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Hubble Notes > Hematology > Flashcards

Hematology Flashcards

1
Q

Liquid portion of unclotted blood

A

Plasma

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2
Q

Effective concentration of EDTA in evacuated tubes

A

1-2 mg/mL (1-2 g/L) of blood

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3
Q

Anticoagulant for cardiopulmonary bypass, seen in OPEN HEART SURGERY

A

Heparin

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4
Q

Anticoagulant used for platelet studies

A

Sodium citrate

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5
Q

Ratio of citrate anticoagulant to blood

A

1:9

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6
Q

Complement dependent test cannot be performed on _____ blood

A

Anti-coagulated

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7
Q

The higher the gauge, the _____ the diameter of the needle

A

Smaller

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8
Q

Avoid using the arm with fistula or cannula for venipuncture due to possibility of _____ or _____

A

Infection or clotting

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9
Q

Once sufficient blood has been collected, release the tourniquet _____ withdrawing the needle

A

Before

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10
Q

Release and remove the tourniquet as soon as blood flow is established or after no longer than ___ minute

A

1

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11
Q

Phlebotomy complications

A

Vascular
Anemia
Neurologic
Dermatologic
Infection
Cardiovascular

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12
Q

Type of light used by AccuVein

A

Near infrared

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13
Q

Safest site for bone marrow aspiration and biopsy

A

Posterior iliac crest

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14
Q

Manner of making a good smear (pushing the spreader slide)

A

Smooth and rapid

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15
Q

Best area to review or perform a differential on a stained blood film

A

RBC mostly separated, few overlapping

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16
Q

Scanning method on smears that minimize distribution errors

A

Battlement method

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17
Q

If buffer is acidic, RBCs would be stained _____ ; if it is alkaline, RBCs would be stained _____

A

Acidic = too pink
Alkaline = too blue

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18
Q

Blood smear appears bluer than normal. What indication?

A

Increased plasma proteins

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19
Q

What happens to RBC if blood smear dries too slowly?

A

Crenated (echinocytes)

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20
Q

Magnification of OIO

A

100x

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21
Q

These are autoantibodies of the IgM class that react optimally at 4C

A

Cold agglutinins

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22
Q

To avoid agglutination on PBS, the slide can be __________ prior to application of blood

A

Warmed to 37C

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23
Q

ANTI-COAGULATED (heparinized) microhematocrit tube ring color

A

Red

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24
Q

Speed of centrifugation for microhematocrit tube

A

10,000-15,000g

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25
Q

Difference between duplicate hematocrit readings should agree within ___ %

A

1%

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26
Q

Effect on insufficient centrifugation on hematocrit

A

False-increase

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27
Q

Microhematocrit method gives _____ hematocrit values than automated method

A

1-3% higher

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28
Q

WBC count, RBC count, hemoglobin, hematocrit and WBC differential

A

CBC (complete blood count)

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29
Q

Rule of 3

A

RBC x 3 = hemoglobin
Hemoglobin x 3 = hematocrit +/- 3%

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30
Q

Calculated rather than directly measured by automated instruments

A

Hematocrit, MCH, MCHC

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31
Q

Normal MCV value ; formula

A

80-100 fL
(HCT / RBC) x 10

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32
Q

Normal MCH value; formula

A

27-32 pg
(HGB / RBC) x 10

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33
Q

Normal MCHC value; formula

A

31-36%
(HGB / HCT) x 100

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34
Q

RBC index NOT AFFECTED by a defective centrifuge used to determine HCT

A

MCH

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35
Q

RBC index NOT USED in the classification of ANEMIA

A

MCH

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36
Q

Numerical expression that correlates with the degree of anisocytosis

A

RDW

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37
Q

Used in conjunction with RDW to determine the cause of anemia

A

MCV

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38
Q

Variation in cell SIZE is called

A

Anisocytosis

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39
Q

Variation in cell SHAPE is called

A

Poikilocytosis

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40
Q

Directly measures the VARIABILITY in platelet size

A

PDW

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41
Q

Normocytic, normochromic

A

Hemolytic anemia
Aplastic anemia
Leukemia
Acute blood loos
Sickle cell anemia

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42
Q

Microcytic, hypochromic

A

Sideroblast anemia
Iron deficiency anemia
Chronic blood loss
Anemia of chronic disease
Thalassemia

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43
Q

Macrocytic, normochromic

A

Megaloblastic anemia
Chronic liver disease
Bone marrow failure
Myelodysplastic syndrome

