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AMT Hem/Coag book etc > AAB/Jarr Heme Coag > Flashcards

AAB/Jarr Heme Coag Flashcards

1
Q

3 main sites of hematopoesis during conception and early fetal months

A

yolk sac, liver, spleen

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2
Q

Adult Bones Hematopoesis, acrynom

A

SS
PRV

Skull, Sternum
Pelvis, Ribs, Vertebrae

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3
Q

Heme needs these two things

A

iron and protoporhyrin

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4
Q

Protein that transports Fe

A

transferrin

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5
Q

Major storage form of iron

A

Ferritin

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6
Q

Long term storage of insoluble Fe

A

Hemosiderin

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7
Q

Enzyme def w/build up of heme precursors is called

A

porhyrias

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8
Q

While in the DELTA,
POR UR COP PRONTO
a cup of HEME

A

Heme Precursors

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9
Q

Hmg F % in newborns versus adults

A

newborn 60-90
adults 1

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10
Q

Hmg A in adults
versus newborns

A

adults 97
newborns 10-40

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11
Q

Hmg A2 in both adults and newborns

A

2%

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12
Q

Gower I/II, Portland Hmg in…

Hmg F in…

Hmg S in…

A

embryonic

both newborn and adult

not normal, sickle cell

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13
Q

In Hmg oxy diss curve, oxygen is released or not released in a shift to the left

A

not released

No, won’t let go

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14
Q

In Hmg oxy diss curve, oxygen is released or not released in a shift to the right

A

released

won’t hold tight

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15
Q

To determine Hmg, the oxidation of hmg to methmg is done with these two reagents

A

K-CN and K-Ferric-CN

Cyanide

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16
Q

HCT % NV
Male
Female

A

Female 37-47
Male 42-52

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17
Q

Diluent used for WBC/PLT CT

A

1% Ammonium Oxalate

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18
Q

MCV formula

A

HCT/RBC x 10

volume/cell

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19
Q

MCV NV

A

80-100fL

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20
Q

MCH formula

A

HGB/RBC x 10

hmg/cell

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21
Q

MCH NV

A

27-31pg

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22
Q

MCHC formula

A

HGB/HCT x 100

concentration=always smaller number at top and percentage

hmg/volume

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23
Q

MCHC NV

A

32-36 g/dL

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24
Q

RDW NV

A

11.5-14.5%

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25
Q

RBC ref
female
male

A

female 3.8-5.2
male 4.5-6.1

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26
Q

Seg ref

A

45-70

About 1/2-2/3

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27
Q

Lymp ref

A

20-40
About a quarter almost 2/3

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28
Q

mono ref

A

3-10

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29
Q

baso

A

0-2, least

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30
Q

eos

A

0-3

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31
Q

plt ref

A

150-400

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32
Q

Romanowsky stain also called

A

Wright stain, Giesma

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33
Q

4 things in wrights stain

A

-methanol
-phosphate buffer
-eosin, methylene blue

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34
Q

Calculation of absolute values

A

Relative% x total cell ct

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35
Q

TB, Syphilis, Malignancies associated with what kind of cell

A

monocytes

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36
Q

Hypersegmented neutrophils ass with what kind of anemia

A

megaloblastic anemia

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37
Q

Hyposegmented neu ass with

A

pelger huet

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38
Q

bacterial infections, burns, chemo ass with what 2 white cell morphologies

A

toxic granulation and vaculoles

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39
Q

Bacterial infections, burns, and May Hegglin ass with what white cell morph

A

Dohle bodies

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40
Q

Varient lymphs ass with

A

IM, viral infections

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41
Q

WBC correct calculation for NRBCS

A

wbc x100/nrbcs + 100

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42
Q

Abetalipoproteinemia and severe liver disease ass with what rbc shape

A

acanthocyte

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43
Q

uremia and artifacts cause what kind of rbc shape

A

echinocyte, burr

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44
Q

DIC causes what rbc shape

A

shisto

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45
Q

HJ bodies composed of

A

DNA

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46
Q

Baso stip composed of

A

RNA

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47
Q

Pappenheimber bodies made of

A

Iron

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48
Q

Heinz bodies made of

A

denatured precipitated hemoglobin

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49
Q

cabot ring made of

A

left over mitotic spindle

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50
Q

Which rbc inclusion is not seen with wright stain

A

Heinz bodies

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51
Q

Heinz bodies and bite cells ass with what deficiency

A

G6PD

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52
Q

Kind of rbc inclusion with thall and lead

A

baso stip

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53
Q

Rule of 3

A

RBC x 3=Hmgx3=Hct

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54
Q

Increased MCV/MCHC and decreased RBC are ass with

A

cold agg disease

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55
Q

What replaces glutamic acid in the 6th position of the beta chain in Hmg C

A

Lysine

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56
Q

What replaces glutamic acid in the 6th position of the beta chain in Hmg S

A

Valine

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57
Q

Hmg A1 chains

A

2 alpha
2 beta

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58
Q

Hmg A2 chains

A

2 alpha
2 delta

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59
Q

Hmg F chains

A

2 alpha
2 gamma

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60
Q

Order from fastest to slowest in cellulose acetate at pH 8.4 (as opposed to citrate 6.2)

