puncture?

A

Tube for blood gas analysis

Slides

EDTA microcollection tubes (filled first before other microcollection tube to ensure adequate volume and accurate result)

Other microcollection tubes with anti coagulant

Serum micro collection tubes

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21
Q

What is the best puncture site for children and infants?

A

Plantar surface (heel portion) medial side (in line with big toe) and lateral side

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22
Q

Puncture site for adults and older children using the skin puncture method.

A

Hand, palmar surface of non dominant hand. 3rd or 4th finger (distal portion)

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23
Q

What are the 3 major veins for venipuncture?

A

Cephalic vein (thumb side), Basilic vein (pinky finger), Median Cubital Vein (connects cephalic and median vein)

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24
Q

Why is it that the median vein is the site of choice in venipuncture?

A

Because it is well anchored.

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25
Q

What is the angle of the needle in venipuncture?

A

15 degrees

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26
Q

What are the effects of prolonged tourniquet application?

A

Hemolysis
Hemoconcentration
Shortened coagulation time (PT & APTT)

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27
Q

What is the distance of the tourniquet on the puncture site and how long should the tourniquet applied in the arm?

A

3-4 inches (7.5-10cm), < 1min

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28
Q

The phlebotomist can only puncture the patient ___

A

No more than 2.

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29
Q

What is the most common needle length and what is the standard bore size?

A

1 & 1.5 inches, 21G

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30
Q

What are the common cause of hemolysis?

A

Prolonged tourniquet application

Moisture or contamination of tube

Small sized needle

Excessive agitation

Frothing of blood sample

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31
Q

Additives that inhibit the use of glucose by the red cells

A

Antiglycolytic agents

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32
Q

Normal value of RBC.

A

Male: 4.6-6
Female: 4-5.40

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33
Q

Normal value of hemoglobin.

A

Male 14-18 d/dL (140-180)

Female 12-15 g/dL (120-150)

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34
Q

Normal value of hematocrit

A

Male 40-54 % (.40-.54 L/L)

Frmale: 35-49 % (.35-49 L/L)

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35
Q

Normal value of MCV

Mean cell volume

A

80-100 fL

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36
Q

Normal value of MCH

Mean cell hemoglobin

A

26-32 pg

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37
Q

Normal value of MCHC

Mean cell hemoglobin concentration

A

32-36 g/dL

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38
Q

Normal value of RDW

A

11.5-14.5 %

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39
Q

Normal value of WBC

A

Male 4.5-11.5

Female 4.5-11.5

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40
Q

Normal value of platelet

A

150-450

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41
Q

It is the process of blood cell production that includes cell renewal, proliferation, differentiation, and maturation.

A

Hematopoeisis

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42
Q

What are the 3 phases of hematopoeisis

A 
Mesoblastic phase (yolk sac phase)
Hepatic phase
Medullary phase (myeloid phase)
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43
Q

It is a phase in the hematopoeisis that is characterized by the development of primitive erythroblasts that produce measurable amounts of hemoglobin, including portland, Gower 1, and Gower 2. This phase does not contribute significantly to definitive hematopoeisis and it occurs intravascularly of within a developing vessel.

A

Mesoblastic phase

Yolk sac phase

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44
Q

The first fully developed organ in the fetus that becomes the major site of T-cell production

A

Thymus

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45
Q

What is the anticoagulant in gray top (Sodium flouride)?)

A

Potassium Oxalate

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46
Q

What is the anticoagulant in gray top (lithium iodoacetate)?

A

Lithium heparin

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47
Q

It converts fibrin ti fibrin clot.

A

Thrombin

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48
Q

What is the additive in Gold top tube?

A

Thixotropic gel

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49
Q

This additive chelates calcium and is mostly used in most hematologic tests.

A

EDTA (Ethylenediaminetetraacetic acid)

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50
Q

CBC’s and reticulocyte counts can be performed on blood stored at room temp for how many hours?

A

4 hours

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51
Q

WBC count, hematocrit and platelet counts can be determined at 4 deg. Celsius up to how many hours?

A

24 hours

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52
Q

ESR should set up within how many hours if stored at room temp?

A

2 hours

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53
Q

ESR should set up within how many hours if specimen is refrigerated?

A

6 hours

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54
Q

Bloodsmears should set up within how many hours after blood collection?

A

2 hours

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55
Q

What is the optimal concentration of EDTA?

A

1.5mg per ml of blood

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56
Q

This is the anticoagulant choice for Osmotic Fragility Test and blood gas analysis.

A

Heparin

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57
Q

What is the optimal concentration of Heparin?

A

15-20 units per ml of blood

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58
Q

What are the three hepain formulation?

