Hematology Flashcards
At what temperature is PT best performed?
37°C
Identify what RBC anomaly:
Red cells that look like shooting targets with a central bullseye and a darker outer edge.
Codocytes/Target cells
Maturational sequence of thrombocyte:
Megakaryoblast - Promegakaryocyte - Megakaryocyte - Thrombocyte
Associated with abetalipopreteinemia
Acanthocytes
Thrombin is what factor
Factor IIa
Factor II
Prothrombin, Prethrombin, Thrombogen
Factor I
Fibrinogen, Thrombin substrate
Factor VII
Stable factor, Proconvertin, Autoprothrombin I, Serum Prothrombin Conversion Accelerator
Factor X
Stuart-prower factor, Autoprothrombin III
FDP is measured using
D-dimer
D-dimer test could be used to diagnose:
DIC, DVC, Pulmonary embolism
When should you remove the tourniquet?
Not more than 1 minute
The tourniquet should be ____ inches or ____ cm above the puncture site.
3-4 inches; 8-10 cm
In what organ does platelet sequestration occur?
spleen
___ of total population of platelets are sequestered in the spleen
1/3
Size of the spleen is ____ to the number of platelets, and ____ to platelet count.
directly proportional; inversely proportional
Red marrow exists in all of the following, except:
Distal ends of long bones
Red marrow to yellow marrow ratio
1:1; 50:50
Yellow marrow is composed of ____, _______, & _______
Adipocytes, mesenchymal, macrophages
What happens when the medtech uses a needle with a larger bore than required?
Hematoma formation
Common gauge of needle in Adults
g21
Major production of EPO occurs in:
Kidneys
Production of platelets:
Thrombopoiesis
could also be thrombocytopoiesis
A child accidentally ingested rat poison. which of the ff tests should be performed to test the effect of the poison on the child’s coagulation mechanism?
PT
Note: rat poison: coumadin: warfarin-like
How will you differentiate Leukemoid reaction from CML?
LAP (Leukocyte Alkaline Phosphatase) score
LAP score method of counting
Kaplow count
What is being described?
Count 100 neutrophils and rate 0-4 depending on its staining; differentiate as CML (Low activity) or Leukemoid reaction (High activity)
LAP score
Microscopic method for sickle cells
Sodium Metabisulfite
Positive reaction for sodium metabisulfite
sickling
Positive reaction for sodium dithonite
Turbidity: black lines
Both myeloid and monocytic cells are present to the extent of at least 20% of the total leukocytes:
M4
Normal value of APTT
25-35 seconds; < or = 32
A clot retraction test is
A reflection of the quantity and quality of platelets and other factors
Pelger-Huet Anomaly: Bilobed or Hyposegmented?
Both
If no both answer Bilobed
Identify the Plasmodium Species:
Gametocytes are crescent, banana or sausage shaped. The chromatin is in a single mass (macrogamete) or diffuse (microgamete).
P. falciparum
P. falciparum causes ____ malaria
severe
What Plasmodium species:
Causes relapsing fever; resides in the liver
vivax
What Plasmodium species:
Only affects young RBCs
P. vivax & P. ovale
What Plasmodium species:
Only affects old or mature RBCs
P. malariae
What Plasmodium species:
- Affects all types of RBCs.
Invades other organs - Invade other organs
- cerebral malaria
- black urine
P. falciparum
Test for PNH
Sucrose Hemolysis
Sugar water screening test indicates ___% lysis to be considered as PNH
5
Confirmatory tests for PNH
Sucrose hemolysis & Acid serum test
Other name for Acid serum test
Ham’s acidified test
Ham’s acidified Test
pH:
Temperature & time:
Sample:
pH: 6.5
Temperature & time : 37 for 1 hour
Sample: Whole blood difribinated
Gold standard for PNH
Flow cytometry (FLAER)
Test for Intrinsic and Common factors
APTT
Test for Extrinsic and common factors
PT
What factor deficiency?
