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Hematology > Hematology: Exam 1 > Flashcards

Hematology: Exam 1 Flashcards

1
Q

EDTA

A

Ethyleneaminetetracetic Acid.
Binds to calcium which prevents clotting.
Liquid form (K3) or dried form (K2).
Used for CBC, hematocrit, Retic count.
Preserves cellular components & morphology.

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2
Q

Order of Draw

A 
Sterile
Light Blue (Sodium Citrate)
Red (none)
Green (Heparin)
Lavender (EDTA)
Gray (Sodium Flouride)
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3
Q

Types of chromatin

A

Euchromatin- loose chromatin. transcription active. in younger cells.

Heterochromatin- condensed chromatin. transcription inactive. in more mature cells.

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4
Q

Wright Stain (Romanowsky)

A

methylene blue- basic so therefore reacts with acidic components

Eosin- acidic so therefore reacts with basic components (hemoglobin).

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5
Q

STEM Cells

A

CD34+
gives rise to all cells.
commits to either common lymphoid progenitor or common myeloid progenitor.
capable of self renewal.

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6
Q

Progenitor Cells

A

Can be any blood cell

CFU-GEMM –> BFU –> CFU

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7
Q

CFU- GEMM

A

granulocytes
erthroid cells
monocytes
megakaryotes

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8
Q

CFU-GM

A

granulocytes

monocytes

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9
Q

CFU-MK

A

megakaryotes

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10
Q

Phases of Hematopoiesis

A
  1. Mesoblastic- embyronic, occurs in yolk sac.
  2. Hepatic- primary at month 3 of pregnancy. Liver is primary.
  3. Myeloid- red bone marrow becomes primary at 6 months pregnant. first is clavicle.
  4. Medullary- from birth until 5-7 years, occurs in ALL bones. Then yellow bone marrow and fat takes over and then only occurs in flat or irregular bones
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11
Q

Flat & irregular bones

A

ribs, sternum, skull, pelvis, iliac crest

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12
Q

Composition of Bone Marrow

A

Hematopoietic- location/maturation of blood cells. Has stroma cells that are for structure and produce cytokines.

Vascular- bone marrow to peripheral blood via sinuses.

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13
Q

Stages of Erythropoiesis

A 
Pronormoblast (rubriblast)
Basophillic normoblast (prorubricyte)
Polychromatic normoblast (rubricyte)
Orthochromic normoblast (metarubricyte)
Polychromatic erythrocyte (reticulocyte)
Erythrocyte (mature erythrocyte)
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14
Q

Differences between polychromatic erythrocyte and reticulocyte

A

Polychromatic erythrocyte aka polychromasia is only on Wright Stain.

Reticulocyte is only with Supravital stain.

At this stage: they both don’t have a nucleus

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15
Q

Variation in size

A

anisocytosis

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16
Q

Auto-agglutination

A

clusters of RBC aka cold agglutination.
Due to presence of IgM.
Heat blood to 37 degrees

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17
Q

Rouleaux

A

RBC appear in overlapping stacks
Occurs when blood is left standing in tubes for a long time.
Suspend in saline to fix.

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18
Q

Hypochromic

A

increased central pallor due to less hemoglobin.

More white

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19
Q

Polychromasia (Variation in color)

A

Immature red.
Looks like spherocytes but will be redish-blueish.
No central pallor.

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20
Q

Variation in shape

A

Poikilocytosis

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21
Q

Acanthocytes

A

Spur cells.
No central pallor with irregular thorns.
Due to altered lipid content in RBC membrane

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22
Q

Codocytes

A

Target cell.

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23
Q

Dacryocytes

A

Tear drop.

Due to stretching within spleen

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24
Q

Drepanocyte

A

Sickle cell

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25
Q

Echinocyte

A

Burr cells.

Has central pallor and short regular spikes

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26
Q

Eliptocytes

A

Ovalocytes

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27
Q

Blister cells

A

contains a vacuole that resembles a blister

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28
Q

Helmet cells

A

due to bad fibrin

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29
Q

Schistocytes

A

small irregular fragments of RBC

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30
Q

Spherocytes

A

no central pallor

will be pink (unlike polychromasia)

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31
Q

Stomatocytes

A

slit like central pallor

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32
Q

Basophilic stippling

A

multiple tiny dark dots composed of RNA

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33
Q

Cabot ring

A

ring/figure 8 shapes

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34
Q

Heinz bodies

A

Purple dot on edge of cell membrane composed of denatured hemoglobin.
Not seen on Wright Stain so if cells are more blue with this inclusion, it is Heinz (do not get confused with Howell-Jolly bodies)

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35
Q

Hemoglobin C crystals

A

dark red hexagons composed of hemoglobin C

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36
Q

Hemoglobin SC crystals

A

dark red crystals with projections composed of hemoglobin SC

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37
Q

Howell-Jolly bodies

A

single dark purple dot composed of DNA fragments

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38
Q

Pappenheimer bodies

A

small cluster of dark dots composed of iron

39
Q

Malaria

A

lives within RBC
ring with diamond
P vivax is most common

40
Q

Types of Malaria

A

P. vivax & P. ovale invades young cells or retics
P. malaraie invades old RBC
P. falciparum invades young & old (most pathogenic)

41
Q

Polycythemia

A

increased concentration of erythrocytes due to EPO (disease)

42
Q

Extramedullary RBC death

A

macrophages recognize old RBC (120 days) and destruction occurs in spleen.
HGB is broken down into heme, globin, and iron which is recycled.

