Hematology

Question 1

Normal platelet count:

Answer 1

150,000-300,000

Question 2

Platelet count increased in:

Answer 2

Active bleeding
Post-splenectomy
Myeloproloferative diseases (slow growing blood cancers in which the bone marrow makes too many abnormal rbcs)

Question 3

Platelet count decreased in:

Answer 3

DIC, TTP, HIT, ITP, drugs

EDTA- dependent agglutination

Question 4

PT/INR normal:

Answer 4

11-14 s

Question 5

What does the PT/iNR evaluate?

Answer 5

Extrinsic and common pathways

Question 6

What is the PT/INR most sensitive to?

Answer 6

Vitamin-K dependent clotting factors 2, 7, 9, 10

Question 7

PT/INR is used to monitor:

Answer 7

Coumadin

Question 8

What is the PT/INT elevated in?

Answer 8

Liver disease
Coumadin therapy 
DIC
Hereditary factor deficiencies in 10, 5, 7, and 1
Massive blood transfusions

Question 9

What is the normal PTT?

Answer 9

26-34 s

Question 10

What does the PTT evaluate and what is it used to monitor?

Answer 10

Evaluates then intrinsic and common clotting pathways

Used to monitor heparin therapy

Question 11

PTT is increased in:

Answer 11

Deficiency in specific coagulation factors in the intrinsic pathway except for factor 13
DIC
Nonspecific inhibitor (lupus anticoagulant)
Heparin, Coumadin, and direct thrombin inhibitors

Question 12

Normal fibrinogen?

Answer 12

150-400 mg/dL

Question 13

Fibrinogen increased in:

Answer 13

Inflammatory states
Pregnancy
Smoking

Question 14

Fibrinogen decreased in:

Answer 14

Liver disease
DIC
Hereditary dysfibrinogenemia

Question 15

D-diner normal?

Answer 15

Less than 500

Question 16

What does the d-dimer represent?

Answer 16

Represents fibrin degradation of a blood clot after fibrinolysis.

Question 17

D-dimer is elevated in:

Answer 17

DVT, DIC, PE, malignancy

Question 18

WBC normal?

Answer 18

4-10000

Question 19

RBC normal?

Answer 19

3.5-5 million/mm3

Question 20

HGB normal:

Answer 20

12-17 grams

Question 21

HCT normal?

Answer 21

36-52%

Question 22

MCV normal?

Answer 22

82-94 fL

Question 23

MCH normal?

Answer 23

27-31 ph

Question 24

MCHC normal?

Answer 24

32-35%

Question 25

RDW normal?

Answer 25

10-12.5%

Question 26

RBCs elevated in:

Answer 26

Dehydration | Bone marrow disorders (p. Vera)

Question 27

RBCs decreased in

Answer 27

Anemia’s Hemolysis Hemoglobinopathies

Question 28

MCV is the:

Answer 28

Size of the WBC Less than 80- microcytic 80-100 normocytic Over 100- macrocytic

Question 29

What is MCH?

Answer 29

Hemoglobin content of RBC. Gives it color

Question 30

What is MCHC?

Answer 30

A measure of the average color of the RBCs.

Question 31

MCHC is decreased in:

Answer 31

Iron def anemia and thalassemia (hypochromic) Normal in macrocytic anemia’s

Question 32

What is RDW?

Answer 32

A measure of the variability of the size of the RBCs. Elevated in iron def anemia

Question 33

What is anisocytosis?

Answer 33

Variable size of RBCs

Question 34

What is poikilocytosis?

Answer 34

RBCs abnormal with variable shapes. Seen in severe iron deficiency anemia

Question 35

WBCs consist of what and in order of most to least:

Answer 35

``` Neutrophils 55-70% Lymphocytes 30-35% Monocytes 1-10% Eosinophils 2-5% Basophils 0-1% ```

Question 36

Immature WBCs increased in:

Answer 36

Trauma | Leukemias

Question 37

Immature WBCs decreased in:

Answer 37

Viral infections Autoimmune disorders (SLE) Bone marrow disorders (aplastic anemia)

Question 38

H/H elevated in:

Answer 38

``` P. Vera Dehydration Burns High altitudes Smoking / COPD ```

Question 39

H/H decreased in:

Answer 39

``` Anemia’s Bleeding Hemoglobinopathies DIC Other bone marrow disorders ```

Question 40

What is TIBC?

Answer 40

Total-iron bonding capacity- a measure of available transferrin that is left inbound to iron.

Question 41

When is TIBC elevated?

Answer 41

If there is not enough iron to transport, as seen in iron- def anemia. When iron count is low

Question 42

Iron levels elevated in:

Answer 42

Hemochromatosis Multiple transfusions Lead poisoning Hemolytic anemia

Question 43

Iron level decreased in:

Answer 43

``` Iron def Nephrotic syndrome Hypothyroidism Anemia of chronic disease Chronic renal failure Infections ```

Question 44

What is HP?

Answer 44

Haptoglobin is synthesized by the liver and is a transport glycoproteins which serves as a carrier for free hemoglobin.

Question 45

When is HP decreased?

Answer 45

``` In: Hemolytic anemias TTP Drugs (methyldopa) Artificial heart valves ```

Question 46

MMA is elevated in?

Answer 46

B12 deficiency

Question 47

MMA is only accurate if:

Answer 47

Renal function is normal

Question 48

Vitamin B12 is decreased in:

Answer 48

Pernicious anemia Vegans IBS Gastrectomy patients

Question 49

Low values of vitamin B12 indicates?

Answer 49

Macrocytic anemia

Question 50

Folic avid decreased in:

Answer 50

Malnutrition Excessive uptake (pregnancy) Hemolytic anemia Acute leukemia’s

Question 51

What is direct Coombs?

Answer 51

Detects antigen-antibody complexes on the RBC. Positive in hemolytic anemia.

Question 52

Normal sodium?

Answer 52

135-145

Question 53

Sodium level increased in:

Answer 53

Hyperaldosteronism Dehydration Inadequate water intake CKD

Question 54

Sodium decreased in:

Answer 54

``` Adrenal insufficiency Excess free water SIADH Hyperglycemia Volume overload Drugs (NSAIDs, diuretics, SSRIs) ```

Question 55

Na and hyperglycemia know:

Answer 55

Na falls 1.6 for every 100mg/dL increase of glucose over 100 | Corrected sodium = measured Na + [1.6(glucose-100)/100]

Question 56

Microcytic anemia’s:

Answer 56

Iron def anemia | Thalassemia

Question 57

Iron def anemia is:

Answer 57

Microcytic and hypochromic

Question 58

Anemia of chronic kidney disease is:

Answer 58

Hypoproliferative, normocytic, normochromic

Question 59

Macrocytic anemias?

Answer 59

Vitamin B12 and folate