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MLT-MLS Spring 2022 > Hematology Exam 1 > Flashcards

Hematology Exam 1 Flashcards

Lecture 1-4

1
Q

What is hematology?

A

Study of blood cell production, destruction, number, and disease.

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2
Q

Normal WBC value

A

3.6-10.6

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3
Q

Normal RBC value for men

A

4.20-6.00

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4
Q

Normal RBC value for women

A

3.80-5.20

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5
Q

What is the difference between serum and plasma?

A

Plasma doesn’t clot due to anticoagulant stopping the coagulation cascade. Serum doesn’t contain clotting factors.

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6
Q

Primary specimen source for hematology

A

Whole blood

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7
Q

Most common anticoagulants used in hematology?

A

EDTA and Sodium Citrate (rarely heparin is used but it does not stain well so you can’t use it for smears)

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8
Q

What types of cells will you find in peripheral blood?

A

Erythrocytes (RBCs), thrombocytes (Platelets/PLTs), leukocytes (WBCs: <=5 banded neutrophils, segmented neutrophils, lymphocytes, monocytes, eosinophils, basophils)

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9
Q

Lifespan of RBCs

A

Up to 120 days

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10
Q

“cyte”

A

Cell

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11
Q

Intra-

A

Within

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12
Q

Medullary

A

Bone marrow

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13
Q

-lysis

A

Break-down

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14
Q

Extra-

A

Outside

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15
Q

Intramedullary hemolysis

A

Cell break-down within bone marrow

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16
Q

Extramedullary hemolysis

A

Cell break-down outside bone marrow

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17
Q

Erythroid hyperplasia

A

Increased red cell formation

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18
Q

Lymphopenia

A

Decreased number of lymphocytes

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19
Q

Eosinophila

A

Increased number of Eosinophils

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20
Q

Polycythemia

A

Many cells increased (all cells in the blood)

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21
Q

Vascular

A

Vessel

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22
Q

-penia

A

Decreased

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23
Q

Cytosis, -philia

A

Increased cell number

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24
Q

This is the term that indicates RBC size

A

MCV - Mean Cell Volume

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25
Q

This is the term for the weight of hemoglobin contained in RBCs

A

MCH - Mean Cell Hemoglobin

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26
Q

Term for average concentration of hemoglobin in RBC

A

MCHC - Mean Cell Hemoglobin Concentration

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27
Q

What occurs if both MCH and MCHC are decreased?

A

Microcytic anemia

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28
Q

What occurs if both MCH and MCHC are increased?

A

Macrocytic anemia

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29
Q

What is included in a CBC?

A

WBC, RBC, Platelet count, Hemoglobin, Hematocrit, and RBC indices

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30
Q

What is the Reticuloendothelial System (RES)?

A

Network of cells and tissues in spleen, liver, thymus, bone marrow, and lymph nodes

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31
Q

The purpose of the RES

A

Network involved in the formation and destruction of blood cells, metabolism of iron, inflammation, and immunity

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32
Q

This network provides cells to fight infection, carry oxygen, and prevent bleeding

A

Reticuloendothelial System

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33
Q

One of the largest organs in the body

A

Bone marrow

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34
Q

Tissue located within the cavities of the cortical bones which consist of trabecular bone resembling a honeycomb-like structure

A

Bone marrow

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35
Q

Two types of bones marrow

A

Red and Yellow

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36
Q

Ratio of red marrow to yellow marrow in adults

A

50:50

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37
Q

Hematopoietically active marrow that produces cells

A

Red marrow

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38
Q

Hematopoietically inactive marrow composed primarily of adipocytes (fat cells)

A

Yellow marrow

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39
Q

True or False:

Sites of hematopoiesis increase during fetal development

A

False- The sites decrease

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40
Q

The age that retrogression occurs for bone marrow locations

A

Between 5-7

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41
Q

Where red marrow is restricted to after retrogression occurs

A

Flat bones: sternum, pelvis, ribs, and skull.
Vertebrae
Proximal ends of the humerus and femur

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42
Q

What Red Marrow is composed of

A

Extravascular cords that contain all of the developing blood cell lineages, stem and progenitor cells, adventitial cells, and macrophages

