HEMATOLOGY must memorize Flashcards
Order of draw
- sterile blood culture
- Citrate (blue)
- non additive (red)
- Heparin (green)
- EDTA (lavender)
- Fluoride (gray)
Routine gauge needle
20g
which hematopoietic period is the 19th day of gestation?
Mesoblastic period
Embryonic hemoglobins
Gower 1 = Zeta2 + Epsilon2
Portland = Zeta2 + Gamma2
Gower 2 = Alpha2 + Epsilon 2
which hematopoietic period is the 3rd month of gestation?
Hepatic period
Hemoglobin production includes what types of hemoglobin?
HbF = Alpha2 + Gamma2
HbA1 = Alpha2 + Beta2
HbA2 = Alpha2 + Gamma2
which hematopoietic period is between the 5th and 6th month of gestation?
Myeloid period
Reference range for hemoglobin on adults.
Male & female (g/dL)
Neonates (%)
Male: 13.5 - 18.0 g/dL
Female: 12.0 - 15.0 g/dL
Neonates: HbF = 60 - 80 %
Reference range for Hematocrit %
Male: 40 - 54 %
Female: 35 - 49 %
MCV reference range (fL)
80 -100 fL
*used to assess if Microcytic, Normocytic, or Macrocytic
MCHC reference range (g/dL)
32- 36 g/dL
*used to assess if Hypochromic, or Normochormic
RBC count reference range (x10^12/L)
Male: 4.20 - 6.00 x10^12/L
Female: 3.80 - 5.20 x10^12/L
PLT reference range (x10^3/uL)
150 - 450 x10^3/uL
Variation in RBC cell size
Anisocytosis
RBC = 6-8 um
MCV & RDW (reference)
Macrocyte is caused by these anemia
Megaloblastic anemia (B12 def)
Non-megaloblastic anemia (BM failure)
Pernicious anemia (autoimmune)
Microcytes cause by (TAILS)
T - Thalassemia
A - Anemia of Chronic Inflammation
I - Iron deficiency Anemia
L - Lead poisoning
S - Siderobalstic Anemia
RBC Central Pallor normal reference
approx. 1/3 of the diameter
*determines color variation (MCHC)
Abnormal variation in RBC shape
*common on severe anemia
Poikilocytosis
RBC anomaly that has small, round, dense RBC with no central pallor
Spherocytes
Good to know:
- Hereditary spherocytosis
- Extensive burns (w/ schistocytes)
RBC with slit-like area of central pallor
Stomatocytes
Good to know:
- RH null syndrome
- Alcoholism
- Hereditary stomacytosis
- Severe liver disease
RBC anomalies in Mackloid syndrome and abetalipoproteinemia
Acanthocytes
*see RBC anomaly photos on Rodak’s Chapter 19 pg. 290 (5th ed)
RBC with blunt or pointed, short projections
Burr cell (Echinocyte)
Good to know:
- Uremia
- Pyruvate kinase
deficiency
RBC associated with primary myelofibrosis
Dacryocytes
RBC associated with DIC and severe burn
Schistocytes
Aka leptocyte,platycyte, codocyte,
Mexican hat cell
Target cell
Good to know:
- Liver disease
- Thalassemia
- Hemoglobinopathies
2 RBC Inclusion Bodies not visible in wright stain
Heinz body
Hb H
*see RBC inclusion bodies table on Rodak’s Chapter 19 pg. 289 (5th ed)
- Stack of coins
- Elevated protein levels
- Increase plasma fibrinogen
Rouleux Formation
Factor I
Fibrinogen
Factor II
Prothrombin
Factor III
Tissue Factor
Factor IV
Ionic calcium
Factor V
Labile factor
Factor VII
Stable factor
Factor VIII
Anti hemophilic factor
Factor VIII carrier
Von Willebrand Factor
Factor IX
Christmas Factor
Factor X
Stuart - Prower
Factor XI
Plasma Thromboplastin Antecedent
(PTA)
Factor XII
Hageman Factor
Other name for Prekallikrein
Fletcher Factor
Other name for High Molecular Weight Kininogen (HMWK)
Fitzgerald Factor
Factor XIII
Fibrin Stabilizing Factor (FSF)
Factors in Intrinsic Pathway
9, 8, 11, 12
*APTT reference
Factors in Extrinsic Pathway
1, 3, 5, 7
*PT reference
Not seen in fresh serum
1, 5, 8, 13
Not seen in aged serum
1, 2, 5, 8, 13
Not seen in aged plasma
5 and 8
Not seen in adsorbed plasma
2, 7, 9, 10
*also Vitamin K dependent factors
Low HBG and HCT means?
Blood loss
How to differentiate chronic and acute blood loss?
Base on reticulocyte count
low retic = acute
high retic - chronic
which marrow is hematopoietically active?
Red marrow
which marrow is hematopoietically inactive?
