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B&L 1 > Hematology > Flashcards

Hematology Flashcards

1
Q

hematopoiesis

A

blood making

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2
Q

erythropoiesis

A

RBC making

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3
Q

hemolysis

A

RBC destructioin

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4
Q

hemostasis

A

arrest of bleeing

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5
Q

thrombosis

A

formation of pathological blood clots

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6
Q

Basic shape and composition of erythrocyte?

A

biconcave disc lacking nucleus and lacking mitochondria with lots of hemoglobin

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7
Q

five types of white blood cells?

A 
basophils
neutrophils
eosinophils
monocytes
lymphocytes
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8
Q

leukemia vs lymphma?

A

leukemia is a cancer in the bone marrow and blood

lymphoma is a cancer in the lymph nodes or other lymphoid tissue, predominately outside the bone marrow

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9
Q

acute leukemia vs chronic?

A

acute: the cells are immature in their degree of differentiation and the clinical course is usually rapidly progressive w/o intervention
chronic: cells are more mature in their differentiation and the disease follows a more indolent clinical course

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10
Q

lymphoid vs myeloid leukemia

A

lymphoid - arising from lymphocytic lineage

myeloid - arising from one of the other cell types in the marrow

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11
Q

platelets

  • origin
  • function
A

platelets are the cellular component of the blood responsible for hemostasis

small cells produced from large polyploid cells in the bone marrow called megakaryocytes

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12
Q

Define the components of peripheral blood that are measured when a CBC is requested (7)

A 
hemoglobin
hematocrit
RBC count
Mean corpuscular volume (MCV)
White blood cell count
platelet count 
Mean Platelet volume
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13
Q

Define the values that are typically calculated when a CBC is requested (6)

A

Hematocrit
Mean corpuscular volume (MCV)
Mean corpuscular hemoglobin Mean corpuscular hemoglobin concentration
Red cell distribution width
Absolute counts of leukocytes (if applicable)

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14
Q

Hematocrit

A

Ratio of volume of erythrocytes to that of the whole blood

RBC/Whole blood

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15
Q

How to calculate hematocrit?

A

RBC volume / Total Volume
or
RBC x MCV

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16
Q

MCV what does it tell you and how do we calculate it?

A

Mean corpuscular volume - i.e. average volume of RBCs

Calculated from hematocrit and red cell count

MCV = Hct / RBC

Note that 10^-15 L = fL

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17
Q

Red cell distribution width

A

measure in variation of size of red cells

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18
Q

Mean Corpuscular Hemoglobin
what is it?
how do you calculate it?

A

content (weight) of Hgb of average red cell

calculated from Hgb concentration and red cell count

MCH = Hgb / RBC

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19
Q

MCHC
What is it
what does it tell you

A

average concentration of Hgb in a given volume of packed red cells

Calculated from Hgb concentration and Hct

MCHC = Hgb / Hct

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20
Q

Who show’s the strongest fluorescence in flow cytometry?

A

immature and activated cells, due to their high RNA content

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21
Q

how does fluorescence of reticulocytes change as they mature?

A

decreases because RNA content decreases during maturation process

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22
Q

when is a differential performed?

A

when requested

when flagged by the analyzer and certain conditions are met

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23
Q

How is the differential performed?

A

Make a blood film (wedge/cover glass/spinner)
Air-dry and fix with methanol
Stain with a Wright-Giemsa

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24
Q

Normal Peripheral Blood Components (3)

A

RBCs
WBCs
Platelets

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25
Q

Diff =

A

(Diff% x WBC) / 100

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26
Q

HCT% =

A

RBC x MCV

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27
Q

Scattergrams differentiate cells based on (2)

A

fluorescence and size

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28
Q

How to we count red cells?

A

Blood passes through an aperture through which current flows - creating a change in voltage - pulse -
Pulse size is proportional to cell size
Histogram created for number of events vs cell size
Note that we always want single file

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29
Q

How to we measure hemoglobin ?

A

Measure change in absorbance following oxidation reaction and compare it to some standard (Beers law)
Cyanide methode
Sodium lauryl sulfide method

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30
Q

How do we count platelets?

A

Same as RBCs, just change the range size of the instrument - note that we always want single file

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31
Q

why might we have a spuriously low platelet count?

A

If they clump together - machine wont count as platelets

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32
Q

Distribution width from histogram?

A

the spread is the range

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33
Q

What is derived from the mean height of the voltage pulses formed during the red cell count?

A

MCV

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34
Q

What is calculated from Hgb concentration and red cell count?

A

MCH

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35
Q

flow cytometry forward scatter tells us about?

A

cell size

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36
Q

flow cytometry side scatter light tells us about

A

internal cell information

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37
Q

flow cytometry side fluorescence tells us about

A

type and quantity of nucleic acid and intracellular organelles

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38
Q

flow cytometry yields scattergram plot with what measures?

A

signal scatter vs. signal fluorescence - indicates cell type

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39
Q

what do we use to quantify reticulocyte?