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43
Q

Where RBCs develop in Bone Marrow

A

Small clusters adjacent to the outer surfaces of the vascular sinuses

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44
Q

Where megakaryocytes develop in Bone Marrow

A

Close to the vascular walls

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45
Q

RBC precursors surround this cell type that carries iron to incorporate iron into hemoglobin

A

Macrophages

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46
Q

Cells that contract allowing mature blood cells to pass through pores of the endothelial cytoplasm and into circulation

A

Adventitial Cells

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47
Q

Organ that produces erythropoietin

A

Kidneys

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48
Q

Bean shaped structures that occur in groups or chains in various intervals that run parallel to but NOT part of the circulatory system

A

Lymph nodes

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49
Q

1st main function of lymph nodes

A

Play a role in the formation of new lymphocytes

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50
Q

2nd main function of lymph nodes

A

Involved in the processing of specific immunoglobulins (antibodies)

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51
Q

3rd main function of lymph nodes

A

Involved in the filtration of particulate matter, debris, and bacteria (causing the inflammation we feel with things like strep throat)

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52
Q

Largest lymphoid organ in the body

A

Spleen

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53
Q

Organ that technically is not essential for life

A

Spleen

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54
Q

Function of the spleen

A

indiscriminate filter of the circulating blood

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55
Q

The spleen filters this much blood per minute

A

350mL/min

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56
Q

The spleen contains about how much blood?

A

350mL

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57
Q

Sponge-like filter composed of an inner “white” pulp and outer “red” pulp

A

Spleen

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58
Q

White pulp of spleen contains what cells?

A

Lymphocytes, macrophages, and dendritic cells

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59
Q

This zone surrounds the white pulp of the spleen

A

Middle Marginal Zone

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60
Q

The middle marginal zone contains these cells

A

Macrophages and memory T & B cells

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61
Q

The outer red pulp of the spleen is composed of what specialized cell?

A

Macrophages

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62
Q

What must RBCs be able to do in order to re-enter circulation from the spleen?

A

Deform

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63
Q

The spleen is the holding area for what percentage of the platelet population in the peripheral blood?

A

30%

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64
Q

It takes this many days for RBCs to proliferate and mature

A

5-7 days

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65
Q

RBCs lifespan

A

120 days

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66
Q

Amount of time for WBCs to proliferate and mature

A

12-20 days

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67
Q

Number of days for platelets to proliferate and mature

A

8-9 days

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68
Q

Cell type that should never be seen outside of bone marrow

A

Megakaryocyte

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69
Q

The cell that cell production starts with

A

Pluripotential stem cell

70
Q

A pluripotential cell will proliferate into this cell

A

Multipotential

71
Q

Cell capable of self-renewal and has the ability to reconstitute the hematopoietic system of a lethally irradiated host

A

Pluripotential Stem Cell

72
Q

CFU

A

Colony-forming unit

73
Q

CFU-S

A

Colony-forming unit - spleen

74
Q

CFU-S =

A

CFU-GEMM

75
Q

CSF

A

Colony-Stimulating Factor

76
Q

Cell that commits to only one cell line

A

Multipotential/Progenitor cell

77
Q

Multipotential/progenitor cells depend on these growth factors to decide which cell line they become (4 types)

A
  • Erythropoietin
  • CSF (colony-stimulating factor)
  • Interleukins
  • Cytokines
78
Q

These cells will continue into the tissue

A

Macrophage and Mast cells

79
Q

Blood oxygen tension causes the kidneys to produce what growth factor?

A

Erythropoietin

80
Q

Primary granules

A

Granules that:

  • Appear 1st
  • Appear in promyelocyte
  • Are purple-red
  • Decrease as the cell matures
81
Q

Secondary granules

A

Granules that:

  • Being to occur in the myelocyte
  • Increase as the cell matures
82
Q

Eosinophilic granules will stain what color and why?

A

Red (acidic)

83
Q

Neutrophilic granules will stain what color and why?

A

Purple (acid and alkaline)

84
Q

Basophilic granules will stain what color and why?

