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BMS 161 Hematology > Exam 4 > Flashcards

Exam 4 Flashcards

1
Q

What is Multiple Myeloma (MM)?

A

Serious disorder characterized by abnormal presence and growth of plasma cells
(Plasma cells grow at a fast rate and eventually crowd out the healthy cells)
(Calcium is sucked out of the bones into the peripheral blood,,, and the bones are like paper,,, and breaks easily)

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2
Q

What are the symptoms of Multiple Myeloma (MM)?

A
  1. Anemia
  2. Leukopenia
  3. Thrombocytopenia
  4. High levels of calcium in the blood
  5. Sudden severe back pain
  6. Numbness especially in the legs
  7. Muscle weakness
  8. Nerve damage
  9. Confusion
  10. Dizziness
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3
Q

What is used to diagnose Multiple Myeloma?

A
  1. Electrophoresis
  2. Immunofixation
  3. Quantitative immunoglobulin assay
  4. CBC
  5. ESR
  6. Bone marrow biopsy
  7. CRP
  8. Chemistry panel
  9. MRI
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4
Q

***What is Plasmacytoma?

A

tumor of the plasma cells

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5
Q

***What is monoclonal gammopathy?

A

overproduction of identical antibodies in the serum or plasma

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6
Q

What is Bence-Jones?

A

Light chains that are secreted on the urine and precipitate at 56 degrees Celsius (indicitive of MM)

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7
Q

What other symptoms are present in Multiple Myeloma (MM)?

A
  1. bone destruction
  2. hypercalcemia
  3. kidney failure
  4. hyper viscosity (sticky RBC = thick blood)
  5. pancytopenia
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8
Q

***1. What is seen on peripheral blood smears of Multiple Myeloma (MM), due to plasma proteins?
2. The answer for the question above, What does this elevate?

A
  1. rouleaux
  2. ESR is elevated (erythrocyte sedimentation rate [seg rates?])
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9
Q

*** What is Amyloidosis? In what disease, does this occur?

A
  1. when immunoglobulin kappa or lambda light chains settle or deposit in organs such as kidneys, heart, nerves, liver, spleen, and the gastrointestinal tract
  2. Multiple Myeloma (MM)
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10
Q
  1. What do IL-6 and osteoclast activating factor (OAF) do?
  2. What disease is associated with?
A

1a. stimulating the development of osteoclasts
1b. play significant roles in the manufacture of the lytic bone lesions
2. Multiple Myeloma (MM)

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11
Q

What happens to calcium in a Multiple Myeloma (MM) patient?

A
  1. calcium is released from the bone
  2. weakens the bone structure
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12
Q

***What is staging in Multiple Myeloma (MM)?

A

provides the advancement of the disease which in turns help to determine the appropriate treatment and prognosis

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13
Q

***What is the primary treatment in Multiple Myeloma?

A

Chemotherapy

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14
Q

What is Waldenstrom’s Macroglobulinemia?

A

Disease recognized by the overproduction of monoclonal IgM antibodies by cells known as plasmacytoid lymphocytes or prolymphs

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15
Q

What are monoclonal IgM antibodies also known as?

A
  1. plasmacytoid lymphocytes
  2. prolymphs
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16
Q

What are symptoms of Waldenstrom’s Macroglobulinemia?

A
  1. hyper viscosity of the blood
  2. ** increased levels of IgM **
  3. fatigue
  4. cryoglobulinemic purpura (purple spots on the skin)
  5. bleeding disorders.
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17
Q

What routine treatments (which serves to remove increased levels of IgM) are used to treat Waldenstrom’s Macroglobulinemia?

A
  1. chemotherapy
  2. plasmapheresis
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18
Q

What is another name for Waldenstrom’s Macroglobulinemia?

A

Oil can disease

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19
Q

Are Malignant Lymphomas a heterogenous or homogeneous group of diseases?

A

heterogeneous

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20
Q

***What is the representative of Hodgkin’s disease?

A

Reed-Sternberg cells

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21
Q

What do Reed-Sternberg cells look like?

A

large in size, multinucleated, and have inclusion –like nucleoli

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22
Q

What is the usual immunophenotype of the Reed-Sternberg cell?

A

CD30+, CD15+, and CD45

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23
Q

***What is the most common cause or agent of Hodgkin’s lymphoma?

A

Epstein-Barr virus (EBV)

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24
Q

***What is the most widely used staging criteria (for lymphomas)?

A

Ann Arbor classification

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25
Q

What is the most common type of Hodgkin’s lymphoma?

A

nodular sclerosing Hodgkin’s lymphoma

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26
Q

What is the most common symptom of Hodgkin’s lymphoma?

A

nonpainful lymph node swelling.

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27
Q

What would you see in a peripheral blood smear of a patient with predominant Hodgkin’s Lymphoma?