- (+) bleeding
- (N) other parameters
Factor XIII deficiency
Test for factor XIII deficiency
Duckert’s test
Red marrow to yellow marrow
retrogression
Sites of active marrow in adults
Ribs
Skull, sternum
Vertebrae
Proximal portion of long bones & Pelvis
Specific site for EPO production in adults
Renal cortex peritubular cells
Major site for EPO production in fetus
liver
Aside from the kidneys, EPO can also be made by the ___, ____, ____, _____
spleen, liver, bone marrow, lungs, & brain
Regulates EPO
PO2
Solution for PCV
Therapeutic phlebotomy
Difference between primary and secondary PCV
1° = dec to normal EPO
2° = Increased EPO
A single megakaryocyte could form ____ to ___ platelets
2000 to 4000 platelets
10 fold increase of platelets
Immune thrombocytopenic pupura
Average size human: 10^8 megakaryocytes producing 10^11 platelets per day and a total turnover rate of __ to __ days.
8 to 9
___ drug inhibits Vitamin K epoxide reductase complex
warfarin
Vitamin K dependent factors and prothrombin group
9, 10, 7, 2
Prothrombin group is not consumed during clot formation except factor __
Factor 2
Contact group.
- Not consumed in clot formation
HK, PK, XII, XI
Fibrinogen group
1, 5, 8, 13
Sample for Sodium metabisulfite
Fresh blood
Reagents for Sodium metabisulfite test
0.2 g of SM in 10 mL of distilled water
FAB classification of AML > or = __% blasts
20%
Automated specimen and reagent volume:
APTT:
PT:
APTT: 0.2 mL plasma & 0.2 mLCaCl2
PT: 0.1 mL plasma & 0.2 thromboplastin reagent
Alder-reilly anomally
Abnormal granulation of metachromatic granules in WBC
Test for platelet quality
Bleeding time
If a pediatric preoperative patient has a family history of bleeding but has never had a bleeding episode herself, what test should be included in a coagulation profile in addition to the PT, APTT, and platelet count?
Bleeding time
If a blood smear is too long, the problem can be resolved by:
Increasing the angle of the pusher slide
Most common factor deficiency
Hemophilia A or factor 8 deficiency
Factor V
Labile factor, Accelerator Globulin (Ac globulin), Proaccelerin
In megaloblastic anemia, the typical erythrocytic indices are:
MCV inc, MCH inc, and MCHC normal
MCV of < 80 fL causes what anemias?
TAILS (Microcytic anemia)
What anticoagulant should be used in cases of platelet satellitism?
Citrate
Citrate to blood ratio
1:4
Correction factor for platelet satellitism
1.1
Example of closed wound
hematoma
Accumulation of blood in the tissue
Hematoma
Petechia: __ mm
1-3 mm
Purpura: __ mm
> or = 3 mm
Ecchymosis __cm
> or = 1 to 2 cm
What is abnormal in dysfribinogenemia?
a. PT
b. APTT
c. TT
d. Fibrinogen level
a, b, c
First step in cleanup when a blood specimen is spilled on a laboratory bench or floor area?
Absorb blood with disposable towels
As a blood cell matures, the N:C ratio:
decreases
Normal range for reticulocytes in adults:
0.5 to 1.5%
The average diameter of a normal erythrocyte:
7.2 um
Increased amounts of 2,3 DPG___ the O2 affinity of the Hb molecule.
Decreases
Variation in size
anisocytosis
variation in shape
poikilocytosis
Stages of neutrophilic granulocyte development
Myeloblast
promyelocyte
myelocyte
metamyelocyte
band & segmented neutrophil
On the basis of the ff data, calculate the absolute value of the segmented neutrophils. Total leukocyte count = 12X10^9; percentage of segmented neutrophils on the differential count = 80%. the absolute segmented neutrophil value is:
9.6x10^9L
Solution: 12x0.8
Niemann Pick Cells are what type of cells?
Macrophage
Low 2,3 DPG, H+, PCO2, T
Love O2
Shift to the Left
Rise in 2,3 DPG, H+, PCO2, T
Reject O2
Shift to the Right
Deficiency in B-glucocerobroside
Gaucher’s disease
Appearance of lysosomes are onion skin or crumpled paper
Gaucher’s disease
Gargoylism
Hunter’s syndrome
Foamy cells
Neimann-Pick disease
Beta-Hexosaminadase A deficiency
Tay-Sach’s diseas
A patient with a severe decrease in Factor X activity would demonstrate normal:
TT and BT
TT - fibrinogen
BT - Platelet function
Th function of thromboplastin in PT test is to provide _____ to the assay:
Phospholipoprotein
Which of the following parameters can be abnormal in classic vWD type 1?
