HEMA Sir Stephen Flashcards
- Anticoagulant of choice for platelet coagulation studies
A. Citrate
B. EDTA
C. Heparin
D. Oxalate
A. Citrate
Coagulation = Citrate
Counting - EDTA
3.2% and 3.8% types of Citrate
- A structure found in WBCs that can be used to determine the sex of an individual.
A. Granules
B. Barr body
C. Mitochondria
D. Chromatin
B. Barr body
SEX = especially women since they only consist of XX chromosome
Based on Staininger and Terjon
- All of the statements are true regarding platelets except:
A. It is a non-nucleated cell that contains granules in the cytoplasm
B. It originated from the bone marrow
C. It came from the megakaryocyte nucleus
D. It looks like a common debris on a peripheral blood smear.
C. It came from the megakaryocyte nucleus
It came from cytoplasm - cell membrane - shedding
B. It originated from the bone marrow - specifically in MEGAKARYOCYTES
- The APTT reagent consists of two components which are:
A. Barium sulfate and aluminum hydroxide
B. Thromboplastin and Calcium chloride
C. Platelet substitute and an activator
D. Thromboplastin and an activator
C. Platelet substitute and an activator
A. are adsorbable reagents
From Staininger Book:
APTT = R1 - Platelet Substitute (brain/ plant phospholipid)
= R2 - Activator (Kaolin, Celite, Silica, Ellagic Acid)
PT = R1 - Thromboplastin (rabbit brain/ lung tissue)
= R2 - Calcium Chloride
- The smallest leukocyte is:
A. Lymphocyte
B. Eosinophils
C. Monocyte
D. Neutrophils
A. Lymphocyte
especially SMALL Lymphocyte
- Another name for juveniles (neutrophils)
A. Myelocyte
B. Metamyelocyte
C. Stab
D. Band
B. Metamyelocyte
C and D are same since Stab is also called Band or Staff
- Diluent for WBC count:
A. Gowers
B. Drabkins
C. NSS
D. None of the above
D. None of the above
Hypotonic Solution:
2% Acetic Acid
1% HCl
Turk’s
Gowers and NSS - RBC
Drabkins - Hgb
- 1% ammonium oxalate in distilled water is a type of diluent for what type of a cell count
A. Platelet
B. Eosinophil
C. Reticulocyte
D. WBC
A. Platelet
1% ammonium oxalate IS ONLY FOR PLATELET
- All of the following are consistent with leukemoid reaction except:
A. Auer rods
B. Leukocytosis
C. Immature granulocytes
D. Increased LAP score
E. Toxic granulations
A. Auer rods
- Which of these EDTA concentrations is recommended for complete anticoagulation without cellular alteration
A. 0.5mg/ml
B. 1.0mg/ml
C. 1.5mg/ml
D. 2.0mg/ml
C. 1.5mg/ml
- High molecular weight kininogen is also known as:
A. Extrinsic factor
B. Passavoy factor
C. Fletcher factor
D. Fitzgerald factor
D. Fitzgerald factor
Fletcher = PK
- The activated partial thromboplastin time (APTT) is used as a screen for the laboratory evaluation of inherited or acquired deficiencies in the:
A. Extrinsic pathway of coagulation cascade
B. Intrinsic pathway of coagulation cascade
C. Platelets
D. Vascular system
B. Intrinsic pathway of coagulation cascade
Pneumonics:
APTT = Titi (pinapasok)
PT = Tennis (labas)
Platelets and Vascular = bleeding & clotting time
- Based on the following data, what is the most likely factor deficiency?
PT Normal
APTT Prolonged
APTT + normal plasma Correction
APTT + adsorbed plasma No correction
APTT + aged serum Correction
A. Factor V
B. Factor VII
C. Factor IX
D. Factor XI
C. Factor IX
- Calculate the WBC count if blood is drawn to the 1.0 mark in a WBC diluting pipette and a total of 150 WBCs are counted in 4 large squares.
A. 37x109/L
B. 375x109/L
C. 3.75x109/L
D. 0.375x109/L
C. 3.75x109/L
150 x 10 x 10/ 4 = 3750
3.75 x 1000 = 3750
- A 50-year-old woman who has been receiving busulfan for 3 years for chronic myelogenous leukemia becomes anemic.
Laboratory tests reveal:
- Thrombocytopenia
- Many peroxidase-negative blasts cells in the peripheral blood
- Bone marrow hypercellular in blast transformation
- Markedly increased bone marrow TdT
Which of the following complications is this patient most likely to have?
