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Clin Lab > Hematology > Flashcards

Hematology Flashcards

1
Q

Define Neutrophilia

A

Elevated neutrophils- caused by physical or emotional stress, myelocytic leukemia, inflammatory disorders

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2
Q

Define Neutropenia

A

Decreased neutropenia- caused by dietary deficiencies (B12 and B9), some overwhelming bacterial infections, viral infections, and radiation & chemotherapy

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3
Q

Define lymphocytosis

A

Elevated lymphocytosis- caused by chronic bacterial infections, viral infections, and lymphocytic leukemias

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4
Q

Define lymphocytopenia

A

Decreased lymphocytes- caused by immunodeficiency diseases and radiation therapy

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5
Q

Define monocytosis

A

Elevated monocytes- caused by chronic inflammatory disorders & TB

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6
Q

Define monocytopenia

A

Decreased monocytes- this is very uncommon

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7
Q

Define eosinophilia

A

Elevated eosinophils- caused by parasitic infections, allergic reactions, and Hodgkin’s lymphoma

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8
Q

Define eosinopenia

A

Decreased eosinopenia- this is very uncommon

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9
Q

Define basophilia

A

Elevated basophils- caused by myeloproliferative diseases

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10
Q

Define basopenia

A

Decreased basophils- this is very uncommon

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11
Q

What is the most common cause of atypical lymphocyte findings in a blood test?

A

viral infection

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12
Q

If you see an increase in neutrophils and a shift to the left what type of infection is this?

A

Bacterial infection

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13
Q

What type of infection decreases the number of neutrophils?

A

Viral

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14
Q

What is a shift to the left?

A

Any increase in the numbers of immature neutrophils observed in the peripheral circulation. Often indicative of acute infection or other causes of neutrophilia.

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15
Q

An immature form of neutrophil which is observed both within and outside of the bone marrow is known as what?

A

Band neutrophils- aka PMN leukocytes

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16
Q

Will we ever see any neutrophils that are less mature than band neutrophils?

A

No

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17
Q

What is megakaryopoiesis?

A

the production of thrombocytes (platelets)

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18
Q

What does granulopoiesis refer to?

A

The maturation of leukocytes that contain granules (eosinophils, basophils, neutrophils)

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19
Q

What are the 3 steps for evaluation of hematopoiesis?

A

Complete Blood Count
Reticulocyte Count
Bone Marrow Aspiration & Biopsy

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20
Q

What 3 tests from the CBC are redundant with one another? What are they measuring?

A

RBC, HGB, and HCT- all 3 tell us whether or not the patient has normal amount of RBCs in different ways

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21
Q

Which test of the CBC is most widely used to evaluate a patient for anemia? What does this measure?

A 
Hemoglobin concentration (HGB)
This measures the weight of hemoglobin in  blood
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22
Q

What is Packed Cell Volume also known as?

A

Hematocrit

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23
Q

What are other names for bone marrow?

A

Myeloid
Myelogenous
Intramedullary tissue

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24
Q

What is hematopoiesis?

A

The formation and development of ALL types of blood cells from their parental precursors

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25
Q

What is the very first blood forming organ during human development?

A

The yolk sac (during the first trimester)

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26
Q

After the first trimester, what organs take over blood formation?

A

Liver & spleen- then about hallway through pregnancy, the bone marrow takes over

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27
Q

True or False- Full grown adults produce blood primarily from the bone marrow of the axial skeleton?

A

True

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28
Q

The ratio of the volume of RBCs after centrifugation to that of whole blood is known as what?

A

Hematocrit or Packed Cell Volume

29
Q

In a hematocrit test, what is a buffy coat?

A

the coating between the WBCs and RBCs due to the migration of the WBCs during centrifugation

30
Q

What are the 3 clinical applications of altered RBC, HGB, and HCT?

A

Anemia
Erythrocytosis
Polycythemia

31
Q

What does polycythemia mean?

A

Elevated blood cells including RBCs, WBCs, and platelets.

32
Q

What does secondary polycythemia refer to?

A

Polycythemia that comes about as a result from another condition (hypoxia), example: smoking polycythemia, or living at high altitude, COPD
There is no increase in WBCs or platelets- it should actually be called secondary erythrocytosis

33
Q

What 3 exams are included in an RBC indices?

A

Mean Corpuscular volume (MCB)
Mean Corpuscular Hemoglobin (MCH)
Mean Corpuscular Hemoglobin Concentration (MCHC)

34
Q

What is MCV? (mean corpuscular volume)

A

the measure of intracellular volume of the average circulating RBC (relates to the size of the average circulating RBC)

35
Q

What is the classic cause (definition) of microcytic anemia?

A

decreased MCV defines microcytic anemia

36
Q

What is the classic cause (definition) of macrocytic anemia?