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44
Q

Compositional parts of the red bone marrow to the yellow bone marrow is called

A

Marrow cellularity

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45
Q

Hematopoiesis that occurs in the bone marrow

A

Medullary hematopoiesis

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46
Q

Sites of medullary hematopoiesis

A

Ribs
Sternum
Skull
Vertebrae
Pelvis (illiac crest)
Extremities of long bones

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47
Q

Hematopoiesis that does not occur in the bone marrow

A

Extramedullary hematopoiesis

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48
Q

Sites of extramedullary hematopoiesis

A

Liver
Spleen
Lymph nodes

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49
Q

Primary site of hematopoiesis during the 5th MONTH of fetal development

A

Liver

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50
Q

Early indication of ENGRAFTMENT SUCCESS after hematopoietic stem cell transplant

A

Immature reticulocyte and platelet functions

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51
Q

Primary cell source of erythropoietin (EPO)

A

Peritubular interstitial cells (kidney)

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52
Q

First type of cell produced by the developing embryo

A

Erythrocytes

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53
Q

Hemoglobin synthesis BEGINS at what erythroid stage

A

Basophilic normoblast

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54
Q

First erythroid stage in which the pink color associated with hemoglobin can be seen

A

Polychromatic normoblast (rubricyte)

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55
Q

Last stage in the erythroid series capable of mitosis

A

Polychromatic normoblast (rubricyte)

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56
Q

Enucleation occurs in what erythroid stage

A

Orthochromic normoblast (metarubricyte)

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57
Q

Last stage in the erythroid series capable of hemoglobin synthesis

A

Reticulocyte

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58
Q

N:C ratio during the RBC development

A

Decreases

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59
Q

In the RBC line, proportion of nucleus shrinks as the cell matures and cytoplasm _____ proportionately

A

Increases

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60
Q

Color of cytoplasm of immature or younger blast stages

A

Dark blue (basophilic)

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61
Q

Used to assess the erythropoietic activity

A

Reticulocyte count

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62
Q

Normal value for reticulocyte count in adult in %

A

0.5 - 1.5 %

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63
Q

Refers to DECREASE in number of erythroid precursors in the bone marrow; DECREASE RBC production

A

Insufficient erythropoeisis

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64
Q

Miller disc is an ocular device used to facilitate counting of

A

Reticulocytes

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65
Q

Absolute reticulocyte count

A

Reticulocyte (%) x RBC count (10^12/L)

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66
Q

Corrected reticulocyte count

A

Reticulocyte (%) x [Hematocrit (%) / 45]

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67
Q

Staining method used to stain and manually count reticulocytes

A

Supravital staining

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68
Q

Supravital stain (s) for reticulocytes

A

NMB (new methylene blue)
BCB (brilliant cresyl blue)

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69
Q

Supravital stains are important because the cell must be alive to see

A

Remaining RNA

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70
Q

Enzyme that incorporates Fe2+ in the center of protoplrphyrin

A

Ferrochelatase / heme synthetase

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71
Q

The greatest portion of operational body iron is normally contained in what compound?

A

Hemoglobin

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72
Q

A hemoglobin molecule is composed of how many heme and globin

A

4 heme, 4 globin

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73
Q

How many iron atom (s) and pyrole ring (s) comprise the HEME portion of hemoglobin molecule

A

1, 4

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74
Q

1 hemoglobin molecule can carry _____ O2 molecules

A

4

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75
Q

Embryonic hemoglobins

A

Gower I
Gower II
Portland

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76
Q

Deoxyhemoglobin is a (n) _____ hemoglobin

A

Normal

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77
Q

1 gram of hemoglobin can carry _____ oxygen

A

1.34 mL

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78
Q

It demonstrates relationship between pH and Hgb affinity to O2

A

Bohr effect

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79
Q

MAUVE LAVENDER blood color; NOT MEASURED by cyanmethemoglobin method

A

Sulfhemoglobin

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80
Q

CHERRY RED blood color is due to

A

Carboxyhemoglobin

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81
Q

BRIGHT RED blood color is due to

A

Oxyhemoglobin

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82
Q

CHOCOLATE BROWN blood color is due to

A

Methemoglobin

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83
Q

Anticoagulant for methemoglobin determination

A

EDTA or Heparin

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84
Q

Shift to the RIGHT O2 dissociation curve

A

Decreased (O2 affinity and pH)
Increased (temperature, 2,3-DPG, and CO2)

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85
Q

Shift to the LEFT O2 dissociation curve

A

Increased (O2 affinity and pH)
Decreased (temperature, 2,3-DPG, and CO2)

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86
Q

Sodium potassium pump regulates concentrations of Na and K; maintaining intracellular to extracellular ratios of _____ & _____, respectively

A

Intracellular (Na : K) = 1:12
Extracellular (Na : K) = 25:1

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87
Q

Pathway that generates 2,3-DPG

A

Rapoport-Luebering

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88
Q

Pathway that generates 2 ATP molecules

A

Embden-Meyerhoff

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89
Q

Pathway that maintains hemoglobin IRON into ferrous state

A

Methemoglobin reductase

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90
Q

Pathway that generates reduced GLUTATHIONE that prevents hemoglobin denaturation

A

Pentose-phosphate (HMS)

