Hema Flashcards by Yormae Quezon

In vivo and in vitro anticoagulant (natural anticoagulant)-

Heparin

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marker for hematopoietic stem cells

CD 34

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Hemoglobin synthesis:

Polychromatophilic normoblast to reticulocyte

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Generates ATP:

Embden-Meyerhof pathway

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Generates 2,3-DPG:

RapoportLeubering pathway

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Includes enumeration of cellular elements, quantitation of hemoglobin, and statistical analyses th

COMPELETE BLOOD COUNT (CBC) or HEMOGRAM

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Hormone produced by hepatocytes to REGULATE BODY IRON LEVELS, particularly absorption of iron in the intestine and release of iron from macrophages

HEPCIDIN

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Detects myelocytic cells by staining cytoplasmic granular contents

MYELOPEROXIDASE (MPO):

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: Detects lymphocytic cells and certain abnormal erythrocytic cells by staining of cytoplasmic glycogen

PERIODIC ACID–SCHIFF (PAS)

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Distinguish myelocytic from monocytic maturation stages (several esterase substrates)

ESTERASES

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Detects tartrate-resistant acid phosphatase granules in hairy cell leukemia

TARTRATE-RESISTANT ACID PHOSPHATASE:

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Corrected WBC count

•Adult ≥5 NRBCs/100 WBC differential
Neonate ≥10 NRBCs/100 WBC differential

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EXAMINATION OF FILM OF FRESH CAPILLARY BLOOD

Poor man’s platelet aggregation

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EXAMINATION OF FILM OF FRESH CAPILLARY BLOOD

Poor man’s platelet aggregation

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Presence of Philadelphia chromosome in CML:

BETTER PROGNOSIS

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Absence of Philadelphia chromosome in CML:

POOR PROGNOSIS

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routine dilution of 1:20

Manual WBC count:

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Darkly staining mass of sex chromosome attached to the end of the nucleus of somatic cells:

BARR BODIES

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First layer of spun hematocrit: FATTY LAYER (barely visible unless lipemic)
Second layer: PLASMA
Third layer: BUFFY COAT (1 mm = 10,000 WBCs/cu.mm)• Bottom layer: PACKED CELLS

SPUN HEMATOCRIT

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Differentiates acute myelogenous and MONOCYTIC leukemias from acute lymphocytic leukemia:

PEROXIDASE

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Differentiates acute myelogenous and MYELOMONOCYTIC leukemias from acute lymphocytic leukemia:

SUDAN BLACK B

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Precipitation of RIBOSOMES and RNA

BASOPHILIC STIPPLING/ PUNCTATE BASOPHILIA

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remnant of microtubules of mitotic spindle

CABOT RINGS

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blood, bright red color

OXYHEMOGLOBIN (HbO2)

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venous blood, purplish red color

DEOXYHEMOGLOBIN (HbCO2):

cherry red color, formation is reversible

CARBOXYHEMOGLOBIN (HbCO)

chocolate reversible

METHEMOGLOBIN/HEMIGLOBIN (Hi)

mauve lavender, formation is IRREVERSIBLE

SULFHEMOGLOBIN

The PERIPHERAL FILM EVALUATION IS THE CAPSTONE of a panel of tests called the

COMPLETE BLOOD COUNT (CBC) or HEMOGRAM.

The rule of three specifies that the value of the hematocrit should be three times the value of the hemoglobin plus or minus________ . A value discrepant with this rule may indicate abnormal red blood cells or it may be the first indication of error.

3 (%) or 0.03 (L/L)

used to assess the ERYTHROPOIETIC ACTIVITY OF THE BONE MARROW, is accomplished through the use of supravital stains (e.g., new methylene blue) or by flow cytometric methods.

RETICULOCYTE COUNT

defined conventionally as a DECREASE IN RBCS, HEMOGLOBIN, and HEMATOCRIT below the reference interval for healthy individuals of the same age, sex, and race, under similar environmental conditions.

ANEMIA

Diagnosis of anemia is based on

history, physical examination, symptoms, and laboratory test results.

Laboratory procedures helpful in the INITIAL DIAGNOSIS OF ANEMIA include the

complete blood count (CBC) with RBC indices and the red blood cell distribution width (RDW), reticulocyte count, and examination of the peripheral blood film with morphology.

manifestation emphasis on RBC ANOMALY is of a the mucopolysaccharidosis characterized by metachromatic granules in leukocytes, which can be confused with toxic granulation.

ALDER-REILLY ANOMALY

is an inherited lethal disorder characterized by giant lysosomes in granular cells and dysfunctional leukocytes.

CHEDIAK-HIGASHI SYNDROME

is characterized by thrombocytopenia, giant platelets, and Döhle body–like inclusions in leukocytes.