A

A, F, S, C

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61
Q

Two reagents usedin solubility test of Hmg S

A

saponin and sodium dithionite

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62
Q

ESR Female

A

0-20mm

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63
Q

ESR male

A

0-15mm

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64
Q

ESR show increase in these two plasma proteins

A

fibrinogen and globulin

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65
Q

decrease temp, old, excess EDTA ESR…

A

decrease ESR

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66
Q

supravital Stain for retic ct

A

new methylene blue

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67
Q

Retic ct monitors

A

etrythropoiesis

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68
Q

Retic ct % calculation

A

retics/10

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69
Q

Absolute retic

A

RBCs x retic%

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70
Q

corrected retic ct (corrects for HCT)

A

retic % x PT HCT/45

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71
Q

retic ref

A

0.5-1.5%

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72
Q

RPI calculation

A

corrected retic/maturation time of 2

need retic # and HCT

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73
Q

M:E ratio

A

3:1-4:1

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74
Q

Stain for bone marrow

A

romanowsky, same for wrights

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75
Q

Cellulose acetate ph8.6, cathode/slowest to fastest/anode

A

-C, S, F, A+

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76
Q

Cellulose acetate ph8.6, anode/fastest to slowest/cathode

A

+A, F, S, C-

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77
Q

Hmg D seen in what race, migrates with

A

East indian, S

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78
Q

Hmg E seen with what race, migrates with

A

Southeast asian, C

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79
Q

Hmg G seen with what race, migrates with

A

African, S

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80
Q

Reducing agent in qualitative screen for Sickle Dex, solubility test

A

sodium di-thionite

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81
Q

In solubility test, what is added to lyse the RBC to release the hmg…

what is added to reduce the hmg…

A

saponin lyses

sodium dithionite reduces it to become deoxygenated and insoluble; will precipitate out of phosphate buffer

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82
Q

What confirms s positive sickle screen

A

hmg electrophoresis

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83
Q

Which electrophoresis separates S

A

citrate agar ph6.2

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84
Q

Lead and Thall trait are what kind of anemias

A

microcytic/hypochromic

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85
Q

IDA and later phase of anemia of Chronic disease what kind of anemia

A

micro/hypo

Initially anemia of chronic is normal,normo

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86
Q

In IDA, all Iron studies are low except for

A

TIBC

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87
Q

Three causes of macrocytic anemia

A

B12 def, folate def

liver disease/alcholism (B12, folate def)

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88
Q

What does G6PD have that PK doesn’t

A

Heinz bodies
Possibly bite cells

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89
Q

G6PD def and HbH uses this stain/prep

A

Heinz body prep

Use as a nonspecific screen for hemolysis due to drugs/toxins, enzyme deficiencies, thalassemias, and unstable hemoglobins.

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90
Q

Test for PCH, IgG, Anti-P Biphasic

A

Donath Landsteiner TEst

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91
Q

Condition with large Azurophilic granules, mucooplysaccharies (Hunter, Hurler)

A

Alder Reily

A=azurophilic

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92
Q

Condition with large lysosomes/fushion of primary granules

A

Chediak-Higashi

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93
Q

Condition with large PLTs, decreased PLTS, Dohle bodies in seg/mono/lymph

A

MayHegglin

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94
Q

Condition with hyposegmented polys

A

PelgerHuet

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95
Q

Dry tap is seen in which condition

A

primary myelofibrosis

myeloid metaplasia: is a disorder in which normal bone marrow tissue is gradually replaced with a fibrous scar-like material. Over time, this leads to progressive bone marrow failure.

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96
Q

Decreased LAP, Ph chromosome in what condition

A

CML

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97
Q

JAK2 seen in what condition

A

Polycythemia Vera

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98
Q

Which reaction has toxic granules and Dohle bodies

A

Leukemoid

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99
Q

WHO acute leukemia how many blasts in BM

FAB

A

WHO >20%
FAB >30%

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100
Q

Leukemia seen with soccer ball nucleus lymphs

A

CLL

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101
Q

Lymphoma associated with EBV, HIV

A

Burkitt

Burkitt lymphoma (BL) is an aggressive non-Hodgkin B-cell lymphoma.

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102
Q

Lymphoma associated with Reed Sternberg cell

A

Hodgkin

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103
Q

Myeloma with bone involvement, IgG and Bence Jones in urine

A

Multiple myeloma

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104
Q

Condition with IgM, increased serum viscosity and normal bone

A

Waldenstrom

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105
Q

Prussion blue stains

A

iron

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106
Q

LAP in CML

A

decreased

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107
Q

LAP in Leukamoid rxn

A

increased

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108
Q

TRAP
tartrate-resistant
ACID PHOSPHATASE
for what condition

A

Hairy cell leukemia

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109
Q

Auer rods in

A

AML
acute myeloid leukemia

A=Auer

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110
Q

BM macrophages have wrinkled/striated cyto with accumulation of glucocerebrosidease

A

Gaucher

G=glucocerebrosidease
Gaucher is wrinkled

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111
Q

BM macrophages w/globular or foamy cyto, sea-blue histiocytes with sphingomyelinase

is a disease in which excess material is stored inside cells (metabolic storage disease). These cells are referred to as foam cells because of their foamy or soap-suds appearance

A

Niemann-Pick

Niemann is foamy

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112
Q

Stain for AML, myelogenous cells for nonspecific/specific granules/fats…

A

Sudan black B

Oil red O stains neutral lipids and is replacing SSB

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113
Q

Stain for glycogen deposits in liver, fungi, and blasts in ALL, stains lymphoblasts not myeloblasts

A

PAS

periodic acid-Schiff

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114
Q

What is added to stabilize WBC when there’s smudge cells causing WBC cts to not match

