Hematology Flashcards
Liquid portion of unclotted blood
Plasma
Effective concentration of EDTA in evacuated tubes
1-2 mg/mL (1-2 g/L) of blood
Anticoagulant for cardiopulmonary bypass, seen in OPEN HEART SURGERY
Heparin
Anticoagulant used for platelet studies
Sodium citrate
Ratio of citrate anticoagulant to blood
1:9
Complement dependent test cannot be performed on _____ blood
Anti-coagulated
The higher the gauge, the _____ the diameter of the needle
Smaller
Avoid using the arm with fistula or cannula for venipuncture due to possibility of _____ or _____
Infection or clotting
Once sufficient blood has been collected, release the tourniquet _____ withdrawing the needle
Before
Release and remove the tourniquet as soon as blood flow is established or after no longer than ___ minute
1
Phlebotomy complications
Vascular
Anemia
Neurologic
Dermatologic
Infection
Cardiovascular
Type of light used by AccuVein
Near infrared
Safest site for bone marrow aspiration and biopsy
Posterior iliac crest
Manner of making a good smear (pushing the spreader slide)
Smooth and rapid
Best area to review or perform a differential on a stained blood film
RBC mostly separated, few overlapping
Scanning method on smears that minimize distribution errors
Battlement method
If buffer is acidic, RBCs would be stained _____ ; if it is alkaline, RBCs would be stained _____
Acidic = too pink
Alkaline = too blue
Blood smear appears bluer than normal. What indication?
Increased plasma proteins
What happens to RBC if blood smear dries too slowly?
Crenated (echinocytes)
Magnification of OIO
100x
These are autoantibodies of the IgM class that react optimally at 4C
Cold agglutinins
To avoid agglutination on PBS, the slide can be __________ prior to application of blood
Warmed to 37C
ANTI-COAGULATED (heparinized) microhematocrit tube ring color
Red
Speed of centrifugation for microhematocrit tube
10,000-15,000g
Difference between duplicate hematocrit readings should agree within ___ %
1%
Effect on insufficient centrifugation on hematocrit
False-increase
Microhematocrit method gives _____ hematocrit values than automated method
1-3% higher
WBC count, RBC count, hemoglobin, hematocrit and WBC differential
CBC (complete blood count)
Rule of 3
RBC x 3 = hemoglobin
Hemoglobin x 3 = hematocrit +/- 3%
Calculated rather than directly measured by automated instruments
Hematocrit, MCH, MCHC
Normal MCV value ; formula
80-100 fL
(HCT / RBC) x 10
Normal MCH value; formula
27-32 pg
(HGB / RBC) x 10
Normal MCHC value; formula
31-36%
(HGB / HCT) x 100
RBC index NOT AFFECTED by a defective centrifuge used to determine HCT
MCH
RBC index NOT USED in the classification of ANEMIA
MCH
Numerical expression that correlates with the degree of anisocytosis
RDW
Used in conjunction with RDW to determine the cause of anemia
MCV
Variation in cell SIZE is called
Anisocytosis
Variation in cell SHAPE is called
Poikilocytosis
Directly measures the VARIABILITY in platelet size
PDW
Normocytic, normochromic
Hemolytic anemia
Aplastic anemia
Leukemia
Acute blood loos
Sickle cell anemia
Microcytic, hypochromic
Sideroblast anemia
Iron deficiency anemia
Chronic blood loss
Anemia of chronic disease
Thalassemia
Macrocytic, normochromic
Megaloblastic anemia
Chronic liver disease
Bone marrow failure
Myelodysplastic syndrome
Compositional parts of the red bone marrow to the yellow bone marrow is called
Marrow cellularity
Hematopoiesis that occurs in the bone marrow
Medullary hematopoiesis
Sites of medullary hematopoiesis
Ribs
Sternum
Skull
Vertebrae
Pelvis (illiac crest)
Extremities of long bones
Hematopoiesis that does not occur in the bone marrow
