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Hematology > Exam 1 > Flashcards

Exam 1 Flashcards

1
Q

What is the function of blood

A

transports oxygen, CO2, glucose, proteins, lipids, moves waste to liver and kidneys

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2
Q

What are the alternative names for
RBCs
WBCs
platelets

A

RBC- erythrocyte
WBC-leukocyte
platelets- thrombocytes

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3
Q

Describe the shape, size, interior and exterior characteristics of RBCs

A

biconcave, anucleate, red cells filled with hemoglobin,

7-8 um in diameter

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4
Q

Describe the zone of pallor of RBCs

A

1/3 of the center of the cell, usually looks white

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5
Q

What is anemia

A

loss of O2 carrying capacity, because of low RBC count or low hemoglobin concentration

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6
Q

What is polycythemia

A

high RBC count that leads to hyperviscosity

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7
Q

How are hemoglobin levels determined

A

whole blood + Drabkin’s reagent turns HGB into cyanmethemoglobin, absorbance of color is measured in spectrometer at 540nm

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8
Q

What is the hematocrit test

A

ratio of volume of packed RBCs compared to volume of whole blood
also call packed cell volume

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9
Q

How is a manual hematocrit test performed, what is the normal result

A

blood is placed in a capillary tube, centrifuged, the column is measured where RBC height is divided by the total length of the column
the normal ratio is 50%

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10
Q

What is an MCV

A

mean cell volume- measures RBC size

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11
Q

What is an MCH

A

mean cell hemoglobin- measures mass of HGB per cell

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12
Q

What is an MCHC

A

mean cell hemoglobin concentration: measures RBC staining intensity and size of central pallor

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13
Q

What is the RDW

A

RBC distribution width- measures how varies RBCs are in size

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14
Q

What is it called when a person has an abnormal RDW

A

anisocytosis-really varied RBC sizes

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15
Q

What tests are included in a CBC

A

RBC count, Hemoglobin, hematocrit, MCV, MCH, MCHC and RBC morphology

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16
Q

What are reticulocytes

A

large immature RBCs released from BM, might indicate RBC anemia or BM issues

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17
Q

What is the difference between Reticulocytes and RBCs

A

they are filled with RNA,

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18
Q

What is the function of WBCs

A

protecting the body from infection and injury

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19
Q

What is a manual WBC count

A

1:20 dilution with diluent: dilute acid solution

acid makes RBC rupture

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20
Q

How are RBCs manually counted

A

whole blood + .85% normal saline, 1:200 dilution
maintains morphology of RBCs
mixture placed in hemacytometer
RBC counted

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21
Q

what is leukopenia, leukocytosis and leukemia

A

luekopenia- low WBC count
leukocytosis- high WBC count
Leukemia-uncontrolled proliferation of malignant cancerous WBCs

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22
Q

What are the functions of neutrophils

A

phagocytic, mostly towards bacteria, immune response

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23
Q

What other name do neutrophils have

A

segmented, polymorphonuclear neutrophils

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24
Q

Describe the structure of neutrophils

A

pink/ lavender cytoplasm filled with bactericidal substances

multilobed nucleus

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25
Q

What is neutrophilia, neutropenia?

A

neutrophilia- too many WBCs usually sign of bacterial infection
neutropenia- decreased WBCs, could be due to viral infection or some medication

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26
Q

What is a band neutrophil and what does it look like

A

less mature neutrophils, non segmented, has C shape, no lobes

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27
Q

What is left shift

A

increased bands due to a bacterial infection

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28
Q

What does a eosinophil look like and what are its functions

A

round, bright orange- red cytoplasmic granules that are filled with proteins that help with immune regulation
functions with allegeric rxns or parasitic infection

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29
Q

What is the structure of basophils

A

dark purple cytoplasmic granules that cover the nucleus, granules have histamines and other proteins

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30
Q

What is the structure of lymphocytes?