A

22% bovine albumin

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115
Q

DF of PLT CT with sodium citrate

A

1.1

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116
Q

Which inclusion isn’t stained with WRights

A

Heinz bodies, uses NMB

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117
Q

Peroxidase stains which cell lines..
not…

A

Myelogenous: myelos, monos

Not lymphs

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118
Q

NASDA/Naf used for which leukemia

addition of Naf makes monos become negative

A

AMML

acute myelol, mono

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119
Q

PAS pos in

A

ALL

acute not chronic lymphoblasts

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120
Q

TRAP pos for whic leukemia

A

hairy cell

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121
Q

3 names for NRBCs, last nucleated rbc

A

metarubricyte

Orthochromic normoblast
Orthochromic erythroblast

NRBC is not Polychromotaphilic, it’s Orthochromatic

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122
Q

2 names for retic

A

reticulocyte

polychromatophilic erythrocyte

Retic is Polychromotaphilic due to RNA

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123
Q

1.)Rubriblast
2.)Pro-rubricyte
3.)Rubricyte
4.)Meta-rubricyte/NRBC

5.)Reticulocyte
6.)RBC

A

1.)Pro-
2.)Basophilic-
3.)Polychromatophilic-
4.)Orthochromic-

-normoblast

5.)Polychromatophillic
erythrocyte
6.)RBC

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124
Q

Male Hmg

A

14-18

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125
Q

female hmg

A

12-15

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126
Q

neonate hmg

A

19

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127
Q

toddler hmg

A

11-13

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128
Q

IDA
iron, ferritin…
TIBC/transferrin…

size, color…

A

iron low
ferritin low

TIBC/transferin high

micro, hypo

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129
Q

Anemia of chronic
iron, TIBC…
ferritin…

size, color…

A

iron/TIBC low
ferritin high

Normo, normo at first
micro, hypo later on

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130
Q

5 micro, hypo anemias

A

IDA, anemia of chronic(can become)
sidero, lead
thall

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131
Q

4 macrocytic anemia

A

B12, folate
liver, alcoholism

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132
Q

2 names for target

A

codocyte, leptocyte

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133
Q

Target, baso stip, tears in

A

thallasemia

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134
Q

sugar water test, sucrose hemolysis, and acidified serum test associated with

A

PNH
Paroxysmal nocturnal

Not PCH

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135
Q

Smudge cells seen in which leukemia

A

CLL

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136
Q

increased sml, mature lymphs and smudge what leukemia

A

CLL

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137
Q

Condition with giant, bizarre PLTs, NRBCs, teardrop, pancytopenia

It causes scarring of the bone marrow which makes it more difficult to produce blood cells causing pancytopenia.

It is one of a group of conditions called myeloproliferative neoplasms or myeloproliferative disorders.

A

myelofibrosis

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138
Q

Condition that’s a subtype of AML, PLTs and WBC decreased

A subtype of acute myeloid leukemia (AML) that is distinguished by erythroblastic proliferation.

Patients usually present with nonspecific signs and symptoms from the anemia, thrombocytopenia, and leukopenia resulting from the replacement of bone marrow by leukemic cells

A

erythroleukemia

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139
Q

Sydrome where decrease in alpha granules and there is a release in proteins that cause myelofibrosis

An inherited bleeding disorder characterized by macro-thrombocytopenia and absence of platelet α-granules resulting in typical gray platelets on peripheral smears.

It is associated with a bleeding tendency, myelofibrosis, and splenomegaly

A

gray PLT syndrome

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140
Q

Factor 12 actived by

A

subendothelium

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141
Q

Vik K dependent factors and what group

A

2,7,9,10
Prothrombin

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142
Q

Factors in fibrinogen group

A

1,5,8-13

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143
Q

Factors in contact group

A

11,12
PK,HMWK

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144
Q

Factors?

Serine proteases form a large family of protein-cleaving enzymes that play an essential role in processes like blood coagulation, apoptosis and inflammation.

-are vit K dependent
-include two factors from contact group

A

2,7, 9,10 (vit K dep)
and
11,12

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145
Q

70% of PLTs are in the…
30% PLTs are stored in the…

A

70 % blood
30 % in spleen

Most in blood, rest in spleen

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146
Q

Adhesion requires what factor

A

VWF

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147
Q

is a platelet agonist that causes platelet shape change and aggregation

A

Adenosine diphosphate (ADP)

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148
Q

What links the PLTs together after being stimulated by ADP

A

fibrinogen

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149
Q

What inhibits active plasmin

A

alpha 2
plasmin inhibitor

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150
Q

Action of plasmin on fibrin. Breaks… Into these 4…

A

cleaves fibrin into X, Y, D, E fragments

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151
Q

3 clot busters

A

streptkinase
urokinase
TPA

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152
Q

WB:anticoag ratio

A

9:1

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153
Q

Screen for extrinsic/common, monifors oral anticoag like warfarin/coumarin

A

PT

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154
Q

PT ref…
INR ref goal…

A

<13 sec
INR. 2.0-3.5

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155
Q

Screen for intrinsic,common
monitors heparin

A

APTT

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156
Q

APTT ref range

A

20-40sec

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157
Q

Fibrinogen factor and ref range

A

Factor 1

200-400 mg/dL

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158
Q

Coag test that doesn’t measure intrinsic/extrinsic but is affected by decreased fibrinogen levels and heparin

A

TT

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159
Q

TT ref

A

<20sec

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160
Q

Coag test that measures PLT fnc/#s

A

BT

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161
Q

PFA measures PLT fnc with theses three aggregating agents

A

collagen, ADP, epi

162
Q

Rapid dissolution of clot indicates increased fibrinolytic activity in this condition

A

DIC

163
Q

Aspirin inhibits 2ndary wave of aggregation by destroying….

