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Hematology > Hematology Exam 1 > Flashcards

Hematology Exam 1 Flashcards

1
Q

Leukopenia

A

decreased WBC count

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2
Q

Leukocytosis

A

Increased WBC count

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3
Q

Leukemia

A

Uncontrolled proliferation of a clone of malignant WBCs

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4
Q

Neutrophilia

A

Increased neutrophils, often signals bacterial infection

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5
Q

Neutropenia

A

decreased neutrophils, many causes including viral infections or certain medications

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6
Q

thrombocytes

A

platelets

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7
Q

leukocytes

A

WBC

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8
Q

erythrocytes

A

RBC

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9
Q

Most common hematology test ordered

A

CBC

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10
Q

Plasma

A

The liquid portion of blood that provides coagulation enzymes

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11
Q

RBC count diluent used and dilution factor

A

Normal saline used at a 1:200 dilution

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12
Q

Anemia

A

loss of oxygen carrying capacity of RBC, often due to decreased RBC or decreased Hb

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13
Q

Polycythemia

A

increased RBC count, leads to hyperviscosity

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14
Q

Description of hemoglobin measurement (what reagent is used, what type of blood is used, how does the test work)

A

Drabkin’s reagent used (potassium cyanide and potassium ferricyanide) with whole blood.
Hemoglobin is converted to cyanmethemoglobin and absorbance is measured at 540nm on spec, color intensity compared to a standard and converted to a hemoglobin concentration

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15
Q

Hematocrit

A

%RBC in whole blood

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16
Q

How to perform a manual hematocrit

A

Put blood in capillary tube, centrifuge, measure column of RBCs and divide by total length (RBCs + plasma)

Hematocrit = RBC/Whole Blood

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17
Q

Function of erythrocytes

A

Biconcave cells filled with hemoglobin which transports O2 and CO2

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18
Q

Mean Cell Volume (MCV)

A

reflects RBC size (fL)

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19
Q

Mean cell hemoglobin (MCH)

A

mass of hemoglobin per cell (pg)

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20
Q

Mean cell hemoglobin concentration (MCHC)

A

reflects RBC staining intensity and amount of central pallor (g/dL)

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21
Q

RBC distribution width (RDW)

A

degree of variation in RBC volume (%)

high variation = increased RDW
low variation = decreased RDW

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22
Q

Reticulocytes (AKA polychromatic erythrocytes)

A

large, immature RBC released from bone marrow that stain slightly blue-gray

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23
Q

What does increased reticulocytes tell you?

A

Indicates the bone marrow responding to anemia or decreased oxygen carrying capacity (bone marrow is trying to increase RBC count)

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24
Q

Manual reticulocyte procedure

A

Counting reticulocytes by microscopy - reticulocytes will have a presence of RNA in the cell and will stain blue/gray on a Wright’s blood smear

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25
Q

Function of WBC

A

protecting host from infection

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26
Q

Manual WBC count diluent and dilution

A

Diluent - dilute acid solution

Dilution - 1:20

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27
Q

Neutrophils - function and structure

A

phagocytic cells that engulf and destroy bacteria

multi-lobed nucleus

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28
Q

band neutrophils vs segmented neutrophils

A

band neutrophils are less mature and have a nucleus in a U or S shape
segmented neutrophils are mature phagocytes and have a multi lobed nucleus

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29
Q

what is a “left shift”

A

increased band on band neutrophils that indicates a bacterial infection

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30
Q

eosinophils - function and structure

A

immune system regulation - associated with allergic response or parasitic infection
bright orange/red cytoplasmic granules

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31
Q

eosinophilia

A

increased eosinophils (allergic response or parasitic infection)

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32
Q

basophils - structure and what does basophilia indicate

A

basophils have dark purple irregular granules that obscure the nucleus
basophilia indicates hematologic disease
(RARE)

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33
Q

lymphocytes - structure and function

A

large and round nucleus, very thin rim of nongranular cytoplasm.
make antibodies and fight viral infections

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34
Q

lymphocytosis

A

increased lymphocyte count, associated with viral infectioons

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35
Q

lymphopenia

A

decreased lymphocytes, associated with drug therapy or immunodeficiency

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36
Q

monocytes - structure and function

A

immature macrophage, identifies and phagocytizes foreign particles, mounts immune response.
“ground glass” appearance with indented nucleus

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37
Q

monocytosis

A

increase monocytes associated with inflammation or certain infections

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38
Q

function of platelets

A

trigger clot formation, major cell controlling hemostasis

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39
Q

cell description of a platelet

A

round/oval, anucleate, slightly granular

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40
Q

rbc description

A

anucleate, biconcave, discoid cells filled with Hgb

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41
Q

what process is used for manual platelet count?

