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ibi test 3 > B3-048 Hematologic Diagnostics > Flashcards

B3-048 Hematologic Diagnostics Flashcards

1
Q

plasma contains

A

water
electrolytes
plasma proteins

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2
Q

middle section of centrifuged blood contains

A

thrombocytes, leukocytes

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3
Q

bottom section of centrifuged blood contains

A

erythrocytes

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4
Q

top section of centrifuged blood contains

A

plasma

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5
Q

oxygen transport

A

RBCs

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6
Q

inflammation/immunity

A

WBCs

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7
Q

hemostasis

A

platelets, plasma proteins, coagulation factors

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8
Q

lab evaluations of oxygen transport

A

CBC: RBC, Hgb, MCV, MCHC, MCH, Hct, RDW
reticulocyte count
blood smear

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9
Q

lab evaluations of inflammation/immunity

WBCs

A

CBC: WBC count
differential
blood smear
flow cytometry (heparin)

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10
Q

proportion of different cell types

A

differential leukocyte count

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11
Q

left shift indicates

A

circulating immature granulocytes

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12
Q

toxic granules
Dohle bodies indicate

A

left shift

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13
Q

left shift + circulating nucleated RBCs

A

leukoerthroblastosis

myelofibrosis
bone marrow infiltration

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14
Q
A

toxic granules

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15
Q
A

dohle body

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16
Q
A

top: metamyelocyte
bottom: myelocyte

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17
Q
A

nucleated RBC

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18
Q

lab evaluations of hemostasis

A

CBC: platelets, immature platelet fraction
Tests of platelet function (citrate)
coagulation tests: PT, PTT, TT (citrate)

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19
Q

extrinsic pathway

A

tissue factor (thromboplastin)
factor VII

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20
Q

intrinsic pathway

A

prekallikrein
HMWK
XII
XI
IX
VIII

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21
Q

common pathway

A

factors X
V
II (prothrombin)
I (fibrinogen)

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22
Q

fibrin stabilization

A

XIII

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23
Q

clotting test for extrinsic and common pathway

A

PT

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24
Q

clotting test for intrinsic and common pathway

A

PTT

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25
Q

PT and PTT are not abnormal until

A

level of clotting factors is less than 30%

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26
Q

tests for platelet function

A

PFA-100, aggregation studies

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27
Q

bone marrow architecture features

A

sinusoids
hematopoietic cells
fat

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28
Q

normal ratio of hematopoietic cells:fat in bone marrow

A

1:1

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29
Q

normal ratio of myeloid to erythroid cells in bone marrow

A

3:1

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30
Q

bone marrow aspirate provides

A

cellular morphology, cell counts

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31
Q

bone marrow biopsy provides

A

architecture, infiltrates

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32
Q

bone marrow immunophenotype provides

A

assessment of lymphoid cells or blasts

flow cytometry
immunohistochemistry

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33
Q

cgenetic analysis of bone marrow can be done via

A

cytogenetics
FISH
molecular techniques

PCR, Sanger, next-gen

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34
Q

B cells are found in the …. of lymph nodes

A

cortex

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35
Q

T cells are found in the …… of lymph nodes

A

paracortex

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36
Q

lymphocytes, macrophages, interdigitating reticulum cells are found

A

paracortex of lymph nodes

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37
Q

primary follicles of lymph nodes are

A

immunologically inactive

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38
Q

secondary follicles of lymph nodes are

A

immunologically active

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39
Q

centrocytes, centroblasts, tingible body macrophages, dedritic reticulum cells are found

A

germinal center of secondary follicles
cortex of lymph node

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40
Q

mantle zone is found in the

A

secondary follicles,
cortex of lymph node

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41
Q

biopsy of lymph nodes provides

A

architecture, cell size and distribution, infiltrates

42
Q

immunophenotype of lymph nodes provides

A

flow cytometry
immunohistochemistry

43
Q

CD20 and CD30 are targets for

A

immunotherapy in neoplastic disorders

44
Q

serum + coagulation factors =

A

plasma

45
Q

does serum contain coagulation factor proteins?

A

No

46
Q

anticoagulants commonly used in hematology and coagulation

A

EDTA, heparin, citrate

47
Q

chelates Ca2+

A

EDTA

blood can’t clot

48
Q

EDTA sequestration of Calcium is

A

irreversible

49
Q

when testing blood for coagulation testing, what anticoagulant is used?

A

citrate

50
Q

when you are not worried about coagulation testing, what anticoagulants can be used?

A

EDTA or heparin

51
Q

CBC
Reticulocyte Count
Blood Smear

what anticoagulant is used for these tests?

A

EDTA

52
Q

what anticoagulant is used in flow cytometry?