A

Increased MCV defines macrocytic anemia

37
Q

What is the classic cause (definition) of normocytic anemia?

A

Normal MCV defines normocytic anemia

38
Q

What defines anemia?

A

Decreased RBC, HGB, and HCT

39
Q

What is MCH? (mean corpuscular hemoglobin)

A

the measure of the weight of hemoglobin within the average circulating RBC
- relates to the intensity of the coloration of the RBCs when stained with Wright stain on peripheral blood smear

40
Q

What are the 3 categories of MCH?

A

Hypochromic RBC
Normochromic RBC
Hyperchromic RBC

41
Q

What is MCHC? (mean corpuscular hemoglobin concentration)

A

the percent of the intracellular volume of the average circulating RBC that is hemoglobin- basically provides the same info as the MCH

42
Q

What is the clinical application of the RBC indices?

A

Used to categorize the three main types of anemia

43
Q

What would iron deficiency anemia present like with a CBC and RBC indices?

A

Decreased RBC, HGB, HCT
Decreased MCV, MCH, MCHC
= microcytic and hypochromic anemia

44
Q

What would a B12 and Folate deficiency anemia present like with a CBC and RBC indices?

A

Decreased RBC, HGB, and HCT
Increased MCV, Normal MCH and MCHC
- macrocytic anemia

45
Q

What would a chronic illness present like on a CBC and RBC indices?

A

Decreased RBC, HGB, HCT
Normal MCV, MCH, & MCHC
- normocytic and normochromic anemia

46
Q

What is RDW?

A

Red Cell Distribution Width

- the index of RBC size differences, or the variability in RBC size populations

47
Q

In health, what is the RDW?

A

There is minimal variation

48
Q

When does an increased RDW occur?

A

Certain types of hematologic conditions–> anemia (can be early sign of anemia)
Increased RDW correlates with increased anisocytosis

49
Q

When does a decreased RDW occur?

A

This is not observed

50
Q

How is RBC morphology observed?

A

Microscopic evaluation of RBCs from a Wright stained peripheral blood smear

51
Q

What are the most common RBC abnormalities?

A 
Macrocytosis
Microcytosis
Hypochromia
Polychromatophilia
Poikilocytosis
Anisocytosis
52
Q

Define WBC count

A

The absolute quantification of the total number of circulating WBCs in a unit volume of blood
Defines the existence of leukocytosis or leukopenia

53
Q

What is the Relative WBC differential count?

A

the relative percentage of each type of circulating WBC as determined by counting 100 WBCs on a stained peripheral blood smear
= the traditional method used during microscopic evaluation of RBC morphology

54
Q

What is the Absolute WBC differential count?

A

Determined by either direct absolute quantification of each type of leukocytes via a modern hematology instrument- the more useful & accurate method

55
Q

If the absolute WBC differential is not provided, how would you calculate it?

A

relative % x total WBC

56
Q

What is a Platelet count?

A

the absolute quantification of the number of circulating thrombocytes in a unit volume of blood
- considered a hemostatic test not a hematologic test

57
Q

Decreased numbers and/or function of platelets may result in what?

A

Platelet associated bleeding

58
Q

What does platelet count tell you about platelet function

59
Q

What platelet count would indicate a risk for spontaneous bleeding?

A

40-50! In both conventional and international units

ex: 40-50 x 10 (to the third) mm (cubed)

60
Q

What is MPV?

A

Mean platelet volume is a calculated index of the internal volume of the average circulating platelet= the size of the average platelet

61
Q

What types of disorders might be seen with altered MPV?

A

Autoimmune disorders:

  • systemic lupus erythematosus
  • idiopathic thrombocytopenic purpura
  • RA
  • pernicious anemia
  • some hematologic malignancies
    • MPV is not imperative to ddx
62
Q

Is the reticulocyte count a routine test or a special test?

A

Special test

63
Q

What is a reticulocyte count most commonly used for?

A

To determine if the bone marrow is responding therapy in factor deficiency anemias such as iron, folate, and vitamin B12 deficiencies

64
Q

Describe the timeline of RBC maturation

A

5-6 days from rubriblast to mature RBC
4-5 days within the bone marrow (intramedullary)
1 day in the peripheral circulation

65
Q

Describe the relationship between anemia and the time of intramedullary maturation

A

The greater the degree of anemia, the shorter the time of intramedullary maturation

66
Q

How do you calculate the reticulocyte % from the routin reticulocyte count?

A

of reticulocytes x 100
divided by
1000 RBCs observed

accepted reference range: 0.5-2.5%

67
Q

What is bone marrow aspiraton and biopsy used for?

A

Rendering the definitive diagnosis in most myeloproliferative and lymphoproliferative disorders such as leukemia & other hematologic disorders

68
Q

Who studies aspirated marrow?

A

by an MD clinical pathologist

Clin Lab (2 decks)

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