Hematology (Exam 2) Flashcards
1
Q
What blood cells are included in complete blood count (CBC)?
A
-RBCs/erythrocytes
-WBCs/leukocytes
-platelets/thrombocytes
2
Q
What prevents blood from clotting?
A
anticoagulants
3
Q
What contains fibrinogen (clotting factor)- serum or plasma?
test q
A
plasma
4
Q
What is another name for WBC count?
A
total WBC count
5
Q
What lab test is this?
-actual number of WBCs per volume of blood
A
WBC count
6
Q
increased WBC count may indicate….
A
bacterial infection, leukemia, or myeloperipheral disorders
7
Q
decreased WBC count may indicate….
A
aplastic anemia, viral infection, or B12 def
8
Q
What lab test is this?
-percentage of types of WBCs present and morphology of cells
-can be done by instrumentation or manual by technologist
A
WBC differential and peripheral smear review
9
Q
increased neutrophils=
A
bacterial infection
10
Q
increased lymphocytes=
A
viral infection
11
Q
increased monocytes=
A
chronic conditions
12
Q
increased eosinophils=
A
allergies or parasites
13
Q
What lab test is this?
-the actual number of RBCs per volume of blood
A
RBC count
14
Q
decreased RBC, HGB, HCT=
A
anemia
15
Q
increased RBC, HGB, HCT=
A
polycythemia
16
Q
What lab test is this?
-measures the amount of hemoglobin (oxygen carrying protein) in the blood
A
hemoglobin count
17
Q
What lab test is this?
-measures the percentage of RBCs in a given volume of whole blood
A
hematocrit count
18
Q
What lab test is this?
-the number of platelets in a given volume of blood
A
platelet/thrombocytes count
19
Q
What are RBC indices?
A
used to categorize anemias
-MCV
-MCH
-MCHC
-RDW
20
Q
What lab test is this?
-measurement of the average SIZE of RBCs
A
mean cell volume (MCV)
21
Q
MCV >100 =
A
macrocytic (RBCs are larger than normal)
22
Q
MCV<80=
A
microcytic (RBCs are smaller than normal)
23
Q
MCV 80-100=
A
normocytic (RBCs are normal size)
24
Q
What lab test is this?
-calculation of the average amount of hemoglobin inside a single RBC
A
mean cell hemoglobin (MCH)
(macrocytic RBCs are large and tend to have higher MCH whereas microcytic RBCs are small and have a smaller MCH)
25
What lab test is this?
-calculation of the average concentration of hemoglobin inside a volume of RBCs
-correlates the hemoglobin content with the volume of the cells
mean cell hemoglobin concentration (MCHC)
26
MCHC <34=
hypochromic (RBCs are pale in color)
27
MCHC 34-36=
normochromic (RBCs are normal in color)
28
What lab test is this?
-the amount of anisocytosis
-calculation of the variation in the size of RBCs
-higher values indicate greater variation in size
red cell distribution width (RDW)
29
What lab test is this?
-count 100 WBCs, differentiate each cell and report out percentage of each cell
manual differential and peripheral smear
30
What is the normal shape of RBCs?
biconcave dsk
31
Condition in which the body does not have enough healthy RBCs to provide oxygen to the body tissues
anemia
32
RBCs decreased = _____________ decreased = ___________ decreased
hemoglobin, oxygen
33
RBCs are of unequal size
anisocytosis (found through RDW)
34
RBCs are various shapes
poiklocytosis
35
RBCs have various shades of blue/grey combined with tinges of pink
polychromasia (polychromic cells are immature RBCs that stain bluish grey)
36
increase in polychromic cells=
increase in bone marrow activity
37
What would cause increase in bone marrow activity?
anemia or leukemia
38
normal MCV= normal size RBC =
normocytic
39
decreased MCV= small RBC=
microcytic
40
increased MCV= large RBC=
macrocytic
41
RBCs have normal color due to adequate amount of...
hemoglobin
42
RBCs are paler than normal due to decreased conc. of....
hemoglobin
43
reticulocytes/ polychromatic/ polychromasia/ polychromatophilla are young RBCs with gray blue color due to....
remnants of RNA (and are larger than mature RBCs)
44
What lab test is this?