A

heparin

53
Q

normal circulating lymphocytes

A

band neutrophils
neuetrophils
eosinophils
basophils
lymphocytes
monocytes

54
Q

circulating immature granulocytes

A

left shift

toxic granulation
Dohle bodies

55
Q

tests of platelet function are done using what anticoagulant?

A

citrate

56
Q

PT, PTT, TT are done with what anticoagulant?

A

citrate

57
Q

immature platelet fraction tells you

A

if the bone marrow is able to make platelets

58
Q

injury to a vessel exposes

A

subendothelial collagen

59
Q

platelet adhesion factor

A

vWF

60
Q

vWF binds

A

Gp1b

61
Q

platelet secretion and aggregation is mediated by

A

Gp2b-3a

62
Q

crosslinks gp2b-3a proteins

A

fibrinogen

63
Q

in vivo, the clotting cascade starts with

A

tissue factor

64
Q

in vitro, the clotting cascade starts with

A

XII

65
Q

all of the catalytic reactions in the coagulation cascade require

A

Calcium

66
Q

fragments of crosslinked fibrin that are formed after fibrinolysis occurs

A

D dimer

67
Q

elevated D dimers tell you

A

clotting has occurred

68
Q

what test is helpful in differentiating cells of unknown lineage?

A

flow cytometry

not helpful if you can easily tell lineage

69
Q

clotting time becomes normal of significantly decreases in mixing study, this indicates

A

factor deficiency

factors in pooled plasma are enough to overcome deficiency in pateints p

70
Q

clotting time remains prolongs without significant decrease in mixing study, this indicates

A

factor inhibitor

inhibitor is not factor specific, the pooled plasma does not alter react

71
Q

what study should follow results of prolonged PTT?

A

1:1 mixing study to determine if factor deficiency or factor inhibitor

72
Q

prior to surgery, what is most important information to get rather than PT/PTT screening?

A

personal/family hx of bleeding
drug hx
physical exam

no point in identifying asymptomatic factor deficiencies prior to surger

73
Q

basic differential for all -cytopenias

A

decreased production
increased utilization/destruction
ineffective production

74
Q

macrocytic anemia differential

A

megaloblastic anemia
myelodysplasia
drugs
hypothyroidism

75
Q

after each cycle of chemotherapy,

A

transient pancytopenia takes a bit longer to recover

76
Q

clonal stem cell disorders characterized by ineffective hematopoiesis

A

myelodysplastic syndromes

77
Q

peripheral cytopenias + hypercellular marrow + abnormal maturation

A

myelodysplastic syndrome

maturation problem, not proliferation but can progress to AML over time

78
Q

etiologic associations for myelodysplastic syndromes

A

benzene
ionizing radiation
alkylating chemotherapeutic drugs
topoisomerase II inhibitors

79
Q

myelodysplastic syndromes may be asymptomatic until

A

pancytopenia becomes severe

80
Q

10-40% of myelodysplastic syndromes transform into

A

AML

81
Q

clonality in lymphoid lineage can be established via

A

receptor gene rearrangement (Ig, TCR)
receptor restriction (kappa/lamda)
clonal genetic marker

82
Q

clonality in myeloid lineage can be established via

A

clonal genetic markers

cytogenetics, FISH, PCR, Sanger, next-gen

83
Q

broad screening test

A

cytogenetics

84
Q

cytogenetics has low

A

sensitivity

85
Q

cannot detect submicroscopic changes

A

cytogenetics

86
Q

indentifies only the abnormality being tested for

A

FISH
PCR/Sanger

87
Q

FISH sensitivity

A

intermediate

88
Q

cannot detect point mutations, small insertions, deletions

A

FISH

89
Q

PCR/Sanger sensitivity

A

high

90
Q

can detected point mutations, small insertions/deletions

A

PCR/Sanger
NGS

91
Q

indentifies broad array of abnormalities

A

NGS

92
Q

NGS sensitivity

A

high

93
Q

might miss an entire translocation if it does not result in fusion

A

NGS

94
Q

what test would indentify favorable/unfavorable translocations?

A

cytogenics, FISH

95
Q

what test would be used to identify KIT, p53, FLT3 mutations?

A

PCR/Sanger

96
Q

what test can perform a myeloid malignancy panel?

A

NGS

50+ genes

97
Q

test selection should consider

A

indication
prior probability
significance of test
clinical desicion to be made

98
Q

before ordering a test consider

A

what will you do with the results? will it change the outcome?

99
Q

the more tests you order the more likely

A

a result will fall out of reference range, simply by chance.

misleading information, daily blood draws can cause anemia

100
Q

when you need 1 specific test that is part of a panel, order

A

that one test individually

ibi test 3 (20 decks)

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