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Essentials of clinical lab > Hematology > Flashcards

Hematology Flashcards

1
Q

Hematology

A

-the study of blood and blood-forming elements

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2
Q

Blood: facts

A

-4-6 liters
-approx. 7-8 % of your body weight

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3
Q

Red blood cells: facts

A

-approx. 97 % of the formed elements in blood
-erythrocytes: RBCs

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4
Q

Hematology and its branches

A

-flow cytometry
-coagulation
-urinalysis
-body fluids
-CBC plus differential

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5
Q

Flow cytometry

A

-used to analyze individual cells for the presence of antigens
-Count cells with a particular immunophenotype
-This is a specialized lab

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6
Q

coagulation

A

-Think of hemostasis on a scale, if it is tipped in one direction bleeding occurs. If it is tipped in the other direction, thrombosis occurs
-Normal hemostasis is both rapid and localized

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7
Q

urinalysis

A

-is used to detect and manage a wide range of disorders, such as urinary tract infections, kidney disease, and diabetes

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8
Q

body fluids

A

-can indicate localized infections or systemic conditions depending on cellular quantities and distributions

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9
Q

CBC and Differential

A

-complete blood count/differential
-the most common hematology test
-a panel consisting of WBC, RBC, Hgb, HCT, MCH, MCHC, MCV, RDW, PLT, Retic, and Differential

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10
Q

What test do you run using a lavender tube?

A

-flow cytometry
-CBC/D
- body fluids
-contains EDTA

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11
Q

What test do you run using a light blue tube?

A

-coagulation
-contains sodium citrate

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12
Q

What test do you run in a syringe?

A

body fluids

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12
Q

What test do you run in a sterile cup?

A

-urinalysis
-body fluids

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13
Q

Circulating blood is divided into

A

45% cells (RBC, WBC, platelets)
55% plasma

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14
Q

Hematopoiesis

A

-blood cell production, hematopoiesis begins in embryonic development, progresses to the fetal liver, and later occurs in the red bone marrow
-CD34+ pluripotent stem cells give rise to the earliest myeloid and lymphoid precursors

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15
Q

Hemoglobulin molecules

A

-heme mostly consists of one protoporphyrin ring (4 pyrrole rings are joined to each other with a single iron atom)
-a complete hemoglobulin molecule contains 4 heme groups
-an adult hemoglobin (A) consists of four heme groups and four globulin chains-two alpha chains and two beta chains

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16
Q

Hemoglobin S

A

-Sickle cell trait will have hemoglobin S and A
-When Glu in an amino acid sequence is substituted with val it becomes a hemoglobin A
-Hemoglobin S is not soluble while A is soluble

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17
Q

Mean corpuscular volume

A

MCV (fL) = Hct *10/ RBC
-where MCV is the mean corpuscular volume, Hct is the hematocrit, and RBC is red blood cell count
-The reference range is 80-96 fL

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18
Q

Mean corpuscular hemoglobin

A

MCH (pg) = Hb *10/ RBC
-where Hb is hemoglobin
-reference range is 27-33 pg

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19
Q

Mean corpuscular concentration

A

MCHC (g/dL) = MCH/MCV *100
-The reference range is 33-36 g/dL

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20
Q

Red cell distribution width

A

-is a measurement of the degree of anisocytosis present, or the degree of variability in RBC size, in a blood specimen
RDW % = Standard deviation of MCV/ Mean MCV *100
-reference range is 11%-15%

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21
Q

Anisocytosis

A

-any significant variation in size
-corresponds to an RDW > 14.5 increased
-can be found in leukemia, anemias, dysplasias

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22
Q

normal erythrocytes

A

-biconcave disc
-MCV: 80-100 dL
-MCH: 28-34 pg
-MCHC: 32-36%
-Lifespan: 120 days
- 7-8 um

23
Q

Macrocytes

A

-Larger than normal RBCs (MCV>100)
-associated with B12 or folate deficiencies

24
Q

Microcytes

A

-smaller than normal RBCs (MCV <80)
-associated with iron deficiency, thalassemia, and lead poisoning

25
Q

Hypochromic

A

-central pallor > 2/3rd of the cell
-less than normal amount of Hgb (MCHC <32)
-associated with iron deficiency

26
Q

Hyperchromic

A

-RBCs with decreased or absent central pallor (slightly elevated MCHC)
- associated with hemolytic anemias, burns

27
Q

polychromasia (reticulocytes)

A

-premature RBC that contain residual RNA
-blue-gray in color

28
Q

poikilocytosis

A

-general term used to describe variation in RBC shape

29
Q

target cells (codocytes)

