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Hematologie Flashcards

1
Q

where is erythrocyte produced?

A

bone marrow (after the fetus is 7 months old)

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2
Q

where is granulocyte produced?

A

bone marrow

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3
Q

where is lymphocyte produced?

A

lymphoid tissu

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4
Q

where is platelets produced?

A

bone marrow

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5
Q

what is the function of erythrocyte?

A

transport oxygen

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6
Q

what is the function of granulocyte?

A

defense againts the bacterial infection

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7
Q

what is the function of lymphocyte?

A

cellular et humoral immunity

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8
Q

what is the function of platelet?

A

coagulation

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9
Q

what are the 3 types of lymphocyte?

A

T-lymp, B-lymp, NK cell

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10
Q

All hematopoietic cell start from what

A

Pluripotential hematopoietic stem cell (HSC) and then become multipopential progenitor cell (MPP)

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11
Q

Which cells fall under common myeloid progenitor?

A

granulocyte, erythrocyte, monocyte, megakaryocyte

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12
Q

which cells fall under common lymphoide progenitor?

A

t-lymph, b-lymph and NK cell

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13
Q

Name all of the embryonic hgb

A

Gower I, gower II and portland

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14
Q

1-2 months of gestation (fetus) where is the erythropoiesis is form (RBC + Hgb)

A

yolk sac (sac vitellin) and aorta-gonads-meonephros

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15
Q

3-6 months of gestation (fetus) where is the erythropoiesis is form (RBC + Hgb)

A

foie et rate

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16
Q

Changes during cell maturation

  • size
  • N:C ration
  • cytoplasm
  • nucleus
A
  • size : becomes smaller
  • N:C ration : becomes smaller
  • cytoplasm : less basophilic due to loss of RNA, granulocyte produces granules and erythrocyte becomes red because of hgb production
  • nucleus : becomes smaller, chromatin condenses, nucleoli disappear.
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17
Q

What stain we use for to see reticulum in reticulocyte?

A

supravital stain

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18
Q

cause of megaloblastic?

A

defiency in vitamin B12 or folic acide

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19
Q

type of megaloblastic anemia

A

pernicious anemia

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20
Q

what causes pernicious anemia

A

defiency vitamine B12

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21
Q

Characteristics of megaloblastic

A

RBC are oval macrocyte

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22
Q

Characteristics of iron deficiency anemia

A

RBC are micro and hypo

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23
Q

cause of iron deficiency anemia

A

inadequate iron for hgb synthesis

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24
Q

Hgb A molecular structure

A

a2b2

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25
Q

Hgb A2 molecular structure

A

a2e2

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26
Q

Hgb F molecular structure

A

a2g2

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27
Q

Hgb S molecular structure

A

valine substituted for glutamic acid in the 6th position of b chain (glutamic becomes valine)

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28
Q

Hgb C molecular structure

A

lysine substituted for glutamic acid in the 6th position of b chain (glutamic becomes lysine)

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29
Q

Which hgb is most common in aldults, second most common and third?

A
  1. Hgb A
  2. Hgb A2
  3. Hgb F
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30
Q

Which hgb is most common in newborns, second most common and third?

A
  1. Hgb F
  2. Hgb A
  3. Hgb A2
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31
Q

Hgb Electrophoresis pH 8.6: which hgb migrates the fastest? (most towards the anode +)

A
  1. Hgb A
  2. Hgb F
  3. Hgb S
  4. Hgb A2 and C

cathode- A2/C—-S——F—-A anode+

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32
Q

Which disorders has anormal hgb?

A

Sickles cell anemia (anémie falciforme), Thalassemia et Hgb C

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33
Q

Hgb in alpha thalassemia

A

Bart’s hgb or H (barts - most severe form a Th.)