A

cyclooxygenase

164
Q

Two adhesion disorders that have abnormal ristocetin agg

A

BS
vWD

165
Q

BS is differentiated from vWD by these two things related to PLTs

A

BS has decreased PLTS and giant PLTS

166
Q

PLT disorder with normal PLT #/morph but abnormal aggregation and abnormal with all aggregating agents

A

Glanzmann

167
Q

DRVVT activates factor… and is prolonged in presence of this anticoagluant

A

Factor 10

Lupus anticoag

168
Q

Assay that monitors LMWH

A

anti-factor 10a

169
Q

Test similar to TT, uses snke venom enzyme,and is not inhibited by heparin

A

Reptilase time

170
Q

Repitilase time ref

A

18-22sec

171
Q

Another name for primary myelofibrosis

A

myeloid metaplasia

172
Q

Myeloid metaplasia can have increased… and thus have…

Primary myelofibrosis/myeloid metaplasia (MF) is a chronic blood cancer in which excessive scar tissue forms in the bone marrow and impairs its ability to produce normal blood cells

A

increased uric acid and have gout

173
Q

BM condition where theres increased IgM, B clonal cells, marked roleaux, and relative/absolute lymphocytosis

A

WM

Waldenstroms macrobulemia

174
Q

Kind of leukemia with B cell neoplasms, increase in small/mature lymphs, and smudge cells

A

CLL

chronic lymphocytic leukemia

175
Q

Leukemia with no peroxidase activity and positive PAS

A

ALL

176
Q

Leukemia with increased baso/eos in early stages

A

CML

177
Q

Xa-Va
phospholipid-Ca complex is called what

A

prothrombinase complex

178
Q

What cleaves fibrin into soluble fragments X/Y,D/E

A

plasmin

179
Q

Which protein inhibitor inactivates/degrades F5,8?

A

Protein C

180
Q

Which protein is a cofactor and accelerates Protein C

A

Protein S

181
Q

Which factors are inactivated by Protein C

A

Factor 5,8

182
Q

Which protein is the primary inhibitor of the fibrinolytic system and inhibits plasmin

A

alpha 2 antiplasmin

183
Q

What is the principal inhibitor that neuralizes thrombin, F10, and all serine proteases?

A

antithrombin III

184
Q

Most frequently acquired inherited inhibitor leading to factor deficiency?

A

anti-8

APTT mixing study to test
usually w/Hem A/B therapy

185
Q

Which inhibitor inactivates coag factors thru phospholipids

A

lupus like anticoag
lupus anticoag

prolong APTT, no factor def or bleeding

186
Q

What is the cause of 25yr old male who has a normal PT and INR, but an increased APTT thats not corrected by a mixing study

A

circulating anticoagulant

possibly lupus anticoag

187
Q

Most common inherited bleeding disorder with decreased F9/vWF, prolonged APTT, and normal PLT CT

A

vWD

issue isn’t with number of PLT but can’t adhere to collagen

188
Q

DDAVP and cryo used to treat

A

vWD

189
Q

Trauma, prego issues, liver disease/hepatitis, cancer/leukemia, sepsis, drugs all can cause

A

DIC

190
Q

PT/INR, PTT, D-dimer all increased and fibrinogen decreased in

A

DIC

191
Q

PT/INR, PTT slight increase with slight decrease in fibrinogen is

A

liver disease

192
Q

2 labile coag factors

A

5,8

193
Q

plasma fibrinogen nv

A

200-400mg/dl

194
Q

Xmas factor

A

9
IX

195
Q

hereditary condition with decreased PLT production and Dohle bodies

A

May Hegglin anomaly

196
Q

Idiopathic thrombocytopenic purpura has less PLTs due to…

A

PLT destruction

197
Q

VWD, Glanzmann, aspirin all have what kind of PLT counts

A

normal

198
Q

BS has what kind of PLT CT

A

decreased

199
Q

vWD and BS are what kind of PLT issue

A

adhesion

200
Q

Glanzmann and aspirin cause what kind of PLT issue

A

aggregation

201
Q

F7 def test

A

PT, extrinsic

202
Q

What tests 1,2,5,8,9,10,11,12

A

APTT

203
Q

Test monitors heparin, FSP, fibrinogen issues

A

TT

204
Q

Hemo associated w/F11 and Jews

A

Hemo C

205
Q

Hemo ass. w/8, men

A

Hemo A

206
Q

Hemo ass. w/9, men

A

Hemo B

207
Q

Factor def detected with 5M urea test

A

F13

208
Q

Most common specific factor inhibitor, APTT mixing studies

A

F8 inhibitor

209
Q

Mutant Factor V, resists action of protein c/s

A

factor v leiden

210
Q

drug that blocks ADP receptor(P2Y12)

A

Plavix
Clopidogrel

211
Q

Drug that inhibits VitK, monitored w/PT/INR

A

Wafarin

212
Q

Drug that inhibits serine protease via AT, monitored with APTT

A

Heparin unfractionated

213
Q

Drug that targets F10a, doesn’t require monitoring

A

LMWH

214
Q

Chains in Gower 1

A

2 zeta, 2 epsilon

215
Q

Chain in Gower 2

A

2 alpha, 2 epsilon

216
Q

Portland chains

A

2 zeta, 2 gamma

217
Q

RBC count calc if 5 square…

A

RBCxDF/(0.04)(5)(0.1)

