Hematology Phys

Question 1

Basophilic stippling

Answer 1

Lead poisoning

Question 2

Acanthocyte/spur cell

Answer 2

Liver disease

Question 3

Bite Cell AKA degmacyte

Answer 3

G6PD deficiency

Question 4

Macro-ovalocyte

and Hypersegmented PMN’s

Answer 4

Megaloblastic anemia

Will also present with hypersegmented PMN’s

Question 5

Ringed sideroblast

Answer 5

Sideroblastic anemia which is excessive iron in mitochondria.

Question 6

What would it mean if you see a tear drop cell?

Answer 6

Dacrocytes are caused by bone marrow infiltration

“Mechanically squeezed out of bone marrow”

Question 7

When would you see Target RBCs?

Answer 7

HbC disease
Asplenia
Liver disease
Thalassemia.

Question 8

When would you find heinz bodies?

Answer 8

Oxidation of the Hb-Sh groups with bite cells most commonly seen in G6PD deficency and alpha thalasemia. `

Question 9

When would you see Howel-Jolly bodies?

Answer 9

Basophillic nuclear remnants normally removed by macrophages in the spleen.

Thus seen in pt with functional hyposplenia or asplenia.

Question 10

What s the normal range of size for RBC?

Answer 10

80-100

Think like a score of 80-100 is an okay score.

Question 11

What is plummer Vinson syndrome?

Answer 11

Iron deficiency
Anemia
Esophageal webs
Atrophic glossitis

Seen in iron deficiency.

Question 12

How will lead poisoning manifest?

Answer 12

Inhibits ferrochelatase and ALA dehydratase.
Decreases heme synthesis and RBC protoporphyrin.

Basophlic stippling wil be seen as well.

Think of an old house, children and chipped paint!!!

Question 13

What are the antidotes of lead poisoning?

Answer 13

EDTA and Dimercaprol

EDTA can be used in children.

Question 14

What vitamin deficiency most commonly leads to sideroblastic anemia?

Answer 14

Vitamin B6

Treat with pyridoxone.

Question 15

What are the most common disorders that lead to microcytic anemias?

Answer 15

Iron deficiencies
Lead poisioning
thalasemias
B6 deficiency –> Sideroblastic anemia.

Question 16

What two factors can lead to megaloblastic anemia?

Answer 16

B12 and Folate deficiency

With folate deficiency there will be no neurologic symptoms!!!

With B12 there will be.

Question 17

Describe bernard soulier syndrome

Answer 17

Defect in GpIb and its binding to Von Willebrand Factor.

Question 18

Describe Glanzmann thrombasthenia

Answer 18

Defect in GpIIb/IIIa and platelet to platelet aggregation.

Question 19

Immune thrombocytopenia

Answer 19

Antibodies directed againt the Gpb/IIa complex. `

Question 20

Thrombotic thrombocytopenic purupura

Answer 20

Increase in vWF multimers.

Question 21

why is PTT increased with lack of VWF?

Answer 21

Because vWF carries factor 8!

Question 22

What is factor V leiden disease?

Answer 22

hypercoaguability along with factor V that is resistant to Protein C degredation.

Will show subcutaneous tissue necrosis after warfarin administration.

Question 23

When would you use fresh frozen plasma?

Answer 23

DIC, cirrhosis, immediate warfarin reversal.

Question 24

What would you use for treatment in a case lacking fibrinogen and factor 8?

Answer 24

Cryoprecipitate