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91
Q

Enzyme deficiency associated with DRUG-INDUCED hemolytic anemia

A

G6PD deficiency

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92
Q

G6PD deficiency affects what RBC metabolic pathway

A

Hexose monophosphate (PPP)

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93
Q

Haptoglobin levels in intravascular hemolysis

A

Decreased

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94
Q

Type of poikilocyte seen in autoimmune hemolytic anemia (AIHA)

A

Spherocytes

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95
Q

Wavelength used in cyanmethemoglobin method

A

540 nm

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96
Q

Drabkin’s reagents contains

A

Potassium ferricyanide
Potassium cyanide
Dihydrogen potassium phosphate
Distilled H2O
Surfactant

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97
Q

LIPEMIA can be corrected by adding ___ mL of plasma to ___ mL of cyanmethemoglobin reagent (then use this as reagent blank)

A

0.01 mL ; 5mL

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98
Q

Reagent that converts methemoglobin to cyanmethemoglobin

A

Potassium cyanide

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99
Q

PLATELET COUNT that indicates the need to adjust Drabkin’s reagent

A

> 700 x 10^9 / L

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100
Q

WBC COUNT that indicates the need to adjust Drabkin’s reagent

A

> 20 x 10^9 / L

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101
Q

In normal adult, this acts as the site of removal of IMPERFECT AND AGED CELLS

A

Spleen

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102
Q

Removal of RBC INCLUSIONS by the spleen

A

Pitting

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103
Q

Removal of AGED/SENESCENT RBCs by the spleen

A

Culling

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104
Q

Reference range for ESR in MALE 50 years of age and BELOW

A

0-15 mm/hr

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105
Q

Reference range of ESR in MALE ABOVE 50 years of age

A

0-20 mm/hr

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106
Q

Reference range for ESR in FEMALE 50 years of age and BELOW

A

0-20 mm/hr

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107
Q

Reference range of ESR in FEMALE ABOVE 50 years of age

A

0-30 mm/hr

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108
Q

Relationship between ESR and RBS mass

A

Directly proportional

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109
Q

Relationship between ESR and plasma viscosity

A

Inversely proportional

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110
Q

Effect of overanticoagulation on ESR results

A

Decreased

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111
Q

Preferred anticoagulant for the osmotic fragility test

A

Heparin

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112
Q

Osmotic fragility of SICKLE CELLS and TARGET CELLS

A

Decreased

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113
Q

Osmotic fragility of spherocytes

A

Increased

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114
Q

Initial hemolysis of NORMAL RBCs in OFT will begin at what NaCl concentration

A

0.45%

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115
Q

Initial hemolysis of SICKLE CELLS in OFT will begin at what NaCl concentration

A

0.35%

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116
Q

Complete hemolysis of SPHEROCYTES in OFT will begin at what NaCl concentration

A

0.45%

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117
Q

Cell with a characteristic CENTRAL hemoglobinized area

A

Codocytes

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118
Q

Thin variant of codocyte

A

Leptocyte

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119
Q

Also known as punched-out cell

A

Anulocyte

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120
Q

This poikilocyte is formed due to imbalance between RBC and plasma lipids

A

Acanthocyte

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121
Q

Poikilocyte associated with abetalipoproteinemia

A

Acanthocyte

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122
Q

RBC membrane folded over (folded cell) is associated with what disease?

A

Hb C disease, Hb SC disease

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123
Q

RBC inclusion resembling “Washington monument” or “gold bar”

A

Hb C crystal

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124
Q

RBC inclusion stained by supravital, wright, and FEULGEN

A

Howell-jolly bodies

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125
Q

RBC inclusion composed of denatured/precipitated hemoglobin

A

Heinz bodies

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126
Q

Howell-jolly bodies are nuclear fragments containing

A

DNA

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127
Q

Heinz bodies are associated with

A

G6PD deficiency, unstable hemoglobin, favism

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128
Q

“Bite cells” are usually seen in what condition

A

G6PD deficiency

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129
Q

They contain aggregates of RIBOSOMES and degenerating mitochondria

A

Basophilic stippling

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130
Q

RBC inclusion body associated with pyrimidine-5’-nucleotidase deficiency

A

Coarse basophilic stippling

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131
Q

RBC inclusion seen in LEAD POISONING

A

Coarse basophilic stippling

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132
Q

Stippling seen in polychromatophilia

A

Fine basophilic stippling

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133
Q

Abnormal IRON GRANULES found inside RBCs, visible with Wright stain

A

Pappenheimer bodies

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134
Q

Polycythemia patient treated by phlebotomy will develop _____ deficiency

A

Iron

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135
Q

Most commonly encountered type of autoimmune hemolytic anemia (AIHA)