1sq=0.04

218
Q

Volume of single RBC square

A

0.04

219
Q

Total volume of 5 RBC squares

A

0.2

0.2x0.2=0.04x5

220
Q

Depth of hemocytometer

A

0.1

221
Q

4 things affect hmg/cause falsely high

A

Lipemic
Icteric

High WBC
Lyse resistant hmg SS, CC

affects the absorption of hmg

222
Q

Hmg composed of…
heme, iron, globin

A

4 globulins, 4 heme inside with 4 iron

223
Q

Defect in heme synthesis leads to

A

porphyria

224
Q

1.)disorder in amino structure
2.)disorder in # globulin chains
3.)disorder of heme synthesis

A

1.)amino sub: hmg-pathy
2.)# globulin chains: thall
3.)heme: porphyria

225
Q

methmg-cytochrome C reductase keeps…

A

iron the ferrous state

keeps it reduced

226
Q

when iron in hmg is oxidized to the ferric state, it becomes…

A

methmg

227
Q

hmg with 200x affinity for oxygen than hmg has

A

carboxyhmg (carbon monoxide)

228
Q

type of hmg that carries iron in ferrous/reduced state

A

oxyhmg

can carry oxygen

229
Q

type of hmg that can’t transport oxygen; irreversible oxidation by drugs

A

sulfhmg

230
Q

type of hmg that is in ferric state, cannot bind oxygen, but is reversible

A

met hmg

231
Q

Ferric state of iron is in this hmg

A

methmg

232
Q

cyanmethmg used to

A

measure hmg

cyanmethmg w/K cyanide, ferricyanide

233
Q

Of these three, which on is irreversible…
carboxyhmg, methmg, sulfhmg

A

sulfhmg

234
Q

Hmg that becomes insoluble under lowered oxygen tension

A

Hmg S

it sickles

235
Q

In hmg C, what replaces glutamic acid…
what position…what chain…

shape of crystal in hmg C…

A

lysine
6th position of beta chain

rod shaped, washington monument

236
Q

what kind of RBC inclusion seen in lead and thall

A

basophillic stippling

237
Q

what kind of inclusion in rbc seen in G6PD def…
What kind of rbc abnormality…

A

Heinz bodies
Bite cell

238
Q

Hmg F made of 2…2…

A

2 alpha, 2 gamma

239
Q

Hmg A1 made of 2..2…

A

2 alpha, 2 beta

240
Q

Hmg A2 made of 2…2..

A

2 alpha, 2 delta

241
Q

Gower 2 made of 2…2…

A

2 alpha, 2 epsilon

242
Q

Gower 1 made of 2..2…

A

2 zeta, 2 epsilon

243
Q

Portland made of 2…2..

A

2 zeta, 2 gamma

244
Q

Hmg resistant to alkali denaturation

A

Hmg F

245
Q

Kleihauer Betke screens for what hmg…
Can differentiate between…and….

A

hmg F
A1 from F

adult from fetal

246
Q

Hmg D seen in what race…
migrates with…

A

East Indian
migrates with S

247
Q

D can be separated from S with … … at ph…

A

cellulose acetate at ph 8.6

248
Q

Only hmg not measured by cyanmethmg

A

sulfhmg

249
Q

Drabkins sln is used to determine…
in the …..method

A

hmg in cyanmethmg methodf

250
Q

Hmg in WB..
Hmg in plasma..

A

WB 14-16 g/dL
plasma 2-3 mg/dL

251
Q

Free hmg binds to…

A

haptoglobin

252
Q

In HA:
RBC, hmg, hct are…
haptoglobin is…
indirect bili is…

A

RBC,hmg,hct are decreased
haptoglobin is decreased/used up

indirect bili is increased, increased hmg but doesn’t get to liver

253
Q

HA is what kind of anemia

A

normo, normo
sudden, doesn’t have enough time to affect size/color yet

254
Q

What reagent do you saturate specimen with to separate myoglobin from hmg

A

ammonium sulfate

255
Q

PACKED rbc VOLUME is also called

A

hematocrit

Volume of packed cells

256
Q

3 factors that influence degree of packing during centrifugation

A

radius, speed, time

257
Q

WBC are found in what part of spun hematocrit…

where is the packed rbc % read from….

A

wbc buffy coat

read packed rbc below buffy

258
Q

How do these affect ESR/rate:
acute infections
rouleaux
macrocytes
MM,Waldstrom M

anemia

vibrations/tilting/increased temp

A

all increase, make fall faster, rate/mm is bigger

bigger cells=fall faster
anemia=less cells, fall faster
proteins/ab fall faster

259
Q

How do these affect ESR/rate:
microcytes, sperocytes
sickle cells
polycythemia
old specimen, decreased temp, EDTA increased

A

all decrease, fall less, smaller rate/mm

260
Q

RBC cell count calculation

A

RBCs x DF/total vol sq x depth(0.1)

ie. 5 small squares
each square is 0.2x0.2=0.4,
x5 squares=0.2

261
Q

CSF has 285 rbc in 5 squares, dilute 1:100
cell ct

A

285 x 100/0.2 x 0.1 =28500/0.02

1,425,000

262
Q

method where cells pass thru aperture increasing resistance of electrical flow between electrodes making a pulse