A

flow cytometry - fluorecent label nucleic acids - more RNA = less mature / still making hemoglobin

40
Q

How can we quantify nucleated red blood cells?

A

flow cytometry - label nuclei / scattergram

41
Q

How can we measure platelet maturation?

A

flow cytometery

42
Q

what provides automated differential?

A

scattergram

43
Q

drawback of scattergram?

A

does not give you morphology - just size

44
Q

what does a manual differential add?

A

Morphology of RBC, WBC, platelets, etc.
Abnormal formed elements in peripheral blood
Relative or absolute quantification of the different WBC populations

45
Q

RBC

A

Round and smooth
Central pallor
Little variation in diameter
Typically not touching

46
Q

Too few platelets?

A

thrombocytopenia

47
Q

too many platelets?

A

thrombocytosis

48
Q

Acidophilic cytoplasm with fine granules

nucleus with clumped chromatin divided into 2-5 disctinct lobes linked by thin thilaments?

A

neutrophil

49
Q

too few neutrophils

A

neutropenia

50
Q

too many neutrophils

A

neutrophilia

51
Q

most abundant white cell?

A

neutrophils

52
Q

smaller with scant cytoplasm and round nucleus with dense chromatin -
10% may be larger with more abundant cytoplasm and less condensed chromatin
small number may have abundant cytoplasm and prominent azurophilic granules

A

lymphocytes

53
Q

most abundant white cell in children?

A

lymphocytes

54
Q

lymphocytosis

A

too many lymphocytes

55
Q

too few lymphocytes

A

lymphopenia

56
Q

slightly larger than neutrophils
bi-lobed nucleus
spherical / large / course / reddish granules

A

eosinophils

57
Q

too few eosinophils?

A

can’t be documented by diff

58
Q

fluxuation in eosinophil count?

A

count remains fairly constant

59
Q

nucleus is obscured by course / purple / black granules

A

basophils

60
Q

least abundant of wbc

A

basophil

61
Q

too few basophil?

A

can’t be documented by diff

62
Q

largest cells in peripheral smear

irregular/lobular nucleus

A

monocytes

63
Q

when thinking about leukocyte counts, are percentage or absolutes more valuable?

A 
Absolutes
e.g.
50% nueutrophils w/ WBC 500
= 250
50% nuetrophils 2/ WBC 8000 = 4000
very different
64
Q

reference range

what is normal?

A

value typical of healthy individual
value typical of individuals not at risk of disease
desireable number

65
Q

practical reference interval?

A

Mean +/- 2 SDs = central 95%

66
Q

Practical reference interval absolute monocyte count lower bound

A

shift to 0.2

67
Q

Is normal count always good?

A

No… as part of typical disease processes, certain tests are expected to be abnormal
Failure to change can indicate an inability of the body to respond appropriately

68
Q

Is abnormal always bad?

A

No… probability of all 16 measures being in reference range only 44%…
More important to consider how far outside normal bound value is

69
Q

WBC method

A

flow cytometry

70
Q

RBC method

A

impedance transducer

71
Q

HGB method

A

spectrophotometry

72
Q

Hct method

A

Impedence transducer

73
Q

PLT method (2)

A

Impedence transducer

flow cytometry

74
Q

NRBC (nucleated) method

A

flow

75
Q

Diff% method

A

flow

76
Q

BA% method

A

flow

77
Q

RET % method

A

flow

78
Q

Heme progenitor cells method

A

flow

79
Q

MCV method

A

RBC histogram

80
Q

MCH method

A

RBC histogram

81
Q

MPV method

A

Platelet histogram

82
Q

MCV calculation

A

HCT/RBC x 10

83
Q

MCH calculation

A

HGB/RBC x 10

84
Q

MCHC calculation

A

HGB/HCT x100

85
Q

Diff # calculation

A

Diff% x WBC / 100

86
Q

Ret # calculation

A

Ret% x RBC / 100

87
Q

do we need a cbc for pre-op

A

no

88
Q

how can we use automated cell counter to determine if baby okay to birth?

A

lamellar bodies which contain surfactant would get counted as platelets in amniotic fluid

89
Q

PRR

A

Recognize a foreign molecular structure that we humans do not have -
Found on most cells in the body / on their surface or on inner membranes

90
Q

Pathogen associated molecular pattern

A

foreign molecular structures recognized by innate immune system

91
Q

Toll like receptor

A

A type of pattern recognition receptor (with homology to the Toll gene in the fruit fly - which control innate immunity in invertebrates) that recognizes foreign molecular structure that we humans due not have

92
Q

What happens when TLR bind a foreign pattern?

A

signaling cascades are activated within teh cell that lead to the expression that cause or increase inflammation

93
Q

damage associated molecular pattern

A

stress or damage indicator molecules express by body cells - recognized by innate immunity

94
Q

Common foreign patterns recgonized by TLR

A

Lipopolysaccharide (part of cell wall of gram negative bacteria)
Peptidoglycan (gram positive bacteria)
double stranded RNA

95
Q

Final transcription factor most commonly activated in inflammation

A

NF-kappaB

B&L 1 (5 decks)

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