Extramedullary hematopoiesis
Sites of extramedullary hematopoiesis
Liver
Spleen
Lymph nodes
Primary site of hematopoiesis during the 5th MONTH of fetal development
Liver
Early indication of ENGRAFTMENT SUCCESS after hematopoietic stem cell transplant
Immature reticulocyte and platelet functions
Primary cell source of erythropoietin (EPO)
Peritubular interstitial cells (kidney)
First type of cell produced by the developing embryo
Erythrocytes
Hemoglobin synthesis BEGINS at what erythroid stage
Basophilic normoblast
First erythroid stage in which the pink color associated with hemoglobin can be seen
Polychromatic normoblast (rubricyte)
Last stage in the erythroid series capable of mitosis
Polychromatic normoblast (rubricyte)
Enucleation occurs in what erythroid stage
Orthochromic normoblast (metarubricyte)
Last stage in the erythroid series capable of hemoglobin synthesis
Reticulocyte
N:C ratio during the RBC development
Decreases
In the RBC line, proportion of nucleus shrinks as the cell matures and cytoplasm _____ proportionately
Increases
Color of cytoplasm of immature or younger blast stages
Dark blue (basophilic)
Used to assess the erythropoietic activity
Reticulocyte count
Normal value for reticulocyte count in adult in %
0.5 - 1.5 %
Refers to DECREASE in number of erythroid precursors in the bone marrow; DECREASE RBC production
Insufficient erythropoeisis
Miller disc is an ocular device used to facilitate counting of
Reticulocytes
Absolute reticulocyte count
Reticulocyte (%) x RBC count (10^12/L)
Corrected reticulocyte count
Reticulocyte (%) x [Hematocrit (%) / 45]
Staining method used to stain and manually count reticulocytes
Supravital staining
Supravital stain (s) for reticulocytes
NMB (new methylene blue)
BCB (brilliant cresyl blue)
Supravital stains are important because the cell must be alive to see
Remaining RNA
Enzyme that incorporates Fe2+ in the center of protoplrphyrin
Ferrochelatase / heme synthetase
The greatest portion of operational body iron is normally contained in what compound?
Hemoglobin
A hemoglobin molecule is composed of how many heme and globin
4 heme, 4 globin
How many iron atom (s) and pyrole ring (s) comprise the HEME portion of hemoglobin molecule
1, 4
1 hemoglobin molecule can carry _____ O2 molecules
4
Embryonic hemoglobins
Gower I
Gower II
Portland
Deoxyhemoglobin is a (n) _____ hemoglobin
Normal
1 gram of hemoglobin can carry _____ oxygen
1.34 mL
It demonstrates relationship between pH and Hgb affinity to O2
Bohr effect
MAUVE LAVENDER blood color; NOT MEASURED by cyanmethemoglobin method
Sulfhemoglobin
CHERRY RED blood color is due to
Carboxyhemoglobin
BRIGHT RED blood color is due to
Oxyhemoglobin
CHOCOLATE BROWN blood color is due to
Methemoglobin
Anticoagulant for methemoglobin determination
EDTA or Heparin
Shift to the RIGHT O2 dissociation curve
Decreased (O2 affinity and pH)
Increased (temperature, 2,3-DPG, and CO2)
Shift to the LEFT O2 dissociation curve
Increased (O2 affinity and pH)
Decreased (temperature, 2,3-DPG, and CO2)
Sodium potassium pump regulates concentrations of Na and K; maintaining intracellular to extracellular ratios of _____ & _____, respectively
Intracellular (Na : K) = 1:12
Extracellular (Na : K) = 25:1
Pathway that generates 2,3-DPG
Rapoport-Luebering
Pathway that generates 2 ATP molecules
Embden-Meyerhoff
Pathway that maintains hemoglobin IRON into ferrous state
Methemoglobin reductase
Pathway that generates reduced GLUTATHIONE that prevents hemoglobin denaturation
Pentose-phosphate (HMS)
Enzyme deficiency associated with DRUG-INDUCED hemolytic anemia
G6PD deficiency
G6PD deficiency affects what RBC metabolic pathway