A

electrical impedance

263
Q

Name of principle that uses laminar flow and hydrodynamic focusing to characterize cells based on granularity and reflectivity

A

laser light scatter

laser is focused at angles

264
Q

3 things used to created scatter plots, one that isnt

A

scatter, volume, conductivity

fluorsence isn’t used for the scatter plot

265
Q

NRBC and lrg PLTs will increase

A

WBC
granularity counted as WBC

266
Q

Shistocytes will…rbc # but …PLTs #

A

decrease rbc, increase PLT ct

counted as PLTs instead of RBC

267
Q

WBC 6.5
RBC 1.69
HGB 9.1
HCT 22.8
MCV 135.0
MCH 53.8
MCHC 39.9

what is cause

A

cold agg,

RBC/HCT decreased

MCV, MCH, MCHC increased

268
Q

DF for PLT ct when using sodium citrate instead of EDTA

A

1.1

269
Q

Adding 22% bovine albumin to hematology specimen will prevent…cells by…WBCs

A

will prevent smudge cells by stabilizing WBC

270
Q

Action if cryoglobulin or cold agg cause issues

A

incubate 37C 15min

271
Q

manual WBC ct on hemacytometer can help count …WBC from… ….. leukemia patients

A

count fragiles WBCs from pseudoleukopenic patients

272
Q

lipemic specin, can perform a .. …

A

saline replacement

273
Q

hyperglycemia:
MCV is…
red cell color is…

A

MCV is normal
color is hypochromic, absorb less iron

274
Q

WBC ct calc

A

WBC x DF/vol sq x depth 0.1

Each sq 1mm

275
Q

WBC ct 50, 8squares, 1:100 dil

A

50x 100/(8x1)x0.1
6250

276
Q

Wright stain:
fixative…
adjust color by adusting… of ….

A

methanol
color change with ph of buffer

277
Q

Giesma can stain which organism

A

malarial parasites

278
Q

Cannot be stained with wrights, needs to use NMB

A

Heinz bodies

279
Q

Stain that stains both nonspecific and specific granules in myelogenous cells

A

SBB
sudan black B

myeloblasts, not lymphoblasts

280
Q

Stain for granulocytes, monocytes but not lymphs

A

MPO
myelo-peroxidase

281
Q

leptocyte is also these two

A

Target, codocyte

282
Q

Most immature RBC, 3 names

A

Rubriblast

Pro-erythroblast/normoblast

283
Q

2nd RBC after most immature, 3 names

A

Prorubricyte

Basophilic- erythroblast/normoblast

284
Q

Rubricyte, comes after…
Two other names…

A

Comes after Prorubricyte

Rubricyte is also called
polychromatic-
erythroblast/normoblast

285
Q

Last stage RBC with nucleus, 3 names

A

Metarubricyte
Orthochromic -erythroblast/normoblast

286
Q

NASDA 3+, NaF 1+ what leukemia

A

AMML
acute myelo mono

287
Q

Leukemia where blasts stain PAS pos

A

ALL
lymphoblastic

lymphs not myelo, acute not chronic

288
Q

Best stain for neutral lipids

A

Oil red O

better than sudan black b as it is more red/visible

289
Q

LAP stands for…
differentiates these two…
which is incresed, decreased…

A

leukocyte alkaline phosphatase

leukomoid increased
CML decreased

290
Q

stain that is positive in hairy cell leukemia

A

TRAP
tarte resistant

acid phosphatase (not alkaline phosphatase)

291
Q

MOST reliable criterion for cells age

A

nuclear chromatin

292
Q

Last cell to retain nucleus before becoming erythrocyte/NRBC two names

A

metarubricyte, orthochromatic normoblast

293
Q

toddler hmg range…

female…
male range…

Neonate hmg range…

A

toddler has the least: 10-12

female: 12-15
male: 14-18

neonate has the most: 16-22

294
Q

anemia based off three things

A

rbc, hmg, hct

295
Q

reticulocytosis is….due to…

A

polychromatophillic due to residual RNA

296
Q

3 things seen in IDA:
size, color, shape

A

micro,hypo
poikilocytosis

297
Q

low ferritin/iron
high TIBC/transferrin

A

IDA

298
Q

high ferrtin
low iron/TIBC/transferrin

A

anemia of chronic

299
Q

cell seen in:
-thallasemia
-liver disease
-postsplenectomy

A

target

Target cells are erythryoctes with an increased cell membrane-to-volume ratio, due either to gain of membrane lipids or to a reduction in cell volume.

Liver disease: Decreased enzymatic activity increases the cholesterol to phospholipid ratio, producing an absolute increase in surface area of the red blood cell membranes or may be increased red cell membrane fluidity.

Post splenectomy: altered erythrocytes will not be removed from the circulation efficiently. Therefore, increased numbers of target cells may be observed.

300
Q

aggregated RNA in RBC causes

A

basophilic stippling

301
Q

best supravital stain for RNA remnants

A

NMB

302
Q

RBC iron stained granules stained with PB..
stained with wrights…

A

siderocytes
pappemheimer

303
Q

increased iron in the mitochondria of normoblasts is seen in what anemia

A

sideroblastic anemia

304
Q

3 cells seen in thallasemia

A

targets, tears
basophilic stippling

Tear drop cells appear in the peripheral blood as a response to red cell alterations by thalassemia when red cell inclusions are expelled by a stripping process through splenic cords.

