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

3RD HEMA - Part 3 Flashcards

1
Q

● Clinical syndrome resembling leukemia (Confused with CML)
● Not a disease, a description only

A

LEUKEMOID REACTION (LR)

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2
Q

● WBC ct.: >__ X 109/L (with neutrophilia and a marked left
shift [presence of immature neutrophilic forms])

A

(50) LEUKEMOID REACTION (LR)

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3
Q

● Excessive leukocytic response in the peripheral blood

A

LEUKEMOID REACTION (LR)

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4
Q

most frequently refers to neutrophils, but the increased
count may be due to an increase in other types of WBCs

A

LEUKEMOID REACTION (LR)

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5
Q

Generally used to distinguish LR from CML

A

LEUKOCYTE (NEUTROPHIL) ALKALINE PHOSPHATASE (LAP/NAP) TEST

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6
Q

Principle: ↑ LAP activity can be observed in neutrophils that have undergone normal growth.

A

LEUKOCYTE (NEUTROPHIL) ALKALINE PHOSPHATASE
(LAP/NAP) TEST

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7
Q

Principle: Hydrolysis of sodium alpha naphthyl phosphate by alkaline phosphatase produces a colored precipitate with a diazotized amine

A

KAPLOW’S METHOD

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8
Q

KAPLOW’S METHOD

: Fixative

A

Methanol and formalin

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9
Q

KAPLOW’S METHOD

Buffer:

A

Propanediole

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10
Q

KAPLOW’S METHOD

Substrate:

A

Sodium alpha naphthyl phosphate

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11
Q

mount in a mounting
solution like

A

Glycerol

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12
Q

KAPLOW’S METHOD

Initial stain:

A

Brentamine-fast garnet salt

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13
Q

KAPLOW’S METHOD

Counterstain:

A

Aqueous Mayer’s hematoxylin

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14
Q

No reddish brown to black precipitate

A

0

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15
Q

Moderately diffused reddish brown to black precipitate

A

2+

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16
Q

Slightly diffused reddish brown to black precipitate

A

1+

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17
Q

Very heavily diffused reddish brown to black precipitate

A

4+

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18
Q

Heavily diffused reddish brown to black precipitate

A

3+

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19
Q

Normal Kaplow’s (LAP) Score =

A

15 to 100

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20
Q

Decreased LAP score

A

Chronic myelogenous
leukemia (CML)

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21
Q

Normal or increased LAP score

A

Leukemoid reaction (LR)

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22
Q

Examples Of Cases With Increased Kaplow’s (Lap) Score

-Characteristics As Having
Leukemoid Reaction (Lr)

(4)

A
  1. Third trimester of pregnancy
  2. Polycythemia vera
  3. Infections
  4. Intoxication
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23
Q

Examples Of Cases With
Decreased Kaplow’s (Lap) Score

(4)

A
  1. CML
  2. Paroxysmal Nocturnal Hemoglobinuria
  3. Sideroblastic anemia
  4. Myelodysplastic syndrome
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24
Q

CML or LEUKEMOID REACTION

Leukocyte in the peripheral blood: Blasts/Promyelocytes

A

CML

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25
Q

CML or LEUKEMOID REACTION

Toxic granulation: Absent

A

CML

26
Q

CML or LEUKEMOID REACTION

Leukocyte in the peripheral blood: Usually Myelocytes

A

LEUKEMOID REACTION

27
Q

CML or LEUKEMOID REACTION

Toxic granulation: Present

A

LEUKEMOID REACTION

28
Q

CML or LEUKEMOID REACTION

Eosinophils/Basophils: increased (↑)

A

CML

29
Q

CML or LEUKEMOID REACTION

Eosinophils/Basophils: Decreased (↓)

A

LEUKEMOID REACTION

30
Q

CML or LEUKEMOID REACTION

LAP: Decreased (↓)

A

CML

31
Q

CML or LEUKEMOID REACTION

Splenomegaly: Usually prominent

A

CML

32
Q

CML or LEUKEMOID REACTION

LAP: Increased (↑)