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34
Q

Hgb Electrophoresis pH 6.2: abnormal conditions which hgb migrates the fastest? (most towards the anode)

A
  1. Hgb C
  2. Hgb S
  3. Hgb A and A2
  4. Hgb F

cathode- F—-A—–S—-C anode+

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35
Q

Cause of methemoglobin

A

the iron in the heme group is in the Fe3+ (ferric) state

(normal Hgb = Fe2+ (ferrous))

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36
Q

Cause of sulfhemoglobin

A

sulfur bound to heme

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37
Q

Cause of carboxyhemoglobin

A

carbon monoxide is bound to heme

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38
Q

Negative affect of methemoglobin

A

can’t bind O2, cyanosis, can be fatal, blue skin

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39
Q

Negative affect of sulfhemoglobin

A

lower affinity of O2, cyanosis

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40
Q

Negative affect of carboxyhemoglobin

A

diminution of O2 in tissu, can be fatal

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41
Q

Which hgb can not be detected in the cyanmethemoglobin method?

A

sulfhemoglobin

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42
Q

Which body inclusion is found in methemoglobin?

A

Heinz bodies

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43
Q

What condition does your skin turn cherry red?

A

carboxyhemoglobin

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44
Q

what is anisocytosis?

A

variation in size of RBC

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45
Q

what is macrocyte?

A

RBC are bigger then 9um

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46
Q

what is microcyte?

A

RBC are smaller then 6um

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47
Q

what is poikilocytosis?

A

variation in shape (couple morphology)

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48
Q

what is elliptocyte/ovalocyte?

A

oval or cigar shape

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49
Q

what is crenated?

A

round cell with knobby, uniform projections

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50
Q

what is burr cells (echinocyte)?

A

evenly spaced blunt or pointed projections

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51
Q

what is spur cells (acanthocyte)?

A

irreguliar blunt or pointed projections

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52
Q

what is shistocyte?

A

RBC fragments

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53
Q

what is sickle cells (depranocyte)?

A

Crescent, S or C shaped

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54
Q

what is hgb C crystals?

A

Blunt, 6 sided, dark staining

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55
Q

what is hgb SC crystals?

A

glove-like intracellular crystals

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56
Q

what is teardrop (dacryocyte)?

A

teardrop shaped

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57
Q

what is target cell(codocyte)?

A

bull’s eye

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58
Q

what is stomatocyte?

A

RBC with slit-like central pallor

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59
Q

what is spherocyte?

A

small, dark-staining RBC

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60
Q

what is rouleaux?

A

stack like coins

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61
Q

what is agglutination?

A

irregular clumps

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62
Q

what is basophilic stippling?

A

RNA aggregation (ribosome)

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63
Q

what is howell-jolly?

A

DNA nuclear remnants

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64
Q

what is cabot ring?

A

remnant of microtubules or fragment of nuclear membrane

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65
Q

what is pappenheimer?

A

iron particules

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66
Q

what is siderotic?

A

aggregations of iron particles

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67
Q

what is reticulocyte?

A

RNA residual (ribosome)

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68
Q

what is heinz?

A

denatured hgb

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69
Q

Which disorders we see macrocyte?

A

megaloblastic, liver disease and reticulocytosis

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70
Q

Which disorders we see microcyte?

A

iron defiency anemia, thalassemia, anemia of chronic infection

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71
Q

Which disorders we see elliptocyte/ovalocyte?

A

many anemias, hereditary ovalocytosis, (membrane defect)

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72
Q

Which disorders we see echynocyte?

A

pyruvate kinase deficiency, could be seen in normal individuals

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73
Q

Which disorders we see acanthocyte?

A

severe liver disease or abetalipoproteinemia

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74
Q

Which disorders we see schistocyte?

A

hemolytic anemia

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75
Q

Which disorders we see sickle cells?

A

sickles cell anemia

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76
Q

Which disorders we see hgb C crystals?

A

hgb C disease

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77
Q

Which disorders we see hgb SC crystals?

A

hgb SC disease

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78
Q

Which disorders we see teardrop?

A

myelofibrosis, thalassemia and other anemia

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79
Q

Which disorders we see target cell?

A

hemoglobinopâthie, thalassemia and liver disease

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80
Q

Which disorders we see stomatocyte?

A

hereditary stomatocytosis, hereditary spherocytosis, thalassemia and cirrhosis

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81
Q

Which disorders we see spherocyte?