Hexose monophosphate (PPP)
Haptoglobin levels in intravascular hemolysis
Decreased
Type of poikilocyte seen in autoimmune hemolytic anemia (AIHA)
Spherocytes
Wavelength used in cyanmethemoglobin method
540 nm
Drabkin’s reagents contains
Potassium ferricyanide
Potassium cyanide
Dihydrogen potassium phosphate
Distilled H2O
Surfactant
LIPEMIA can be corrected by adding ___ mL of plasma to ___ mL of cyanmethemoglobin reagent (then use this as reagent blank)
0.01 mL ; 5mL
Reagent that converts methemoglobin to cyanmethemoglobin
Potassium cyanide
PLATELET COUNT that indicates the need to adjust Drabkin’s reagent
> 700 x 10^9 / L
WBC COUNT that indicates the need to adjust Drabkin’s reagent
> 20 x 10^9 / L
In normal adult, this acts as the site of removal of IMPERFECT AND AGED CELLS
Spleen
Removal of RBC INCLUSIONS by the spleen
Pitting
Removal of AGED/SENESCENT RBCs by the spleen
Culling
Reference range for ESR in MALE 50 years of age and BELOW
0-15 mm/hr
Reference range of ESR in MALE ABOVE 50 years of age
0-20 mm/hr
Reference range for ESR in FEMALE 50 years of age and BELOW
0-20 mm/hr
Reference range of ESR in FEMALE ABOVE 50 years of age
0-30 mm/hr
Relationship between ESR and RBS mass
Directly proportional
Relationship between ESR and plasma viscosity
Inversely proportional
Effect of overanticoagulation on ESR results
Decreased
Preferred anticoagulant for the osmotic fragility test
Heparin
Osmotic fragility of SICKLE CELLS and TARGET CELLS
Decreased
Osmotic fragility of spherocytes
Increased
Initial hemolysis of NORMAL RBCs in OFT will begin at what NaCl concentration
0.45%
Initial hemolysis of SICKLE CELLS in OFT will begin at what NaCl concentration
0.35%
Complete hemolysis of SPHEROCYTES in OFT will begin at what NaCl concentration
0.45%
Cell with a characteristic CENTRAL hemoglobinized area
Codocytes
Thin variant of codocyte
Leptocyte
Also known as punched-out cell
Anulocyte
This poikilocyte is formed due to imbalance between RBC and plasma lipids
Acanthocyte
Poikilocyte associated with abetalipoproteinemia
Acanthocyte
RBC membrane folded over (folded cell) is associated with what disease?
Hb C disease, Hb SC disease
RBC inclusion resembling “Washington monument” or “gold bar”
Hb C crystal
RBC inclusion stained by supravital, wright, and FEULGEN
Howell-jolly bodies
RBC inclusion composed of denatured/precipitated hemoglobin
Heinz bodies
Howell-jolly bodies are nuclear fragments containing
DNA
Heinz bodies are associated with
G6PD deficiency, unstable hemoglobin, favism
“Bite cells” are usually seen in what condition
G6PD deficiency
They contain aggregates of RIBOSOMES and degenerating mitochondria
Basophilic stippling
RBC inclusion body associated with pyrimidine-5’-nucleotidase deficiency
Coarse basophilic stippling
RBC inclusion seen in LEAD POISONING
Coarse basophilic stippling
Stippling seen in polychromatophilia
Fine basophilic stippling
Abnormal IRON GRANULES found inside RBCs, visible with Wright stain
Pappenheimer bodies
Polycythemia patient treated by phlebotomy will develop _____ deficiency
Iron
Most commonly encountered type of autoimmune hemolytic anemia (AIHA)
Warm AIHA
Antibody frequently seen in patients with warm AIHA
Anti-e
Anemia with BONE MARROW INFILTRATION by tumor cells
Myelophthisic anemia
Anemia due to DECREASED DNA SYNTHESIS, resulting in OVAL AND MACROCYTIC red cells
Megaloblastic anemia
Anemia caused by FAILURE TO PRODUCE RBCs, WBCs and platelets
Aplastic anemia
Anemia characterized by IRON LOADING and its accumulation in the mitochondria
Sideroblastic anemia
Anemia caused by IMPAIRED PRODUCTION of protoporphyrin
