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MTAP 2 - HEMATOLOGY > 3RD HEMA - Part 1 > Flashcards

3RD HEMA - Part 1 Flashcards

1
Q

Increase in the number of immature or young forms of white blood cells

A

Shift to the Left

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2
Q

2 Types of Shifts to the left

A

*Degenerative shift to the left
*Regenerative shift to the left

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3
Q

Normal or low WBC count

May be exhibited in cases of Tuberculosis

A

Degenerative shift to the left

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4
Q

Increased WBC count

May be exhibited in cases of Appendicitis

A

Regenerative shift to the left

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5
Q

Shift to the Right

Usually seen with ________ and cases such as _________ Anemia

A

Usually seen with neutrophils and cases such as Pernicious Anemia

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5
Q

Increase in the number of mature or old forms of WBC

A

SHIFT TO THE RIGHT

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6
Q

RBC Shift to the left denotes _______________

WBC Shift to the left denotes ________________

A

RBC Shift to the left denotes microcytosis

WBC Shift to the left denotes immature WBCs

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6
Q

Also known as

Leukoerythroblastosis
Leukoerythroblastic Anemia

A

LEUKOERYTHROBLASTIC REACTION

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7
Q

_________ is an autoimmune disease where antibodies attack parietal cells of the stomach, inhibiting HCl and IF release

A

Pernicious Anemia is an autoimmune disease where antibodies attack parietal cells of the stomach, inhibiting HCl and IF release

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8
Q

LEUKOERYTHROBLASTIC REACTION

The presence of the following are seen in PBS:

1.
2.
3.

A

Immature Neutrophils
Nucleated RBCs
Teardrop RBCs (Dacrocytes)

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8
Q

Observed in conditions involving the presence of space occupying lesion in the marrow (myelophthisis) such as:

Metastatic Tumor
Fibrosis
Lymphoma
Leukemia

A

Striking and Sustained leukoerythroblastic

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9
Q

Often, but not always, accompanied by Neutrophilia

A non-specific reaction, but provides important evidence of underlying disease or stress to the hematopoietic compartment of the body

Strongly associated with Primary Myelofibrosis (PMF)

A

LEUKOERYTHROBLASTIC REACTION

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10
Q

Hemolytic Anemia
Severe Infections
Cardiac Failure
Uremia
Megaloblastic Anemia

A

Mild and Transitory Leucoerythroblastic Reactions

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11
Q

Nuclear remnants of lymphocytes

Looks like thumbprint

Structureless Chromatin

A

Smudge Cells

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12
Q

Nuclear Remnants of Granulocytic Cells

Netlike Chromatin Pattern

A

Basket Cells

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13
Q

May be found normally in few numbers

Chronic Lymphocytic Leukemia

A

Smudge Cells

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13
Q

Contaminant of venipuncture (occasionally)

Must not be confused with malignant cells

A

Endothelial Cells

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14
Q

May be found normally in few numbers

Leukemias

A

Basket Cells

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15
Q

Neutrophils that engulfed foreign bodies like bacteria and fungi

A

Phagocytic Cells

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16
Q

Overwhelming Septicemia

Bacterial and Fungal Infections

Erythrophagocytosis (In which neutrophils engulfs RBCs)

A

Phagocytic Cells

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16
Q

Granulocytic Cells with Pyknotic Nuclei and Agranular Cytoplasm

A

Necrotic Cells

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17
Q

Prolonged EDTA exposure

Chemotherapy (rarely)

A

Necrotic Cells

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18
Q

Large cells (20 to 30 um) which line the veins

Stretched and ovoid in appearance

Single Nucleus with dense chromatin

Abundant cytoplasm which appears translucent

Usually found at the feathery edge

A

Endothelial Cells

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19
Q

Nude nuclei that stain dark purple

A

Megakaryocyte Fragments

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20
Q

Found in Newborns

May be found in aberrant platelet production, myelofibrosis, essential thrombocythemia

A

Megakaryocyte Fragments

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21
Q

Found in newborns

May be found also in cases of hemolysis, leukemia, myeloproliferative disorders, and others

A

Nucleated RBC
(NRBCS)