A

phase microscopy

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42
Q

Order of most common white blood cells to least common

A

neutrophils, lymphocytes, monocytes, eosinophils, basophils

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43
Q

Do males or females have a higher CBC reference range? Why?

A

Males will have a higher reference range due to having testosterone and more muscle mass

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44
Q

QA vs QC

A

QC is more of the “analytical” quality control (measures that are included during the process to ensure the test is working properly and results are valid and reproducible)
QA is more of the “post- and pre-analytical” quality control (ensures final results are accurate)

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45
Q

how to calculate SD when given the variance

A

the SD is the square root of the variance

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46
Q

How to calculate CV% (coefficient of variation)

A

CV% = (standard deviation/mean) x 100

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47
Q

How to determine 95.5% confidence interval

A

95.5% CI = mean +/- 2 SD

48
Q

precision vs accuracy

A

accuracy - how close a measurement is to the true/expected value
precision - how close measurements of the same item are to each other (reproducibility)

49
Q

Frequency Distribution Graph - accuracy and precision

A

Skinny curves are precise

Fat curves are less precise

50
Q

What do you do if an assay result is out of linearity (too high)?

A

Patient results above linearity must be diluted and reassayed

51
Q

What does a Levy-Jennings chart show?

A

displays each data point in comparison with the mean and standard deviations

52
Q

Westgard Rules - 1 3s

A

one control value is outside the +/- SD limit

53
Q

Westgard rules - 2 2s

A

Two control values are outside the +/- 2 SD limit

54
Q

Westgard rules - R4s

A

Two consecutive control values within a run are >4 SD apart (one is +2 SD and one is -2 SD)

55
Q

Westgard Rules - 41s

A

four consecutive control values within a run exceed the mean by +/- 1 SD

56
Q

Westgard Rules - 10x

A

“shift” series of 10 consecutive control values are on one side of the mean

57
Q

Westgard rules - 7T

A

“trend” series of 7 control values trend in a constant up/down direction

58
Q

Delta check

A

compares current analyte results with the most recent previous result on the same patient
- a flag will occur if the difference between the two results is too high (20% deviation)

59
Q

PPV formula - what does it tell us?

A

(TP/TP + FP) x 100

PPV tells us the probability that a patient with a positive result actually has the disease

60
Q

NPV formula - what does it tell us?

A

(TN/TN+FN) x 100

NPV tells us the probability that a patient with a negative result actually does not have the disease

61
Q

Euchromatin

A

uncondensed genetically active area of the nucleus where DNA transcription occurs

62
Q

Heterochromatin

A

condensed/clumped transcriptionally inactive area of the nucleus

63
Q

Which organelle has this function?

Modifies and packages macromolecules for other organelles and for secretion

A

Golgi apparatus

64
Q

Which organelle has this function?

Synthesizes proteins

A

Ribosomes

65
Q

Which organelle has this function?

Synthesizes phospholipids and steroid, detoxifies drugs, stores calcium

A

SER

66
Q

Which organelle has this function?

Synthesizes membrane bound and secreted proteins

A

RER

67
Q

Which organelle has this function?
Physical barrier for cell, facilitates and restricts interchange of substances with environment, maintains electrochemical gradient

A

Plasma membrane

68
Q

Which organelle has this function?

Controls cell division and functions, contains genetic code

A

Nucleus

69
Q

Which organelle has this function?

Synthesizes ribosomal RNA, assembles ribosome subunits

A

Nucleolus

70
Q

Which organelle has this function?

Produces most of the ATP for the cell

A

Mitochondria

71
Q

Which organelle has this function?

Contains hydrolytic enzymes that degrade unwanted material in the cell

A

Lysosomes

72
Q

Which organelle has this function?

Provides strong structural support

A

Intermediate Filaments

73
Q

Which organelle has this function?

Supports cytoskeleton and motility

A

Microfilaments

74
Q

Which organelle has this function?

Contains centrioles that serve as insertion points for mitotic spindle fibers

A

Centrosome

75
Q

Which organelle has this function?

Maintains cell shape, involved in cell and organelle motility and the mitotic process

A

Microtubules

76
Q

Phospholipids found on the inner layer of the membrane

A

phosphatidyl serine and phosphatidylethanolamine

77
Q

Phospholipids found on the outer layer of the membrane

A

spingomyelin and phosphatidylcholine

78
Q

where are cisternae found?

