B3.048 Prework Hematologic Diagnostics Flashcards
what is in plasma
water
electrolytes
plasma proteins
how does blood separate in a tube
plasma (top)
platelets
WBC
RBC (bottom)
main functions of blood
oxygen transport (RBC)
inflammation/immunity (WBC)
hemostasis (platelets, plasma)
what is hemoglobin composed of
iron + heme + globin
what is plasma made up of?
plasma = serum + coag factor proteins
what happens if you centrifuge blood without anticoagulant?
you separate clot (cells + coag factor proteins) from serum
which anticoags are used in hematology and coagulation
EDTA
citrate
heparin
how does EDTA work
chelates calcium in an irreversible and aggressive manner
calcium is required for clot formation, so EDTA prevents clot formation
how does citrate work
also inhibits calcium, but in a more gentle and stoichiometric ratio
if you add excess Ca2+ you can re-coagulate the blood
what lab tests do you do to evaluate oxygen transport functions of blood?
CBC (EDTA) retic count (EDTA) blood smear (EDTA)
what lab tests do you do to evaluate inflammation/immunity functions of blood?
CBC (EDTA) diff count (EDTA) blood smear (EDTA) flow cytometry (heparin)
what cells are differentiated in the differential count?
bands neutrophils basophils eosinophils lymphocytes monocytes
what are some features of a left shift?
toxic granulation (visible primary granules) Dohle bodies (areas of basophilia)
what is leukoerythroblastosis
left shift + circulating nucleated RBCs
occur due to bone marrow fibrosis or infiltration
what lab tests do you do to evaluate hemostasis functions of blood?
CBC (EDTA) tests of platelet function (citrate) coag tests (citrate)
what are the coag tests
PT
PTT
TT
fibrinogen and other coagulation factor assays
functional elements of hemostasis
vascular wall platelets von Willebrand factor coag factors calcium
extrinsic pathways factors
TF, 7
intrinsic pathways factors
prekallikrein, HMWK, 12, 11, 9, 8
common pathway factors
10, 5, 2 (prothrombin), 1 (fibrinogen)
what screening tests evaluate platelets
platelet count platelet function (PFA-100, aggregation studies)
how low do clotting factor levels have to be before you see an elevated PT, PTT or clinical risk of bleeding
levels less than 30-50% give abnormal tests
clinical bleeding at <10%
what makes up BM?
sinusoids hematopoietic cells fat cells: fat = 1:1 myeloid: erythroid = 3:1
what does a bone marrow aspirate evaluate
cellular morphology
cell counts
what does a bone marrow biopsy evaluate
architecture
infiltrates
what is an immunophenotype and how is it evaluated
assessment of lymphoid cells or blasts
flow cytometry or immunohistochemistry
what are some genetic analysis tests for BM/lymph nodes
cytogenetics FISH molecular techniques -single/few = PCR, sanger -many = next gen
what makes up the cortex of the lymph nodes?
B cells
primary follicles - immunologically inactive
secondary follicles - immunologically active
-germinal center: centrocytes, centroblasts, tingible body macrophages, dendritic reticulum cells
-mantle zone
what makes up the paracortex of the lymph nodes?
t cells
lymphocytes, macrophages, interdigitating reticulum cells
what does a bone marrow biopsy evaluate
architecture, cell size and dist, infiltrates
B lineage CDs
CD10, CD19, CD20, CD22, CD79a
T lineage CDs
CD1, CD2, CD3, CD5, CD7, CD4, CD8
NK cells CDs
CD16, CD56, CD57
myeloid lineage CDs
CD13, CD15, CD33, CD 34, CD117