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21
Q

Varies according to cell maturity

A

Nucleated RBC
(NRBCS)

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22
Q

Defect or Deficiency in the catabolic enzyme: β-glucocerebrosidase

A

Gaucher Disease

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23
Q

WBC type of Gaucher Disease

A

Monocyte/ Macrophages

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24
Q

Most common of the lipidoses

An autosomal recessive disorder

A

GAUCHER DISEASE

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25
Q

Found in bone marrow

Large macrophage with small, eccentric nucleus

Cytoplasm is distended by glucocerebrosidase

A

Gaucher Cell

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26
Q

“Crumpled tissue paper” or onion like appearance

A

Gaucher Cell

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27
Q

These are the false/fake kinds of Gaucher cells

NOT found in Gaucher disease

Can be encountered in:

Thalassemia
Chronic Myeloid Leukemia
Acute Lymphoblastic Leukemia
Non-Hodgkin Lymphoma
Plasma Cell Neoplasms

A

Pseudo-Gaucher cells

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28
Q

What material accumulates in the cytoplasm of Gaucher Disease?

A

B-glucocerebrosides

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29
Q

What cell has a characteristic of crumpled tissue paper appearance?

A

Gaucher Disease

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30
Q

(2) Tests used in Gaucher Disease

A

● Chitotriosidase
● Periodic acid-Schiff Stain
○ From periodate

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31
Q

● Washington Monument Hemoglobin Crystals

○ Associated with ____ _

A

○ Associated with Hb C

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32
Q

Not unique in megaloblastic anemia

A

HYPERSEGMENTED NEUTROPHILS

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33
Q

WBC type of Hyper segmented Neutrophils

A

Neutrophils

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34
Q

Morphologic of Functional Defect of Hyper segmented Neutrophils

Nucleus has ≥ __ lobes

A

Nucleus has ≥ 6 lobes

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35
Q

Can be encountered in:

Megaloblastic anemias
Myelodysplastic syndromes
Hereditary neutrophil
Hypersegmentation
Myelokathexis

A

HYPERSEGMENTED NEUTROPHILS

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36
Q

Pertains to a rare hereditary condition characterized by normal granulocytic production; nevertheless, there is impaired release in to the blood (leads to neutropenia)

Here, neutrophils appear hypermature. There may be hypersegmentation, hyper condensed chromatin, and pyknotic changes in this condition.

A

Myelokathexis (Hypersegmented Neutrophils)

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37
Q

Expected in:

● Megaloblastic anemias
○ Vit. B12 & folate deficiency

A

Hypersegmented Neutrophils

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38
Q

2 Nutritional deficiencies associated with the megaloblastic anemia:

A

● Vitamin B12 deficiency
● Folate deficiency

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39
Q

3-5 lobes

A

Normal neutrophil

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40
Q

> 5 lobes

A

Hypersegmented

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40
Q

<3 lobes

A

Hyposegmented

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41
Q

AKA
True/Congenital PHA

A

PELGER-HUET ANOMALY

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41
Q

WBC type of PELGER-HUET ANOMALY

A

Neutrophils

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42
Q

Failure of the neutrophil nucleus to segment

A

PELGER-HUET ANOMALY

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43
Q

Pince-nez or “spectacle” form of neutrophil nucleus

A

Pelger-Huet Cell

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44
Q

Hyposegmented neutrophils (with 1 to 2 nuclear lobes)

Autosomal dominant disorder

A

PELGER-HUET ANOMALY

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45
Q

Most common genetic disorder of WBCs

A

PELGER-HUET ANOMALY

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46
Q

Decreased

nuclear segmentation (bilobed, unilobed)

coarse chromatin clumping pattern potentially affecting all leukocytes, although morphologic changes are MOST obvious in mature neutrophils

A

PELGER-HUET ANOMALY

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47
Q

A result of a mutation in the lamin β-receptor gene

an inner nuclear membrane protein

plays a major role in leukocyte nuclear shape changes that occur during normal maturation

A

PELGER-HUET ANOMALY

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48
Q

Neutrophils show normal granulation in true ___
Neutrophils in ___ appear to function normally

A

PELGER-HUET ANOMALY

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49
Q

Round, ovoid, peanut-shaped

A

Unilobed

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50
Q

Spectacle-like (“pince nez”) morphology with nuclei attached by a thin filament

A

Bilobed

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51
Q

All neutrophils are affected and demonstrate round nuclei

A

Homozygous PHA

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52
Q

55% to 93% of the neutrophil population are affected (there is generally a mixture of all of the aforementioned nuclear shapes)

A

Heterozygous PHA

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53
Q

What WBC has a “pince nez” appearance for their nuclei?