A

Blue (alkaline)

85
Q

Main purpose of a mature neutrophil

A

Phagocytosis of bacteria

86
Q

Name this cell:

  • observed only in the bone marrow (may be observed in peripheral blood with leukemia)
  • nucleus is round or oval with abundant, unclumped, light purple reticulated chromatin
  • 2-5 nucleoli
  • moderate basophilic cytoplasm (blue-gray)
  • N:C ratio 4:1
A

Myeloblast

87
Q

Name this cell:

  • observed in bone marrow (may be observed in peripheral blood due to leukemia or severe infection)
  • about the size of blasts
  • nucleus is round or oval, slight chromatin clumping
  • 1-2 nucleoli - beginning to fade
  • cytoplasm more evident
  • primary granules are observed
A

Promyelocyte

88
Q

Name this cell:

  • observed in bone marrow (may be observed in peripheral blood due to leukemia or severe infection)
  • round or oval nucleus with chromatin getting coarser and may be slightly flattened on one side
  • possible “dawn of neutrophilia” seen (clearing near nucleus)
  • NO nuclei present
  • cytoplasm contains primary and secondary granules and is becoming less blue
  • LAST CELL TO DIVIDE
A

Myelocyte

89
Q

First stage of cell to differentiate into eosinophil, basophil, or neutrophil

A

Myelocyte

90
Q

Name this cell:

  • Observed in bone marrow or peripheral blood due to infections
  • smaller than myelocyte
  • kidney-bean shaped nucleus with chromatin becoming coarser and staining darker
  • secondary granules are more evident with cytoplasm being more pink
A

Metamyelocyte

91
Q

Name this cell:

  • smaller
  • first cell normally seen in peripheral blood
  • nucleus is horse-shoe shaped and very clumped
  • <5% in peripheral blood
  • abundant cytoplasm with many fine granules, more secondary granules are evident
A

Neutrophilic band

92
Q

Name this cell:

  • purpose is to engulf and destroy bacteria
  • 50-70% circulate in peripheral blood
  • Capable of diapedesis and phagocytosis
  • nucleus is pinched into segments connected with a fine filament creating 3-5 loves
  • abundant pink cytoplasm with secondary granules
A

Segmented neutrophil

93
Q

Name this cell:

  • main purpose is humoral and cellular immunity
  • nucleus is round, oval
  • highest N:C ratio other than a blast
  • Chromatin is evenly coarse with dark clumping
  • Nucleolus may be seen
  • cytoplasm is blue and may have azurophilic granules
  • 20-40% in peripheral blood
A

Lymphocyte

94
Q

Precursors for lymphocytes

A

Lymphoblast and prolymphocyte

95
Q

Differentiates in to T and B cells

A

Lymphocytes

96
Q

Name this cell:

  • Main purpose is processing antigens to present to lymphocytes and collect garbage (scavengers/”clean-up crew”)
  • Become macrophages when they leave peripheral blood and enter tissues
  • Largest cell in normal blood
  • Nucleus is indented, folded brain-like convolutions, pale chromatin with abundant and distant open spaces, “lace-like”, usually no nuclei
  • Gray or gray-blue cytoplasm with pseudopods
  • May contain vacuoles
  • <10% in peripheral blood
A

Monocyte

97
Q

Precursors for monocytes

A

Monoblasts and promonocytes

98
Q

Name this cell:

  • Purpose: immunity against parasites, control of inflammation, and allergic responses
  • Large orange-red cytoplasmic granules due to acidity
  • Banded or bi-lobed nucleus
  • <5% found in peripheral blood
A

Eosinophil

99
Q

Name this cell:

  • Involved in cell mediated immunity (interacts with IgE)
  • huge dark blue or black granules that contain histamine and are so large they may hide the nucleus
  • <2% seen in peripheral blood
A

Basophil

100
Q

Name this cell:

-Main function is to produce platelets for clotting blood

A

Megakaryocyte

101
Q

Precursors of megakaryocyte

A

Megakaryoblast, promegakaryocyte

102
Q

Name this cell:

  • Main purpose is to make antibodies
  • nucleus is round and eccentric with clumped chromatin
  • cytoplasm is dark blue with pale perinuclear zone
  • comes from B cell
A