A
  1. Ammonium heparin
  2. Sodium heparin
  3. Lithium heparin
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59
Q

Why is it that heparin is not a choice of anticoagulant in hematologic tests?

A

Because heparin causes cellular clumping (especially platelets), which leads to pseudoleukocytosis (falsely increase WBC) and pseudothrombocytopenia (falsely decrese platelets).

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60
Q

Why should we not use heparin in blood smears?

A

Because it causes morphologic distortion of platelets and leukocytes.

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61
Q

What is the critical ratio of sodium citrate and blood?

A

1:9

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62
Q

What is the concentration of sodium citrate that is used in coagulation tests?

A

3.2%

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63
Q

Give the order of draw in Syringe method.

A 
B- blood culture tube (yellow)
C- citrate (light blue)
R- Red 
H- Heparin (green)
E- EDTA (lavander/purple)
S- sodium chloride (gray)
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64
Q

This anti coagulant prevents phagocytosis, neutralizes some antibiotics, prevent complement activation and is used for blood culture.

A

SPS (Sodium polyanethol sulfonate)

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65
Q

This anti coagulant is mostly used in blood bank, paternity testing, HLA testing and DNA testing.

A

ACD- Acid Citrate Dextrose

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66
Q

This additive is used for lead determination.

A

Tan top

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67
Q

What is the anti coagulant of tan top tube?

A

K2 EDTA

68
Q

This additive is used for trace element determination, nutritional chemistry and toxicology.

A

Royal blue top (ag: K2 EDTA)

69
Q

This additive is used for molecular diagnostic test

A

White top tube (K2 EDTA with gel)

70
Q

This additive is used foe westergren ESR

A

Black top (3.8% Sodium Citrate)

71
Q

This additives preserves glucose in 3 days and is used for glucose and alcohol determination.

A

Gray top (Sodium fluoride)

72
Q

This additive preserves glucose in 1 day/24 hours and is used for glucose and alcohol determination.

A

Gray top (Lithium iodoacetate)

73
Q

Responsible for the RBC production

A

EPO

74
Q

Where is EPO produced?

A

Kidney

75
Q

It is a female hormone that indirectly inhibits erythropoeisis.

A

Estrogen (Estrogen - kidney)

76
Q

It is a male hormone that indirectly stimulates erythropoeisis.

A

Testosterone (Testosterone to kidney, then kidney will stimulate erythropoeisis)

77
Q

This hormone directly stimulates erythropoeisis in bone marrow

A

Growth hormone

78
Q

This is the first stage of hemoglobin synthesis in erythropoeisis.

A

Rubricyte, Polychromatic Normoblast, Polychromatic erythroblast

79
Q

This is the last stage of hemoblobin synthesis in erythropoeisis.

A

Reticulocyte

80
Q

This is the last stage with nucleus in erythropoeisis.

A

Metarubricyte, Orthocromatic normoblast, orthochromatic erythroblast

81
Q

Increased in number in cells with variation in size.

A

Anisicytosis

82
Q

What is the normal value of MCV?

A

80-100 fL

83
Q

What are the 3 ways to detect anisocytosis?

A
  1. using the nucleus of a small lymphocyte
  2. Using the MCV value
  3. Using the RDW value
84
Q

What is the formula of MCV?

A

MCV= (HCT /RBC) x 10

85
Q

What is the referennce range of RDW?

A

11.5 % -14.5 %

86
Q

It is a calculated index (from RBC histogram) given by hematology analyzers to help identify anisocytosis

A

RDW (Red cell Distribution Width)

87
Q

General term for variation in coloration.

A

Anisochromia

88
Q

What is the normal size of the central pallor of the RBC?

A

1/3 the diameter.

89
Q

Give 3 conditions that may picture anisochromia.

A

Sideroblastic anemia, (hypo and normochromic cells)
After transfusion with normal cells (hypochromic anemia)
After iron therapy for IDA

90
Q

This cell is pale, central pallor is less than 1/3 of diameter and is usually microcytic

A

Hypochromic Cells

91
Q

GRADING OF HYPOCHROMIA:

Area of central pallor is 3/4 of diameter.

A

3+

92
Q

GRADING OF HYPOCHROMIA:

Area of central pallor is 1/2 of diameter.

A

1+

93
Q

GRADING OF HYPOCHROMIA:

Area of central pallor is thin rim of hemoglobin.

A

4+

94
Q

GRADING OF HYPOCHROMIA:

Area of central pallor is 2/3 of diameter.

A

2+

95
Q

It has a large clear central pallor and is also known as thin rim of Hgb, Ghost cells and Pessary Cells,

A

Anulocyte

96
Q

In what condition can we observe anulocyte?