Sideroblastic anemia
RBC containing IRON GRANULES stained with Prussian blue is known as
Siderocyte
1st laboratory test that is abnormal in early stages of IDA
Serum ferritin
High TIBC and free erythrocyte protoporphyrin (FEP)
Iron deficiency anemia
Marker useful in diagnosis of IDA as well as an EARLY INDICATOR OF RECOVERY after iron therapy
Reticulocyte hemoglobin content
Binds FERROPORTIN and TARGETS IT for degradation, resulting to decrease circulating iron
Hepcidin
Anemia with SHORT STATURE, hypogonadism, skin pigmentation, organ malfunction
Fanconi anemia
Also known as congenital aplastic anemia
Fanconi anemia
Also known as congenital pure red cell aplasia
Diamond-Blackfan anemia
__________ and __________ deficiencies may cause megaloblastic anemia
Vitamin B12 and folic acid
It differentiates Vitamin B12 deficiency (⬆️) from folate deficiency (N)
MMA (serum methylmalonic acid)
H. pylori infection may also cause _____ anemia
Megaloblastic
Vitamin B12 or folic acid deficiency hinder erythroblast in manufacturing _____
DNA
Factor deficient in pernicious anemia
Intrinsic factor
MCV in megaloblastic anemia
Increased
Growth factor GIVEN in cases of anemia due to chronic kidney disease
Erythropoietin
QUANTITATIVE globin chain defect (reduced globin synthesis)
Thalassemia
QUALITATIVE globin chain defect (amino acid substitutions)
Hemoglobinopathy
Glutamic acid on the 6th position of beta chain is replaced by VALINE
Hemoglobin S
Glutamic acid on the 6th position of beta chain is replaced by LYSINE
Hemoglobin C
Glutamic acid on the 26th position of beta chain is replaced by LYSINE
Hemoglobin E
Glutamic acid on the 121st position of beta chain is replaced by LYSINE
Hemoglobin O
Glutamic acid on the 121st position of beta chain is replaced by GLUTAMINE
Hemoglobin D
Bluish discoloration of the skin is termed
Cyanosis
Major cause of death in sickle cell anemic patients
Bacterial infection (due to autosplenectomy)
Traditional sickling test that involves formation of HOLLY-LEAF appearance of RBCs
Metabisulfite test
Screening test for PNH
Sugar water, sucrose hemolysis
Confirmatory test for PNH
Ham’s test (old), flow cytometry
Anticoagulant for sugar water screening and sucrose hemolysis test
Citrate
Evaluates sensitivity of patient’s blood to complement-mediated lysis
Ham’s acidified serum test
In HAM’s test, when patient has received transfusions, less _____ occurs because of the transfused normal RBCs
Lysis
Primary target cells of G-CSF
Neutrophil precursors
Fibroblasts
Leukemic myeloblasts
Cytokines involved in stem cell mobilization
G-CSF
GM-CSF
IL-3
Dendritic cells and lymphocytes (B, T, NK cells) originated from what cell
Common lymphoid progenitor
3 pools of the developing neutrophils in the bone marrow
Stem cell pool
Proliferation pool
Maturation pool
Granulopoiesis takes about ___ days from the blast stage to the release of mature granulocytes
14
It has a curved nucleus with MORE THAN 1/2 nuclear indentation
Band cell
Primary / azurophilic / nonspecific granules begin to appear on what stage
Promyelocyte
Myelocytic stage where a given granulocyte can be identified
Myelocyte
Myelocytic stage where the cell begins to produce secondary / specific granules
Myelocyte
Last stage in the myelocytic series capable of mitosis
Myelocyte
Myelocytic stage where the cell has KIDNEY or BEAN-SHAPED nucleus
Metamyelocyte
Youngest cell in the peripheral blood, with SAUSAGE-SHAPED nucleus
Band cell
Once metamyelocyte stage has been reached, cells have undergone _____ cell divisions and the proliferation phase comes to an end
4 or 5
Should band cells be included within neutrophil counts?
