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hematology > final exam > Flashcards

final exam 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

D. Latum infections
ovalocytes: pernicious anemia
b12 deficiency
liver disease

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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 (vitamin b12 deficiency)?

A

pancytopenia
oval macrocytes
hypersegs (shift to right)

BM: megaloblasts, WBC precursors

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5
Q

what is the Schilling test anew hat 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
if 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

LARGER THEN 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

cell membrane

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8
Q

what are the distinguishing characteristics of hereditary ovalocytosis

A

normal central pallor
ovalocytes
don’t need BM to confirm and 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 (DAT)

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10
Q

what poikilocyte is associated with ABO HDN

A

spherocytes

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11
Q

what poikilocyte is associated with extremedullary hematopoiesis

A

teardrop cells

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12
Q

what are the laboratory findings in PCH

A

= sugar water test and hams test
+ DAT
+ donate landsteiner (which is an ab)
symptoms after exposure to cold

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13
Q

what are the hemoglobin electrophoresis results in sickle cell anemia?

A

has Hgb S, F

no Hgb A

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14
Q

what hemoglobin is insoluble in reducing agents such as sodium dithionite and sodium metabisulfite?

A

Hgb S

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15
Q

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

A

beta chain

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16
Q

what does the PBS of a patient with sickle cell trait usually have?

A

target cells

everything else is normal

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17
Q

what does the PBS of a patient with IDA show?

A

pale microcytic hypochromic cells

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18
Q

what are the serum ion and TIBC results in IDA?

A

decreased iron

increased TIBC

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19
Q

what its he specific cause of thalassemia

A

decreased rate of synthesis of either alpha or beta chain inherited not normal

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20
Q

what is another name for homozygous alpha thalassemia?

A

barts disease

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21
Q

what is another name for heterozygous alpha thalassemia?

A

Hemoglobin H disease

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22
Q

what causes relative polycythemia

A 
increased erythropoietin
stress
dehydration
severe burns
plasma volume is decreased
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23
Q

what are the typical laboratory findings in acute leukemia?

A

anemia
thrombocytopenia
normal plt. and RBC are not consistent with acute leukemia
young cells

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24
Q

what type of leukemia is indicated by auer rods and a positive peroxidase stain?

A

AML

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25
Q

what type of leukemia is indicated by positive PAS (periodic acid-schiff) stain?

A

ALL

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26
Q

what type of leukemia is indicated by positive chloroacetate esterase stain? (specific)

A

AMoL (schilling’s)

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27
Q

what type of leukemia is indicated by presence of myelomonocytes

A

AMML ( Naegli’s)

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28
Q

what type of leukemia is indicated by presence of philadelphia chromosome?

A

CML

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29
Q

what type of leukemia is indicated by hypermature lymphs and smudge cells?

A

CLL

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30
Q

what type of leukemia is indicated by extreme thrombocytosis?

A

CML

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31
Q

what type of leukemia is indicated by increased incidence of bleeding disorders (i.e DIC)

A

APL

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32
Q

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

A

CLL

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33
Q

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

A

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

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34
Q

what is the end stage of Diguglielmo’s syndrome?

A

AML

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35
Q

what condition would be described as acute granulocytopenia?

A

severe neutropenia

agranulocytosis

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36
Q

what are the laboratory findings in Hodgkin’s disease?

A

increased monos
increased eos (leukomoid reacting with eosinophilia)
decreased lymphs
reed sternberg cells

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37
Q

what are the laboratory findings multiple myeloma?

A

rouleaux
occasional plasma cell
bence jones protein
increased sed rate

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38
Q

what is the L.E. factor?

A

IgG antibody

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39
Q

how is a downey cell described?

A

scalloping around RBC
blue at edges
AKA reactive lymphs

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40
Q

what disease is indicated by a positive ANA?

A

SLE (lupus)

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41
Q

with what conditions is a decreased LAP associated?

A

CML
AML
increased leukomoid reactions

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42
Q

what are the causes of bleeding?

A

trauma
decreased clotting factor synthesis
DIC
genetic defects

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43
Q

what is the immediate response to vessel injury?

A

vasoconstriction

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44
Q

what compromises the initial plug in the wall of an injured vessel?

A

platelets

45
Q

what is meant by platelet adhesion?

A

sticks to surfaces

46
Q

what is meant by platelet aggregation?