Yellow marrow
cells in bone marrow that secrete semifluid extracellular matrix
Stromal cells
Hematopoietic stem cell marker
CD34
CALLA marker (Common Acute Lymphoblastic Antigen)
CD10
Closest cells to mast cells
Basophils
+ color in sulfhemoglobinemia
Mauve lavender
+ color in methhemoglobinemia
Choco brown
+ color in deoxyhemoglobinemia
Dark red
+ color in carboxyhemoglobinemia
Cherry red
Positive instrumental errors
Bubbles
Electrical Pulses
Aperture plugs
Affected by side angle scatter
Cytoplasmic granularity
Affected by forward light scatter
Cell size
cells seen in G6PD
Bite cells
Hemoglobin associated with Clostridium perfringens
Sulfhemoglobin
Reagent used for RBC count
Drabkin’s reagent
Enzyme that differentiates acute myelocytic and acute lymphoblastic
Peroxidase
Marker for T cells
CD2, CD3
Marker for B cells
CD19, CD20
Primary stimulus of erythropoiesis
Hypoxia
Erythropoietin is produced in
Kidney
Stain used for Reticulocytes with polychromasia
Romanowsky stain
Juvenile granulocyte not capable of mitosis
*predominant WBC in BM
Metamyelocyte
Youngest cell in the series present in peripheral blood
Resembles pelger-huet
Band cell AKA stab/staff
NK cells marker
CD16, CD56
Bone forming cells? confused with?
Osteoblasts confused with plasma cells
Bone destroying cells? confused with?
Osteoclasts confused with megakaryocytes
Sequence of erythropoiesis
CFU-E
Proerythroblast (Rubriblast 8:1)
Basophilic erythroblast (Prorubricyte 6:1)
Polychromatic erythroblast (Rubricyte 4:1)
Orthochromic erythroblast (Metarubricyte 1:2)
Reticulocyte
Mature RBC
Sequence of granulopoiesis
CFU-GM
Myeloblast (4:1)
Promyelocyte (3:1)
Myelocyte (1:1)
Metamyelocyte (no mitosis, WBC in BM)
Band (in PBS, resemble pelger-huet)
———————————-
Neutrophil
Eosinophil
Basophil
Colors of granulocytic myelocytes (earliest recognizable)
Neutrophil myelocyte
Rose pink graules
Colors of granulocytic myelocytes (earliest recognizable)
Eosinophil myelocyte
Orange-red granules
Colors of granulocytic myelocytes (earliest recognizable)
Basophil myelocyte
dark purple
sequence of monopoiesis
monoblast
promonocyte
monocyte
sequence of lymphopoiesis
lymphoblast
prolymphocyte
lymphocyte
Largest cell in Peripheral Blood
Monocyte
Life span of T lymphocyte
4-10 yrs
Life span of B lymphocyte
3-4 days
Sequence of Thrombopoiesis
Megakaryoblast (10:1)
Promegakaryocyte (4:1 to 7:1)
Granular and mature megakaryocyte (<1:1)
Metamegakaryocyte
Platelet/Thrombocyte (8-11 days)
Largest cell in BM
Megakaryocyte
Major pathway in glycolysis
Embden-Meyerhoff pathway (Anaerobic glycolysis)
3 types of glycolysis diversion pathways (shunts)
Hexose monophosphate shunt
Rapoport-Luebering pathway
Methemoglobin reductase pathway
It is the removal of inclusion by the spleen
Pitting
It is the removal of senescent/aged RBCs by the spleen
Culling
Associated anemia in normo-normo (AHA)
Acute blood loss
Hemolytic anemia
Aplastic anemia
Associated anemia in micro-hypo (CCITS)
Chronic blood loss
Chronic disease
Iron Deficiency Anemia
Thalassemia
Sideroblastic anemia
Associated anemia in macro-normo (MN)
Megaloblastic anemia (B12/folate def)
Nonmegaloblastic anemia (Liver disease, alcoholism)
Congenital aplastic anemia
Fanconi’s anemia/syndrome
Acquired aplastic anemia
Radiation, chemicals, drugs
↓WBCs
↓RBCs
↓Retics
↓Plts
Pancytopenia
It differentiates Iron Deficiency Anemia from other micro-hypo anemia
TIBC (Total Iron Binding Capacity) high in IDA
GRADING:
Area of palor is 1/2 of cell diameter
1+
GRADING:
Area of palor is 2/3 of cell diameter
2+
GRADING:
Area of palor is 3/4 of cell diameter
3+
GRADING:
Area of palor is a thin rim of Hbg
4+
Inclusions in megaloblastic anemia
Oval macrocytes
Howell-jolly bodies
Hypersegmented neutrophils
Ineffective erythropoiesis
Microscopic: RBCs gray (or blue)
WBC too dark
Eosinophil: Gray
Stains/buffers too basic (most common)
Inadequate Rinsing
Heparinized blood specimen
STAINING:
Microscopic: RBCs too pale (red)
WBC barely visible
Too acidic stain (mc)
Over rinsing
Inadequate buffering
Red cell grading of positive and negative
Sickle cell
Basophilic stippling
Pappenheimer
Howell-jolly
examples of myeloproliferative disorder
Chronic myelogous leukemia (CML)
Myelofibrosis
Polycythemia vera
Essential thrombocythemia
Number of WBC in peripheral blood?
Leukemic leukemia
> 15,000 WBC/uL
no. of WBC in peripheral blood?
Subleukemic leukemia
<15,000 WBC/uL with immature cells
no. of WBC in peripheral blood?
Aleukemic leukemia
<15,000 WBC/uL without immature cells
+AML , -ALL
Myeloperoxiase and Sudan Black
-AML, +AML (marker for immature lymphocyte)
Terminal Deoxyribonucleotidyl Transferase
Normal All blood cells except erythroblast
(PAS +)
Periodic Acid-Schiff Stain
+Granulocyte,
- Monocyte
Naphthol AS-D Chloroacetate Esterase
-Granulocyte, +Monocyte
Alpha-Naphthyl Acetate Esterase
+Hairy cell leukemia and T cell Leukemia,
- non T cell Leukemia
Acid Phosphatase (Tartrate Resistant AP)
Basophils and mast cells recognition
Toluidine Blue