Yes
Color of eosinophil cytoplasm
Orange-red
Mature basophils are myeloperoxidase (positive or negative)
Negative
Phagocytic cell (s) containing lysozyme
Neutrophils, monocytes
Precursor of macrophage
Monocyte
The MATURE MONOCYTE spends about ___ hours in the peripheral blood before going to the tissues
12
Corrected WBC count formula
(WBC count x 100) / (#nRBCs + 100)
Neutrophil count is high in the _____ and low in the _____ at rest
High = afternoon
Low = morning
3-part differential includes
Granulocytes
Lymphocytes
Monocytes
5-part differential includes
Neutrophils
Lymphocytes
Monocytes
Eosinophils
Basophils
If >10% eosinophils, >2% BASOPHILS, >11% monocytes and more lymphocytes than neutrophils (except in children), use a
200-cell differential
What condition shows an AMETH-SCHILLING COUNT or shift to the left
Infection
PALE BLUE WBC INCLUSIONS of ribosomal RNA caused by infections, burns, and toxic states
Dohle bodies
Lazy leukocyte syndrome affects what blood cell
Neutrophil
Characterized by the presence of DEFECTIVE LYSOSOMES in WBCs
Chediak-Higashi syndrome
Characterized by the presence of “PINCE-NEZ” nulceus in WBCs
Pelger-Huet anomaly
Pelger-Huet anomaly is most frequently seen in the _____ state
Heterozygous
Pelger-Huet anomaly must be differentiated from shift to the _____ increase in immature WBCs
Left
_____ granules are peroxidase-negative and PAS-positive
Alder-Reilly granules
What anomaly is associated with mucopolysaccharidosis
Alder-Reilly
Alder-Reilly bodies are found in what organelle
Lysosomes
Dohle bodies are inclusion seen in
WBCs
Toxic granulations may be observed in what condition
Leukemoid reaction, infection, inflammation
These are needle-shaped bodies composed of lysosomal material and fused primary (azurophilic) granules
Auer rods
Auer rods are NOT seen in _____, but they may be seen in myeloblasts, promyelocytes, and monoblasts
Lymphoblasts
Individual globules of immunoglobulin in plasma cells are known as
Russel bodies
Accumulation of SPHINGOMYELIN due to sphingomyelinase deficiency
Niemann-pick disease
Niemann-pick cella are of what cell type
Macrophage
What accumulates in Gaucher disease
Glucocerebrosides
Monocyte or macrophage that is positive with PAS stain
Gaucher cell
REED-STERNBERG cells are seen in
Hodgkin’s lymphoma
FLOWER CELLS are associated with what disease
Adult T-cell leukemia / lymphoma
POPCORN CELLS are associated with what disease
Lymphocye-predominant Hodgkin’s lymphoma
Mycosis fungoides is a cutaneous lymphoma of what cell type
T lymphocyte
Cell increased in CLL (chronic lymphocytic leukemia)
Smudge cell
Characteristics of reactive lymphocytes
High N:C ratio
Prominent nucleoli
Basophilic cytoplasm
Test for CGD (chronic granulomatous disease)
Nitroblue tetrazolium dye
Disease characterized by absolute increase in TOTAL RBC MASS
Polycythemia vera
Level of vitamin B12 binding capacity in polycythemia vera
Increased
An increase in BASOPHILS can be seen
Chronic myelogenous leukemia (CML)
Prognosis in the PRESENCE of philadelphia chromosome (seen in CML)
Good
Prognosis in the ABSENCE of philadelphia chromosome (seen in CML)
Poor
Philadelphia chromosome results from translocation between chromosomes ___ & ___
9 and 22 (long arms)
Term denoting shift to the left increase in immature WBCs accompanied by nRBCs
Leukoerythroblastosis
Dacryocytes are associated with what condition
Myelofibrosis
Bone marrow malignancy is termed
Myeloma
An M:E ratio of 10:1 is most often seen in
Leukemia
ALL and AML cause _____ change in blood picture