A. Acute lymphocytic leukemia
B. Acute myelocytic leukemia
C. Acute myelomonocytic leukemia
D. Busulfan toxicity
A. Acute lymphocytic leukemia
CLUE: TdT common to ALL
- The recommended type of microscopy for the performance of MANUAL PLATELET COUNT is?
A. Electron
B. Dark field
C. Light
D. Phase contrast
D. Phase contrast
- To evaluate normal platelet numbers in an appropriate area of a blood smear, approximately how many platelets, should be observed per oil immersion field?
A. 1-4
B. 8-20
C. 4-10
D. 20-50
B. 8-20
- A patient has a history of mild hemorrhagic episodes. Laboratory results include a prolonged prothrombin time and activated partial thromboplastin time. The abnormal prothrombin time was corrected by normal and adsorbed plasma, but not aged serum. Which of the following coagulation factors is deficient?
A. Prothrombin
B. Factor V
C. Factor X
D. Factor VII
B. Factor V
- The abnormal APTT seen in pathological circulating anticoagulants is:
A. Corrected with aged serum
B. Corrected with adsorbed plasma
C. Corrected with normal plasma
D. Not corrected with any of the above
D. Not corrected with any of the above
- Which of the following laboratory results would be seen in a patient with acute disseminated intravascular coagulation (DIC)?
A. prolonged PT, elevated platelet count, decreased FDP
B. normal PT, decreased fibrinogen, decreased platelet count, decreased FDP
C. prolonged PT, decreased fibrinogen, decreased platelet count, increased FDP
D. normal PT, decreased platelet count, decreased FDP
C. prolonged PT, decreased fibrinogen, decreased platelet count, increased FDP
- The Philadelphia chromosome is associated with
A. chronic granulocytic leukemia
B. chronic lymphocytic leukemia
C. multiple myeloma
D. acute granulocytic leukemia
A. CGL
A normal bleeding time by the Ivy method falls in what range?
A. 1-3 minutes
B. 5-10 minutes
C. 1-6 minutes
D. 3-5 minutes
C. 1-6 minutes
- PARAHAEMOPHILIA is due to a deficiency of factor
A. II
B. V
C. VII
D. IX
B. V
aka Owren’s syndrome or disease
- Type of Pelger Huet Anomaly usually seen at what state?
A. Heterozygous
B. Dominant
C. Recessive
D. Homozygous
A. Heterozygous
Heterozygous is dominant
Homozygous is rare
- Describes the morphology of Pelger Huet Anomaly
A. Giant lysosomal granules
B. More than 5 lobes
C. Pince nez appearance
D. Pale blue cytoplasmic granules
C. Pince nez appearance
A = Chediak
B = Undritz
D = Dohle bodies
- Deficiency of sphingomyelinase in MACs
A. Gaucher cell
B. Niemann Pick Disease
C. Fabry’s Disease
D. Tay Sach’s Disease
B. Niemann Pick Disease
A = B-Glucosidase
D = Hexosaminidase A
- First factor affected by Coumarin
A. VII
B. VIII
C. V
D. X
A. VII
But it also the prothrombin or vitamin K– dependent: II, VII, IX, and X
- Factor affected when plasma is stored
A. VII
B. X
C. VIII
D. HMWK
C. VIII
Labile Factors: V and VIII
- Describes a well-made blood film
A. Used 1 mm drop of blood
B. Covered 1/3 of the slide
C. Gradual transition from thick to thin
D. Greasy
C. Gradual transition from thick to thin
- Gradual transition
- Smear 1/2 to 2/3 to 3/4
- NO overlapping
- Feathery edge
- Small drop in middle
- Distance: 1 cm/ 0.25 in.
- Angle: 30-45 deg.
- Drop of blood: 2-3 mm
- Poor blood smear = too large/ too small drop of blood
- Identify ANLL type: >30% of non-erythroid cells. 50% erythrocytes
A. M2
B. M3
C. M6
D. M5
C. M6
M6 = INCREASED
M4 - decrease
M5 = decrease
- Which of the following is contained in the primary granules of the neutrophil?
A. Lactoferrin
B. Myeloperoxidase
C. Histamine
D. Alkaline phosphatase
B. Myeloperoxidase
A = Secondary
D = SV
Lysosome = Tertiary
- Disseminated intravascular coagulation (DIC) is most often associated with which of the following types of acute leukemia?
