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hematology > exam 1 > Flashcards

exam 1 Flashcards

1
Q

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

A

cell membrane

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2
Q

where is the main site of hematopoiesis in the fetus?

A

liver

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3
Q

where is the main site of hematopoiesis in the adult?

A

bone marrow

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4
Q

what is the major site of extramedullary hematopoiesis?

A

spleen

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5
Q

what three major criteria are used to identify blood cells?

A

size
shape of nucleus
appearance of cytoplasm

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6
Q

how is bone marrow cellularity determined?

A

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

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7
Q

what is the normal M:E ratio ?

A

between 2:1 - 4:1

average 3:1

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8
Q

how does a doctor use a bone marrow exam?

A

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

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9
Q

what is the dualistic theory of blood cell origin?

A

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

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10
Q

rubriblast (proerythroblast, pronormoblast)

A 
youngest cell
nucleus present 
fine chromatin
present cytoplasm
14-24 micrometers
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11
Q

prorubricyte (Basophilic normoblast/ basophilic erythroblast)

A

12-17 micrometers

coarser chromatin and nucleoli than rubriblast

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12
Q

Rubrictye (polychromatic normoblast/ polychromatic erythroblast)

A

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

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13
Q

Metarubricyte ( orthochromic normoblast / orthochromic erythroblast)

A

stage that the nucleus is lost

8-12 micrometers

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14
Q

reticulocyte (polychromatic erythrocyte/ diffusely basophilic erythrocyte )

A

8-10 micrometers

RNA present

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15
Q

erythrocyte

A

7-8 micrometers

pink color

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16
Q

what is the average life of a RBC?

A

100-120 days

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17
Q

what is erythropoietin?

A

a mucoprotein

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18
Q

where is erythropoietin produced?

A

kidneys

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19
Q

how is erythropoietin secretion stimulated?

A

stimulation in bone marrow in response to tissue hypoxia

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20
Q

apoferritin

A

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

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21
Q

ferritin

A

submicroscopic iron

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22
Q

hemosiderin

A

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

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23
Q

transferrin

A

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

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24
Q

what is asynchrony?

A

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

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25
Q

what is karyorrhexis?

A

nuclear fragments

26
Q

how does the RBC count vary for physiological reasons ?

A

because of the normal response to decreased oxygen and decreased plasma

27
Q

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

A

high altitudes
obstructed pulmonary disease
pulmonary cardiac disease
polycythemia vera

28
Q

what are the characteristics of a good RBC diluent?

A

isotonic to the RBC

prevents lysis and crenation to preserve original morphology and prevent clumping

29
Q

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

A

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

30
Q

what is the structure of normal hemoglobin A?

A

2 alpha and 2 beta polypeptide chains

4 iron containing heme groups

31
Q

what pathway provides most of the energy for a mature RBC

A

emden-meyerhof glycolytic pathway

32
Q

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

A

Fe 2+

33
Q

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

A

acid hematin

34
Q

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

A

cyan methemoglobin

35
Q

what hemoglobin pigment can not be converted to oxyhemoglobin?

A

sulfhemoglobin

36
Q

which manual hematology procedure is the most reliable and reproducible?

A

hematocrit

37
Q

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

A

hematocrit

38
Q

how is the hematocrit test performed?

A

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

39
Q

what are two methods of the hematocrit test?

A

macromethod of wintrobe

micromethod

40
Q

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

A 
micromethod because it's a simple process, 
small samples of blood are used
simple equipment is used
reproducible 
very accurate
41
Q

what test measures the “suspension stability” or RBC’s?

A

erythrocyte sed. rate

42
Q

name two methods used for the ESR

A

wintrobe-landesburg

westergren

43
Q

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

A

westergren;

because diluting the blood offsets any anemia effects

44
Q

what factors can cause an increased ESR?

A

bacterial infections

45
Q

what factors can decrease an ESR?

A

polycythemia, SCA, spherocytosis

46
Q

what is the “rule of three”?

A

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

47
Q

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

A

reticulocyte counts

48
Q

what is the normal reticulocyte count ?

A

Adults: 0.5-2.0 %

49
Q

what stains are used in the reticulocyte count?

A

1% Newmethylene blue
brilliant cresyl blue
supravital stains

50
Q

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

A

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

51
Q

what reagent is used for the sickle cell solubility test?

A

sodium dithianite

52
Q

what reagent is used for the slide test?

A

sodium metabisulfate

53
Q

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

A

slide test is read by a microscope

the solubility test is read by ability to see lines behind tube or not

54
Q

what is the reagent used in the osmotic fragility test?

A

saline (NaCl)

55
Q

how is the osmotic fragility test read?

A

by reading the color of the supernatant of spectrophotometer

56
Q

what conditions cause an increased osmotic fragility?

A

hereditary spherocytosis

hemolytic anemias

57
Q

what conditions can cause a decrease in osmotic fragility?

A

sickle cell anemia

any conditions with target cells or thalessemia

58
Q

what chemical composition do basophilic stipplings have?

A

RNA

59
Q

what chemical composition do Heinz bodies have?

A

denatured hgb

60
Q

what chemical composition do Howell-Jolly bodies have?

A

DNA

61
Q

what chemical composition do pappenheimer bodies have?

A

iron

62
Q

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

A

basophilic stipplings

hematology (9 decks)

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