A

Warm AIHA

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136
Q

Antibody frequently seen in patients with warm AIHA

A

Anti-e

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137
Q

Anemia with BONE MARROW INFILTRATION by tumor cells

A

Myelophthisic anemia

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138
Q

Anemia due to DECREASED DNA SYNTHESIS, resulting in OVAL AND MACROCYTIC red cells

A

Megaloblastic anemia

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139
Q

Anemia caused by FAILURE TO PRODUCE RBCs, WBCs and platelets

A

Aplastic anemia

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140
Q

Anemia characterized by IRON LOADING and its accumulation in the mitochondria

A

Sideroblastic anemia

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141
Q

Anemia caused by IMPAIRED PRODUCTION of protoporphyrin

A

Sideroblastic anemia

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142
Q

RBC containing IRON GRANULES stained with Prussian blue is known as

A

Siderocyte

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143
Q

1st laboratory test that is abnormal in early stages of IDA

A

Serum ferritin

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144
Q

High TIBC and free erythrocyte protoporphyrin (FEP)

A

Iron deficiency anemia

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145
Q

Marker useful in diagnosis of IDA as well as an EARLY INDICATOR OF RECOVERY after iron therapy

A

Reticulocyte hemoglobin content

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146
Q

Binds FERROPORTIN and TARGETS IT for degradation, resulting to decrease circulating iron

A

Hepcidin

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147
Q

Anemia with SHORT STATURE, hypogonadism, skin pigmentation, organ malfunction

A

Fanconi anemia

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148
Q

Also known as congenital aplastic anemia

A

Fanconi anemia

149
Q

Also known as congenital pure red cell aplasia

A

Diamond-Blackfan anemia

150
Q

__________ and __________ deficiencies may cause megaloblastic anemia

A

Vitamin B12 and folic acid

151
Q

It differentiates Vitamin B12 deficiency (⬆️) from folate deficiency (N)

A

MMA (serum methylmalonic acid)

152
Q

H. pylori infection may also cause _____ anemia

A

Megaloblastic

153
Q

Vitamin B12 or folic acid deficiency hinder erythroblast in manufacturing _____

A

DNA

154
Q

Factor deficient in pernicious anemia

A

Intrinsic factor

155
Q

MCV in megaloblastic anemia

A

Increased

156
Q

Growth factor GIVEN in cases of anemia due to chronic kidney disease

A

Erythropoietin

157
Q

QUANTITATIVE globin chain defect (reduced globin synthesis)

A

Thalassemia

158
Q

QUALITATIVE globin chain defect (amino acid substitutions)

A

Hemoglobinopathy

159
Q

Glutamic acid on the 6th position of beta chain is replaced by VALINE

A

Hemoglobin S

160
Q

Glutamic acid on the 6th position of beta chain is replaced by LYSINE

A

Hemoglobin C

161
Q

Glutamic acid on the 26th position of beta chain is replaced by LYSINE

A

Hemoglobin E

162
Q

Glutamic acid on the 121st position of beta chain is replaced by LYSINE

A

Hemoglobin O

163
Q

Glutamic acid on the 121st position of beta chain is replaced by GLUTAMINE

A

Hemoglobin D

164
Q

Bluish discoloration of the skin is termed

A

Cyanosis

165
Q

Major cause of death in sickle cell anemic patients

A

Bacterial infection (due to autosplenectomy)

166
Q

Traditional sickling test that involves formation of HOLLY-LEAF appearance of RBCs

A

Metabisulfite test

167
Q

Screening test for PNH

A

Sugar water, sucrose hemolysis

168
Q

Confirmatory test for PNH

A

Ham’s test (old), flow cytometry

169
Q

Anticoagulant for sugar water screening and sucrose hemolysis test

A

Citrate

170
Q

Evaluates sensitivity of patient’s blood to complement-mediated lysis

A

Ham’s acidified serum test

171
Q

In HAM’s test, when patient has received transfusions, less _____ occurs because of the transfused normal RBCs

A

Lysis

172
Q

Primary target cells of G-CSF

A

Neutrophil precursors
Fibroblasts
Leukemic myeloblasts

173
Q

Cytokines involved in stem cell mobilization

A

G-CSF
GM-CSF
IL-3

174
Q

Dendritic cells and lymphocytes (B, T, NK cells) originated from what cell

A

Common lymphoid progenitor

175
Q

3 pools of the developing neutrophils in the bone marrow

A

Stem cell pool
Proliferation pool
Maturation pool

176
Q

Granulopoiesis takes about ___ days from the blast stage to the release of mature granulocytes

A

14

177
Q

It has a curved nucleus with MORE THAN 1/2 nuclear indentation

A

Band cell

178
Q

Primary / azurophilic / nonspecific granules begin to appear on what stage

A

Promyelocyte

179
Q

Myelocytic stage where a given granulocyte can be identified

A

Myelocyte

180
Q

Myelocytic stage where the cell begins to produce secondary / specific granules

A

Myelocyte

181
Q

Last stage in the myelocytic series capable of mitosis

A

Myelocyte

182
Q

Myelocytic stage where the cell has KIDNEY or BEAN-SHAPED nucleus

A

Metamyelocyte

183
Q

Youngest cell in the peripheral blood, with SAUSAGE-SHAPED nucleus

A

Band cell

184
Q

Once metamyelocyte stage has been reached, cells have undergone _____ cell divisions and the proliferation phase comes to an end

A

4 or 5

185
Q

Should band cells be included within neutrophil counts?

