Hematology Flashcards
A 28-year-old woman in her second trimester of pregnancy, complains of fatigue, shortness of breath, light headedness, and pallor. Her blood work results show the following: low hemoglobin and hematocrit, microcytic and hypochromic RBCs, low MCV, low normal WBC count and slightly increased platelet count. What is the most probable diagnosis for this patient?
a. Anemia of inflammation
b. Aplastic anemia
c. Pernicious anemia
d. Iron deficiency anemia
d. Iron deficiency anemia
LOW HEMOGLOBIN AND HEMATOCRIT, MICROCYTIC AND HYPOCHROMIC RBCS, LOW M CV, LOW NORMAL WBCCOUNT, SLIGHTLY INCREASED PLATELET COUNT
A 58-year-old female patient sought consult due to shortness of breath on minimal exertion, nausea, and occasional diarrhea. She also complains of numbness in her hands and abnormal tingling sensations in her lower extremities. Microscopic examination of her blood sample showed reduced number of erythrocytes and leukocytes, many of which are macro-ovalocytes and giant hypersegmented neutrophils. The MCH is increased and the MCHC is normal. What is the most probable diagnosis for this patient?
a. Polycythemia vera
b. Thalassemia
c. Pernicious anemia
d. Acute intermittent porphyria
c. Pernicious anemia
SYMPTOMS INCLUDE WEAKNESS, NUMBNESS IN THE HANDS AND FEET, LOSS OF APPETITE, WEIGHT LOSS, AND FEVER. PERNICIOUS ANEMIA CAN DAMAGE THE NERVE CELLS IN THE BRAIN AND SPINAL COLUMN.
Which of the following is an erythrocytic staining characteristic implies reticulocytosis and is most marked in hemolysis and acute blood loss?
a. Polychromatophilia
b. Hyperchromia
c. Hypochromia
d. Anisochromia
a. Polychromatophilia
POLYCHROMATOPHILIA: YOUNG CELLS WITH RESIDUAL RNA ARE POLYCHROMATOPHILIC RED CELLS ON AIR-DRIED FILMS STAINED WITH WRIGHT’S STAIN BUT ARE RETICULOCYTES WHEN STAINED SUPRAVITALLY WITH BRILLIANT CRESYL BLUE. THEREFORE, INCREASED POLYCHROMASIA IMPLIES RETICULOCYTOSIS → IT IS MOST MARKED IN HEMOLYSIS AND IN ACUTE BLOOD LOSS
In this disorder, globin chains are produced at a decreased rate. However, it is not the lack of the affected globin chain but rather the accumulation of the unaffected one that causes hemolysis. Based on its clinical classification, which of the following will present with hematologic abnormalities but without clinical symptoms?
a. Thalassemia minor
b. Chronic post-hemorrhagic anemia
c. Acute intermittent porphyria
d. Acute post-hemorrhagic anemia
a. Thalassemia minor
IN Β THALASSEMIA, THE SYNTHESIS OF NORMAL Α GLOBIN CHAINS FROM THE UNAFFECTED Α GLOBIN GENES CONTINUES AS NORMAL, RESULTING IN THE ACCUMULATION WITHIN THE ERYTHROID PRECURSORS OF EXCESS UNMATCHED Α GLOBIN. THE FREE Α GLOBIN CHAINS ARE NOT ABLE TO FORM VIABLE TETRAMERS AND INSTEAD PRECIPITATE IN THE RED CELL PRECURSORS IN THE BONE MARROW FORMING INCLUSION BODIES. INDIVIDUALS WITH BETA THALA SSEMIA MINOR USUALLY DO NOT HAVE ANY SYMPTOMS (ASYMPTOMATIC) AND INDIVIDUALS OFTEN ARE UNAWARE THAT THEY HAVE THE CONDITION. SOME INDIVIDUALS DO EXPERIENCE A VERY MILD ANEMIA.