A

Bilobed Pelger-Huet Cell

54
Q

are eyeglasses worn on the bridge of the nose

A

Pince nez

55
Q

True or false, The Pseudo-Pelger-Huet cell can be found in PHA?

A

False

56
Q

Chronic Myeloproliferative Neoplasms
Myelodysplastic Syndromes
HIV
Leukemia
Mycoplasma Pneumoniae
Severe Bacterial Infections

A

ACQUIRED PELGER-HUET ANOMALY

57
Q

Russell Bodies are globules found in plasma cells, containing ___ antibodies or immunoglobulins

A

GRAPE CELL

ONLY

57
Q

AKA

Morula Cell or Mott cell

A

GRAPE CELL

58
Q

An abnormal plasma cell with a cytoplasm that is completely filled with ________ _______

A

GRAPE CELL

An abnormal plasma cell with a cytoplasm that is completely filled with Russell Bodies

59
Q

Multiple Myeloma or Plasma Cell Myeloma

A

GRAPE CELL

60
Q

What is the abnormal protein found in the urine excreted by patients with Plasma Cell Myeloma?

A

Bence Jones proteins are made with immunoglobulin light chains

61
Q

GRAPE CELL

Characteristics of patients with Plasma Cell Myeloma:

[C-R-A-B]

A

[C-R-A-B]
Hypercalcemia
Renal Insufficiency
Anemia
Bone Lesions

62
Q

WBC type of Grape Cell

A

Plasma Cell

63
Q

WBC type of Chediak-Higashi Syndrome

A

Phagocytes and Lymphocytes, also a platelet disorder

64
Q

A rare autosomal recessive disease of immune
dysregulation

A

Chediak-Higashi Syndrome

65
Q

Basic defect: Golgi Complex

● Responsible for granule assembly w/in WBCs
● Defect in Golgi Complex results in incorrect
distribution of granules (e.g. aggregation)
○ If there is a defect there will be giant
granules in the WBCs

A

Chediak-Higashi Syndrome

66
Q

Characterized by the presence of LARGE (GIANT),

● abnormal cytoplasmic GRANULES in
phagocytes (granulocytes and monocytes),
and occasionally in lymphocytes

A

Chediak-Higashi Syndrome

67
Q

Abnormal granules in phagocytes are:

A

Peroxidase (+)

68
Q

Abnormal granules in lymphocytes are:

A

Peroxidase (-)

69
Q

Numerous types of cells in the body are affected and show abnormally large, lysosomes

○ Which contain fused dysfunctional granules

A

Chediak-Higashi Syndrome

70
Q

_________ _______ is observed due to abnormal
packaging of melanosomes

○ (patient has silvery hair, pale skin and suffers from photophobia)

A

Partial albinism

Chediak-Higashi Syndrome

71
Q

WBC type of Hairy Cells

A

Lymphocytes

72
Q

Small lymphocytes with little cytoplasmic
projections

○ Hair like projections

A

Hairy Cells

73
Q

TRAP (+) stain

A

Hairy Cells

74
Q

TRAP (+) stain stands for

○ Cytochemical stain used

A

Tartrate
Resistant
Acid
Phosphatase

75
Q

It is TRAP (+) because the hairy cell produces abundant amount of _________ _

A

isoenzyme 5

76
Q

● Found in ___________________ (chronic lymphocytic leukemia)

● Nearly all blood cells contain 7 non erythroid isoenzymes of acid phosphatase (0, 1, 2, 3,
3b, 4 and 5)

A

● Found in Hairy Cell Leukemia (chronic
lymphocytic leukemia)

76
Q

Tartrate resistant

Produced in abundance by the hairy cells

A

Isoenzyme 5

77
Q

● Nearly all blood cells contain 7 non erythroid isoenzymes of acid phosphatase

A

(0, 1, 2, 3, 3b, 4 and 5)

78
Q

What is the cytochemical stain utilized to
demonstrate hairy cells?