A

LEUKEMOID REACTION

33
Q

CML or LEUKEMOID REACTION

Philadelphia chromosome (Ph1): Usually present

A

CML

34
Q

CML or LEUKEMOID REACTION

Philadelphia chromosome (Ph1): Absent

A

LEUKEMOID REACTION

35
Q

CML or LEUKEMOID REACTION

Splenomegaly: Mild (if present)

A

LEUKEMOID REACTION

36
Q

CML or LEUKEMOID REACTION

Platelet count: Normal

A

LEUKEMOID REACTION

37
Q

CML or LEUKEMOID REACTION

Platelet count: >600 or <50 X 109
/L

A

CML

38
Q

Most common clinical application of flow cytometry: (2)

A

Diagnosis of Leukemias and Lymphomas

39
Q

● Originally designed to evaluate physical properties of cells based on their ability to deflect light.

A

FLOW CYTOMETRY

40
Q
  • Measures physical antigenic, and functional properties of particles suspended in a fluid.
A

Flow cytometry

41
Q
  • Can describe antigen expression on many viable cells. Currently, ____ antigens can be detected at the same time on an individual cell. This is accomplished by the conjugation of monoclonal antibodies to a variety of fluorochromes that can be detected directly
A

17 antigens

Flow cytometry

42
Q

Most significant discovery that led to improvement of flow cytometry and its subsequent widespread application in clinical practice:

A

Development of Monoclonal Antibodies

43
Q

Although the term flow cytometry suggests the measurement of a cell, this procedure is successfully
applied to study other particles, including _____________, ______________, and __________.

A

Chromosomes,
Microorganisms, and
Proteins.

44
Q

A flow cytometer is composed of

A
  • Fluidics
  • Light source
  • Multiple detectors
  • Computer
45
Q

Laser =

A

Light Amplified by Stimulated Emission of Radiation

46
Q

The basic unit of all radiation:

A

Photon

47
Q

Commonly analyzed specimen in Flow Cytometry

(5)

A

● Bone marrow
● Peripheral blood
● Lymphoid tissue
● Body cavity fluids
● Solid tissue

48
Q

● Must be processed within 24
to 48 hours from time of collection

A

For peripheral blood and bone marrow specimens

49
Q

● Collected into a tube or
container with an anticoagulant (preferably heparin) and are transported to a flow cytometry laboratory at room temperature.

A

For peripheral blood and bone marrow specimens

50
Q

This method, called
____________ __________, created a
central core of individually aligned cells surrounded by a
sheath fluid.

A

hydrodynamic focusing

51
Q

The detector located directly in line with the illuminating laser beam measures _____________ scatter (FS or FSC), which is proportional to particle __________ or _______.

A

The detector located directly in line with the illuminating laser beam measures forward scatter (FS or FSC), which is proportional to particle volume or size.

52
Q

A photodetector positioned to the side measures _____ scatter (SS or SSC), which reflects surface __________ and _______ structures such as granules and vacuoles.

A

A photodetector positioned to the side measures side scatter (SS or SSC), which reflects surface complexity and internal structures such as granules and vacuoles.

53
Q

● CD 34
● CD117
● Terminal deoxynucleotidyl
transferase

A

Lineage

54
Q

● CD 33
● CD 13
● CD 15
● CD 14

A

Granulocytic/
Monocytic

55
Q

● CD 71
● Glycophorin A

A

Erythroid

56
Q

● CD 41
● CD 42
● CD 61

A

Megakaryocytic

57
Q

● CD 19
● CD 20
● CD 22
● κ Light chain
● Λ Light chain

A

B lymphocytes

58
Q

● CD 2
● CD 3
● CD 4
● CD 5
● CD 7
● CD 8

A

T lymphocytes

59
Q

__, __, and ___________ are displayed at the same time on
the instrument screen and registered by the computer system.

A

FS, SS, and fluorescence

60
Q

Counterstain for __ to __ minutes

A

10 to 15 minutes

MTAP 2 - HEMATOLOGY (5 decks)

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