Abrupt
CLL and CML cause _____ change in blood picture
Gradual
Percentage of BLAST for acute leukemia diagnosis according to WHO
More than or equal to 20%
Percentage of BLAST for acute leukemia diagnosis according to FAB
More than or equal to 30%
FAB classification of ALL is based on
Morphology
On PBS, many erythrocytes and myeloblasts seen. What FAB class
M6
(+) TRAP is seen in
Hairy cell leukemia
Alternative anticoagulant for LAP staining
Heparin
Leukocyte alkaline phosphatase (LAP) and myeloperoxidase (MPO) tests require _____ sample
Fresh
Bone marrow or blood smears need NOT to be fresh to obtain good results with the __________ stain
Sudan black B
Increases LAP score
Leukemoid reaction
3rd trimester pregnancy
Myelofibrosis
Polycythemia vera
Decreased LAP score
Chronic myelogenous leukemia
PNH
Old method used in the identification of leukemias
Cytochemical staining
Stain stored in the DARK
Periodic-acid-Schiff (PAS)
Cytochemical stain positive in L1, L2, and M6
PAS
Stain that is used to differentiate AML and AMoL from ALL
(Myelo)peroxidase
AML/AMoL (+) ALL (-)
Stain that is used to differentiate AML and AMLL from ALL
Sudan Black B
AML/AMLL (+) ALL (-)
TdT and PAS stains are positive in _____ and negative in _____ (what leukemia?)
ALL (+) ; AML (-)
Terminal deoxyribonucleotidyl transferase (TdT) is present in what cells
Precursor B and T lymphoid cells
Higher-than-average risk of malignancy in the hematopoietic system (what profession?)
Chemist
Radiologist
Rubber industry worker
Woodworker
Involves blood vessels and platelets; formation of PLATELET PLUG
Primary hemostasis
Involves coagulation factors; formation of FIBRIN CLOT
Secondary hemostasis
Process of formation of thrombocytes in the bone marrow
Thrombopoiesis
Number of platelet stages
6
Megakaryoblast
Promegakaryocyte
Granular megakaryocyte
Mature megakaryocyte
Metamegakaryocte
Platelets
The maturation of cells of the megakaryocytic system has been divided into _____ stages
Four
In _____, the more mature a cell is, the more nucleus it has
Megakaryopoiesis
Hormone and cytokines that control megakaryopoiesis
TPO, IL-3, IL-6, IL-11
Least mature platelet progenitor
BFU-Meg
Most mature platelet progenitor
LD-CFU-Meg
Least differentiated platelet precursor
Megakaryoblast (MK-I)
Largest cell in the bone marrow
Megakaryocyte
Cell that undergoes the first stage of endomitosis
LD-CFU-Meg
Stage in the megakaryocytic series where THROMBOCYTES ARE ALREADY VISIBLE
Metamegakaryocyte
Cell with maturation time of 5 days and life span of 8-11 days
Platelets (thrombocytes)
TRUE OR FALSE: Platelets are NOT true cells
True; they are fragments of cytoplasm derived from megakaryocytes in the bone marrow
Major source of energy of platelets
Glucose
Process of STICKING platelets to SURFACES such as sub-endothelial collagen
Platelet adhesion
Process of STICKING platelets to ONE ANOTHER
Platelet aggregation
Some coagulation factors are stored in what part of the platelet structure
Alpha granules
Contents of platelet DENSE GRANULES
*CAMPAS
Calcium
ATP
Magnesium
Pyrophosphate
ADP
Serotonin
It reflects the number and quality of platelets, fibrinogen concentration, fibrinolytic activity, and packed red cell volume
Clot retraction
Site of platelet sequestration
Spleen
In uremia, platelet function is impaired due to high levels of
Nitrite oxide
Known as the “GIANT PLATELET SYNDROME”
Bernard Soulier Syndrome
Characteristic of platelets in Wiskott-Aldrich syndrome
Extremely small
vWD and Benard-Soulier syndrome have defects in what platelet function