A

Yes

186
Q

Color of eosinophil cytoplasm

A

Orange-red

187
Q

Mature basophils are myeloperoxidase (positive or negative)

A

Negative

188
Q

Phagocytic cell (s) containing lysozyme

A

Neutrophils, monocytes

189
Q

Precursor of macrophage

A

Monocyte

190
Q

The MATURE MONOCYTE spends about ___ hours in the peripheral blood before going to the tissues

A

12

191
Q

Corrected WBC count formula

A

(WBC count x 100) / (#nRBCs + 100)

192
Q

Neutrophil count is high in the _____ and low in the _____ at rest

A

High = afternoon
Low = morning

193
Q

3-part differential includes

A

Granulocytes
Lymphocytes
Monocytes

194
Q

5-part differential includes

A

Neutrophils
Lymphocytes
Monocytes
Eosinophils
Basophils

195
Q

If >10% eosinophils, >2% BASOPHILS, >11% monocytes and more lymphocytes than neutrophils (except in children), use a

A

200-cell differential

196
Q

What condition shows an AMETH-SCHILLING COUNT or shift to the left

A

Infection

197
Q

PALE BLUE WBC INCLUSIONS of ribosomal RNA caused by infections, burns, and toxic states

A

Dohle bodies

198
Q

Lazy leukocyte syndrome affects what blood cell

A

Neutrophil

199
Q

Characterized by the presence of DEFECTIVE LYSOSOMES in WBCs

A

Chediak-Higashi syndrome

200
Q

Characterized by the presence of “PINCE-NEZ” nulceus in WBCs

A

Pelger-Huet anomaly

201
Q

Pelger-Huet anomaly is most frequently seen in the _____ state

A

Heterozygous

202
Q

Pelger-Huet anomaly must be differentiated from shift to the _____ increase in immature WBCs

A

Left

203
Q

_____ granules are peroxidase-negative and PAS-positive

A

Alder-Reilly granules

204
Q

What anomaly is associated with mucopolysaccharidosis

A

Alder-Reilly

205
Q

Alder-Reilly bodies are found in what organelle

A

Lysosomes

206
Q

Dohle bodies are inclusion seen in

A

WBCs

207
Q

Toxic granulations may be observed in what condition

A

Leukemoid reaction, infection, inflammation

208
Q

These are needle-shaped bodies composed of lysosomal material and fused primary (azurophilic) granules

A

Auer rods

209
Q

Auer rods are NOT seen in _____, but they may be seen in myeloblasts, promyelocytes, and monoblasts

A

Lymphoblasts

210
Q

Individual globules of immunoglobulin in plasma cells are known as

A

Russel bodies

211
Q

Accumulation of SPHINGOMYELIN due to sphingomyelinase deficiency

A

Niemann-pick disease

212
Q

Niemann-pick cella are of what cell type

A

Macrophage

213
Q

What accumulates in Gaucher disease

A

Glucocerebrosides

214
Q

Monocyte or macrophage that is positive with PAS stain

A

Gaucher cell

215
Q

REED-STERNBERG cells are seen in

A

Hodgkin’s lymphoma

216
Q

FLOWER CELLS are associated with what disease

A

Adult T-cell leukemia / lymphoma

217
Q

POPCORN CELLS are associated with what disease

A

Lymphocye-predominant Hodgkin’s lymphoma

218
Q

Mycosis fungoides is a cutaneous lymphoma of what cell type

A

T lymphocyte

219
Q

Cell increased in CLL (chronic lymphocytic leukemia)

A

Smudge cell

220
Q

Characteristics of reactive lymphocytes

A

High N:C ratio
Prominent nucleoli
Basophilic cytoplasm

221
Q

Test for CGD (chronic granulomatous disease)

A

Nitroblue tetrazolium dye

222
Q

Disease characterized by absolute increase in TOTAL RBC MASS

A

Polycythemia vera

223
Q

Level of vitamin B12 binding capacity in polycythemia vera

A

Increased

224
Q

An increase in BASOPHILS can be seen

A

Chronic myelogenous leukemia (CML)

225
Q

Prognosis in the PRESENCE of philadelphia chromosome (seen in CML)