-determines exactly how many cells are polychromatic (immature)
-stains the RNA remnants to enable accurate counting of the immature cells
-reflects the number of young cells that are being released from marrow
reticulocyte count
45
1% of all circulating RBCs should be....
reticulocytes
46
Reticulocyte count is performed to help determine what is causing anemia. What are the 2 options?
1) increased destruction of RBCs due to increased RBC loss = increased reticulocyte count (bone marrow trying to make more to keep up with RBC loss)
2) decreased RBC production = decreased reticulocyte count (bone marrow cannot make any because its not functioning)
47
Elevated retic (reticulocyte) count indicates....
-bleeding**
-hemolytic anemia**
-hemolytic disease of the newborn
-sickle cell disease
-secondary anemia to chronic disease
-renal disease with EPO production (secondary polycythemia)**
48
decreased retic (reticulocyte) count indicates
test q
-bone marrow failure
-aplastic anemia
-folate def
-vit B12 def
49
What are the 4 different variations in shape of RBCs?
1) sickle cells/drepanocytes
2) target cells/codocytes
3) spherocytes/microspherocytes
4) teardrop cells/dacrocytes
50
What RBC shape variation is this?
-crescent shaped RBCs with one or both ends pointed
-RBCs become stiff and sticky due to polymerization of abnormal type of hemoglobin (HgbS)
sickle cells/drepanocytes
51
What is the other name for sickle cells?
drepanocytes
52
What is the other name for target cells?
codocyte
53
What RBC shape variation is this?
-center is darker and looks like a target
-maldistribution of hemoglobin
-membrane is too big for the size of the RBCs (like a bag too big for its contents)
target cells/codocyte
54
What cell shape is seen in sickle cell disease?
sickle cells/drepanocytes
55
What cell shape is seen in sickle cell disease, HgbC disease, or chronic liver disease?
target cells/codocyte
56
What RBC shape variation is this?
-center has lost its biconcave shape
-round, small, compact
-looks like water balloon
-a portion of the RBC membrane is lost****
-the increase in cell thickness makes the cell appear more densely stained than the surrounding RBCs with a loss of central pallor
-cells are very fragile
spherocytes/microspherocytes
57
Which RBCs are very fragile and can be seen in the osmotic fragility test?
test q
spherocytes/microspherocytes
58
Which RBCs are shaped like a teardrop?
teardrop cells/dacrocytes
59
Whats another name for teardrop cells?
dacrocytes
60
Which cell shape is seen in myelofibrosis/myelophthisic anemia?
teardrop cells/dacrocytes
61
Which RBC inclusion is this?
-dark blue granules scattered throughout RBC
-aggregation of rRNA in the cytoplasm indicating abnormal RBC formation
basophilic stippling
62
Where is basophilic stippling most commonly seen?
test q
lead posioning/plumbism
63
-stacks of RBCs which form because of the unique discoid shape of the RBCs
-****occurs when the plasma protein conc. is high
-ex: increased globulin from multiple myeloma
test q
rouleaux
64
What is the oxygen carrying protein molecule found in RBCs?
hemoglobin
65
What makes up a hemoglobin molecule?
4 globin chains and 4 heme groups
66
At the center of each heme group is an iron atom in the ________ form
ferrous
67
1 heme holds....
1 oxygen
68
1 hemoglobin holds....
4 oxygens
69
Normal hemoglobin is made of 2 pairs of AA chains. What are the chains?
2 alpha chains and 2 beta chains
70
Sickle cell anemia is caused by a mutation in which chain of hemoglobn?
beta globin chain
71
heme is produced by a metabolic pathway involving ______ enzyme controlled steps
8
72
Where does the hemoglobin synthesis pathway begin and end?
test q
in mitochondria
73
Heme synthesis begins with the condensation of glycine and succinyl CoA to form.....
delta aminolaevulinic acid (ALA)
74
What is the rate limiting step of heme synthesis?
formation of delta aminolaevulinic acid (ALA)
75
After delta aminolaevulinic acid (ALA) is formed, it goes to cytoplasm for a series of reactions and then returns to mitochondria to produce.....
protoporphyrin
76
Protoporphyrin is combined with iron to form?
heme
77
Heme exits the mitochondria and combines with the globin molecule which is synthesized in the
ribosome
78
A disruption at any point in the synthesis of hemoglobin can result in the following anemias:
test q!!!!!