A

Tartrate Resistant Acid
Phosphatase (TRAP)

79
Q

WBC type of Tart Cells

A

Monocytes

80
Q

A monocyte that has ingested
a whole lymphocyte or a
nucleus (with an identifiable
nuclear chromatin)

A

TART CELLS

81
Q

May be seen in drug sensitivity

A

TART CELLS

81
Q

WBC type of Toxic Granulations

A

Neutrophil only

82
Q

Altered primary granules found
in certain instances within
neutrophils (present because of
rapid cell maturation)

A

TOXIC GRANULATIONS

83
Q

Described as dark-blue to black
granules found in the cytoplasm
of neutrophils

A

TOXIC GRANULATIONS

84
Q

Seen in
○ Several and certain
bacterial infections
○ Chemical poisoning (e.g.
lead)
- Plumbism (lead
poisoning)

A

TOXIC GRANULATIONS

85
Q

In Plumbism (lead poisoning), what RBC
inclusion body/abnormality is seen?

A

Basophilic
stippling

86
Q

In Plumbism (lead poisoning), what WBC inclusion body/abnormality is seen?

A

Toxic granulation

87
Q

WBC Type of Auer Rods

A

● A cytoplasmic inclusion body not a
WBC

  • Found in leukemic cells and/
    promyelocytes
88
Q

● Linear projections of primary
granules
● Abnormal needle-shaped, Rod-like
or round pink to purple inclusion in
the cytoplasm of myeloblasts and
promyelocytes;
● Composed of condensed primary
granules.

A

AUER RODS / AUER BODIES

88
Q

● Seen in certain types of Acute
Myelogenous Leukemia (AML)
● Must be differentiated from toxic
granules (appearance)

A

AUER RODS / AUER BODIES

89
Q

Appear as needles

A

FAGGOT CELLS

90
Q

Are abnormal WBCs with bundles of Auer rods in its cytoplasm

A

FAGGOT CELLS

91
Q

If there is only one Auer rod in the cell, it is reported as

A

abnormal WBC with an Auer rod

92
Q

If there is a bundle or many Auer rods in the cell, it is now called as

A

faggot cell

93
Q

WBC Type of REED-STERNBERG CELLS

A

Lymphocyte

93
Q

● Characterized by its owl’s eyes
appearance due to the existence of two nuclei (with eosinophilic nucleoli within the nuclei) within the giant lymphoid
cell

A

REED-STERNBERG CELLS

94
Q

● A large lymphoid cell which may
demonstrate two nuclei/or
binucleates (with eosinophilic
nucleoli) and an abundant
cytoplasm

A

REED-STERNBERG CELLS

95
Q

● Presence of these cells is the
definitive histologic characteristic of Hodgkin’s Disease (Hodgkin’s Lymphoma)

A

REED-STERNBERG CELLS

96
Q

WBC Type of Flower Cells

A

Lymphocytes

97
Q

Nuclei is characterized with its
flower-like appearance (petal of
flowers)

A

FLOWER CELLS

98
Q

Seen in Adult T-Cell Leukemia

A

FLOWER CELLS

99
Q

POPCORN CELLS AKA?

A

L and H cell

100
Q

What type of leukemia can the flower cells be seen?

A

Adult T-Cell Leukemia

100
Q

L and H cell means

A
  • L = lymphocytic
  • H = histiocytic
101
Q

WBC Type of POPCORN CELLS (L & H CELLS)

A

● Lymphocytes
● Histiocytes

102
Q

● Distinctive popcorn-like
appearance with polylobulated
nuclei and abundant cytoplasm

A

POPCORN CELLS (L & H CELLS)

103
Q

● Large lymphoid cells with
abundant cytoplasm and
vesicular multilobulated nuclei or
popcorn nuclei

A

POPCORN CELLS (L & H CELLS)