A

Good

226
Q

Prognosis in the ABSENCE of philadelphia chromosome (seen in CML)

A

Poor

227
Q

Philadelphia chromosome results from translocation between chromosomes ___ & ___

A

9 and 22 (long arms)

228
Q

Term denoting shift to the left increase in immature WBCs accompanied by nRBCs

A

Leukoerythroblastosis

229
Q

Dacryocytes are associated with what condition

A

Myelofibrosis

230
Q

Bone marrow malignancy is termed

A

Myeloma

231
Q

An M:E ratio of 10:1 is most often seen in

A

Leukemia

232
Q

ALL and AML cause _____ change in blood picture

A

Abrupt

233
Q

CLL and CML cause _____ change in blood picture

A

Gradual

234
Q

Percentage of BLAST for acute leukemia diagnosis according to WHO

A

More than or equal to 20%

235
Q

Percentage of BLAST for acute leukemia diagnosis according to FAB

A

More than or equal to 30%

236
Q

FAB classification of ALL is based on

A

Morphology

237
Q

On PBS, many erythrocytes and myeloblasts seen. What FAB class

A

M6

238
Q

(+) TRAP is seen in

A

Hairy cell leukemia

239
Q

Alternative anticoagulant for LAP staining

A

Heparin

240
Q

Leukocyte alkaline phosphatase (LAP) and myeloperoxidase (MPO) tests require _____ sample

A

Fresh

241
Q

Bone marrow or blood smears need NOT to be fresh to obtain good results with the __________ stain

A

Sudan black B

242
Q

Increases LAP score

A

Leukemoid reaction
3rd trimester pregnancy
Myelofibrosis
Polycythemia vera

243
Q

Decreased LAP score

A

Chronic myelogenous leukemia
PNH

244
Q

Old method used in the identification of leukemias

A

Cytochemical staining

245
Q

Stain stored in the DARK

A

Periodic-acid-Schiff (PAS)

246
Q

Cytochemical stain positive in L1, L2, and M6

A

PAS

247
Q

Stain that is used to differentiate AML and AMoL from ALL

A

(Myelo)peroxidase
AML/AMoL (+) ALL (-)

248
Q

Stain that is used to differentiate AML and AMLL from ALL

A

Sudan Black B
AML/AMLL (+) ALL (-)

249
Q

TdT and PAS stains are positive in _____ and negative in _____ (what leukemia?)

A

ALL (+) ; AML (-)

250
Q

Terminal deoxyribonucleotidyl transferase (TdT) is present in what cells

A

Precursor B and T lymphoid cells

251
Q

Higher-than-average risk of malignancy in the hematopoietic system (what profession?)

A

Chemist
Radiologist
Rubber industry worker
Woodworker

252
Q

Involves blood vessels and platelets; formation of PLATELET PLUG

A

Primary hemostasis

253
Q

Involves coagulation factors; formation of FIBRIN CLOT

A

Secondary hemostasis

254
Q

Process of formation of thrombocytes in the bone marrow

A

Thrombopoiesis

255
Q

Number of platelet stages

A

6
Megakaryoblast
Promegakaryocyte
Granular megakaryocyte
Mature megakaryocyte
Metamegakaryocte
Platelets

256
Q

The maturation of cells of the megakaryocytic system has been divided into _____ stages

A

Four

257
Q

In _____, the more mature a cell is, the more nucleus it has

A

Megakaryopoiesis

258
Q

Hormone and cytokines that control megakaryopoiesis

A

TPO, IL-3, IL-6, IL-11

259
Q

Least mature platelet progenitor

A

BFU-Meg

260
Q

Most mature platelet progenitor

A

LD-CFU-Meg

261
Q

Least differentiated platelet precursor

A

Megakaryoblast (MK-I)

262
Q

Largest cell in the bone marrow

A

Megakaryocyte

263
Q

Cell that undergoes the first stage of endomitosis

A

LD-CFU-Meg

264
Q

Stage in the megakaryocytic series where THROMBOCYTES ARE ALREADY VISIBLE

A

Metamegakaryocyte

265
Q

Cell with maturation time of 5 days and life span of 8-11 days

A

Platelets (thrombocytes)

266
Q

TRUE OR FALSE: Platelets are NOT true cells

A

True; they are fragments of cytoplasm derived from megakaryocytes in the bone marrow

267
Q

Major source of energy of platelets

A

Glucose

268
Q

Process of STICKING platelets to SURFACES such as sub-endothelial collagen

A

Platelet adhesion

269
Q

Process of STICKING platelets to ONE ANOTHER

A

Platelet aggregation

270
Q

Some coagulation factors are stored in what part of the platelet structure

A

Alpha granules

271
Q

Contents of platelet DENSE GRANULES

A

*CAMPAS

Calcium
ATP
Magnesium
Pyrophosphate
ADP
Serotonin

272
Q

It reflects the number and quality of platelets, fibrinogen concentration, fibrinolytic activity, and packed red cell volume