A 12-year-old girl was brought to a clinic because of upper respiratory symptoms of two weeks duration. The patient presents with mild fever, thick but clear mucous secretions from her nose, malaise and swollen cervical lymph nodes. Her mother noticed that her coughing continues to increase and consistently becoming more forceful. What is the most probable blood picture in this case?
a. Lymphocytosis
b. Neutrophilia
c. Basophilia
d. Neutropenia
a. Lymphocytosis
LYMPHOCYTOSIS IS UNUSUAL IN ACUTE BACTERIAL INFECTIONS BUT IS COMMONLY ASSOCIATED WITH VIRAL INFECTION (EPSTEIN -BARR VIRUS [EBV], HEPATITIS) .
Which red cell factor accelerates the ESR?
a. Spherocytosis
b. Rouleaux formation
c. Cholesterol increase
d. Sickling of cells
b. Rouleaux formation
Erythrocytes that are thinner than normal and when stained show a peripheral rim of hemoglobin with a dark central hemoglobin-containing area are commonly seen in which condition?
a. Malaria
b. Thalassemia
c. Hereditary spherocytosis
d. Lead poisoning
b. Thalassemia
TARGET CELLS ARE ERYTHROCYTES THAT ARE THINNER THAN NORMAL (LEPTOCYTES) AND WHEN STAINED SHOW A PERIPHERAL RIM OF HB WITH DARK, CENTRAL, HB- CONTAINING AREA. THEY ARE FOUND IN OBSTRUCTIVE JAUNDICE, POST-SPLENECTOMY STATE, HYPOCHROMIC ANEMIA, ESPECIALLY THALASSEMIA AND HBC DISEASE.
A 24-year-old female was admitted to the hospital with complaints of recurrent epistaxis, progressive weakness and shortness of breath. She has experienced recurrent fever reaching 38.2° Upon physical examination, there is skin pallor and many bruises on her legs and thighs. There is no lymphadenopathy or hepatosplenomegaly. Her
blood work results show peripheral pancytopenia with very low hemoglobin and platelet count. Bone marrow examination showed hypocellularity with no dysplasia. What is the most probable diagnosis for this patient?
a. Thalassemia
b. Megaloblastic anemia
c. Anemia of inflammation
d. Aplastic anemia
d. Aplastic anemia
| APLASTIC ANEMIA IS DEFINED AS PANCYTOPENIA WITH
HYPOCELLULAR BONE MARROW IN THE ABSENCE OF AN
ABNORMAL INFILTRATE AND WITH NO INCREASE IN
RETICULIN. AA USUALLY REFERS TO PANCYTOPENIA
ASSOCIATED WITH A SEVERE REDUCTION IN THE
AMOUNT OF HEMATOPOIETIC TISSUE THAT RESULTS IN
DEFICIENT PRODUCTION OF BLOOD CELLS IN THE
ABSENCE OF A BONE MARROW INFILTRATIVE PROCESS
OR INCREASED RETICULIN.
Which of the following granulocytic disorders is typically associated with allergic processes and parasitic
infections?
a. Eosinophilia
b. Monocytosis
c. Neutropenia
d. Lymphocytopenia
a. Eosinophilia
| SECONDARY EOSINOPHILIA OCCURS WHEN EOSINOPHILS
ARE MOBILIZED INTO THE PERIPHERAL BLOOD AS A
REACTION TO DEFEND AGAINST AN ANTIGEN (USU ALLY A
PROTEIN) THAT IS CONSIDERED FOREIGN BY THE BODY’S
IMMUNE SYSTEM. THE MOST COMMON CAUSES OF AN
ELEVATED AEC ARE ALLERGENS AND INFECTIONS,
PARTICULARLY PARASITIC INFECTIONS.
In hereditary spherocytosis wherein the cells are
hyperchromic and have reduced surface/volume ratio, what are the expected erythrocyte indices?
a. MCH normal, MCHC increased
b. MCH increased, MCHC normal
c. MCH normal, MCHC decreased
d. MCH increased, MCHC increased
a. MCH normal, MCHC increased
| HEREDITARY SPHEROCYTOSIS: SPHEROCYTES ARE
NEARLY PERFECTLY ROUND IN SHAPE, SMALLER THAN
NORMAL RED CELLS, AND LACK CENTRAL PALLOR
(HYPERCHROMIC). MCH IS NORMAL, MCH IS USUALLY
INCREASED BECAUSE OF A REDUCED SURFACE /VOLUME
RATIO.