A

IDA

97
Q

This term refers to the RBC’s lack of central pallor even though they lie in a desirable area for evaluation

A

Hyperchromic cells

98
Q

In what parameter can we say that true hyperchromia occurs?

A

when MCHC is high

99
Q

Larger than normal red cells with bluish tinge (Wright’s Stain) causes by residual RNA

A

Polychromatophilic erythrocytes

100
Q

Increased number of red cells with variation in shape

A

Poikilocytosis

101
Q

RBC’s with irregular spiculated surface and is usually associated with Abetalipoproteinemia, McLeod Syndrome, and PK def.

A

Acanthocyte (Spur Cell)

102
Q

Elongated RBC with a slit-like central pallor and is associated with Rh Null Syndrome, Alcoholism, Hereditary Stomatocytosis, Electrolyte imbalance, severe liver disease.

A

Stomatocyte (Mouth Cells)

103
Q

Almost Spherical in shape, lacks the central pallor and is associated with Hereditary Spherocytosis, Hemolytic anemia, burns, ABO HDN.

A

Spherocyte
NOTE: spherocyte may be wrongly reported if one examines the feathered edge of the blood film because the RBC in the said area lack central pallor.

104
Q

Folded RBCs that is associated with Hgb SC disease

A

Biscuit cell

105
Q

Bipolar or central distribution of Hgb that is associated with sickle cell anemia

A

Bronze elliptocyte

106
Q

RBCs which show a centrally stained area with a thin outer rim of Hgb that is associated with Thalassemia (aka. hhereditary leptocytosis)

A

Leptocyte (mexican hat cell, platycyte, codocyte, bulls eye cell, target cell)

107
Q

Sickle or crescent shapeed rbcs that is associated with sickle cell anemia andHgb SC disease

A

Drepanocyte (sickle cill, miniscocyte)

108
Q

This form of sickle cell when reoxygenated thhey tend to fragment.

A

ISC irreversible sickle cell

109
Q

This form of sickle cell when reoxygeenated they return to the original biconcave disk shape

A

Oat-shape cells

110
Q

Fragmented RBCs tthat is associated with DIC, uremia patientts with artificial heart valve

A

Schistocyte (schizocyte)

111
Q

Pear shaped or tear drop shaped RBCs and is associated with Primary myeloid fibrosis, pernicious anemia.

A

Dacryocyte (tear drop cell)

112
Q

Oval-shaped RBCs that is associated with hereditary elliptocytosis

A

Ovalocytes

Elliptocytes- more oval than ovalocytes, are cigar-shaped

113
Q

RBCs with regularly spiculated surface (pointed at tips) that is associated with uremia, PK disease

A

Burr cells

114
Q

RBCs with regularly spiculated surface (rounded tips) that is associated with Bile acid abnormalities

A

Echinocyte (crenated rbc)

115
Q

THis cell is as large as leukocytes, pale pink staining ghost of the red cell (membrane remaining after the contents have been released) and it is seen in malaria and in other conditions causing overt hemolysis

A

Semilunar bodies

116
Q

RBC inclusion bodies that has denatured and precipitated Hgb and is associated with G6PD, favism (sensitive to fava bean) and drug induced hemolytic anemias

A

Heinz bodies
Supravital Stains: YES
Wright’s Stain: NO

117
Q

RBC inclusion bodies that has microtubules rings remaining from a mitotic spindle and is associated with Lead poisoning, pernicius anemia and cases of abnormal erythropoeisis.

A

Cabot Rings

Wright stain : Reddish-Violet

118
Q

RBC inclusion bodies that has remnants of nuclear chromatin (DNA) that is associated with Megaloblastic anemia and after splenectomy

A

Howell-Jolly bodies

Supravital Stains: New Methylene blue
Wright’s Stain: Reddish-blue or purple
Feulgen rxn (+) POSITIVE (histochem stain for DNA)

119
Q

RBC inclusion bodies that has intraerythrocytic collection of iron and is associated with sideroblastic anemias

A

Siderotic granules (aka pappenheimer bodies)

Iron stain: Perl’s Rgt
Supravital stain: New methylene blue
Wright’s stain: dark staining dots

120
Q

RBC inclusion bodies that has aggregated RNA and is associated with Lead poisoning (plumbism), Arsenic poisoning, Pyrimidine-5’- nucleotidase deficiency.

A

Basophilic stiplings (punctate basophilia)

Supravital stain: YES
Wright’s stain: deep blue to purple

121
Q

RBC inclusion bodies that has pricipitated Hb H and is associated with Hb Disease

A

Hb H (pitted golf ball)

122
Q

abnormal Hgb composed of 4 beta globin chains

A

Hb H

123
Q

Nucleated cells that function in body defense.

A

WBC

124
Q

What is the normal value of WBC in newborn?