What is their function

A

round, large nuclei, larger than RBCs, non granular cytoplasm
mostly immune response functions

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31
Q

What is lymphocytosis? Lymphopenia?

A

lymphocytosis- high lymphocytes, indicates viral infection

lymphopenia- decreased lymphs, drug therapy or immunodeficiency

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32
Q

What are monocytes and what is their function?

A

immature macrophages, that pass through blood from the bone marrow to a target tissue, phagocytize, immune response APC

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33
Q

What are the physical characteristics of monocytes

A

larger than other WBCs, blue-gray cytoplasm with fine azure granules, ground glass appearance, nucleus folded

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34
Q

What is monocytosis

A

increased monocytes, could be associated with inflammation or certain infections

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35
Q

What is the function of platelets

A

help maintain blood vessels, repair vessel wall, adhere, aggregate, secrete to trigger clot formation. Controls hemostasis

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36
Q

What are the physical characteristics of platelets

A

2-4 um in diameter

round or oval, anucleate, slightly granular

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37
Q

What can occur if platelets become uncontrolled?

A

deep vein thrombosis, pulmonary embolism, heart attacks, strokes, peripheral artery disease, miscarriage

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38
Q

How is platelet function tested?

A

MPV- mean platelet volume with a manual or automated platelet count

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39
Q

What is thrombocytosis? thrombocytopenia?

A

thrombocytosis- too many platelets, could be due to inflammation, trauma, internal bleeding
thrombocytopenia- low platelets, could be easy bruising and uncontrolled hemorrhage

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40
Q

Practice Ch1 slide 23

A

A RBC

B Neutrophil

C Band

D Eosinophil

E basophil

F lymph

G monocyte

H platelet

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41
Q 
Put the following cells in order of most to least common
Monocytes
eosinophil
neutrophil
lymphocyte
basophil
A 
neutrophil
lymphocyte
monocyte
eosinophil
basophil
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42
Q

Define Quality Control QC

A

control and monitoring of the testing process to ensure that results are valid and reproducible

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43
Q

Define Quality Assurance QA

A

a broader term that encompasses preanalytical, analytical and postanalytical variables

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44
Q

ID the QA as pre, post or analytical

  • legible forms
  • abnormal result flagging
  • accurate result transcription
  • delivery of specimen
A
  • pre
  • post
  • post
  • pre
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45
Q

What does variance show

A

the deviation of each data point from its expected value

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46
Q

Practice standard deviation formula

A

SD=

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47
Q

Practice variance formula

A

sigma ^2=

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48
Q

What does the standard deviation measure

A

dispersion, the distance between all data points and the mean

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49
Q

What is the Coefficient of variance formula

A

CV=100xSD/mean

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50
Q

What does the CV measure?

A

the normal expression of the SD

lower values are a good thing

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51
Q

What is the confidence interval

A

95.5%
2SD +- the mean
any points outside of this range are “abnormal”

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52
Q

practice Ch2 slide 16

A

Variance
SD=0.126
95.5 CI = 7.878-8.13
CV= 1.54%

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53
Q

How is accuracy tested

A

reagent-instrument system does a reference assay for comparison to new reagent system

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54
Q

How is precision measured

A

SD or CV%

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55
Q

Label graphs on Ch2 slide 27

A

A- accurate and precise
B- inaccurate, precise
C-accurate, imprecise
D- inaccurate, imprecise

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56
Q

Define linearity

A

the ability to generate results proportional to the calculated concentration

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57
Q

What if an assay results a value above linearity?

A

the sample must be diluted and re-assayed

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58
Q

What is an example of a process that is done in the lab to ensure quality control?