BT (best answer)
PT (would be N° or Decreased)
Which parameters are calculated rather than directly measured?
a. HCT & RDW
b. RBC & WBC count
c. WBC count & HCT
d. Platelet count and PCV
A
What source of of error will have greatest effect on PCV (hematocrit)
a. Incorrect dilution of blood & diluent
b. Hemolysis of whole blood specimen
c. excessive anticoagulant will produce shrinkage of cells
C
Excess anticoagulant may cause ___ in HCT
False decrease
Insufficient centrifugation will cause ____ in HCT
False increase
Major application of flow cell cytometry:
a. determining cell size and granularity
b. sorting of cells and cellular identification using monoclonal Abs
c. treating cancer cells and identifying specific virus types
d. Counting leukocytes and platelets
B
Determines cell size and granularity
scatterplot
Passage of the cell in a single file in front of a LASER
Flow cell cytometry
In an erythrocyte histogram, the erythrocytes that are larger than normal will be the ___ of the normal distribution curve.
Right
Test most affected when there is excess anticoagulant:
a. RBC count
b. HGB
c. HCT
d. ESR
C
Poikilocyte with membrane folded over:
HGB C
Azurophilic granules are produced in what stage?
a. promyelocyte
b. myelocyte
c. metamyelocyte
d. band
A
Product of CLP
a. Megakaryocyte
b. T lymphocyte
c. HCT
d. granulocyte
T lymphocyte
Which of the ff morphologic changes occurs during normal blood cell maturation?
a. Inc. in cell diameter
b. development of cytoplasm basophilia
c. condensation of nuclear chromatin
d. appearance of nucleoli
C
An acquired platelet disorder:
a. Facto V deficiency
b. vWD
c. BSS
d. Uremia
D
Increased BUN and Crea
Normal PT and APTT
Increased BT
Uremia
Source of light in AccuVein
Near Infrared
Patient has normal PT, PTT, and TT
Factor XIII deficiency
Which organ is not hematopietic?
Kidneys
Hematopoietic organs include:
BM, Liver, & yolksac
RDW and MCV are quantitative description of red cells. if both of these are increased, ___ is possible.
a. megaloblastic anemia
b. acute aplastic anemia
c. Iron deficiency anemia
d. NOTA
A
Scatterplot cell population:
- Forward plot:
cell size or diameter
Scatterplot cell population:
- Side scatter:
cell granularity & cell complexity
Electronic impedance:
(+) resistance of electric charge = larger pulse of cell population
Fibrous tissue sources:
Fibroblast seen in connective tissues
APTT normal value for people under therapy:
1.5 - 2.5X
Snake bite
DIC
RBC size
6-8 um
Slide smear spread angle
< 30 - 45°
Macrocytes effect to ESR
Increased
Too much acids in slide preparation:
reddish cells
Coumadin
Vitamin K inhibitor
_ also affects protein C and protein S
What is deficient in Howell jolly bodies:
Bitamin B12 & Vitamin B9
Which of the ff is not STORED by the liver?
a. Vit A
b. Vit D
c. Vit C
d. Vit K
C
- vitamin C is excreted
ESR is increased. what is the cause of the increase with WBC as the basis?
Leukemia
Hyperfibrinogenemia _____ESR:
Increased
Which drug can cause AIHA:
Methyldopa
ESR is decreased. What is the cause of the decrease with WBC as the basis?
Leukocytosis
Precursor of Kallikrein
Prekallikrein, Fletcher factor
Aplastic anemia antibiotic:
Chloramphenicol
Normal newborn hemoglobin:
16.5 g/dL
Normal Hemoglobin in adults:
12-15 g/dL
Hemoglobin value as basis for blood bank transfusion:
< 7g/dL
Hemglobin value as basis for blood bank transfusion in patients with heart failure:
< 10 g /dL
Monocyte cytoplasm color with wright stain
Bluish gray
A small hemorrhagic spot but larger than petechiae characterized by a rounded or irregular blue or purplish patch; also known as bruise and is found in skin and mucus membrane.