A
  1. mixture of small and normal appearing lymphocytes
  2. benign histiocytes
  3. rare typical Reed-Sternberg cells
  4. several variant Reed Sternberg cells
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28
Q

***What is a common lymphoma for immunocompromised patients, esp. AIDS?

A

Burkitt Lymphoma

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29
Q

***Is the growth rate for Burkitt Lymphoma, high or low?

A

high

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30
Q

***What lymphoma is characterized by the “Starry Sky” pattern?

A

Burkitt Lymphoma

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31
Q

***What do the cells look like microscopically in Burkitt Lymphoma?

A
  1. The uniform cells are medium in size
  2. uniformly round nuclei
  3. multiple small nucleoli
  4. a high amount of intensely basophilic cytoplasm
  5. Lipid vacuoles in the cytoplasm
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32
Q

***What do the cells look like microscopically in Mantle Cell Lymphoma?

A
  1. small to medium sized lymphocytes
  2. very/scant pale stained cytoplasm
  3. nucleus is irregular
  4. nucleoli are inconspicuous
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33
Q

What surface immunoglobulin are expressed on cells with Mantle Cell Lymphoma?

A
  1. CD5
  2. CD43
  3. t(11;14)
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34
Q

What is the purpose of Leukocyte Alkaline Phosphatase Stain (LAP)?

A

to distinguish CML (Chronic Myeloid Leukemia) from leukemoid reactions and myeloproliferative disorders

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35
Q

What is the purpose of Myeloperoxidase (MPO) Stain?

A

to distinguish myeloblastic or myelomonocytic leukemia from acute lymphoblastic leukemia

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36
Q

How does Myeloperoxidase (MPO) Stain distinguish myeloblasts and lymphocytes?

A

MPO is found in the primary granules and Auer rods of late myeloblasts through the neutrophils including eosinophils and monocytes. Does not include lymphocytes.

TL;DR: MPO only in myeloblasts not in lymphocytes; Positive MPO = not lymphoblastic leukemia

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37
Q

What is phlebotomy?

A

Process of making a puncture in a vein usually in the arm to obtain blood

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38
Q

What is the procedure of taking out blood from the vein called?

A

venipuncture

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39
Q

What is a tourniquet?

A

a rubber band on the arm that helps the veins to “pop” out

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40
Q

If the patient has an abnormally high potassium, what could have POSSIBLY happened?

A

carry over;
the phlebotomist drew blood out of order; used the lavender top tube BEFORE the green top tube

41
Q

If there are any platelet clumps the sample needs to be recollected in… what type/color top tube?

A

sodium citrate tube (blue top tube)

42
Q

What tube is used for basic hematology procedures? color top?

A
  1. EDTA anticoagulant
  2. lavender top tube
43
Q

How do you do a WBC count with a hemacytometer?

A
  1. count the four (4) corner squares
  2. calculate w/ formula lol
44
Q

***What is the formula for hemacytometer?

A

(# of WBC * 10 * dilution) / # of squares counted

45
Q

What are body fluids?

A

liquids inside living humans and can be excreted or secreted from the body

46
Q

***How do you take a Cerebrospinal Fluid (CSF) sample?

A

Puncture from the lumbar area

47
Q

Who can have their Cerebrospinal Fluid (CSF) taken (age)?

A

everyone (any age)

48
Q

What diseases would you take Cerebrospinal Fluid (CSF) for analysis?

A
  1. Meningitis (most common, severe headaches, college kids, neckache, high fever)
  2. Encephalitis
  3. Syphilis
  4. Brain abscess/Tumor
  5. Intracranial hemorrhage
  6. Leukemia/Lymphoma with CNS involvement
49
Q

What color SHOULD Cerebrospinal Fluid (CSF) be?

A

clear/colorless

50
Q

What is Xanthrochromia?

A

pink, orange or yellow CSF supernatant (usually due to hemoglobin)

51
Q

Why would you get a Xanthrochromic CSF tube?

A

probably hemorrhage

52
Q

What would a hemorrhage CSF tube look like?

A
  1. every tube is equally red/blood (xanthromchromic)
  2. no clots
53
Q

What would a traumatic tap CSF tube look like?

A
  1. tube goes from red to clear (gradient)
  2. clear supernatant
  3. CLOTS!!! (b/c fibrinogen)
54
Q

What are the three causes of Meningitis?

A
  1. bacterial
  2. viral
  3. fungal
55
Q

What would bacterial meningitis look like?
(1. protein
2. glucose
3. WBC)

A
  1. increased protein
  2. decreased glucose
  3. neutrophils present
56
Q

What would viral meningitis look like?
(1. protein
2. glucose
3. WBC)

A
  1. increased protein
  2. normal glucose
  3. lymphocyte present
57
Q

What would Fungal meningitis look like?
(1. protein
2. glucose
3. WBC)

A
  1. increased protein
  2. normal/decreased glucose
  3. lymphocytes and monocytes present
58
Q

What is the most common reason to analyze CSF?

A

meningitis

59
Q

What are keywords when meningitis is present?

A
  1. severe headaches
  2. college kids
  3. neckache
  4. high fever
60
Q

What does a plasma cell look like?

A
  1. slightly larger than a RBC
  2. DARK DARK blue cytoplasm
  3. halo/shadow around the nucleus
61
Q

What does a blast cell look like?