305
Q

3 main causes of macrocytic anemia

A

B12/folate def (d.latum, taperworm B12)
liver/alcoholism

306
Q

4 main causes of micro,hypo anemia

A

IDA, anemia of chronic in later stages
sideroblastic, lead

307
Q

Megaloblastic anemia:
WBC seen in BM…
3 things seen in smear…

A

BM: giant metamyelocytes
smear: oval macro, hyperseg, less PLTs

Megalo: big not small
Anemia: less

308
Q

Hereditary disease where osmotic fragility and autohemolysis are normal…

Hereditary disease where osmotic fragility is increased…

A

elliptocytosis

spherocytosis

309
Q

PNH:
3 tests

PCH:
1 test

A

PNH: sugar, sucrose, acidified

PCH: Donath Landsteiner

310
Q

Most common thallasemia in US

A

beta thall MINOR

311
Q

Disorder with enzyme defect in aerobic glycolysis

A

G6PD

312
Q

Pancytopenia seen in this anemia

A

aplastic

313
Q

Panhyperplasia of BM seen in

A

polycythemia vera

314
Q

Leukemia
viral infection
chemo
WBC will be….

A

decreased

leukemia: sick cells push out good cells
viral: HIV
chemo: kill

315
Q

euchormatin
darker cyto
nucleoli
nonspecific granules
charasteristic in…

A

immature blood cells

*most characteristic of immature is euchromatin

316
Q

Light blue endoplasmic reticulum found in neutrophils
seen in infections, burns, MayHegglin

A

Dohle bodies

317
Q

nonspecific primary granules in…
specific secondary granules in…

A

non/primary: promyelocyte
specific/secon: myelocyte

318
Q

Order of myeloid…
1-6

A

1.)Myeloblast
2.)Promyelocyte
3.)Myelocyte
4.)Metamyelocyte
5.)Band
6.)Seg

319
Q

WBC NV most to least…

A

Seg 50-70
Lymph 20-40
Mono 3-10
Eos 0-3
Baso 0-2

320
Q

Largest leukocyte in blood…
Largest cell in BM:

A

mono
megakaryo

321
Q

Inclusions of blue black, coarse mucopolysaccharide granules

Hurlers/Hunters

A

Alder Reilly

322
Q

Giant PLTs, Dohle bodies
decreased PLTs

A

May Hegglin

323
Q

giant lysosomal granules,
defective PLTs/WBCs,
albinism

A

Chediak Higashi

324
Q

Things that can be seen with…. …
are shift to left, vacuolization, Dohle bodies

A

toxic granulation

325
Q

In lupus, what cell phagocytizes the nucleoprotein

A

neutrophil

326
Q

monocyte/histiocyte thats engulfed nuclear material

similar to LE but no diagnositic value

A

tart cell

327
Q

cell that neutraphil/macrophage engulfed denatured nuclear

lupus erythromatosus

A

LE cell

328
Q

cell that is plasma cell with cytoplasmic inclusions called russell bodies packed with immunoglobulins

constipated plasma cell

A

Mott cells

329
Q

reactive leukocytosis occurs when absolute granulocyte count is >…

A

7.0 x10^9/L

Granulocytes not all WBC

330
Q

Smudge cells seen in this leukemia but not in this

A

seen in CLL not in acute

331
Q

Use as a nonspecific screen for hemolysis due to drugs/toxins, enzyme deficiencies, thalassemias, and unstable hemoglobins.

A

Heinz body prep
Heinz, hmgH

332
Q

Cyanide can be used to oxidize … To…

A

Hmg to methmg

333
Q

Hmg to methmg iron becomes…to…
Methmg to hmg iron becomes…to…

A

Hmg to methmg, iron becomes oxidized to ferric

Methmg to hmg, iron becomes reduced to ferrous

334
Q

Eosinophilia and basophilia associated with what leukemia

A

CML

335
Q

Smudge cells seen in this leukemia

A

CLL

chronic not acute

336
Q

L1 kids, homo, high N/C

L2 adults, hetero, nucleoli

L3 Burkitts, vacuolization, abundant cyto

A

FAB classifications
of acute lymphocytic leukemia

337
Q

ALL L1
3 main characteristics

A

homgenous
high N/C
kids

338
Q

ALL L2
3 main characteristics

A

hetero
adults
nucleoli

339
Q

ALL L3
2 main characteristics

A

vacuolization, abundant cyto

340
Q

FAB ALL classification for mostly homo, high N/C ratio

A

L1

341
Q

FAB ALL prominent cytoplasmic vacuolization

A

L3

also abundant cyto

342
Q

FAB ALL hetero, nucleoli, seen in more adults

A

L2

343
Q

FAB AML,
M2/type 2 has … … …
as compared to M1/type 1 that has… and ….

A

M2/type 2 has few cytoplasmic granules

M1/type 1 has granules

344
Q

FAB AML that has no cytoplasmic granules

A

M0

345
Q

M0 no granules

M1 granules
M2 traces of primary/few

M3 intense granules, DIC

A

This is stupid

346
Q

Auer rods seen in which leukemia

A

AML

347
Q

DIC ass with what AML class

A

M3

348
Q

Stain to differentiate AML from ALL

A

MPO

349
Q

Leukemia with Philadephia chromosome and increased baso/eos in early stages

A

CML

350
Q

Condition with increased LAP, toxic granulation, dohle bodies

A

Leukomoid

351
Q

DIC seen in what leukemia

A

AML

352
Q

BM of this condition has increased plasma cells, IgM, rouleaux, lymphocytosis

A

Waldenstroms macroglobulinemia

353
Q

giant bizarre PLTs
NRBCs
Tears
seen in…

A

myelofibrosis

354
Q

Hereditary with decreased alpha granules resulting in tiny, decreased PLTs

A

gray PLT syndrome

355
Q

Prothrombinase complex (acts on prothrombin)