MAY-HEGGLIN ANOMALY

is an inherited disorder of the NADPH oxidase system resulting in neutrophils that are incapable of killing many microorganisms due to a failure in the respiratory burst, which is necessary to produce antibacterial agents.

CHRONIC GRANULOMATOUS DISEASE

stains primary granules and is useful in differentiating granulocytic from lymphoid cells.

MYELOPEROXIDASE (MPO)

stains lipids and results PARALLELthose with the MPO stain.

SUDAN BLACK B (SBB)

help differentiate granulocytes and their precursors from cells of monocytic origin - Butyrate esterase testing gives positive results in monocytes but not in granulocyte precursors -Naphthol esterase precursors.AS-D stains

ESTERASES

is caused by the lack of expression of GP Ib/IX/V complexes on the platelet surface. This receptor complex is responsible for platelet adhesion and its absence results in a severe bleeding disorder.

BERNARD-SOULIER SYNDROME

is caused by the lack of expression of GP IIb/IIIa complexes on the platelet surface. This complex is known as the platelet aggregation receptor, and its absence is associated with a severe bleeding disorder.

GLANZMANN THROMBASTHENIA

If evacuated tubes are stored at low temperature, the pressure of the gas inside the tube will ________. This would lead to an ________ in draw volume for the evacuated tube. Conversely, higher temperatures could cause reductions in draw volume.

decrease; increase

If evacuated tubes are stored at low temperature, the pressure of the gas inside the tube will decrease. This would lead to an increase in draw volume for the evacuated tube. Conversely, higher temperatures could cause reductions in draw volume.

Low temperature – increase in draw volume• High temperature – decrease in draw volume

Shelf life of an evacuated tube is defined by the STABILITY OF THE ADDITIVE, as well as VACUUM RETENTION. Most evacuated tubes on the market have AT LEAST A ___________.FACTORS THAT INTERFERE WITH THE VALIDITY OF CLOT-BASED TEST RESULTS

12-MONTH SHELF LIFE

BLOOD COLLECTION VOLUME LESS THAN SPECIFIED MINIMUM

PT falsely prolonged; recollect specimen.

HEMATOCRIT ≥55%

Adjust anticoagulant volume using formula and recollect specimen anticoagulant volume.

CLOT IN SPECIMEN

All results are affected unpredictably; recollect specimen.

CLOT IN SPECIMEN

All results are affected unpredictably; recollect specimen.

VISIBLE HEMOLYSIS

PT falsely shortened; recollect specimen.

ICTERUS OR LIPEMIA

Measure PT coagulometer.

Use reagent known to be insensitive to heparin or one that includes a heparin neutralizer such as polybrene.

HEPARIN THERAPY

PT result is invalid; use chromogenic factor X assay instead of PT.

LUPUS ANTICOAGULANT

INCORRECT CALIBRATION, INCORRECT DILUTION OF REAGENTS.

Correct analytical error and repeat test

Characterized by increased platelets and megakaryopoiesis; however, platelets may not function normally

Essential Thrombocythemia

Mature B-cell disorder with an indolent course. CBC shows elevated WBC counts with a predominance of small lymphoid cells, usually with dense, hypermature nuclei and little cytoplasm, and smudge frequently seen

Chronic Lymphocytic Leukemia (CLL)/Small Lymphocytic Lymphoma

Chronic B-cell neoplasm with lymphocytes showing threadlike or “hairy”projections

Hairy Cell Leukemia (HCL)

Flow cytometry is positive for

CD 19 CD20 CD22 CD11c CD25 CD103

Positive for tartrate-resistant acid phosphatase (TRAP) stain

Hairy lymphocytes may be seen

is the most specific marker for HCL, in addition to being positive for DBA

Annexin A1

is the most specific marker for HCL, in addition to being positive for DBA

Annexin A1

is the most specific marker for HCL, in addition to being positive for DBA

Annexin A1

The presence of hypochromic cells and normochromic cells in the same film is called anisochromia or, sometimes_________. This characteristic is of SIDEROBLASTIC also is found ANEMIAS but some weeks after IRON THERAPY FOR IRON DEFICIENCY ANEMIA, or in a hypochromic anemia AFTER TRANSFUSION with normal cells

DIMORPHIC ANEMIA

Caused by traumatic cardiac hemolysis (RBC fragmentation from damaged valves) or or prosthetic cardiac exercise-induced hemolysis (mechanical trauma from forceful impact on feet or hands or strenuous exercise)

MACROANGIOPATHIC ANEMIA:HEMOLYTIC

Characterized by the shearing of RBCs as they pass through small blood vessels partially blocked by microthrombi Fragmented RBCs (called schistocytes) are formed, and the premature RBC destruction results in hemolytic anemia. Ischemic injury to the brain, kidney, and other organs also occurs.

MAHA