A

13.0 - 38.0 x109/L (133,000-38,000/mm3)

125
Q

What is the predominant WBC in adult?

A

Neutrophil

126
Q

What is the predominant WBC in children <4 years of age?

A

Lymphocyte

127
Q

What is the most valuable and reliable criterion in determining WBC maturity?

A

Nuclear chromatin pattern

128
Q

Give the WBC granulocytes.

A

Basophil
Eosinophil
Neutrophil

129
Q

Give the WBC agranulocyte

A

Lymphocyte

Monocyte

130
Q

Give the WBC polymorphonuclear cells.

A

Basophil
Eosinophil
Neutrophils

131
Q

Give the WBC mononuclear cells

A

MOnocyte

Lymphocyte

132
Q

Give the Phagocyte cells

A

Basophil
Eosinophhil
Neutrophil
Monocyte

133
Q

Give the WBC immunocyte cell

A

Lymphocyte

134
Q

Increase level of this WBC cell is associated with Asthma, Psoriasis, Scarlet fever, Parasitic infection (mostly helminthic except protozoan), trichinosis (T. spiralis may possibly produce the highest count)

A

Eosinophil

135
Q

Earliest recognizable granulocytic precursor using the light microscope

A

Myeloblast

136
Q

Last stage capable of mitosis and it is the stage of synthesis of the secondary granules aka specific granules

A

Myelocyte

137
Q

Stage of synthesis of primary granules (non specificaka Azurophilic)

A

Promyelocyte

138
Q

aka as juvenille cell -> young cell

the first stage of nuclear indentation (nucleus is kidney bean shape) and its the most common cell in the bone marrow

A

Metamyelocyte

139
Q

aka stab cell, staff cell

Youngest granulocytic precursor to normally appear in PBS.

A

Band cell

140
Q

Increased level of this is associated with bacterial infection (generally), appendicitis, Parasites (malaria, liver flukes)

A

Neutrophil

141
Q

Decreased level of this cell is associated with ACTH administration

A

Eosinophil

142
Q

The decreased level of this cell is associated with chemical toxicity (benzene), and nutritional deficiencies

A

Neutrophil

143
Q

Aka extreme neutropenia (<0.5x109/L) and is associated drugs are amidopyrine and cephalosporin

A

Agranulocytosis

144
Q

Decreased level of this cell is associated with Acute infection, stress and hyperthyroidism

A

Basophil

145
Q

Increased level of this cell is associated with Immediate hypersensitvity reactions and hypothyroidism

A

Basophil

146
Q

It is the final maturation stage of B-lymhocyte

A

Plasma cell

147
Q

What is the most malignant disease of plasma cells?

A

Multiple myeloma

148
Q

Increased lever of this cell is associated with Bordetella pertusis ifection, Toxoplasmosis and decreased level is associated with HIV infection (T lymphocytopenia)

A

Lymphocyte

149
Q

It is the largest WBC cell and is associated with Tubercullosis, Syphilis, Protozoal and rickettsial infections (malaria, thypus) Sub acute Bacterial endocarditis and decreased level is associated with Aplastic anemia

A

Monocyte

150
Q

What do we call the round discreet globules containing immuno globulins in cytoplasm of plasma cell?

A

Russel bodies

151
Q

It is the most abundant cell in the body and some of its functions are:
Phagocytosis
Release Interleukin 1 (Stimulates T lymphocyte)
Produce transcobalamin II (the primary transport factor for Vit B12)

A

Macrophages

152
Q

Name of macrophage in placenta.

A

Hoffbauer cell

153
Q

Name of macrophage in bone

A

Osteoclast

154
Q

Name of macrophage in spleen

A

Littoral cells/ Splenic MAcrophages

155
Q

Name of macrophage in skin

A

Langerhans cell

156
Q

Name of macrophage in brain

A

Microglial cells

157
Q

Name of macrophage in kidney

A

Mesangial cell

158
Q

Name of macrophage in lungs

A

Alveolar macrophages/ Dust cell

159
Q

Name of macrophage in liver

A

Kupffer cell

160
Q

It is the cancer of blood.

Malignant neoplasm of the blood forming tissue of the bone marrow, spleen, and lymph system.

A

Leukemia

161
Q

What is the of M:E ratio?

A

10:1

162
Q

Type of anemia usually present in cases of acute leukemia:

A

Normocytic Normochromic

163
Q

This cytochemical stain is used in differentiating AML and ALL, Positive stain rules our ALL.

A

Myeloperoxidase (MPO)

164
Q

It is the only dse in which the MCHC is above the reference range

A

Hereditary spherocytosis

165
Q

Confirmatory test for hereditary spherocytosis

A

OFT (increased OFT test)

HEMA- random questions (1 decks)

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