1) iron def anemia
2) lead poisoning
3) thalassemia
4) sideroblastic anemia
5) porphyria
79
altered forms of hemoglobin that do not allow oxygen to be moved properly through the body
dyshemoglobins
80
________ levels of hemoglobin derivatives can lead to major health problems
high
81
dyshemoglobins can lead to
tissue death
82
-disorders in which the hemoglobin is functionally altered and prevented from carrying oxygen**
-they include carboxyhemoglobin, methemoglobin, and sulfhemoglobin
dyshemoglobinemias
83
Is carboxyhemoglobinemia congenital or acquired?
acquired
84
What is the fancy name for carbon monoxide posioning?
test q
carboxyhemoglobinemia
85
What is one of the most common causes of fatal poisoning?
carboxyhemoglobinemia
86
-complex of carbon monoxide and hemoglobin forms in red cells upon contact with carbon monoxide
-displacement of oxygen from hemoglobin
-affinity between hemoglobin and CO is 230x stronger than the affinity between Hgb and O2
-person becomes hypoxic (deprived of oxygen)
carboxyhemoglobinemia
87
What is the testing for carboxyhemoglobinemia?
test q
carbon monoxide levels done by arterial blood gas
88
Who has high levels of carbon monoxide?
people who live in urban areas (2-7% CO in blood) and smokers (15% CO in blood)
89
What percentage of carbon monoxide is toxic in blood?
20%
90
What percentage of carbon monoxide is deadly in blood?
60%
91
What are the symptoms of increased CO levels?
test q
-headache
-mental confusion
-nausea
-neurological impairment
-increased heart rate
-decreased BP
92
What color is the skin on a patient who died of CO poisoning?
test q
cherry red
93
What is the tx for CO poisoning?
breathing pure oxygen
94
Is methemoglobinemia congenital or acquired?
can be congenital or acquired
95
When does methemoglobinemia occur?
when hemoglobin is oxidized from ferrous state to ferric state
96
methemoglobinemia causes
cyanosis and death
97
What are the 4 causes of methemoglobinemia?
1) genetics
2) exposure to oxidizing agents
3) medical conditions
4) dietary sources
98
What oxidizing agents can cause methemoglobinemia?
1) nitrates and nitrites in contaminated water, food, or meds
2) meds from local anesthetics and antibiotics
3) industrial chemicals from aniline dyes and benzene derivatives
99
What dietary source can cause methemoglobinemia?
infants <6 months with excessive intake of nitrates form formula made with well water
100
What is the tx for methemoglobinemia?
supplemental oxygen and IV of methylene blue
101
Is sulfhemoglobinemia congenital or acquired?
acquired
102
Rare condition caused by the incorporation of a sulfur atom into the hemoglobin molecule
sulfhemoglobinemia
103
What are the 3 causes of sulfhemoglobinemia?
1) exposure to sulfur containing drugs
2) exposure to industrial chemicals that contain sulfur like hydrogen sulfide or sulfur dioxide
3) ingestion of sulfur continuing compounds from food with high fertilizer content or contaminated water
104
What are the 3 normal types of hemoglobin in adults?
1) HbA
2) HbA2
3) HbF/fetal hemoglobin
105
Which hemoglobin makes up the majority of hemoglobin in adults?
HbA
106
What are the protein chains in HbA?
alpha and beta
107
What are the protein chains in HbA2?
alpha and delta
108
What are the protein chains in HbF?
alpha and gamma
109
What is the primary hemoglobin produced by the fetus during pregnancy?
HbF
110
What is the other name for hematocrit?
packed cell volume (PCV)
111
decreased hematocrit indicates
-anemia
-hemoglobinopathies
-increased hydration**
112
increased hematocrit indicates
-polycythemia vera/compensatory polycythemia
-severe dehydration**
113
the degree of similarity of the alleles for a trait in an organism
zygosity