A

hereditary spherocytosis, autoantibodies, burns, hemoglobinophatie and hemolysis

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82
Q

Which disorders we see rouleaux?

A

abnormal serum protein. seen in multiple myeloma and macroglobulinemia

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83
Q

Which disorders we see agglutination?

A

autoantibodies, cold agglutination

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84
Q

Which inclusion are stain with wrigth’s?

  • Reticulum
  • Howell-jolly
  • Pappenheimer
  • Siderotic
  • Heinz
A
  • Reticulum: cell appears polychrome
  • Howell-jolly: yes
  • Pappenheimer: yes
  • Siderotic: yes but called pappenheimer
  • Heinz: no
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85
Q

Which inclusion are stain with new methylene bleu?

  • Reticulum
  • Howell-jolly
  • Pappenheimer
  • Siderotic
  • Heinz
A

all

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86
Q

Which inclusion are stain with prussian bleu?

  • Reticulum
  • Howell-jolly
  • Pappenheimer
  • Siderotic
  • Heinz
A
  • Reticulum: no
  • Howell-jolly: no
  • Pappenheimer: yes
  • Siderotic: yes
  • Heinz: no
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87
Q

VGM formula

A

Hct / RBC = average volume RBC

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88
Q

TGMH formula

A

Hgb / RBC = average weight of hgb in each RBC

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89
Q

CGMH formula

A

Hgb / Hct = average concentration hgb per L RBC

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90
Q

which erythrocyte indices is use for classify anemias?

A

VGM

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91
Q

When should a prewarm is done?

A

CGMH over 360 g/L

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92
Q

Difference between hemoglobinopathy and thalassemia?

A
  • hemoglobinopathy: qualitative abnormaly, abnormaly in globin chain, not in amount of globin produced
  • thalassemia: quantative abnormaly, normal globin chains, but underproduction of globin chains
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93
Q

In coagulation we should run the controles every?

A

8 hours

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94
Q

How long do we have to do the following test

  • PT
  • PTT
  • heparin
A
  • PT : 24h
  • PTT: 4h
  • heparin: 1h
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95
Q

What is the blood to anticoagulation ratio in sodium citrate tube

A

9:1

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96
Q

If the blood to coagulation ratio can not be achieved, what can we do?

A

calculate the amount of anticoagulation we need

volume anticoagulation=(1.85 x 10-^3)(100-hct) x volume total du tube

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97
Q

quel % hct pour reduire le montant anticoagulant?

A

55%

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98
Q

What action does coumadin(warfarin) have?

A

vitamin K antagonist

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99
Q

What action does heparin have?

A

inhibition of thrombin

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100
Q

between PT and PTT which one is affected by coumadin?

101
Q

between PT and PTT which one is affected by heparin?

102
Q

what cause Hgb C trait?

A

inheritance of gene for Hgb C from 1 parent (non trait = receive gene frrom both parents)

103
Q

what cause Hgb SC trait?

A

inheritance of 1 sickle cell gene and 1 hgb C gene

104
Q

what cause hereditary spherocytosis trait?

A

defect of cell membrane

105
Q

what cause autoimmune hemolytic anemia trait?

A

autoantibodies

106
Q

what is positif in the solubility test?

A

Sickle cell anemia and SC disease

107
Q

Hereditary spherocytosis

  • CGMH usually
  • Osmotic fragility
A
  • CGMH usually : over 360 g/L

- Osmotic fragility : high (more fragile)

108
Q

how to differenciate megaloblastic and nonmegaloblastic anemia?

A

megaloblastic has hypersegmentation and oval macrocyte

nonmegalo : does not have hyperseg and has round macrocyte

109
Q

name normochrotic anemia

A

Sickle cell, hgb c, hereditary spherocytosis and autoimmune hemolytic anemia

110
Q

name microcytic anemia

A

iron deficiency, siderolastic, thalassemia, chronic inflammation

111
Q

Cause of sideroblastic anemia?

A

enzymatic defect in heme synthesis

112
Q

difference between major and minor b-thalassemia

A

major: homozygous, severe anemia, has aniso and poik

minor : heterozygous, mild anemia

113
Q

cause of b thalassemia

A

decreased production in beta chains

114
Q

Which micro/hypo anemia has a high level hgb A2?