A

Clot retraction

273
Q

Site of platelet sequestration

A

Spleen

274
Q

In uremia, platelet function is impaired due to high levels of

A

Nitrite oxide

275
Q

Known as the “GIANT PLATELET SYNDROME”

A

Bernard Soulier Syndrome

276
Q

Characteristic of platelets in Wiskott-Aldrich syndrome

A

Extremely small

277
Q

vWD and Benard-Soulier syndrome have defects in what platelet function

A

Platelet adhesion

278
Q

Aspirin inhibits what enzyme

A

Cyclooxygenase

279
Q

Defect in platelet aggregation due to lack of Gp IIb/IIIa complex

A

Glanzmann’s thrombasthenia

280
Q

Platelet satellitosis may occur using what anticoagulant

A

EDTA

281
Q

Remedy for platelet satellitosis

A

Uses sodium citrate (then result x 1.1)

282
Q

Diluent for platelet count using phase contrast microscope

A

1% ammonium oxalate

283
Q

Degree of thrombocytopenia is _____ proportional to the number of blood units transfused

A

Directly

284
Q

MASSIVE TRANSFUSION may cause thrombocytopenia because of the _____ of the platelets by RBC transfusion

A

Dilution

285
Q

The earliest hematological change in acute blood loss is a transient fall in the _____ count

A

Platelet

286
Q

Reticulated platelets are seen in what condition

A

Immune thrombocytopenic purpura

287
Q

Effect of splenectomy on platelet count

A

Increased

288
Q

Effect of splenomegaly on platelet count

A

Decreased

289
Q

Vomiting of blood

A

Hematemesis

290
Q

Leakage of large amount of blood into tissues around venipuncture site

A

Hematomas

291
Q

Seepage of blood into large areas of skin but not into deep tissues (>1cm)

A

Ecchymosis

292
Q

Ecchymosis would suggest a deficiency in

A

Platelets

293
Q

Hemorrhage of blood into small areas of the skin (3 mm)

A

Purpura

294
Q

Pinpoint hemorrhagic spots

A

Petechiae

295
Q

EPISTAXIS, petecchiae, purpura, ecchymosis, gum bleeding, hematemesis, and menorrhagia are symptoms of

A

Primary hemostasis defect

296
Q

Coagulation factors that function as SERINE PROTEASES

A

II, VII, IX, X, XI, XII, Prekalekrain

297
Q

Coagulation factors that function as COFACTORS

A

III, V, VIII, HMWK

298
Q

Coagulation factor that function as TRANSGLUTAMINASE / TRANSAMIDASE

A

XIII

299
Q

What is Factor IIa

A

Thrombin

300
Q

Substrate of thrombin

A

Factor 1

301
Q

Fibrinogen increases by _____ per decade

A

10 mg/dL

302
Q

Coagulation factors activated at COLD TEMPERATURE

A

Factor VII and XI

303
Q

LABILE coagulation factors

A

Factor V and VIII

304
Q

Coagulation factor that plays a role in coagulation, in VITRO, but not in vivo

A

XIIa

305
Q

What cell (s) produce (s) von Willebrand factor

A

Endothelial cells and megakaryocytes

306
Q

von Willebrand factor carries what coagulation factor

A

Factor VIII

307
Q

Most common inherited coagulation factor deficiencies

A

vWD, Hemophilia A and B

308
Q

Coagulation factor deficiency commonly found in ASHKENAZI JEWS

A

Factor XI deficiency

309
Q

Coagulation factor deficiency associated with menorrhagia

A

vWD

310
Q

Factor XIII deficiency will yield normal coagulation tests except

A

Duckert’s test (5M urea solubility test)

311
Q

Proteins C and S degrade what coagulation factors

A

Va and VIIIa

312
Q

Normal agglutination response to epinephrine, collagen, ADP, but ABNORMAL response to RISTOCETIN

A

vWD and Bernard-Soulier syndrome

313
Q

NORMAL agglutination response to RISTOCETIN, but abnormal response to epinephrine, collagen, ADP

A

Glanzmann’s thrombasthenia

314
Q

Normal anticoagulant circulating in the body

A

Heparin

315
Q

In vivo and in vitro anticoagulant

A

Heparin

316
Q

Treatment for heparin overdose

A

Protamine sulfate

317
Q

Heparin therapy causes _____ thrombin time results

A

Prolonged

318
Q

Bleeding time measures what platelet function (s)

A

Adhesion and aggregation

319
Q

BLEEDING time result in factor X deficiency

A

Normal

320
Q

CLOTTING time result on partially clotted blood sample

A

Shortened

321
Q

Effect of UNDERFILLED TUBE on clotting time results

A

Prolonged (due to excess anticoagulant)

322
Q

Fibrinogen level in dysfibrinogenemia

A

Normal

323
Q

PT and APTT results in polycythemia vera

A

Both prolonged

324
Q

PT and APTT are prolonged when fibrinogen levels fall below

A

100 mg/dL

325
Q

Prolonged PT and APTT not corrected by normal plasma. What indication

A

Circulating (lupus) anticoagulant

326
Q

Prolonged APTT, PT, and TT, LOW platelet count. What is the diagnosis?