Echymosis
Lymphocyte cytoplasm color in Wright stain
pale blue
RBCs color in Wright stain
Salmon Pink
Acute leukemia type of anemia
Normocytic, normochromic
> 11x10^9 WBCs
Leukocytosis
Tertiary granules appear during what stages?
Metamyelocyte/Band
It is referred to as gamma heavy chain disease
Franklin’s disease, Frank anemia
Serine proteases
2, 7, 9, 10, 11, 12, PK
Cofactors
3, 5, 8, HMWK
Intrinsic factors
8, 9, 11, 12
Extrinsic factors
3, 7
Intrinsic factors
8, 9, 11, 12, PK, HMWK
Common pathway factors
1, 2, 5, 10
Fresh plasma
No 3 & 4
Aged plasma
No 5 & 8
Aged serum
No 1, 2, 5, 8, &13
Adsorbed plasma
No 2, 7, 9, & 10
Factor 5 deficiency
Parahemophilia
Giant Platelet syndrome
BSS
Drabkin’s reagent wavelength
540 nm
Carboxyhemoglobin wavelength and color
576 nm
cherry red color
Sulfhemoglobin wavelength and color
618 nm
Mauve lavender
Methemoglobin wavelength and color
630 nm
chocolate brown
Capillary tube length and bore:
7 to 7.5 cm (70 to 75 mm) long, 1 mm bore (1.2 mm)
Wintrobe tube
11.5 cm lng, 3 mm bore
Westergren tube
30 cm long, 2.5 mm bore
The maintenance of high intracellular potassium level is governed by the ____.
sodium-Potassium pump
Cyclooxygenase is inhibited by:
Aspirin, specifically NSAID
Last stage in RBC series capable of mitosis:
Rubricyte, 3rd stage
Last stage in WBC series capable of mitosis:
Myelocyte
Last nucleated stage (RBCs)
Metarubricyte, Orthochromatophilic erythrocyte
What is the solid tumor counterpart of stem cell leukemia?
Undifferentiated lymphoma
Erythrocyte morphology abnormality: marked
4+
BD transfer needle
18
An RES component that removes RBC inclusions without lysing it.
Spleen
M3 usually manifests this coag problem
DIC
pediatric needle gauge
23
Autosplenectomy is common in
sickle cell anemia
Computation:
corrected Reticulocyte count:
(% retic count x HCT)/45
Computation:
corrected WBC count:
(uncorrected WBC count x 100)/(100+NRBCs per 100 WBCs)
Function of eosinophil storage vesicles
carry protein from secondary granules to be release to the ECF
Clotting factor with “Fitzgerald factor” as another name
HMWK
Result of fibrinogen deficiency in clot test/coagulation studies
Increased PT, APTT
Normal TT
Decreased Fibrinogen
Fibrin clot electromechanical method
Fibrometers
Carboxyhgb and Methgb
Incapable for O2 transport
Helmet cells with horn-like projections
Keratocytes
Calculate the MCHC
(Hgbx100)/HCT
unit %
Characteristic RBC in Primary myelofibrosis
Dacrayocytes
What is the primary inhibitor of fibrinolytic system?
A2-antiplasmin
SCD anemia
normocytic, normochromic
What is the major leukocyte in aplastic anemia? BM?
Lymhocytes
Result of facto X deficiency in clote test/coagulation studies?
Increased PT, APTT,
Normal TT
Embryonic hemoglobins
Gower I
Gower II
Portland I
Miller disk is utilized for
reticulocytes
nRBCs are counted in
WBC chambers
smallest platelets
Wiskot-Aldrich syndrome
Blood cell disorder with a low platelet count and cytoplasmic inclusions with granules that look like dohle bodies
May Hegglin Anomaly
CML negative for philadelphia chromosome
Poor prognosis
Better prognosis
AML
TRAP (Tartrate Resistant Acid Phosphatase) hallmark
Hairy Cell Leukemia
Not affected by falsely elevated HCT
MCH
A cell seen normally in the peripheral blood and is considered as the youngest type regularly seen in smears
band cells
Nucleated RBCs seen in smears is
accelerated RBC production
A black line is used for this Hgb S
Sodium dithionate test
Cell count
(Cell count x DF)/(Area x depth)
Preferred anticoagulant for ESR
EDTA/ Na citrate (Black)
Not stained by Sudan Black B
Lymphocytes
G6PD deficiency is characterized by
Bite cells/Heinz bodies
The only unmeasured hemoglobin in Cyanmeth.