Platelet adhesion
Aspirin inhibits what enzyme
Cyclooxygenase
Defect in platelet aggregation due to lack of Gp IIb/IIIa complex
Glanzmann’s thrombasthenia
Platelet satellitosis may occur using what anticoagulant
EDTA
Remedy for platelet satellitosis
Uses sodium citrate (then result x 1.1)
Diluent for platelet count using phase contrast microscope
1% ammonium oxalate
Degree of thrombocytopenia is _____ proportional to the number of blood units transfused
Directly
MASSIVE TRANSFUSION may cause thrombocytopenia because of the _____ of the platelets by RBC transfusion
Dilution
The earliest hematological change in acute blood loss is a transient fall in the _____ count
Platelet
Reticulated platelets are seen in what condition
Immune thrombocytopenic purpura
Effect of splenectomy on platelet count
Increased
Effect of splenomegaly on platelet count
Decreased
Vomiting of blood
Hematemesis
Leakage of large amount of blood into tissues around venipuncture site
Hematomas
Seepage of blood into large areas of skin but not into deep tissues (>1cm)
Ecchymosis
Ecchymosis would suggest a deficiency in
Platelets
Hemorrhage of blood into small areas of the skin (3 mm)
Purpura
Pinpoint hemorrhagic spots
Petechiae
EPISTAXIS, petecchiae, purpura, ecchymosis, gum bleeding, hematemesis, and menorrhagia are symptoms of
Primary hemostasis defect
Coagulation factors that function as SERINE PROTEASES
II, VII, IX, X, XI, XII, Prekalekrain
Coagulation factors that function as COFACTORS
III, V, VIII, HMWK
Coagulation factor that function as TRANSGLUTAMINASE / TRANSAMIDASE
XIII
What is Factor IIa
Thrombin
Substrate of thrombin
Factor 1
Fibrinogen increases by _____ per decade
10 mg/dL
Coagulation factors activated at COLD TEMPERATURE
Factor VII and XI
LABILE coagulation factors
Factor V and VIII
Coagulation factor that plays a role in coagulation, in VITRO, but not in vivo
XIIa
What cell (s) produce (s) von Willebrand factor
Endothelial cells and megakaryocytes
von Willebrand factor carries what coagulation factor
Factor VIII
Most common inherited coagulation factor deficiencies
vWD, Hemophilia A and B
Coagulation factor deficiency commonly found in ASHKENAZI JEWS
Factor XI deficiency
Coagulation factor deficiency associated with menorrhagia
vWD
Factor XIII deficiency will yield normal coagulation tests except
Duckert’s test (5M urea solubility test)
Proteins C and S degrade what coagulation factors
Va and VIIIa
Normal agglutination response to epinephrine, collagen, ADP, but ABNORMAL response to RISTOCETIN
vWD and Bernard-Soulier syndrome
NORMAL agglutination response to RISTOCETIN, but abnormal response to epinephrine, collagen, ADP
Glanzmann’s thrombasthenia
Normal anticoagulant circulating in the body
Heparin
In vivo and in vitro anticoagulant
Heparin
Treatment for heparin overdose
Protamine sulfate
Heparin therapy causes _____ thrombin time results
Prolonged
Bleeding time measures what platelet function (s)
Adhesion and aggregation
BLEEDING time result in factor X deficiency
Normal
CLOTTING time result on partially clotted blood sample
Shortened
Effect of UNDERFILLED TUBE on clotting time results
Prolonged (due to excess anticoagulant)
Fibrinogen level in dysfibrinogenemia
Normal
PT and APTT results in polycythemia vera
Both prolonged
PT and APTT are prolonged when fibrinogen levels fall below
100 mg/dL
Prolonged PT and APTT not corrected by normal plasma. What indication
Circulating (lupus) anticoagulant
Prolonged APTT, PT, and TT, LOW platelet count. What is the diagnosis?