A

-associated with hemoglobinopathies, thalassemias, IDA, and liver disease

30
Q

spherocytes

A

-decreased surface: volume ratio resulting in no central pallor
-associated with hereditary spherocytosis, autoimmune hemolytic anemia, severe burns

31
Q

stomatocytes

A

-can be an artificial or artifact of chemical reagents, commonly an artifact of albumin
-associated with hereditary stomatocytosis (rare)

32
Q

ovalocytes

A

-egg-shaped, vary in Hgb content
- often in conjunction with macrocytes (macroovalocytes)
-associated with myelodysplastic syndromes (MDS). B12, or folate deficiencies

33
Q

elliptocytes

A

-lack of central pallor
-associated with hereditary elliptocytosis, iron deficiency, and idiopathic myelofibrosis

34
Q

Burr Cells (Echinocytes)

A

-many small undulations evenly space around the RBC surface
-often an artifact of contamination
-associated with uremia, peptic ulcers, heparin therapy, liver disease

35
Q

Acanthocytes (spur cells)

A

-often hyperchromic
-few (3-5) blunt spicules of uneven length
-associated with congenital abetalipoproteinemia or acquired with severe hepatic disease

36
Q

teardrop (dacrocytes)

A

-associated with idiopathic myelofibrosis can be seen in thalassemia, iron deficiency, and in any disorder with RBC inclusions

37
Q

Schistocytes (fragments/ bite cells)

A

-results of trauma to the RBC membrane

38
Q

Sickle cells (drepanoncytes)

A

-triggered by low O2 tension
-Pt can be homozygous or heterozygous for Hgb S
-Dense elliptocytes are often in conjunction with SS

39
Q

Nucleated RBCs (NRBCs)

A

-immature RBC that has not yet ejected the nucleus
-normal finding for bone marrow, abnormal in peripheral blood
-indicates extreme RBC regeneration or myeloproliferative disorder

40
Q

Howell-Jolly Bodies

A

-DNA remnants
-can be associated with absent or non-functioning spleen

41
Q

Basophilic stipling

A

-RNA and mitochondrial remnants
-can be found in any condition with defective or accelerated heme synthesis: alcoholism, thalassemias, megaloblastic anemias, and lead poisoning

42
Q

Pappenheimer bodies (Siderotic granules)

A

-composed of non-heme iron, resulting from excess iron in the body
-small irregular inclusions along the periphery of RBCs and usually appear in clusters
-Wright stain - pappenheimer bodies
Prussian blue stain - siderotic granules

43
Q

Heinz bodies

A

-denatured or precipitated Hgb
-cannot be seen on wrights stain (only via crystal violet or brilliant cresyl blue)
-associated with thalassemia, G6PD, or RBC injury due to chemicals

44
Q

Cabot rings

A

-rare
-may be found in megaloblastic anemias, erythropoiesis and homozygous thalassemia

45
Q

RBC inclusions

A

-Hemoglobin CC crystals (bars of gold)
-Hemoglobin SC crystals (SC Crystals)

46
Q

Protozoan inclusions

A

-malaria
-babesia

47
Q

water artifacts

A

-non-pathological
-slide was not completely dry when staining

48
Q

albuminized slides (artifacts)

A

-stomatocytes
-Never do RBC morphology on an albuminized slide

49
Q

stain precipitation (artifacts)

A

-appears as dark granules on top of and next to RBCs
-can mimic bacteria

50
Q

Anemia

A

-not a specific disease, but a condition in which there is a decrease in the competence of blood to carry oxygen to tissues, thereby causing tissue hypoxia.
-in clinical medicine refers to a decrease in the normal concentration of hemoglobin and or erythrocytes

51
Q

Anemia symptoms

A

-fatigue, shortness of breath, faintness, heart palpitation, headache
-severity depends on the hemoglobin concentration

52
Q

laboratory diagnostic criteria for anemia include

A

-decreased HGB
-decreased HCT
-decreased RBC
-erythrocyte indices used in morphological classification of anemia

53
Q

reticulocyte count

A

indicates the degree of effective bone marrow erythropoietic activity and is one of the most useful lab tests in monitoring anemia in response to therapy

54
Q

How can anemia be classified?

A

-according to either the appearance of the RBCs (morphologic classification) or the physiologic cause of anemia (etiology or pathogenic)

55
Q

Microcytic hypochromic

A

-associated with defective Hgb synthesis. Serum Iron studies and Hgb electrophoresis are usually adequate tests

Essentials of clinical lab (9 decks)

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