Sulfhemoglobin
Primary or nonspecific granules truly appear on this stage:
Promyelocyte
vasoconstriction is under:
Primary hemostasis
Length of slide covered in PBS
2/3; 3/4
Shift to the left includes:
Immature cells
It shows a problem in platelet adhesion due to mutations to platelet GP IB or GP IX
BSS
PPE required in strict isolation
Gown, mask, gloves
Smudge cells, soccer-ball, clover leaf (reider cells)
CLL
Smudge cells in ISBB could be due to
too much force when spreading
- add albumin
Rule of 3
Only applicable for normocytic normochromic results
Rule of 3 formula
RBC x 3 = HGB +/- 0.5
HGB x 3 = HCT +/- 3
WBC with bilobed nucleus and large granules that does not obstruct the nucleus.
Pelger-Huet
Target INR/recommended INR range for treatment of deep venous thrombosis.
2-3, warfarin therapy
INR of people with mechanical heart valve
2.5-3.5
A cutaneous T cell lymphoma characterized by peripheral lymphadenopathy, exfoliative erythroderma.
Sezary syndrome
First RBC stage that becomes vividly pink (cytoplasm)
Polychromatophilic or Rubricyte
_____ is characterized by macrophages with starry sky pattern under low power seen with numerous apoptotic debris
Burkitt’s lymphoma
Condition with thin flattened and concave fingernails; seen in IDA
Koilonychial
symptom: Pica
Factor deficiency in Ashkenazi jews
Rosenthal syndrome, factor XI deficiency
Pattern in Rosenthal:
Type of bleeding:
Factor deficiencies that may show such pattern:
Pattern in Rosenthal: Increased APTT, Normal PT and TT
Type of bleeding: mild bleeding
Factor deficiencies that may show such pattern: 7 & 9
Hemoglobinopathy versus thalassemia:
Hemo: qualitative problem
Thal: quantitative problem
Platelet phospholipids (APAS) are inhibited by:
Lupus AC
Megaloblastic anemia description
Macrocytic chromic
CALLA marker
CD10
Tube for microhematocrit
7 cm, 1 mm/ 1-2 mm
Found in infections, poisoning, burns, and chemotherapy and are decribed as RER with RNA with localized cytoplasmic maturation.
Dohle bodies
Aka stress platelets
Reticulated platelets
> 12-14 platelets
what parameter can’t differentiate IDa from ACD?
TSAT decreased
Provides a cytoskeleton to maintain platelet shape and a contractile system
Sol-gel zone
Sol-gel zone maintains platelet shape through____
microtubules, actomyosin
Flow cytometry includes:
a. electronics
b. fluidics
c. optics
d. computer
a, b, c, & d
Not a normal embryonic hemoglobin
Portland 2
WBC correction is necessary because
False increase
A thin, flat cell with hemoglobin at periphery and increased central pallor showing a characteristic hypochromic cell
Ellipytocyte, pencil, cigar-shaped
Patient’s battery of Test
Lipid Profile
Liver Profile
CBC
PT & APTT
What is the correct order of draw?
Light blue
Red
Lavender
Nodular lymphocyte-predominant hodgkin cell
Popcorn cell
Adult population neutrophil differential count range.
40-70%
A second x chromosome seen in females
Barr bodies/ drumstick bodies
Lab findings in Anemia of chronic disease
Decreased TIBC, serum iron, and TSAT
If RBCs are excessively lysed, a ___ is possible.
Negative instrumental error
Needle length in routine phlebotomy
1-1.5 inches
Coarse azurophilic MPS granules are seen in all leukocytes and more commonly in myelocytic series.