A. Acute myeloid leukemia without maturation
B. Acute promyelocytic leukemia
C. Acute myelomonocytic leukemia
D. Acute monocytic leukemia
B. Acute promyelocytic leukemia
DIC = M3 or Faggot cell
- In essential thrombocythemia, the platelets are:
A. Increased in number and functionally abnormal
B. Normal in number and functionally abnormal
C. Decreased in number and functional
D. Decreased in number and functionally abnormal
A. Increased in number and functionally abnormal
- Which of the following initiates IN VIVO COAGULATION by activation of FACTOR VII?
A. Protein C
B. Tissue factor
C. Plasmin activator
D. Thrombomodulin
B. Tissue factor
- ASPIRIN prevents platelet aggregation by inhibiting the action of which enzyme?
A. Phospholipase
B. Cyclo-oxygenase
C. Thromboxane A2 synthetase
D. Prostacyclin synthetase
B. Cyclo-oxygenase
PROBLEM: If OVERDOSED can affect PLATELET FUNCTION
- Which of the following is associated with MULTIPLE FACTOR DEFICIENCIES?
A. An inherited disorder of coagulation
B. Severe liver disease
C. Dysfibrinogenemia
D. Lupus anticoagulant
B. Severe liver disease
- Which statement regarding protein C is correct?
A. It is a vitamin K–independent zymogen
B. It is activated by fibrinogen
C. It activates cofactors V and VIII
D. Its activity is enhanced by protein S
D. Its activity is enhanced by protein S
protein C regulates coagulation which is helped by protein S
- A Miller disk is an ocular device used to facilitate counting of:
A. Platelets
B. Reticulocytes
C. Sickle cells
D. Nucleated red blood cells (NRBCs)
B. Reticulocytes
Miller disk makes it easier and faster to count
- What is the normal value of MCH?
A. 80-100 fL
B. 27-32 fL
C. 80-100 pg
D. 27-32 pg
D. 27-32 pg
80-100 fL = MCV
32-36 g/dL = MCHC
- Abnormal Cells seen in Hodgkin’s lymphoma.
A. Reed-Sternberg Cell
B. Alder Reily
C. Auer Rods
D. May Hegglin Bodies
A. Reed-Sternberg Cell
Reed-Sternberg Cell - looks like OWL’s EYE
From RODAK’s
- Stage in megakaryocytic series where thrombocytes are already visible.
A. Megakaryoblast
B. Promegakaryocyte
C. Megakaryocyte
D. Metamegakaryocyte
D. Metamegakaryocyte
From Staininger
- Coagulation Factors that are members of the contact group.
A. High Molecular Weight Kininogen
B. Pre-Kallikrein
C. Factor XI
D. All of the above
D. All of the above
Namely: XI, XII, prekallikrein, and high-molecular-weight kininogen.
- Coagulation factors that are members of the prothrombin group.
A. Factor II
B. Factor VII
C. Factor IX
D. All of the above
D. All of the above
Namely: Factors II, VII, IX, and X
- WBC anomaly that is characterized as having ineffective phagocytosis and recurrent fungal infection?
A. Dohle Bodies
B. Alder-Reilly Granules
C. Chediak Higashi Granules
D. Job Syndrome
C. Chediak Higashi Granules
Characteristics:
Do not eat
Giant lysosomal granules
A = inclusion body to other inflammation
B = mucopolyssacharides
- Which of the following if deficient would cause clinically significant bleeding?
a. prothrombin
b. Cofactors
c. Contact factors
d. A and C
a. prothrombin
- Which of the following has multiple autocatalytic functions and is considered as the key protease of the coagulation pathway?
a. Fibrinogen
b. Thrombin
c. Stuart Prower
d. Hageman
b. Thrombin
HEART of coagulation
- What is the color of the vacuum tube stopper that is used for blood collection for PCR?
a. Pink
b. Purple
c. Tan
d. White
B. Purple
Purple = CBC, EDTA
Pink = BB
Tan = Lead Poisoning
White = Mol. Bio
Difference of Pink and Purple top = PINK has LABEL
- The Philadelphia chromosome
a. Translocation between long arm of 12 and 9
b. Translocation between long arm of 9 and 22
c. Translocation between short arm 9 and 22
d. Translocation between short arm 12 and 9
b. Translocation between long arm of 9 and 22
- Which is a character of an ideal blood film.
I – The film is 2/3 to ¾ the length of slide.
II - The film formed a bullet shape.
III – The feather edge contain a rainbow edge.
IV - The films contains holes on sides.
a. I, III
b. I, II
c. I, IV
d. II, IV
a. I, III
- Most common Leukemia found in children.
a. Acute granulocytic
b. Acute Lymphocytic
c. Acute monocytic
d. Chronic granulocytic
b. Acute Lymphocytic
Acute Lymphocytic = 80%
Acute granulocytic = 20%