A

lot to lot comparisons

old and new assays are compared

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59
Q

Define analytical specificity

A

The ability to identify interfering substances versus the substance of interest. Like if there is lipemia or hemolysis

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60
Q

Define analytical sensitivity

A

the lowest value that can be found by a test, the higher the sensitivity the better, a high specificity indicates we can detect things in very small amounts

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61
Q

What is the purpose of the Levy Jennings chart

A

displays data points compared with mean and limits

62
Q

What westgard rule indicates there is a trend

A

7T- at least 7 control values that are going in a consistent direction

63
Q

Define a delta check

A

a way to monitor if the difference between two results that happened one after the other is flagged. 20% SD

64
Q

What should you do if a delta check occurs

A

investigate, look for intervention, transfusion, changes in patient

65
Q

Practice drawing the chart in Ch2 slide 43

A

TP vs TN vs FP vs FN

66
Q

What is the formula for PPV? NPV?

A

positive predictive value
TP/TP+FPx 100

Negative predictive value
TN/TN+FNx 100

67
Q

What does the PPV and NPV tell us?

A

PPV- probability that those who have a condition will get a positive result
NPV-probability that those who do not have a condition will get a negative result

both demonstrate the efficacy of a test

68
Q

What is the function of the plasma membrane

A

a physical barrier, establishes selective permeability, maintains electrochemical gradient, receptors for signaling,

69
Q

What is the function of the nucleus

A

controls cell division and functions, contains genetic code

70
Q

What is the function of a nucleolus

A

synthesizes ribosomal RNA and assembles ribosome subunits

71
Q

What is the function of ribosomes

A

to synthesize proteins

72
Q

What is the function of the RER

A

rough endoplasmic reticulum- synthesizes membrane bound and secreted molecules, has ribosomes on exterior

73
Q

What is the function of the smooth ER

A

synthesizes phospholipids and steroids, detoxifies drugs, stores Ca

74
Q

What is the function of the Golgi apparatus

A

modifies and packages macromols for other organelles and for secretion

75
Q

What is the function of the mitochondria

A

ATP production through aerobic respiration/ oxidative phosphorylation

76
Q

What is the function of lysosomes

A

has hydrolytic enzymes that degrade/ recycle unwanted material

77
Q

What is the function of microfilaments

A

supports the cytoskeleton and motility

78
Q

What is the function of intermediate filaments

A

provides a strong structural support to cell

79
Q

What is the function of microtubules

A

maintains cell shape, helps with cell and organelle motility, mitosis

80
Q

What is the function of the centrosome

A

has centrioles that form mitotic spindle fibers during mitosis

81
Q

What are clusters of differentiation

A

CD is the term for blood cell antigens, each are assigned a system

82
Q

What is the cell membrane composed of

A

phospholipids and cholesterol arranged in a hydrophilic and hydrophobic layer

83
Q

What is the inner layer of the cell membrane made of

A

phosphatidylserine and phosphatidylethanolamine

84
Q

What is the outer layer of the cell membrane made of

A

sphingomyelin and phosphatidylcholine

85
Q

What can you find attached to a cell outer membrane

A

carbs liked to membrane proteins and phospholipids

86
Q

What is glycocalyx

A

carbs on the outside of cells made of glycoproteins and glycolipids

87
Q

What is a cell nucleus composed of

A

chromatin, nuclear envelope, nucleoli

88
Q

Name the levels of folding of chromatin

A

nucleosomes: DNA wrapped around histones
chromatin fibers
supercoiled chromatin fibers

89
Q

What is hetero and euchromatin?

A

hetero- inactive, tightly coiled

eu-active, loosely coiled

90
Q

What is the name of the internal structure within the golgi apparatus

A

sacs called cisternae

91
Q

What is the name of the internal structure in the mitochondria

A

infoldings called cristae

92
Q

True or False, the mitochondria is capable of self replication

A

True it has its own DNA and RNA

93
Q

Put the following in order of thickest to thinnest
microfilaments
microtubules
intermediate filaments

A

microfil
inter
microtub

94
Q

Practice labelling Ch 3 slide 31

A 
A- microfilaments
B glycogen aggregates
C golgi complex
D centriole
E microtubule
F vacuole
G mitochondria
H lysosome
I heterochromatin
J euchromatin
K nucleolus
L RER
M nuclear pore
N nuclear envelope
95
Q

What structure protects the BM?

