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Hemotology/Hemostasis > FINAL > Flashcards

FINAL Flashcards

1
Q

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

A

retic count

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2
Q

What conditions (including parasitic infections) produce a macrocytic/normochromic picture

A

Ovalocytes: Pernicious Anemia, Hemophilia B, folate deficiency, B12 deficiency
Round macrocytes: Liver disease, alcoholism

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3
Q

What conditions (including parasitic infections) produce a Microcytic/hypochromic blood picture?

A

Thalassemia, Cooley’s Anemia, iron deficiency, sideroblastic anemia, Pb poisoning, hookworm infection

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4
Q

What are the typical findings (including RBC, WBC and platelets) in pernicious anemia (or vitamin B12 deficiency)

A

Pancytopenia, oval macrocytes, hypersegs (shift to right)

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5
Q

What is the Schilling test and what body fluid is used for the test?

A

The Schilling test is an indirect measure of intrinsic factor. Pernicious Anemia: Intake of radioactive B12, look for it in urine. Not in urine indicates lack of intrinsic factor and no B12 absorption in intestines.

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6
Q

What are macropolycytes

A

large cells with 5-7 lobes in nucleus. They are larger than hypersegs.

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7
Q

What portion of the red blood cell is damaged leading to the formation of burr cells and thorn cells?

A

membrane

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8
Q

What are the distinguishing characteristics of hereditary ovalocytosis?

A

Ovalocytes are seen. It does not need bone marrow to confirm. It is a cell membrane abnormality.

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9
Q

What is the most unusual and significant finding in patients suffering from AIHA

A

Positive Direct Coombs (Positive DAT)

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10
Q

What poikilocyte is associated with ABO HDN?

With extramedullary hematopoiesis?

A
  • Spherocytes

- teardrop cells

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11
Q

What are the laboratory findings in PCH

A

+ Direct Coombs, + Donath Lansteiner, symptoms after exposure to cold.

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12
Q

What are the hemoglobin electrophoresis results in sickle cell anemia?

A

Has Hgb S,F

No Hgb A.

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13
Q

What hemoglobin is insoluble in reducing agents such as sodium dithionite and sodium metabisufite

A

Hgb S

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14
Q

Which chain of the hemoglobin molecule is abnormal in hemoglobin C disease, sickle cell anemia, and thalassemia major?

A

Beta chain

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15
Q

What does the PBS of a patient with sickle cell trait usually show?

A

Occasional target cells

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16
Q

What does the PBS of a patient with IDA show

A

Pale, microcytic/ hypochromic cells

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17
Q

What are the serum iron and TIBC results in IDA?

A

decreased iron

increased TIBC

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18
Q

What is the specific cause of thalassemia?

A

decreased rate of synthesis of either Alpha or Beta chain

inherited not normal

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19
Q

What is another name for homozygous alpha thalassemia?

Heterozygous alpha thalassemia?

A
  • Bart’s Disease

- Hemoglobin H Disease

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20
Q

What causes relative polyycthemia?

A

stress, dehydration, severe burns, plasma volume is decreased

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21
Q

What are the typical laboratory findings in acute leukemia:

Auer rods and a positive peroxidase stain:

A
  • anemia, thrombocytopenia, young cells

- AML

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22
Q

What type of leukemia is indicated by the following:

Positive periodic acid-Schiff(PAS) stain:

A

ALL

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23
Q

What type of leukemia is indicated by the following:

Positive chloroacetate esterase staind:

A

AMML

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24
Q

What type of leukemia is indicated by the following:

presence of myelomonocyes:

A

Naegli’s or AMML

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25
Q

What type of leukemia is indicated by the following:

presence of the Philadelphia chromosome

A

CML

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26
Q

What type of leukemia is indicated by the following:

“hypermature lymphs” and smudge cells

A

CLL

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27
Q

What type of leukemia is indicated by the following:

extreme thrombocytosis

A

CML

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28
Q

What type of leukemia is indicated by the following:

increased incidence of bleeding disorders (i.e. DIC)

A

APL

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29
Q

What leukemia is most frequently seen in patients over the age of 50?

A

CLL

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30
Q

What type of cells might be expected to be found in the bone marrow of a leukemic patient?

A

same cells as in PBS (acute = blasts, CML = all stages of granulocytes)
except IM

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31
Q

What is the “end stage” of DiGuglielmo’s syndrome

A

AML

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32
Q

What condition would be described as acute granulocytopenia?