Plasma cell

103
Q

Name this cell:

  • Purpose: immunity, phagocytosis, storage of iron
  • only seen in bone marrow and tissues
  • small nucleus in large amount of cytoplasm
  • often observe vacuoles or particle matter
  • named based on what tissue type they enter
A

Macrophage

104
Q

Destroys bone

A

Osteoclast

105
Q

Makes bone

A

Osteoblast

106
Q

Time in which a peripheral blood smear should be made

A

No more than 5-6 hours, preferably 3-4

107
Q

Wright-Giemsa stain:

-This stains acidic cellular structures blue

A

Alkaline methylene blue

108
Q

Wright-Giemsa stain:

-This stains basic hemoglobin and eosinophilic granules red

A

Acidic eosin

109
Q

Your slide came out too blue with the Wright’s stain, what’s your solution?

A
  • decrease staining time
  • decrease pH
  • increase buffer time/amount
110
Q

Your slide came out too pink with the Wright’s stain, what’s your solution?

A
  • increase staining time
  • increase pH
  • decrease buffer time
111
Q

Your slide has water artifacts, what’s your solution?

A
  • replace methanol
  • keep dishes covered to prevent water absorption
  • check humidity
  • increase drying speed
112
Q

If sodium citrate tube (blue) is used for a CBC what must you multiply by to get a correct platelet and WBC count?

A

1.1

113
Q

More immature WBCs seen in a differential is referred to as

A

Left shift

114
Q

Erythrocytosis or polycythemia (are due to)

A

Heart/lung problems, dehydration, or myeloproliferative disorder (cancer)

115
Q

Thrombocytosis is caused by

A

Infections, inflammation, or rare malignancy

116
Q

Leukopenia is due to

A

Severe infections, blood malignancies, certain types of anemia, chemotherapy

117
Q

Anemia is due to

A

Blood loss, nutritional deficiencies, inherited conditions

118
Q

Thrombocytopenia is caused by

A

Blood malignancies, chemotherapy, and coagulation disorders.

119
Q

Normal platelet reference range

A

150,000-450,000/uL

120
Q

Normal male RBC range

A

4.2-6.0 x 10^6/uL

121
Q

Normal female RBC range

A

3.8-5.2 x 10^6/uL

122
Q

Normal newborn RBC range

A

4.1-6.1 x 10^6/uL

123
Q

What causes males to have a higher RBC value?

A

Androgen

124
Q

Total number of individual WBC in 1 uL of blood

-relative percentage x total WBC count = # cells in 1 uL of blood

A

Absolute Count

125
Q

Percentage based on a total of 100 WBC

A

Relative Count

126
Q

Depth of hemocytometer

A

0.1 mm

127
Q

Number of “large” squares counted for WBC count

A

4 or 9 (low cell counts)

128
Q

Where are RBCs and PLTs counted on the hemocytometer?

A

Middle square

129
Q

How many small squares are in the middle square?

A

25

130
Q

What squares are platelets counted on the hemocytometer?

A

All 25 of the middle square

131
Q

What squares are RBCs counted on the hemocytometer?

A

4 corners and very center of the middle square

132
Q

Measurement of single small middle square

A

0.2 mm

133
Q

Measurement of single small square in WBC count of hemocytometer

A

0.25 mm

134
Q

Measurement of one large square used to count WBCs in hemocytometer

A

1 mm

135
Q

Typical dilution ratio for WBC manual cell count

A

1:20 (4 squares) or 1:100 (9 squares)

136
Q

Dilution ratio used for RBC and PLT manual counts

A

1:100

137
Q

Usual Diluting fluid used for WBC and PLT estimates

A

1% ammonium oxalate

138
Q

Manual counts: DO NOT count which sides of each square?

A

Right and Bottom

139
Q

Manual counts:

Must agree within what %?

A

10%

140
Q

Calculation for manual count

A

Total count = cells counted x dilution factor (20 or 100) x depth (10) / area counted based on 1 large square

141
Q

What may cause an error in manual counting?