43
Q

Intramedullary RBC death

A

apoptosis. HGB is released and binds to haptoglobin which goes to liver

44
Q

Hemoglobin components

A

Iron
Heme
Globin

45
Q

Heme

A

iron chelated to a porphyrin ring (ring of C, H, and N)

46
Q

Iron

A

Allows HGB to carry oxygen.
Must be in Fe2+ form (NOT FE3+ aka ferric state)
two types: non-heme (not easily absorbed) and heme (easily absorbed)

most iron is recycled. no way of excreted it from body.

47
Q

Ceruloplasmin

A

in the intestine

reduces iron to Fe2+ state

48
Q

Distribution of Iron

A

70%- hemoglobin
29%- storage (two types: ferritin-readily available & hemosiderin- not readily available)
1% in transit (transferrin)

49
Q

Serum Ferritin

A

indicator of iron storage (iron study)

50
Q

Serum Iron/TIBC (total iron binding sites)

A

indicator of iron supply in tissues bound to transferrin

51
Q

Serum transferrin

A

indicator of nutritional status

52
Q

% saturation of transferrin

A

indicator of tissue iron supply (how many binding sites of transferrin are filled)

53
Q

Globin

A

chains of proteins.
6 possible chains in humans.
Made of 4 globin chains.

54
Q

HgbA

A

2 alpha 2 beta

55
Q

HgbA2

A

2 alpha 2 delta

56
Q

HgbF

A

2 alpha 2 gamma

fetal but we keep some in our adult life

57
Q

Hgb Gower 1

A

2 zeta, 2 epsilon

fetal declines shortly after birth

58
Q

Hgb Gower 2

A

2 alpha 2 epsilon

fetal declines shortly after birth

59
Q

Hgb Portland

A

2 zeta 2 gamma

fetal declines shortly after birth

60
Q

T-State

A

Once an O2 molecule leaves, it wants all the O2 molecules to leave as well. Therefore wants no more O2 = low affinity. Deoxyhemoglobin

61
Q

R-State

A

Once an O2 molecule binds it wants more O2 to bind. Therefore wants more O2 = high affinity. Oxyhemoglobin.

62
Q

2,3 BPG

A

Will bind to heme after oxygen is released to change to T-state to ensure all the oxygen leaves the heme. Due to Bohr affect (homeostasis) after a while, oxygen will start to bind to heme again and 2,3 BPG is released causing a R-state.

Increase in high altitudes and pregnant women.

63
Q

SO2%

A

% of heme groups carrying oxygen at a given PO2

64
Q

Right shift of SO2%

A

Increase PCO2, H+, temperature, 2,3 BPG, hypoventilation

Decrease pH.

There is a lower saturation because hemoglobin has to release more oxygen to compensate

65
Q

Carboxyhemoglobin

A

exposure of CO.
incapable of transporting oxygen due to CO binding to hemoglobin (hgb has high affinity of CO)

treat with respiratory support and oxygen

66
Q

Methemoglobin

A

hemoglobin with iron in the ferric Fe3+ state
cannot bind oxygen.

treat with methylene blue of ascorbic acid.

can be congenital

67
Q

Sulfhemoglobin

A

hemoglobin binds with sulfur rearing it ineffective.

treatment is removal of exposure

68
Q

Conventional Unit

A

10^6/microliters

only in US

69
Q

SI Unit

A

10^12/L

70
Q

RBC reference range

A

Males: 4.6-6.0
Females: 4.0-5.4

71
Q

RBC calculation

A

of cells/(# of squares counted0.20.2*0.1)

then multiply by 200
count 4 corners and center square

72
Q

Hemoglobin range

A

Males: 14-18
Females: 12-15

73
Q

Hematocrit calculation

A

% of RBC volume to the total volume of blood

(RBCxMCV)/10

74
Q

Hematocrit range

A

Males: 40-54%
Females: 35-49%

75
Q

MCV calculation

A

mean corpuscular volume

10*hematocrit)/RBC

76
Q

MCV range

A

80-100

77
Q

MCH calculation

A

mean corpuscular hemoglobin

(10*hemoglobin)/RBC

78
Q

MCH range

A

28-32

79
Q

MCHC calculation

A

mean corpuscular hemoglobin concentration

100*(hemoglobin/hematocrit)

80
Q

MCHC range

A

32-36%

81
Q

RDW

A

measure of the variation in size.

can only increase from 11.5-14.5%

82
Q

Relative Retic Count (RRC)

A

(#of retics/1000)*100

83
Q

Miller disc method

A

Alternative to RRC.
Count RBC AND retics in square B. Count retics in square A. Min of 20 fields counted.

((#of retics)/#(RBCs x9)) *100

84
Q

RRC/Miller/CRC disc range

A

0.5-1.5%

85
Q

Corrected Retic Count (CRC)

A

MUST do if anemic

(Pt Hct * %retic)/45

86
Q

Absolute Retic Count (ARC)

A

(Retic% * RBC count)/100

87
Q

ARC Range

A

25-75

88
Q

Retic production index (RPI)

A

CRC/(correction factor)

2 is appropriate BM response

89
Q

Immature Retic fraction

A

same thing as RPI except is automated and is based on RNA concentrations

90
Q

Sedimentation Rate

A

rate at which RBC settle from plasma.
Non-specific..indictative of inflammation.
Factors: protein composition, size/shape of RBC, and [RBC]

91
Q

Sed Rate range

A

Males/children: 0-10mm

Females: 0-20mm

92
Q

Rule of Three

A

if RBC is NORMAl then:
RBC x 3 = hemoglobin
hemoglobin x 3 = hematocrit plus or minus 3

93
Q

Interpretations

A

decreased hgb = anemia
increased hgb = polycythemia
decreased MCHC = hypo chromic

94
Q

Corrected WBC count

A

do if there are 5 or more NRBC per 100 WBC

WBC count * 100)/(100 + #NRBC

Hematology (1 decks)

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