A

stromal cells- special endothelial cells

96
Q

What do stromal cells do

A

secrete growth factors that regulate proliferation and differentiation of precursor blood cells

97
Q

What are the 4 stages of the cell cycle

A

Gap 1- cell growth and synthesis
S- DNA synthesis- DNA replication occurs
Gap 2- tetraploid DNA is checked for damage or mistakes
M- Mitosis- disivion of chromosomes into 2 daughter cells

G0- quiescence- cell not in cycle

98
Q

What is the purpose of the cell cycle

A

replicate DNA and distribute identical chromosome copies to daughter cells

99
Q

What are the stages of mitosis

A 
prophase
prometaphase
metaphase
anaphase
telophase
cytokinesis
100
Q

What are the checkpoints that occur in the cell

A

G1, S, G2 and metaphase checkpoints

101
Q

What regulates the cell cycle?

A

cyclin and cyclin dependent kinases (CDK)

102
Q

What is necrosis? What is apoptosis?

A

necrosis- pathological, happens because of injury to cells

apoptosis-self inflicted cell death

103
Q

Would toxins cause necrosis or apoptosis??

A

necrosis

104
Q

Would a viral infection cause necrosis or apoptosis?

A

apopotosis

105
Q

If a cell is swelling this indicates _____
If a cell nucleus condenses and becomes fragmented this indicates ____
If a cell leaks and this leads to inflammation it indicates _____

A

necrosis
apoptosis
necrosis

106
Q

If a cell shrinks this indicates ____
If a cell plasma membrane is ruptured this indicates___
If a cell nucleus randomly breaks and lysis
If a plasma membrane is intact but loses phospholipids slowly this is ____

A

apoptosis
necrosis
necrosis
apoptosis

107
Q

Which stages of the cell cycle make up interphase?

A

G1, S and G2

108
Q 
Where does hematopoiesis occur when humans are 
20th day of life
3rd month of life
8th month of life
adulthood
A

20th- yolk sac
3rd- liver
8th- BM
adult- BM

109
Q

Where else do adults have hematopoietic tissue

A

the BM, lymph nodes, spleen, liver, thymus

110
Q

What cells develop in the BM? and the lymphoid tissue?

A

BM- RBCs, myeloid cells, megakaryocytes, lymphoid cells

Lymphoid cells- in lymphoid tissue

111
Q

What are the primary lymphoid tissues? and the secondary?

A

1ary-BM, thymus

2ndary- spleen, lymph nodes, MALT

112
Q

What is MALT

A

mucosa associated lymphoid tissue- this is where lymphoid cells respond to antigens

113
Q

Red marrow is ____ composed of _____

Yellow marrow is ____ composed of _____

A

red- active, developing blood cells

yellow- inactive, fat cells

114
Q

What is an adipocyte? what is its function

A

large cell with fat vacuoles, regulate volume of marrow, secrete cytokines and growth factors

115
Q

What are endothelial cells and what are their functions

A

broad flat cells that form a layer on the surface of arteries/ veins/ vascular sinuses

116
Q

What are macrophages and what is their function

A

phagocytosis, secrete cytokines and regulate hematopoiesis

117
Q

What are osteoblasts? and osteoclasts

A

blast- bone forming

clast- bone resorbing

118
Q

What is the function of reticular adventitial cells

A

secrete extracellular matrix to anchor developing cells in bone, regulate HSCs and progenitor cell survival and differentiation

119
Q

As we age we experience more _____ which means our ____ marrow is replaced with more ___ marrow

A

retrogression, red, yellow

120
Q

Describe the structure of the liver

A

2 lobes, kupffer cells- special macrophage that remove old cells from blood

121
Q

What are the functions of the liver in adults

A

protein synthesis and degradation, coagulation factor synthesis, card and lipid metabolism, drug and toxin clearance, iron recycling and storage, HGB degradation

122
Q

What is extramedullary hematopoiesis?