A

b-thalassemie

115
Q

Iron defiency anemia

  • serum iron
  • TIBC
  • serum ferritin
A
  • serum iron: low
  • TIBC : high
  • serum ferritin : low
116
Q

Which micro/hypo anemia has a low level TIBC?

A

anemia of chronic inflammation

117
Q

Which micro/hypo anemia has a high level RBC?

A

b-thalassemia

118
Q

sideroblastic anemia

  • serum iron
  • TIBC
  • serum ferritin
A
  • serum iron : high
  • TIBC : normal
  • serum ferritin : high
119
Q

Difference between acute blood loss and chronic blood loss

A

acute blood loss: normo/normo, low WBC

chronic blood loss: micro/hypo, normal WBC, hgb and hct low, iron low

120
Q

Order of maturation granulocyte (youngest to oldest)

A
  • myeloblast
  • promyelocyte
  • myelocyt
  • metamyelocyte
  • band
  • segmented neutrophil
121
Q

differience between myeloblast and promyelocyte

A

promyelocyte has specific granules

122
Q

differience between myeloblast and myelocyte

A

myeloblast has nucleoli

123
Q

differience between myelocyte and metamyelocyte

A

metamyelocyte has a indent in the nucleas (bean shaped)

124
Q

What color is the cytoplasm of a lymphocyte

A

blue sky, few azurophilic granules

125
Q

What color is the cytoplasm of a monocyte

A

gray-bleu, vacuoles or pseudopods

126
Q

is there more/less oxygen in the tissu when 2.3 DPG is low

A

more oxygen in tissu

127
Q

what does left shift mean?

A

presence of immature granulocyte

128
Q

significance of toxic granulation

A

infection or inflammation

129
Q

significance of dohle body

A

infection or burns

130
Q

significance of vacuolization in neutrophile?

A

septicemia, drugs, toxins and radiation

131
Q

significance of hypersegmentation

A

first sign of pernicious amenia (more then 5 lobes)

132
Q

Which anomaly we fond hyposegmentartion of the neutrophile?

A

Pelger-Huet

133
Q

significance of auer rods

A

only found in myeloblast (rules out CLL)

134
Q

significance of variant lymph (atypical or reactive)

A

viral infection (ex : mononucleosis)

135
Q

Causes of high basophile (basophilia)

A

CML or polycythemia vera

136
Q

How do we detect lupus anticoagulant?

A

unexplained prolongation of APTT that is not corrected after addition of equal volume normal plasma (not factor deficiency)

137
Q

What cause Factor V Leiden

A

Mutation that makes V resistant to activity of activated protéine C

138
Q

what is protein S

A

cofacteur protéine C

139
Q

what is protein C

A

coagulation inhibiteur, inactives FV and VIII

140
Q

Which test is used to diagnosed Factor V leiden?

A

Russell viper venom time

141
Q

What method is use for he D dimer test

A

ELISA, antibody vs D-dimer

142
Q

What is D-dimer

A

fragment that results from lysis of fibrin by plasmin

143
Q

what is fibrinogen?

A

product of action of plasmin on fibrinogen

144
Q

What can cause factor deficiencies?

A
  • liver disease
  • vitamine K deficiency
  • Disseminated intravascular coagulation
  • primary fibrinolysis
  • inhibitors
145
Q

Why is the liver important in coagulation?

A

coagulation proteins are synthesized in liver

146
Q

Which factors need vitamine K

A

II, VII, IX and X

147
Q

Other name for christmas disease?

A

hemophilia B

148
Q

which factor is deficient in hemophilia B

149
Q

which factor is deficient in hemophilia A

150
Q

Which inherited coagulation disorder is sex linked

A

Hemophilia (occurs in male and mothers are carriers)

151
Q

Which test is use for Von Willebrand disease?

A
  • platelet agregation : abnormal with ristocetin
  • FVIII: low
  • VWF:Ag : low
152
Q

In a mixing study what does it mean if the time is corrected?