A
  • Inadequate mixing or dilution
  • non-random distribution
  • observer bias
  • Incorrect calculation
142
Q

This principle uses cell impedance

A

Coulter Principle

143
Q

When do you have to perform a correction calculation for WBCs?

A

When NRBCs are >5

144
Q

Calculation for corrected WBC

A

WBC x 100 / #NRBC + 100

145
Q

Primary responsibility of RBCs

A
  • Carry oxygen from lung to tissues

- Return CO2 to lungs

146
Q

Where does erythropoiesis occur?

A

Bone marrow

147
Q

Earliest recognizable erythrocyte precursors in bone marrow

A

Pronormoblasts

148
Q

Pronormoblast is also known as

A

Rubriblast

149
Q

Name the cell:

  • 1% of bone marrow cells
  • Earliest recognizable cell of erythroid series
  • homogeneous nucleus with nucleoli and chromatin strands
  • nucleus stains reddish-blue
  • royal blue/navy cytoplasm
A

Pronormoblast/Rubriblast

150
Q

Basophilic normoblast is also known as

A

Prorubricyte

151
Q

Name the cell:

  • nuclear material has begun to coarsen (nucleoli not evident)
  • parachromatin evident (more RNA and hemoglobin)
  • cytoplasm may have patches of pink (may see perinuclear halo)
  • 1-4% of bone marrow cells
A

Basophilic normoblast/Prorubricyte

152
Q

Polychromatic normoblast is also known as

A

Rubricyte

153
Q

Name the cell:

  • nuclear chromatin is thickened and irregularly condensed with pyknotic areas
  • no nucleoli visible
  • eccentric nucleus
  • gray-blue cytoplasm
  • 10-20% bone marrow cells
  • may be seen in newborns
A

Polychromatic normoblast/ Rubricyte

154
Q

Orthochromatic normoblast is also known as

A

Metarubricyte

155
Q

Name the cell:

  • Incapable of further DNA synthesis
  • nucleus is small and dense, round or bizarre shaped, will soon be extruded
  • Cytoplasm is blue-pink-orange (increased with hemoglobin synthesis)
  • 5-10% bone marrow cells
  • Not normally in peripheral blood of adults
  • small number may be seen in newborns
A

Orthochromatic normoblast/Metarubricyte

156
Q

Polychromatic erythrocyte is also known as

A

Reticulocyte

157
Q

Name the cell:

  • Nucleus has been extruded
  • cytoplasm is diffusely basophilic, polychromatophilic (due to RNA causing blue color)
  • larger than mature erythrocyte
  • Contains 2/3 of total hemoglobin
A

Polychromatic erythrocyte/Reticulocyte

158
Q

Polychromatic erythrocyte is called what when stained with Wright’s stain

A

Polychromasia

159
Q

Polychromatic erythrocyte is called what when stained with New Methylene Blue

A

Reticulocyte

160
Q

Name the cell:

  • Thin central pillow
  • biconcave disc
  • pliable, deformable
  • pink to orange color
  • does not synthesize protein
  • transports oxygen to tissue
A

Erythrocyte (Mature RBC)

161
Q

What % of cell hemoglobin is made during the normoblast stages?

A

65%

162
Q

65% of cell hemoglobin is made during what stage of the erythroid proliferation?

A

Normoblast

163
Q

What % of cell hemoglobin is made during the reticulocyte (polychromatic) stage?

A

35%

164
Q

35% of cell hemoglobin is made during what stage of the erythroid proliferation?

A

Reticulocyte (polychromatic)

165
Q

What % of aged erythrocyte destruction is extravascular?

A

90%

166
Q

Where does about 90% of aged erythrocyte destruction happen?

A

Extravascularly

167
Q

What % of aged erythrocyte destruction is intravascular?

A

10%

168
Q

Where does about 10% of aged erythrocyte destruction happen?

A

Intravascularly

169
Q

What is returned by transferrin to bone marrow?

A

Iron

170
Q

What is transferrin?

A

Carrier protein

171
Q

What is protoporphyrin broken down to and where?

A

Bilirubin in the liver

172
Q

Approximately how much iron and RBCs are removed from circulation on a daily basis?

A

1%

MLT-MLS Spring 2022 (14 decks)

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