104
Q

● Seen in Nodular Lymphocyte
Predominant Hodgkin’s
Lymphoma (NLPHL)

A

POPCORN CELLS (L & H CELLS)

105
Q
  • _____neoplasm composed
    of relatively rare neoplastic
    cells scattered within nodules
    of reactive lymphocytes
A
  • B-cell neoplasm composed
    of relatively rare neoplastic
    cells scattered within nodules
    of reactive lymphocytes

POPCORN CELLS (L & H CELLS)

106
Q
  • Hallmark cells of Hodgkin
    lymphoma (HL) (Acc to
    Rodaks)
A

POPCORN CELLS (L & H CELLS)

107
Q

● Seen in Mycosis Fungoides
- Most common cutaneous
lymphoma

A

SEZARY CELLS

107
Q

WBC Type of Sezary Cells

A

Lymphocytes

108
Q

● Cerebriform nucleus
- Brain-like appearance

A

SEZARY CELLS

109
Q

● Small to medium sized lymphoid
cells with irregular nuclear outlines
(source: rodaks)

A

SEZARY CELLS

110
Q

● Round or oval blue-staining
cytoplasmic inclusions

A

DÖHLE BODIES

111
Q

WBC Type of Dohle Bodies

A

● An cytoplasmic inclusion body, not a
WBC
- Found in Neutrophils

112
Q
  • A type/kind of cancer
    (Non-Hodgkin’s Lymphoma)
  • Not a fungal infection
A

SEZARY CELLS - Mycosis Fungoides

113
Q

● No giant platelets

A

DÖHLE BODIES

113
Q

● Arranged in parallel rows and
consisting of ribosomal RNA
● Toxic granulation

A

DÖHLE BODIES

114
Q

● Non-specific and can be found in:
- Pregnancy
- Severe burns
- Aplastic anemia
- Scarlet fever
- Other infectious diseases
- Following administration of toxic
agents

A

DÖHLE BODIES

115
Q

● Autosomal dominant platelet
disorder

A

MAY-HEGGLIN ANOMALY (MHA)

115
Q

WBC Type of MAY-HEGGLIN ANOMALY (MHA)

A

Leukocytes and platelets

116
Q

● Characterized by variable
thrombocytopenia, giant platelets,
and large Dohle body-like
inclusions in neutrophils,
eosinophils, basophils, and
monocytes (source: Rodaks)

A

MAY-HEGGLIN ANOMALY (MHA)

117
Q

● If they have Dohle body like
inclusions they have ____________________ which are treated
differently

A

MAY-HEGGLIN ANOMALY (MHA)

117
Q
  • Gray-blue, spindle-shaped
    inclusions in the cytoplasm of
    granulocytes and monocytes
A

Dohle body-like Inclusions

118
Q

● Has Giant platelets

A

MAY-HEGGLIN ANOMALY (MHA)

119
Q

Characteristics of _____________
- Leukopenia
- Variable thrombocytopenia
- Spindle shape Inclusions
- Giant platelets

A

May-Hegglin Anomaly

120
Q

Dohle Bodies: SIZE

A

Smaller

121
Q

Dohle Bodies: PAS

A

Positive

121
Q

Dohle Bodies: SHAPE

A

Round

122
Q

Dohle Bodies: CONTENT

A

Ribosomal RNA

123
Q

Dohle body-like inclusions in MHA: SIZE

A

Larger

124
Q

Dohle body-like inclusions in MHA: shape

A

Spindle-shaped

125
Q

Dohle body-like inclusions in MHA: PAAS

A

Negative

125
Q

PAS:

A

Periodic Acid-Schiff

125
Q

Dohle body-like inclusions in MHA: CONTENT

A

Messenger RNA

125
Q

______________ are composed of lamellar rows of rough endoplasmic reticulum.

A

Döhle bodies

125
Q

Brain-like appearance

A

Cerebriform nucleus

126
Q

The basophilic _________________________ in May-Hegglin anomaly are composed of precipitated myosin heavy chains.

A

Döhle body–like leukocyte inclusions

126
Q

MHA:

A

May-Hegglin Anomaly

MTAP 2 - HEMATOLOGY (5 decks)

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