A

platelets stick to each other

47
Q

which platelet factor is most instrumental in the clotting process

A

factor 3

48
Q

factor VIII

A

hemophilia A

49
Q

factor IX

A

hemophilia B

christmas factor

50
Q

Factor X

A

stuart prower

51
Q

Factor XI

A

plasma thromboplastin anticedient

52
Q

Factor XII

A

Hageman’s Factor

53
Q

intrinsic factors

A

12 11 9 8 10 5 2 1

54
Q

extrinsic factors

A

7 10 5 2 1

55
Q

factors in common of intrinsic and extrinsic

A

10 5 2 1

56
Q

Vitamn K dependent factors

A

2 7 9 10

57
Q

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

A

Factor VIII (8)

58
Q

labile factors

A

5 8

59
Q

adsorbed plasma factors

A

5 8 11 12 (1)

60
Q

aged serum

A

2 7 9 10 11 12

61
Q

factors which don’t have an enzymatically active form

A

NOT 5 8

62
Q

components of thromboplastin

A

activated factor X
platelet factor 3
calcium
factor V

63
Q

end result of stage I

A

plasma thromboplastin

64
Q

end result of stage II

A

thrombin

65
Q

end of stage III

A

fibrin

66
Q

substance which initiates the extrinsic system

A

tissue factor 3

tissue thromboplastin

67
Q

substance which initiates the intrinsic system

A

platelet factor 3

68
Q

precursor of thrombin

A

prothrombin

69
Q

substance which converts fibrinogen to fibrin

A

thrombin

70
Q

activated substance responsible for clot lysis

A

plasmin (activated)

71
Q

final end products of the breakdown of fibrin and fibrinogen

A

frag 1E

2 D frag

72
Q

components which are depleted in DIC

A

I V VIII

platelet factor 3

73
Q

factor deficiency that would be incompatible with life

A

IV calcium

74
Q

principle of the coagulyzer (or MLA)

A

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

75
Q

principle of the fibrometer

A

completion of electrical circuit due to formation of clot

76
Q

bleeding time (duke and ivy method)

A

Duke: earlobe 1-3 minutes
Ivy: forearm 1-7 minutes

77
Q

tourniquet test

A

for capillary fragility

78
Q

thrombin time

A

availability of fibrinogen (factor 1)

15-20 seconds

79
Q

Lee-white clotting time (use)

A

monitoring heparin therapy, detect intrinsic defects

80
Q

prothrombin consumption test (use)

A

measures amount of prothrombin remaining in serum after clotting

81
Q

fibrinogen (normal values)

A

200-400 mg/dl

82
Q

clot retraction (factors which influence it)

A

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

83
Q

PT (what deficiency is it especially sensitive to)

A

deficiency in factor VII

84
Q

PTT (what abnormalities could be indicated by an increased PTT)

A

liver disease
Hemophilia A & B
** any intrinsic defect, no platelet abnormality. cannot detect platelet abnormality

85
Q

plasma recalcification time

A

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

86
Q

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

A

Russels Viper Venom - Factor VII

87
Q

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

A

know what factors increase PT AND PTT

88
Q

Euglobulin lysis (use)

A

fibrinolysis measure

89
Q

thrombowellco test (especially normal values)

A

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

90
Q

TGT (use of adsorbed plasma and aged serum)

A

thromboplastin generation time

know factors for increased not factor 7

91
Q

5 M urea test (what factor does it detect)

A

only factor 13

92
Q

test useful in diagnosis of DIC

A

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

93
Q

effect of aspirin on testing (esp. BT and Saltzman glass bead test)

A

both prolonged
increased BT
abnormal decreased glass bead test

94
Q

Hemophilia A

A 
deficiency of VIII
sex-linked recessive
increased PTT (not PT)
95
Q

Hemophilia B

A

christmas disease
deficiency of factor IX
increased PTT
clinically cannot be distinguished from Hemophilia A

96
Q

VonWillebrand’s disease

A

increased PTT
increased bleeding time (factor VIII def)
bleeding time distinguishes Hem A from Von Willebrands

97
Q

idiopathic thrombocytopenic purpura

A 
due to anti-platelet Ab,
increased bleeding time
decreased platelets
pinpoint hemorrhages petechiae 
BM increased
megacaryocytes
98
Q

Glanzmann’s thrombasthenia

A

platelets are functionally defective

99
Q

Hereditary Telangiectasia

A

Vascular abnormality

100
Q

Parahemophilia

A

Factor V def

101
Q

what is the mode of action of the common anticoagulants coumadin and heparin

A

coumadin: anti-Vitamin K
heparin: neutralized/inactivated thrombin

102
Q

what tests are used to monitor them?

A

coumadin: PT
heparin: PTT

103
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%

104
Q

what is anti-thrombin III

A

natural anticoagulant required for heparin to work

105
Q

name a test that will distinguish between primary and secondary fibrinolysis

A

D-Dimer

106
Q

what factors are removed when plasma is absorbed?

A

vitamin K dependant factors 2 7 9 10

107
Q

BONUS

what reagents can be used to prepare adsorbed plasma

A

barium sulfate or aluminum hydroxide

108
Q

what is viscous metamorphosis?

A

irreversible aggregation of platelets
1st aggregate is reversible
2nd is irreversible

109
Q

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

A

streptokinase
urokinase
TPA- tissue plasminogen activator

hematology (9 decks)

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