Alder-Rey anomaly
A cell that is enucleated 1/ central pallor
discocytes
This method is a key way of initial classification and a reliable assessment or measure of effective RBC production.
RPI
What is the usual marker for hematopoietic stem cells?
CD34
Normal variants of hemoglobin
A1, A2, F
A patient with PCV will have a ____ RP and APTT
Falsely increased
Macrohematocrit: Centrifuge at 2000 to 2300 g for ___ minutes
Microhematocrit: centrifuge at 10,000 to 15,000 g for __ minutes
Macrohematocrit: Centrifuge at 2000 to 2300 g for 30 minutes
Microhematocrit: centrifuge at 10,000 to 15,000 g for 5 minutes
NK cell CD markers
CD16/CD56
A normal (wedge) blood smear should demonstrate approximately _____ cells (platelets) per 100x field.
7 to 21
Platelet estimate formula:
(Ave. no of platelets X total RBC count)/200 RBCs per field
Platelet estimate reporting:
0 to 49,000/uL:
50,000 to 99,000/uL:
100,000 to 149,000/uL:
150,000 to 199,000/uL:
200,000 to 400,000/uL:
401,000 to 599,000/uL:
600,000 to 800,000/uL:
Above 800,000/uL:
0 to 49,000/uL: Marked decrease
50,000 to 99,000/uL: Moderate decrease
100,000 to 149,000/uL: slight decrease
150,000 to 199,000/uL: Low normal
200,000 to 400,000/uL: Normal
401,000 to 599,000/uL: slight increase
600,000 to 800,000/uL: Moderate Increase
Above 800,000/uL: Marked increase
Sezary cells are present in ____, _____, & ____.
Skin, lymphnodes, Peripheral blood
ALP is part o the neutrophil’s _____
Secretory granules
Next test for normocytic anemia:
a. Indices
b. Hemoglobin
c. absolute reticulocyte count
a, b, c
60% leukocytes is normal in ______.
Children (6M - 2 yrs old)
A surgical connection between two structures, it usually means a connection that is created between tubular structures, such as blood vessels or loops of intestines.
Anastomosis
Fibrinolysis screening test
Euglobin clot lysis
Duration of myelocyte to metamyelocyte
4.3 days
Disease of connective tissue and coagulation factor deficiency
vWF disease
Source of energy for platelets
Glucose
This reagent converts methemoglobin to cyanmethemoglobin
Potassium cyanide
Normal template bleeding time range
6-10 minutes
Expected ESR in Poikilocytosis
decreased
Most common complication of venipuncture; leakage of small amount of blood.
bruising
Histologic presence is definitive of hodgkin’s
Reed-Sterberg
Hematocrit layers
First:
Second:
Third:
Bottom:
First: Fatty Layer
Second: Plasma
Third: Buffy coat
Bottom: Packed cells
Sealing clay
Nucleated RBCs and schistocytes are seen in:
Microangiopathic Hemolytic Leukemia
Parameters for MCV computation
HCT and RBC count
what factor is transglutaminase
factor XIII
MCV and RDW are from:
MPV and PDW are from:
MCV and RDW are from: RBC histogram
MPV and PDW are from: platelet histogram
Increased EDTA will lead to __ ESR and __ HCT.
Increased EDTA will lead to DECREASED ESR and DECREASED HCT.
Fibrinogen level in hemophilia A, B, & C
Normal
why use only 1 inch needle?
Better control, Less frightening, Less intimidating
A patient with BJ proteins and multiple myeloma show this characteristic in a peripheral smear:
Myelocyte
Specific or secondary granules appear on this stage:
Myelocyte
Erythropoietin actions:
- stop apoptosis
- Early cell release
- Reduce maturation
COAG-A-MATE, electra and Ortho-Koagulab are
Photo optical mid
The platelet glycocalyx is known as ____.
outer surface of platelets
Factor XI deficiency
Rosenthal syndrome
False elevation in ESR could be due to
Increased in temperature
In Sulfhemoglobinemia, blood is colored
Mauve lavender
The very first cell produced he developing embryo
RBC on the1th day of gestation
Corrections for WBC
A: >5, Neonates: >10
What is extramedullary hematopoiesis?