A

a response from the liver to infectious agents, hematopoiesis outside of BM

123
Q

What disease can cause extramedullary hematopoiesis

A

diseases of Kupffer cells that have enzyme deficiencies,

124
Q

What is the function of the spleen

A

blood filtration, not essential for life

125
Q

Define culling and pitting, what organ performs this?

A

Removal of abnormal RBCs by the spleen
culling- cells phagocytized
pitting- hole punching RBCs removes damaged things on surface and allows it back into circulation for a while longer

126
Q

Where does blood enter the spleen through?

A

the central splenic artery

127
Q

What is splenomegaly

A

enlarged spleen

128
Q

What is a splenectomy

A

removal of spleen, can be done if RBCs are being destroyed too much

129
Q

What is hypersplenism

A

enlarge of the spleen, causing pancytopenia, all cells are low

130
Q

Where are the lymph nodes located,

A

along the lymphatic capillaries, all over body some superficial others deep

131
Q

What is lymph? what is its function

A

fluid portion of blood that escapes into connective tissue, lymphocyte proliferation, specific immune response, filters debris, bacteria, particulate matter that enters the lymph node

132
Q

Afferent lymphatic vessels carry circulating lymph ___ the lymph nodes
Efferent lymphatic vessels carry circulating lymph ____ the lymph nodes

A

into, out of

133
Q

What is the function of the thymus

A

T cell maturation, has a waiting and holding zome for T cells to differentiate and go into circulation

134
Q

The thymus contains ___% of mature T cells in the body

A

15%

135
Q

What other cells are present in the thymus

A

B cells, eosinophils, neutrophils, myeloid cells

136
Q

What is the name of the stem cell that is the progenitor for myeloid cells

A

CFU-GEMM or CFU S

colony forming, granulocyte, erythrocyte, monocyte, megakaryocyte

137
Q

What abilities do HSC have

A

self renewal, pluripotent, control of hematopoietic system

138
Q

What are the two major types of hematopoietic progenitor cells

A

non committed- become progenitors

committed- become lymphoid or myeloid lineage

139
Q

What are the 3 possible fates of HSCs

A

self renewal
differentiation
apoptosis

140
Q

What morphological changes occur to a cell as it matures

A

decreases in volume, decreases in N:C ratio

141
Q

what morphological changes do maturing cells have in their nucleus

A

loss of nucleoli, smaller diameter, condensation of chromatin, could change in shape

142
Q

What morphological changes do cells have in their cytoplasm as they mature

A

decreased basophilia
increase in proportion of cytoplasm
sometimes granules

143
Q

What are the hematopoietic growth factors?

A

cytokines, CSF- colony stimulating factor, KIT signals nucleus of HSCs and stimulates their proliferation

144
Q

Describe the process of erythropoeisis

A

CFU-GEMM-> BFU-E burst forming unit –> CFU-E-> erythropoietin-> pronormoblasts

145
Q

Where is red and yellow marrow in children? and adulthood?

A

children- mostly Red, all over

adults- equal parts red and yellow, changes into yellow in long bones, stays red in axial skeleton

146
Q

A range of results that defines the upper and lower limits of linearity

A

analytical measurement range

147
Q

True of false: interphase is a stage of mitosis

A

False

148
Q

What is the mesoblastic phase of hematopoiesis?

A

yolk sac phase- 19th day of gestation

149
Q

What is the hepatic phase of hematopoiesis

A

5-weeks old- occurring in liver

150
Q

What is the medullary phase of hematopoiesis

A

4th month- Bone marrow

151
Q

True or False: The thymus increases in size as we age

A

false- it gets smaller

Hematology (4 decks)

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