A
  1. HUGEEEEEE compared to a RBC
  2. small, pale/light (purple/blueish) cytoplasm
62
Q

Why would you analyze seminal fluid?

A
  1. Infertility (most common)
  2. Post vasectomy (cutting up some BWALLSSSS lol)
  3. (TL;DR rape cases) Forensic medicine-presence of acid phosphatase confirms presence of semen in accused rape cases; flavin in semen fluoresces on clothing under UV light
63
Q

What is normal ____ for seminal fluid?
1. volume
2. morphology
3. count
4. motility

A
  1. volume: 2-5mL
  2. morphology: <30% (abnormal)
  3. count: 20-250 million/mL
  4. motility >50%
64
Q

What is Serous Fluid?

A

Fluids that fill the inside of body cavities (abdominal, around the heart, etc.)

65
Q

What is Serous Fluid made of?

A

Pleural, Peritoneal, and Pericardial Effusions

66
Q

Where does Serous Fluids originate from?

A

serous glands

67
Q

***Where is Synovial Fluid found?

A

joints

68
Q

Why would you analyze Synovial Fluids?

A
  1. Gout
  2. Sepsis
  3. Hemorrhage
  4. Crystal induced inflammation
69
Q

What should Synovial Fluids look like?

A

clear, pale, yellow

70
Q

*** If the patient has gout, what would you find in the Synovial Fluid?

A

monosodium urate crystals

71
Q

What is present in the synovial fluid, if the patient has PSEUDO gout (painful arthritis)?

A

Calcium pyrophosphate crystals

72
Q

What is used to differentiate Calcium pyrophosphate crystals and monosodium urate crystals?

A

Compensated polarization

73
Q

What does the Compensated polarization
result for gout look like?

A

Monosodium urate appears yellow when parallel to compensator and blue when perpendicular

parallel: yellow
perpendicular: blue

74
Q

What does the Compensated polarization
result for pseudo gout look like?

A

Calcium pyrophosphate appears blue when parallel to compensator and yellow when perpendicular

parallel: blue
perpendicular: yellow

75
Q

What has a clear and watery turbidity, transudates or exudates?

A

transudates

76
Q

What has a cloudy and viscous turbidity, transudates or exudates?

A

exudates

77
Q

What is the specific gravity of transudates?

A

less than 1.015

78
Q

What is the specific gravity of exudates?

A

greater than 1.015

79
Q

What exudate color is indicative of inflammation?

A

yellow or white

80
Q

What exudate color is indicative of hemorrhage?

A

red or brown

81
Q

What exudate color is indicative of bilirubin?

A

yellow or brown

82
Q

What exudate color is indicative of chylous fluid (fatty)?

A

milky green

83
Q

What is pleural fluid?

A

Thoracic cavity-fluid accumulation around the lungs

84
Q

Why would you order analysis for Pleural Fluid?

A
  1. TB
  2. malignancy
  3. trauma
  4. pancreatitis
85
Q

*** What is pericardial fluid?

A

Fluid in the pericardial cavity (around the heart)

86
Q

Why would you order analysis for pericardial fluid?

A
  1. Malignancy
  2. bacterial infection
  3. bacterial endocarditis
  4. tumor
  5. tuberculosis
87
Q

What is Peritoneal (ascites)?

A

Fluid around the abdomen

88
Q

Why would you order an analysis for Peritoneal (ascites)?

A
  1. peritonitis
  2. malignancy
  3. pancreatitis
  4. trauma
  5. GI perforation
  6. ruptured bladder
89
Q

*** When would Sodium chloride be elevated in a sweat test?

A

Cystic fibrosis

90
Q

What is measured in a sweat test?

A

NaCl (sodium chloride)

91
Q

Sweat test are ordered for who?

A

kids

92
Q

Why is it difficult to measure Amniotic Fluid?

A

Done on all pregnant woman, need to be done at the right time (otherwise it would be falsely elevated)

93
Q

Why are Amniotic Fluid analysis ordered?

A
  1. Fetal Lung maturity (if baby is not developing correctly)
  2. neural tube disorders
  3. fetal age
  4. red cell destruction
94
Q

What is tested in Amniotic fluid?

A
  1. Bilirubin
  2. L/S ratio
  3. creatinine
  4. Phosphatidylglycerol
  5. alpha fetoprotein (spinal bifida)
95
Q

What does promyelocyte look like?

A
  1. huge
  2. dark purple
  3. primary (azurophilic) granules both in the cytoplasm and overlying the nucleus
    3a. red/purple grains of sand-like granules
96
Q

What does a myelocyte look like?

A
  1. nucleus is round
  2. both primary (azurophilic) and secondary/specific (pink or lilac) cytoplasmic granules
    3.
97
Q

What does a metamyelocyte look like?

A
  1. a bent nucleus (bean!)
  2. cytoplasmic granules
  3. purple/pinkish cytoplasm
98
Q

What is howell jolly bodies?

A

RBC w/ blue dot

BMS 161 Hematology (4 decks)

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