A

severe neutropenia

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33
Q

What are the laboratory findings in Hodgkin’s disease

A

Increased Eos (Leukomoid reaction with eosinophilia), decreased lymphs, Reed Sternberg cell

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34
Q

What are the laboratory findings in multiple myeloma

A

occasional plasma cell, Bence Jones protein, rouleaux, increased sed rate

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35
Q

What is the L.E. factor?

A

anti-nucleoprotein

IgG antibody

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36
Q

How is a Downey cell described?

A

Atypical lymph in IM- scalloping around RBC, blue at edges

AKA Reactive Lymphocyte

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37
Q

What disease is indicated by a positive ANA?

A

SLE (Lupus)

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38
Q

With what conditions is a decreased LAP associated?

A

CML, AML, increased Leukomoid reactions

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39
Q

What are the causes of bleeding?

A

trauma, decreased clotting factor synthesis, DIC, increased utilization of clotting factors, genetic defects

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40
Q

What is the immediate response to vessel injury?

A

vasocontriction

41
Q

What comprises the initial plug in the wall of an injured vessel?

A

platelets

42
Q

What is meant by platelet adhesion

A

sticks to surfaces

43
Q

What is meant by Platelet aggregation

A

platelets stick to each other

44
Q

Which platelet factor is most instrumental in the clotting process?

A

Factor 3

45
Q

Intrinsic factors

A

XII XI IX VIII X V II I
12 11 9 8 10 5 2 1
(NOT 7)

46
Q

Extrinsic factors

A

VII X V II I

7 10 5 2 1

47
Q

Factors in common

A

X V II I

10 5 2 1

48
Q

Vitamin K dependent factors

A

II VII IX X

2 7 9 10

49
Q

Which factor NOT made in the liver is increased in liver disease?

A

VIII (8)

50
Q

Labile factors

A

V VIII

5 & 8

51
Q

Adsorbed plasma factors

A

V VIII XI XII (I)

5 8 11 12 (1)

52
Q

Aged serum factors

A

VII IX X XI XII (II)

7 9 10 11 12 (2)

53
Q

Factors which have an enzymatically active form

A

NOT 5 8

54
Q

Components of thromboplastin

A

Activated factor X
platelet factor 3
Calcium
Factor V

55
Q

End result of Stage I

A

Plasma thromboplastin

56
Q

. End result of Stage II

A

thrombin

57
Q

End result of Stage III

A

fibrin

58
Q

Substance which initiates the extrinsic system

A

tissue factor 3

+ thromboplastin

59
Q

Substance which initiates the intrinsic system

A

platelet factor 3, Plasma Factor XII (12), contact with exposed collagen

(NOT by Tissue Factor III!)

60
Q

Precursor of thrombin

A

prothrombin

61
Q

Substance which converts fibrinogen to fibrin

A

thrombin

62
Q

Activated substance responsible for clot lysis

A

plasmin (activated)

63
Q

Final end products of the breakdown of fibrin and of fibrinogen

A

frag 1E

2 D frag

64
Q

Components which are depleted in DIC

A

I V VIII

platelet factor 3

65
Q

Factor deficiency that would be incompatible with life

A

IV (calcium)

66
Q

Principle of the coagulyzer (or MLA)

A

formation of clot changes ocular density of light detected by photoelectric cell

67
Q

Principle of the Fibrometer

A

completion of electrical circuit due to formation of clot

68
Q

Know the principle and the normal values for the various coagulation tests:

Tourniquet test

A

capillary fragility

69
Q

Know the principle and the normal values for the various coagulation tests:

Thrombin time

A

availability of fibrinogen

15-20 sec

70
Q

Know the principle and the normal values for the various coagulation tests:

Lee-White clotting time (use)

A

monitoring heparin therapy, detect intrinsic defects

71
Q

Know the principle and the normal values for the various coagulation tests:

Prothrombin consumption test

A

Measures amount of prothrombin remaining in serum after clotting

72
Q

Know the principle and the normal values for the various coagulation tests:

Fibrinogen (normal values)

A

200-400 mg/dl

73
Q

Know the principle and the normal values for the various coagulation tests:

Clot retraction (factors which influence it)

A

fibrinogen level, platelet count, thrombosthenin VI
Platelet function test only if fibrinogen level is normal, normal platelet count, thombosthenin produced by platelets is present. (Normal HCT?)