A

on golgi apparatus

79
Q

where are cristae found?

A

on inner membrane of mitochondria

80
Q

4 stages of the cell cycle and what is occurring

A
  1. G1 phase (gap 1 phase) - cell growth
  2. S phase - DNA synthesis and replication
  3. G2 phase (gap 2 phase) - DNA checked for proper replication and damage
  4. M phase - mitosis (division of chromosomes into 2 daughter cells)
81
Q

What is G zero phase?

A

quiescence, cell is not actively in the cell cycle

82
Q

Interphase includes which stages of the cell cycle?

A

G1, S phase, and G2

83
Q

prophase

A

chromosomes condense, mitotic spindles appear

84
Q

prometaphase

A

nuclear envelope disappears, centrosomes move to opposite poles, sister chromatids attach to spindle fibers

85
Q

metaphase

A

sister chromatids align on the mitotic spindle fibers

86
Q

anaphase

A

sister chromatids separate and move toward separate poles

87
Q

telophase

A

nuclear membrane reassembles around each set of chromosomes, mitotic spindles disappear

88
Q

cytokinesis

A

cell divides into 2 identical daughter cells

89
Q

necrosis vs apoptosis

A

necrosis - cell death due to external injury to cells (pathologic)
apoptosis - self-inflicted cell death due to activation signals within the cell (physiologic)

90
Q

When does hematopoiesis begin? Where?

A

19th day of embryonic trimester. It occurs in the yolk sac

91
Q

When does hematopoiesis occur in the liver?

A

5-7 weeks gestation

92
Q

When does hematopoiesis occur in the bone marrow?

A

It starts at the end of the first trimester (4th month) until the 5th month of fetal development. It then occurs in the bone marrow until adulthood.

93
Q

Where would hematopoiesis occur in a 10 year old? A 60 year old? 8th month of gestation? 20th day of gestation? 3rd month of gestation?

A 
Bone marrow 
Bone marrow 
Bone marrow 
Yolk sac 
Liver
94
Q

Red marrow

A

hematopoietically active marrow composed of developing blood cells

95
Q

Yellow marrow

A

Hematopoetically inactive marrow composed of adipocytes

96
Q

Broad, flat cells that form a continuous layer along the inner surface of arteries/veins/vascular sinuses

A

Endothelial Cells

97
Q

Large cells with a vacuole that play a role in regulating volume of marrow in which active hematopoiesis occurs, also secrete cytokines and growth factors

A

Adipocytes

98
Q

Retrogression

A

The replacement of active red marrow with inactive yellow marrow

99
Q

Function in phagocytosis and secrete cytokines that regulate hematopoiesis

A

Macrophage

100
Q

bone-forming cells

A

osteoblasts

101
Q

bone-resorbing cells

A

osteoclasts

102
Q

secrete extracellular matrix to anchor developing hematopoietic cells in the bone cavity

A

Reticular adventitial cells

103
Q

Extramedullary hematopoiesis + where does it take place

A

Formation and activation of RBC outside of the bone marrow in response to infection ; occurs in the liver

104
Q

What organ functions to filter circulating blood?

A

Spleen

105
Q

What are the spleen’s 2 methods for removing old/abnormal RBC from circulation?

A

Culling and pitting

106
Q

What organ is the major site of hematopoiesis during the second trimester?

A

Liver

107
Q

What organ synthesizes and degrades proteins, synthesizes coag factors, is involved in drug and toxin clearance, and degrades Hgb?

A

Liver

108
Q

Function of the lymph nodes?

A

Contain lymph which is involved in the initiation of immune response and filters particulate matter

109
Q

Function of the thymus?

A

Site of maturation of T-cell progenitors

110
Q

T/F: The thymus gets smaller as we age.

A

True

111
Q

Splenomegaly

A

enlarged spleen

112
Q

Splenectomy

A

Removal of the spleen

113
Q

Hypersplenism

A

enlargement of the spleen resulting in pancytopenia despite a hyperactive blood marrow

114
Q

HSCs

A

capable of self-renewal and can give rise to any type of cell

115
Q

progenitor cells

A

differentiate into many types of cells

116
Q

precursor cells

A

can only differentiate into a particular type of cell

117
Q

Morphological changes in maturing hematopoietic stem cells

A

Decreased volume, decreased N:C ratio, loss of nucleoli, condensed chromatin, decreased basophilia, increase in cytoplasm

Hematology (10 decks)

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