A

factor defiency

153
Q

In a mixing study what does it mean if the time is not corrected?

A

factor inhibitor

154
Q

Except for PTT what other test we can do to monitor heparin?

A

anti-factor Xa assay

155
Q

Is the reptilase time affected by heparin?

156
Q

Name common factors

A

I, II, V, X

157
Q

Name extrinsèque factors

158
Q

name intrinsèque factors

A

XIII, IX, XI, XII

159
Q

What reagent is used for PT

A

thromboplastin phospholipid and Calcium

160
Q

What reagent is used for PTT

A

phospholipide activator and CaCL

161
Q

RNI calcul

A

RNI = (PT patient / normal PT)ISI

162
Q

Acute vs chronique leukemia

A
  • Acute: WBC high, normal or low, usually blast

- chronique: WBC very high, more mature cells

163
Q

which leukemia is more then 20% blast?

164
Q

which leukemia is most common in children

165
Q

which leukemia has usually 5-30 WBC

166
Q

Which leukemia that 50% of WBC affected can be elevated, N or low

167
Q

which leukemia is over 100 WBC?

168
Q

Which leukemia has 30-200 WBC?

169
Q

Which leukemia has usually smudge cells (ombre de gumpretch)

170
Q

Which is the most common type of leukemia in older adults?

171
Q

The philadelphia chromosome is related with what

172
Q

Which leukemia is most common for people after the age of 55?

173
Q

Which leukemia is positive with myeloperoxidase stain

174
Q

Which leukemia is positive with sudan noir stain

175
Q

Which leukemia is positive with specific esterase stain

176
Q

Which leukemia is positive with periodic acid-Schiff PAS stain

177
Q

Which couting-chamber is used for WBC count in CFS?

A

Neubauer hemacytometer

178
Q

what is the purpose of a retic count

A

assess rate of erythropoiesis

179
Q

what stain is used for retic?

A

methylene blue

180
Q

What is the purpose of ESR erythrocyte sedimentation rate?

A

screen for inflammation

181
Q

what is the method of ESR erythrocyte sedimentation rate?

A

whole blood added to Westergren tube and placed in vertical rack. height of RBC colum read after 1 h

182
Q

what is the best way to determine Hgb S?

A

electrophoresis (not solubilty test)

183
Q

what is the reagent in the solubilty test for hgb S?

A

sodium dithionite

184
Q

what is the reagent in the osmotic fragility test?

185
Q

which morphology has a low osmotic fragility

A

target cells and sickle cells

186
Q

Which antibody is Donath-landsteiner

A

autoanti-P

187
Q

What is the purpose of the donath-landsteiner test

A

diagnose of paroxysmal cold hemoglobinuria

188
Q

what is a positive Donath-landsteiner test

A 
patient = hemolysis (disolved)
control = no hemolysis
189
Q

What does the electrical impedance (coulter principal) used for?

A

cell counting and sizing

190
Q

What is the optical light scattering (flow cytometry) used for?

A

cell counting, sizing and WBC differential

191
Q

What does the X and Y axes in a histogramme mean?

A 
x = cell size
y= number of cells
192
Q

how does the cytogram group the cells?

A

Volume and light scatter

193
Q

What is a method to mesure hgb

A

cyanmethemoglobin

194
Q

What is the formula for retic %

A

(retics in square A x100) / (RBS in square B x 9)

195
Q

rules of three

A

RBC x 3 = hgb +- 0.5

HGB X 3 = HCT +- 3%

196
Q

What is the corrected WBC formula?