74
Q

Know the principle and the normal values for the various coagulation tests:

PT (What deficiency is it especially sensitive to?)

A

deficiency in factor VII

75
Q

Know the principle and the normal values for the various coagulation tests:

PTT (What abnormalities could be indicated by an PTT?)

A

liver disease
Hemophilia A & B
**Any intrinsic defect, no platelet abnormality. Cannot detect platelet abnormality

76
Q

Know the principle and the normal values for the various coagulation tests:

Plasma recalcification time

A

Amount of time required for a clot to form in plasma (add Ca to plasma, time to clot)

77
Q

Know the principle and the normal values for the various coagulation tests:

Stypven time (factor for which it is most useful for diagnosis of deficiency)

A

Russels viper venom - factor VII

78
Q

Know the principle and the normal values for the various coagulation tests:

Substitution testing(how to use adsorbed plasma & aged serum)

A

know what factors increase PT & PTT

79
Q

Know the principle and the normal values for the various coagulation tests:

Euglobulin lysis (use)

A

fibrinolysis measure

80
Q

Know the principle and the normal values for the various coagulation tests:

ThromboWellco test (especially normal values)

A

If agglutination occurs:
in 1:5 dilution but not in 1:20: FDP >1040
in neither:

81
Q

Know the principle and the normal values for the various coagulation tests:

TGT (use of adsorbed plasma & aged serum)

A

Thromboplastin generation time
Know factors for increased
not factor 7

82
Q

Know the principle and the normal values for the various coagulation tests:

5 M urea test (what factor does it detect?)

A

only factor 13

83
Q

Know the principle and the normal values for the various coagulation tests:

Tests useful in the diagnosis of DIC

A

jbleeding time, abnormal PT/PTT, fibrinolysis, 1,5,8 platelets

84
Q

Know the principle and the normal values for the various coagulation tests:

Effect of asprin on testing (esp. BT and Saltzman glass bead test)

A

increased BT, abnormal glass bead test

85
Q

Know the characteristics and laboratory results for the following diseases:

Hemophilia A

A

Deficiency of VIII
sex-linked recessive
increased PTT (NOT PT)

86
Q

Know the characteristics and laboratory results for the following diseases:

Hemophilia B

A

Christmas disease
Deficiency of factor IX
Increased PTT
Clinically cannot be distinguished from Hemophilia A

87
Q

Know the characteristics and laboratory results for the following diseases:

VonWillebrand’s disease

A

increased PTT, abnormal bleeding time (Factor VIII def)

Bleeding time distinguishes Hem A from VonWillebrands

88
Q

Know the characteristics and laboratory results for the following diseases:

ITP

A

due to anti-platelet Ab, increased bleeding time, decreased platelets, pinpoint hemorrhages petechiae BM increased megacaryocytes

89
Q

Know the characteristics and laboratory results for the following diseases:

Glanzmann’s thrombasthenia

A

Defect in platelet aggregation - abnormal platelet function

90
Q

Know the characteristics and laboratory results for the following diseases:

Hereditary telangiectasia

A

vascular defect

91
Q

Know the characteristics and laboratory results for the following diseases:

Parahemophilia

A

factor V def

92
Q

What is the mode of action of the common anticoagulants coumadin and heparin?

What tests are used to monitor them?

A

Coumadin: anti-Vitamin K
heparin: neutralized/inactivates thrombin

  • coumadin: PT
    heparin: PTT
93
Q

What level (expressed as a percentage of normal) must be reached for a clotting factor to cause an abnormality in coagulation?

A

30-40%

norm 50-150%

94
Q

What is anti-thrombin III?

A

Heparin cofactor needs anti-thrombin to be bound, wouldn’t work without it

95
Q

Name a test that will distinguish between primary and secondary fibrinolysis.

A

D-Dimer

96
Q

What factors are removed when plasma is adsorbed?

A

vitamin K dependent factors II VII IX X

97
Q

What reagents can be used to prepare adsorbed plasma?

A

barium sulfate or aluminum hydroxide

98
Q

What is viscous metamorphosis?

A

irreversible aggregation of platelets

1st aggregation is reversible 2nd is irreversible

99
Q

What plasminogen activators are now being used to treat heart attack and stroke victims?

A

streptokinase, urokinase, TPA if stroke within 4hrs

Hemotology/Hemostasis (8 decks)

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