A

10a+5a
phospholipid+Ca

356
Q

1.)C will degrade 5,8
2.)S cofactor acclerates

A

…

357
Q

Which protein degrades factor Va and 8a…

A

C

358
Q

Which protein is a cofactor of C and helps accelerate the degradation of Va/VIIIa

A

S

359
Q

Primary inhibitor of fibrinolytic system;
stops this from breaking down fibrin

A

alpha 2
antiplasmin

360
Q

What is the principal inhibitor of thrombin
and factor Xa

A

anti-
thrombin III

also neutralizes serum proteases

361
Q

Most ACQUIRED inhibitor in hereditery deficiencies
(acquire during treatment of this hereditary deficiency)

A

anti 8

usually acquired from HemA(8) therapy

362
Q

acquired inhibitor against phospholipoproteins inactivating coagulation factors prolonging aPTT

A

lupus like anticoag

363
Q

disease with:
-abnormal adhesion to collagen
-decreased VIII:C, VIIIR:Co
-increased BT, aPTT
-normal PLT ct

A

vWD

364
Q

Condition with slightly increased PT,INR, PTT but low fibrinogen

A

liver disease

365
Q

Severe liver disease monitor these two factors

A

I, 5

366
Q

Factor 5 Leiden

A

Helps make clots,
Protein C supposed to slow 5 down,

Most common cause of hypercoaguable State, thromboembolism

367
Q

Protein S And C roles

A

Stop
Clots

Cleave 5,8

368
Q

Anemia with inhibition of DNA, -decreased megakaryocytes, -decreased PLTs
-giant metamyelocytes in BM

-oval macrocytes
-hypersegmented segs

A

Megaloblastic anemia

369
Q

Hereditary red cell membrane deformation with >25% cells deformed, normal osmotic fragility, and most people are asymptomatic and few have HA

A

Hereditary elliptocytosis

370
Q

Most common thallasemi

A

beta thall minor

371
Q

Cooleys anemia, increased A2, decreased A1

A

beta thall major

372
Q

Thall with 2 of 4 alpha deleted, micro/hypo

A

alpha thall minor

373
Q

hydrops fetalis, thall with no normal Hmg, all 4 alpha deleted

A

alpha thall major

374
Q

Enzyme def that is x linked, oxidative stress leads to RBCs breaking down/HA, aerobic glycolysis ineffective

A

G6PD

375
Q

Dohle body is seen in which cell

A

neutrophil

376
Q

Primary granules in…
Secondary granules in…

A

Primary: promyelocyte
Secondary: myelocyte

377
Q

Infections you will see toxic granulation in neutrophils and these three things…

A

shift to left
Dohle bodies
vacuolizations

378
Q

Neutrophil that phagocytizes/engulfs nuclear material/nucleoprotein in lupus

A

LE cell

not a tart (mono/histiocyte)

379
Q

Only heterogenous cell Acute leukemia FAB classification

A

L2

380
Q

L3 ALL has prominent

A

vacuoles

381
Q

L1 has high…with…cells

A

high N/C
homogenous cells

382
Q

L2 has …cells

A

heterogenous

383
Q

FAB AML that is hypergranular and related to DIC

A

M3

384
Q

FAB AML with no granules

A

M0

385
Q

Monocytic FAB classfications

A

M4/5

386
Q

M2 has …granules

A

few

387
Q

Best stain that differentiates AML from ALL

A

MPO
as opposed to SBB

388
Q

chronic lymphocytic leukemias are usually neoplasms of what cell

A

B cells

389
Q

Hemostasis 3 processes

A

vasoCONSTRICTION
adhesion
aggregation

390
Q

Two PLT disorders with decreased and giant PLTs

A

May Hegglin, BS

391
Q

WASP issue in males, small/decreased PLTS, impaired immune, increase in IgA/E

A

Wiskott Aldrich anomaly

392
Q

PLT disorder where ab attack own PLTs, leads to increased PLT destruction

cause not known

A

Idiopathic thrombocytopenia purpura

ITP

393
Q

vWD, Glazmann, and aspirin all have …PLT cts but abnormal…time

A

normal
abnormal BT

394
Q

PLTdisorder with abnormal
-primary agg…
-secondary agg..

A

primary agg: Glanzmann
secondary agg: Wiskott

395
Q

PLT disorders with adhesion issues

A

BS, VWD

396
Q

Condition where BM makes too many PLTs and is ass with polycythemia vera

A

Thrombocy-themia

397
Q

How many PLTs/1000x is normal

A

8-20

398
Q

BT increased in destruction of PLTs, decreased PLTs, blood vessel damage,
-qualitative,quantitative PLT disorder
-primary vascular ab

BUT not affected in…

A

autoimmune thrombocytopenia

who knows why, stupid AAB

399
Q

Test that monitors heparin, FSP, and fibrinogen ab

A

TT

400
Q

At alkaline pH slowest Hmg…

Fastest….

A

C slowest

H is fastest

-C, S, F, A/H

401
Q

Biliary obstruction has…. As major serum component

A

Conjugated bilirubin

402
Q

Biliary obstruction has…. As major serum component

A

Conjugated bilirubin

AMT Hem/Coag book etc (1 decks)

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