exam 1

Question 1

what controls the entrance and exit of substances into and out of blood cells?

Answer 1

cell membrane

Question 2

where is the main site of hematopoiesis in the fetus?

Answer 2

liver

Question 3

where is the main site of hematopoiesis in the adult?

Answer 3

bone marrow

Question 4

what is the major site of extramedullary hematopoiesis?

Answer 4

spleen

Question 5

what three major criteria are used to identify blood cells?

Answer 5

size
shape of nucleus
appearance of cytoplasm

Question 6

how is bone marrow cellularity determined?

Answer 6

by comparing nucleated cells to total amount of cells and fat present

Question 7

what is the normal M:E ratio ?

Answer 7

between 2:1 - 4:1

average 3:1

Question 8

how does a doctor use a bone marrow exam?

Answer 8

aid in making definitive diagnosis,
management of patient and evaluation of treatment,
assessment of iron stores

Question 9

what is the dualistic theory of blood cell origin?

Answer 9

granulocytes and all other WBC’s develop from on precursor and lymphocytes develop from another

Question 10

rubriblast (proerythroblast, pronormoblast)

Answer 10

youngest cell
nucleus present 
fine chromatin
present cytoplasm
14-24 micrometers

Question 11

prorubricyte (Basophilic normoblast/ basophilic erythroblast)

Answer 11

12-17 micrometers

coarser chromatin and nucleoli than rubriblast

Question 12

Rubrictye (polychromatic normoblast/ polychromatic erythroblast)

Answer 12

1st stage of visible hemoglobin production
10-15 micro meters
more cytoplasm and smaller nucleus than prorubricyte

Question 13

Metarubricyte ( orthochromic normoblast / orthochromic erythroblast)

Answer 13

stage that the nucleus is lost

8-12 micrometers

Question 14

reticulocyte (polychromatic erythrocyte/ diffusely basophilic erythrocyte )

Answer 14

8-10 micrometers

RNA present

Question 15

erythrocyte

Answer 15

7-8 micrometers

pink color

Question 16

what is the average life of a RBC?

Answer 16

100-120 days

Question 17

what is erythropoietin?

Answer 17

a mucoprotein

Question 18

where is erythropoietin produced?

Answer 18

kidneys

Question 19

how is erythropoietin secretion stimulated?

Answer 19

stimulation in bone marrow in response to tissue hypoxia

Question 20

apoferritin

Answer 20

a protein that ferrous iron (Fe2+) can bind too if not absorbed by the small intestine

Question 21

ferritin

Answer 21

submicroscopic iron

Question 22

hemosiderin

Answer 22

“conglomeration” of ferritin which can be seen with a microscope

Question 23

transferrin

Answer 23

a protein that aids in transportation (along with oxidation) of iron to the bone marrow

Question 24

what is asynchrony?

Answer 24

nuclear maturation and cytoplasmic maturation are not correct (not at same rate)

Question 25

what is karyorrhexis?

Answer 25

nuclear fragments

Question 26

how does the RBC count vary for physiological reasons ?

Answer 26

because of the normal response to decreased oxygen and decreased plasma

Question 27

what are some physiological conditions that can cause the RBC count to vary?

Answer 27

high altitudes obstructed pulmonary disease pulmonary cardiac disease polycythemia vera

Question 28

what are the characteristics of a good RBC diluent?

Answer 28

isotonic to the RBC | prevents lysis and crenation to preserve original morphology and prevent clumping

Question 29

how do you calculate a RBC count when it is performed on a hemocytometer

Answer 29

add both sides of the meter and then divide by 10,000

Question 30

what is the structure of normal hemoglobin A?

Answer 30

2 alpha and 2 beta polypeptide chains | 4 iron containing heme groups

Question 31

what pathway provides most of the energy for a mature RBC

Answer 31

emden-meyerhof glycolytic pathway

Question 32

in order to function as an oxygen carrier, the iron in hemoglobin must be in what oxidation state?

Answer 32

Fe 2+

Question 33

what is the Sahli method of hemoglobin determination and to what molecule is hemoglobin converted to in this method?

Answer 33

acid hematin

Question 34

what is the most commonly used method for hemoglobin determination in the modern hematology lab?

Answer 34

cyan methemoglobin

Question 35

what hemoglobin pigment can not be converted to oxyhemoglobin?

Answer 35

sulfhemoglobin

Question 36

which manual hematology procedure is the most reliable and reproducible?

Answer 36

hematocrit

Question 37

what test measures the percentage of the RBC volume of whole blood?

Answer 37

hematocrit

Question 38

how is the hematocrit test performed?

Answer 38

a capillary tube is filled 1/2 - 1/3 full with either venous or capillary blood one end of the tube is sealed with clay and then spun on the special hematocrit centrifuge for 3-5 minutes at 12,000 rpms the tube is then placed on a hematocrit reading device and then you have your results

Question 39

what are two methods of the hematocrit test?

Answer 39

macromethod of wintrobe | micromethod

Question 40

which of the two methods of the hematocrit test is preferred?

Answer 40

``` micromethod because it's a simple process, small samples of blood are used simple equipment is used reproducible very accurate ```

Question 41

what test measures the "suspension stability" or RBC's?

Answer 41

erythrocyte sed. rate

Question 42

name two methods used for the ESR

Answer 42

wintrobe-landesburg | westergren

Question 43

which method for the ESR uses a saline dilution and why?

Answer 43

westergren; | because diluting the blood offsets any anemia effects

Question 44

what factors can cause an increased ESR?

Answer 44

bacterial infections

Question 45

what factors can decrease an ESR?

Answer 45

polycythemia, SCA, spherocytosis

Question 46

what is the "rule of three"?

Answer 46

an internal check on values given from instrument 3 X RBC = hgb 3 X hgb = hct

Question 47

what test is the most reliable assessment of the effective erythroid activity of the bone marrow?

Answer 47

reticulocyte counts

Question 48

what is the normal reticulocyte count ?

Answer 48

Adults: 0.5-2.0 %

Question 49

what stains are used in the reticulocyte count?

Answer 49

1% Newmethylene blue brilliant cresyl blue supravital stains

Question 50

how are retics observed on a wright's stained smear?

Answer 50

the RNA and organelles precipitate from dye formaing a filamentous network of reticulum polychromatophilic or polychromasia

Question 51

what reagent is used for the sickle cell solubility test?

Answer 51

sodium dithianite

Question 52

what reagent is used for the slide test?

Answer 52

sodium metabisulfate

Question 53

how is the slide test and sickle cell solubility test read?

Answer 53

slide test is read by a microscope | the solubility test is read by ability to see lines behind tube or not

Question 54

what is the reagent used in the osmotic fragility test?

Answer 54

saline (NaCl)

Question 55

how is the osmotic fragility test read?

Answer 55

by reading the color of the supernatant of spectrophotometer

Question 56

what conditions cause an increased osmotic fragility?

Answer 56

hereditary spherocytosis | hemolytic anemias

Question 57

what conditions can cause a decrease in osmotic fragility?

Answer 57

sickle cell anemia | any conditions with target cells or thalessemia

Question 58

what chemical composition do basophilic stipplings have?

Answer 58

RNA

Question 59

what chemical composition do Heinz bodies have?

Answer 59

denatured hgb

Question 60

what chemical composition do Howell-Jolly bodies have?

Answer 60

DNA

Question 61

what chemical composition do pappenheimer bodies have?

Answer 61

iron

Question 62

according to their composition, which abnormal RBC should be counted as reticulum in a reticulocyte count?

Answer 62

basophilic stipplings