A

DIC

327
Q

Other names for DIC

A

Consumption coagulopathy
Defibrination syndrome

328
Q

BETHESDA, platelet neutralization and Dilute Russell viper venom are tests for

A

Lupus anticoagulant

329
Q

Test for quantitating Factor VIII inhibitor

A

Bethesda assay

330
Q

Sensitive early marker for Factor VII activity in mild liver disease

A

Prothrombin time

331
Q

PT is performed at what temperature

A

37C

332
Q

Purpose of thromboplastin in the PT test is to provide _____ to the assay

A

Phospholipoprotein

333
Q

The thromboplastin in the PT reagent is derived from what organ

A

Rabbit brain or lung

334
Q

Visual detection of fibrin clot formation

A

Tilt-tube method

335
Q

Patient ingested RAT POISON, what test to order to test its effect on coagulation mechanism

A

PT

336
Q

This is used to monitor patients undergoing WARFARIN THERAPY

A

PT (INR)

337
Q

This is used to monitor patients undergoing unfractionated HEPARIN THERAPY

A

APTT

338
Q

Specimens for PT should be tested within

A

24 hours (no unfractionated heparin)

339
Q

Specimens for APTT should be tested within

A

4 hours (no unfractionated heparin)

340
Q

Patients under heparin therapy may produce antibodies against

A

PF4 (platelet factor 4)

341
Q

4.5 mL blue top filled with 2.0 mL blood was sent to the lab for PT and APTT. What to do?

A

Reject the sample (underfilled tube)

342
Q

How to prepare platelet poor plasma (PPP)

A

Centrifuge blood for 15 mins at 1500g

343
Q

INR is used to standardize _____ results. The INR calculation uses the international sensitivity (ISI) value

A

PT

344
Q

The closer the ISI to ___, the more sensitive the reagent is; the higher the ISI, the less sensitive the reagent is

A

1

345
Q

Euglobulin clot lysis time is a _____ procedure for the measurement of FIBRINOLYTIC ACTIVITY

A

Screening

346
Q

D-dimer is produced from

A

Crosslinked and stabilized fibrin clot

347
Q

Effect of microcytosis on platelet count using automated counters

A

Spurious increase

348
Q

Automation principle that uses 2 electrodes to determine cell size

A

Electrical impedance

349
Q

Directly counted by the electrical impedance instrument

A

RBC, WBC, Platelets, Hgb, Reticulocytes

350
Q

Forward light scatter measures

A

Cell size

351
Q

Side angle or 90 degrees scatter measures

A

Cytoplasmic granularity

352
Q

Printed on the electrical impedance written report

A

Scattergram, histogram, flagging

353
Q

If the cells are larger than normal, the histogram curve will be more to the

A

Right

354
Q

If the cells are smaller than normal, the histogram curve will be more to the

A

Left

355
Q

RBCs with NORMAL RDW are HOMOGENOUS in character and exhibit ___ anisocytosis on PBS

A

Very little

356
Q

RBCs with INCREASED RDW are HETEROGENOUS in character and exhibit ___ anisocytosis on PBS

A

High degree

357
Q

Principle of Coulter counter and Sysmex counter

A

Electrical impedance

358
Q

Principle of Technicon Autoanalyzer

A

Optical light scattering

359
Q

Values derived from RBC histogram

A

MCV, RDW

360
Q

Values derived from PLATELET histogram

A

MPV, PDW

361
Q

MPV should be measured at what time period

A

1-3 (1-4) hours after collection

362
Q

If platelet count is low, the MPV is usually

A

High (inversely proportional)

363
Q

Effect (s) of AUTOAGGLUTINATION on RBC parameters

A

Decrease RBC count and hematocrit
Increase MCV and MCHC

364
Q

Effect (s) of COLD AGGLUTININS on RBC parameters

A

Decrease RBC count and hematocrit
Increase MCV and MCHC

365
Q

Most common problem in cell counting, causing an increase in current

A

Aperture plugs

366
Q

4 components of flow cytometer

A

Fluidics
Optics
Computer
Electronics

367
Q

Applications of flow cytometry

A

Cell sorting
Cellular identification

368
Q

Process of selecting a population of interest as defined by >1 flow cytometric pattern

A

Gating

369
Q

Ohm’s law formula

A

Voltage (V) = current (I) x resistance (R)

Hubble Notes (13 decks)

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