Blood production outside the BM
These are needle-shaped or round inclusions in the cytoplasm of myoblasts and promyelocyte; described to be composed of condensed primary granules.
Auer rods
5th month gestation major hematopoietic site
liver
This is a neutrophilic protein seen in secondary granules with a function of binding iron.
Lactoferrin
Also known as the labile factor
Factor 5, Proacelerin
Recommendation for counting band cells
Segmenters
Factor VII and XI are activated by _____.
Cold temeprature
Flower cells are seen in _____.
Adult T Cell Leukemia
In smear preparation, a drop of blood must be __cm from the edge of the slide.
1 cm
IDA anemia
Microcytic, hypochromic
Clot retraction is possible due to_____.
thrombasthenin
What age group has the predominance of red bone marrow in the bones?
early childhood
This is characterized by mutations to platelet GP IIB or IIIA resulting into a defect of fibrinogen-dependent platelet aggregation.
Glanzmann thrombasthenia
RPI formula:
((retics % X (HCT/0.45))/maturation time)
In adults, these 2 sites are the best sites for bone marrow collection.
Sternum or Posterior Iliac crest
Initial sickle cell hemolysis in OFT begins at __NaCl concentration
0.30%
Factor for platelet estimate in patients with normal RBC count
20,000
When blood escapes on the small skin and MM areas, It is referred to as ____.
Purpura
Hemolytic anemia, Acute blood loss, aplastic anemia
Normocytic, normochromic
Factor III
Tissue factor, Thrombokinase, Tissue thromboplastin
Factor IV
Calcium, Mineral factor
Factor VIII
AHF-A, AHG, Platelet cofactor I
Factor IX
Christmas factor, AHF-B, Plasma thromboplastin component, platelet cofactor II
Factor XI
AHF-C, Plasma thromboplastin antecedent
Factor XII
Hageman factor, Glass factor, Contact factor
Factor XIII
Fibrin stabilizing factor
Fibrinoligase
Fibrinase
Laki-Lorand factor
Plasma transglutaminase/Transamidase
Pre-Kalikrein
Fletcher factor
High Molecular Weight Kininogen
Contact Activation factor
Reid factor
Williams factor
Flajeauc factor
Fitzgerald factor
Preferred adult site for BM collection?
Illiac crest
Flame cells
IgA myeloma
The mechanism about oxygenation status that communicates or relays information to erythropietin producing sites is found in the _______.
Kidneys
Grease or dirt in the slide may lead to _____ in smears.
Holes
Complete hemolysis in SCA is seen in _____% NaCl.
0.20%
Normal: 0.3%
HS: 0.45%
Cause of menorrhagia (excessive menstrual bleeding)
vWF
Side light scatter
cell granularity
Forward light scatter
cell size
The bleeding time measures:
a. Ability of platelets to stick together
b. Antibodies against platelets
C. Platelet adhesion and aggregation
d. Quality and quantity of platelets
C
If globin synthesis is insufficient in a patient, iron acummulates in the cell at _____ aggregates.
Ferritin
Proper way if mixing anticoagulant
gentle inversion
Used in measuring platelet aggregation
ADP
collagen
thrombin
ristocitin
All are correct about SOP except
It should follow the CMP
Which of the ff flow cytometry methods is the most appropriate in diagnosing and classifying chronic lymphocytic leukemia.
Immunophenotyping
Flow cytometry principle that diagnose and… CLL15-20
Immunophenotyping
Which describes a combined scatter, it measures
cell size and granularity
A typical therapeutic range of APTT in seconds
15-20
The rbc stains more red than its usual color, neutrophil is barely visible, eosinophil is bright orange
the stain is too acidic
What is the meaning of calibration
Value is compared to a known physical value
Which of the ff cells can further differentiate in the tissues?
Monocytes
Which is abnormal in Von Willebrand’s disease type 1
Bleeding time
Specific fragment release upon degradation of cross-linking fibrin
D-dimer
What is thrombin
Factor IIa
Which is deficient if the liver failed to produce the factors 2, 7, 9, 10
Vitamin K
What is the average size of an RBC?
7.2 um
TPO will induce megakaryocytes to
Differentiate and mature
What coagulation factors are affected in coumarin therapy?