A

(uncorrecte WBC x 100) / (100 + NRBC)

197
Q

manual cell count formula

A

WBC =
(#cell counted x dilution x 10^6) /
(carré compté x profondeur(=0.1))

198
Q

Name the steps in primary hemostatis

A
  1. vasoconstriction
  2. platelet adhesion
  3. platelet aggregation
199
Q

Name the steps in secondary hemostatis

A
  1. interaction with coagulation factors

2. fibrin stabilized by XIII

200
Q

Name the steps in fibrinolysis

A
  1. release of tissu plasminogen activator
  2. conversion of plasminogen to plasmin
  3. conversion of fibrin to fibrin degradation products
201
Q

What is the Bernard-Soulier syndrome

A

GP Ib/IX/V unfunctional, abnormal plt adhesion to collagen

202
Q

What is the Glanzmann

A

GP IIb/IIIa unfunctional, fibrinogen can not attach to plt surface and initiate plt aggregation

203
Q

What is the Glanzmann

A

GP IIb/IIIa unfunctional, fibrinogen can not attach to plt surface and initiate plt aggregation

204
Q

Giant plt with granules can be seen in which disorder?

A

Bernard-Soulier

205
Q

which test can be used for Glanzmann

A

collagen, epinephrine, abnormal aggregation with ADP, and PFA

206
Q

which test can be used for bernard-soulier

A

abnormal aggregation with ristocetin and PFA

207
Q

which reagent is in PFA

A

ADP, collagen and epinephrine

208
Q

which reagent is in platelet aggregation?

A

ADP, collagen, epinephrine and ristocetin

209
Q

which anormality can the platelet aggregation test detect?

A

Von willebrand and bernard-soulier

210
Q

Why do Von willebrand can be diagnose with platelet based tests ?

A

platelets dont function normally in Von willebrand disease

211
Q

Other name for FI?

A

fibrinogen

212
Q

Other name for FII?

A

prothrombine

213
Q

Other name for FIII?

A

tissu factor

214
Q

Other name for FIV?

215
Q

Other name for FV?

A

labile factor

216
Q

Other name for FVII?

A

stable factor

217
Q

Other name for FVIII?

A

antihemophilic factor

218
Q

which factor deteriorates rapidly?

219
Q

where is the FIII (tissu factor) released?

A

phospholipide released in vessel wall. not normally in blood

220
Q

Other name for FIX?

221
Q

Other name for FX?

222
Q

Other name for FXI?

A

plasma thromboplastin antecedent

223
Q

Other name for FXII?

224
Q

Other name for FXIII?

A

fibrin stabilizing

225
Q

Other name for HMWK?

A

fitzgerald

226
Q

Other name for PK?

227
Q

which factor is hemophilia C

228
Q

Name the factors for the contact group

A

PK, HMWK, XII, XI

229
Q

Name the factors for the fibrinogen group

A

I, V, VIII, XIII

230
Q

labile factors

231
Q

which factors is not in the serum

A

I, II, V, VIII, XIII

232
Q

Where are the factors produced ?

233
Q

what is the extrinsic tenase complex and acts on what?

A

VIIa/TF acts on X

234
Q

what is the intrinsic tenase complex and acts on what?

A

IXa/VIIIa acts on X

235
Q

what is the protrombinase complex and acts on what?

A

Xa/Va acts on prothrombin

236
Q

what is the vitamine K required factors also called?

A

prothrombin group

237
Q

start of extrinsic patheway : The TF from injured blood vessel all activates what?

238
Q

TF:VIIa activates what?

239
Q

start of intrinsic patheway: collagen activates which factor?

240
Q

IIa and what else activates XI?

A

HMWK and PK

241
Q

XIa activates what?

242
Q

when does the extrinsic and intrinsic pathway meet in the cascade of coagulation?

A

when IXa:VIIIa activates X (intrinsic)

when VIIa/TF acitvates X (extrinsic)

243
Q

How does the common pathway start?

A

Xa:Va converts prothrombine(II) to thrombin(IIa)

244
Q

What dos the thrombin do in the cascade?

A

splits fibrinogen(I) into fibrin and activates factor XIII to stabilize clot

245
Q

Which lymphocyte is produced in thymus and which in bone marrow

A

thymus : T-lymph (T-helper and T-suppressor)

bone marrow : B-Lymph and NK cells

246
Q

function of NK cells

A

first line of defense againts tumor cells and cells with virus

247
Q

Which lymphocyte defense against bacteria?

248
Q

Which lymphocyte defense against virus/fungi?

249
Q

What cell releases histamine

A

basophile during allergic reaction

🦠RT (11 decks)

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