DIC
Other names for DIC
Consumption coagulopathy
Defibrination syndrome
BETHESDA, platelet neutralization and Dilute Russell viper venom are tests for
Lupus anticoagulant
Test for quantitating Factor VIII inhibitor
Bethesda assay
Sensitive early marker for Factor VII activity in mild liver disease
Prothrombin time
PT is performed at what temperature
37C
Purpose of thromboplastin in the PT test is to provide _____ to the assay
Phospholipoprotein
The thromboplastin in the PT reagent is derived from what organ
Rabbit brain or lung
Visual detection of fibrin clot formation
Tilt-tube method
Patient ingested RAT POISON, what test to order to test its effect on coagulation mechanism
PT
This is used to monitor patients undergoing WARFARIN THERAPY
PT (INR)
This is used to monitor patients undergoing unfractionated HEPARIN THERAPY
APTT
Specimens for PT should be tested within
24 hours (no unfractionated heparin)
Specimens for APTT should be tested within
4 hours (no unfractionated heparin)
Patients under heparin therapy may produce antibodies against
PF4 (platelet factor 4)
4.5 mL blue top filled with 2.0 mL blood was sent to the lab for PT and APTT. What to do?
Reject the sample (underfilled tube)
How to prepare platelet poor plasma (PPP)
Centrifuge blood for 15 mins at 1500g
INR is used to standardize _____ results. The INR calculation uses the international sensitivity (ISI) value
PT
The closer the ISI to ___, the more sensitive the reagent is; the higher the ISI, the less sensitive the reagent is
1
Euglobulin clot lysis time is a _____ procedure for the measurement of FIBRINOLYTIC ACTIVITY
Screening
D-dimer is produced from
Crosslinked and stabilized fibrin clot
Effect of microcytosis on platelet count using automated counters
Spurious increase
Automation principle that uses 2 electrodes to determine cell size
Electrical impedance
Directly counted by the electrical impedance instrument
RBC, WBC, Platelets, Hgb, Reticulocytes
Forward light scatter measures
Cell size
Side angle or 90 degrees scatter measures
Cytoplasmic granularity
Printed on the electrical impedance written report
Scattergram, histogram, flagging
If the cells are larger than normal, the histogram curve will be more to the
Right
If the cells are smaller than normal, the histogram curve will be more to the
Left
RBCs with NORMAL RDW are HOMOGENOUS in character and exhibit ___ anisocytosis on PBS
Very little
RBCs with INCREASED RDW are HETEROGENOUS in character and exhibit ___ anisocytosis on PBS
High degree
Principle of Coulter counter and Sysmex counter
Electrical impedance
Principle of Technicon Autoanalyzer
Optical light scattering
Values derived from RBC histogram
MCV, RDW
Values derived from PLATELET histogram
MPV, PDW
MPV should be measured at what time period
1-3 (1-4) hours after collection
If platelet count is low, the MPV is usually
High (inversely proportional)
Effect (s) of AUTOAGGLUTINATION on RBC parameters
Decrease RBC count and hematocrit
Increase MCV and MCHC
Effect (s) of COLD AGGLUTININS on RBC parameters
Decrease RBC count and hematocrit
Increase MCV and MCHC
Most common problem in cell counting, causing an increase in current
Aperture plugs
4 components of flow cytometer
Fluidics
Optics
Computer
Electronics
Applications of flow cytometry
Cell sorting
Cellular identification
Process of selecting a population of interest as defined by >1 flow cytometric pattern
Gating
Ohm’s law formula
Voltage (V) = current (I) x resistance (R)