2, 7, 9, 10
Which condition causes increased total leukocyte count?
a. TB
b. asthma
c. urticaria
d. Inflammation
D
Which of the ff is used to stain glycogen, polysaccharides, and glycoproteins
PAS
Lazy leukocyte syndrome
Neutrophil
Neimann pick disease
Monocytic-macrophage series
stain for reticulocytes
New Methylene blue
Hypochromic, macrocytes in blood film
IDA
Acceptable limits of a control value must fall
within +2 SD of the mean
Which characteristic is inaccurate with respect to the anticoagulant K3 EDTA?
a. Removes ionized Ca2+ from fresh whole blood by the process of chelation
b. Is used for most routine coagulation studies
c. Is the most commonly used anticoagulant in hematology
d. Is conventionally placed in lavender-stoppered evacuated tubes
B
What is the immature erythrocyte found in the bone marrow with the ff characteristics: 12 to 17 mm in diameter, N:C of 4:1, nucleoli not usually apparent, and basophilic cytoplasm?
Prorubricyte (Basophilic normoblast)
If an alkaline (pH 8.6) electrophoresis is performed, hemoglobin E has the same mobility as hemoglobin.
C
If you are grading changes in erythrocytic size or shape using a scale of 0 to 4+ and many erythrocytes deviate from the normal per microscopic field, the typical score would be
3+
Paroxysmal nocturnal hemoglobinuria exhibits sensitivity of one population of red blood cells to
complement
Which antibody test has replaced the LE cell preparation of red blood cells to
ANA test
An acute leukemia can be described as being
of short duration with many immature leukocyte forms in the peripheral blood
The abbreviation LASER stands for
Light Amplified by Stimulated Emission Radiation
The delta check method of quality control
compares the patient’s leukocyte and platelet counts with his or her previous results.
In the photo-optical method, the change in light transmission versus the___ is used to determine the activity of coagulation factors or stages.
time
If you are grading changes in erythrocytic size or shape using scale of 0 to 4+ and many erythrocytes deviate from normal per microscopic field, the typical score would be
3+
The final common pathway of the intrinsic-extrinsic pathway is
Factor X actiavtion
What is the appropriate procedure and characteristic for Westergren method?
The procedure measures the rate of erythrocyte settling
Two SDs from the mean in normal distribution curve would include
95% of all values
The bevel of the needle should be held ___ in the performance of a venipuncture.
Upward
A blue top tube is drawn for coagulation studies, the sample is a short draw result may be:
Falsely prolonged
Pappenheimer bodies
Iron deposits
Hereditary pyropikilocytosis (HP) is a red cwll membrane defect characterized by
Increased oval macrocytes
Absolute leukocyte count
(Total leukocytebcount x % lymphocyte count)/100
What clotting factors are inhibited by protein S
Va, VIIIa
Platelet aggregation will occur with the end production of
Thromboxane A2
Mouth like cells
stomatocytes
Hematopiloietic stem cells produce all lineages of blood cells in sufficient quantities over the lifetime of an individual because they
Have the ability of self renewal by asymmetric division
Automated analyzers can detect all of the ff except:
A. RBC fragments
B. Large platelets
C. Cold agglutinins
D. Platelet clumps
C
EDTA induced pseudothrombocytopenia
platelets adhere to WBCs
Thrombin time 18seconds, APTT 60 secs, PT 38 secs
Factor X deficiency
First automated hematology analyzer
Coulter
Where does TCA cycle occur
mitochondria
Hyperemia
blushing
True about semi-quantitative WBC analyzers
Can replace/substitue WBC count
Philadelphia chromosomes
Trans 9,22
How do platelets shed
Proplatelet process
Cause of stomatocytes
RH deficiency
Most predominant population of WBCs
Neutrophil
Endpoint of mechanical clot detection system
Fibrin attachment
Acanthocyte, stomatocyte, and codocyte pictures and clinical manifestations
abetalipoproteinemiaa
Schistocytes
fragmented cell
What is the first step to antithrombin assay
neutralize plasma ATIII
Substance release after platelet aggregation
thromboxane A2
40 year old woman.
PT 20 secs
APTT 50 secs
TT 18 secs
Factor 10 deficiency
