Hematology Polansky Review Flashcards
1
Q
Erythropoesis
1-2 mos gestation
A
yolk sac and gonads, primative erythroblasts
2
Q
3-6mos gestation erythropoesis
A
liver and spleen, Liver is primary site
3
Q
7mos - age 4 erythropoesis
A
bone marrow, all marrow active
4
Q
Adult erythropoesis
A
bone marrow, pelvis vertebrae, sternum and skill, long bones filled with fat
5
Q
Rubriblast
A
pronormoblast
6
Q
proubricyte
A
basophilic normoblast
7
Q
rubricyte
A
polychromatophilic normoblast, last stage to divide
8
Q
metarubricyte
A
orthochromic normoblast
last nucleated stage
9
Q
reticulocyte
A
poly erythro, seen with supravitial stain
10
Q
pH 8.6 hgb electrophoresis
A
A2/C, S, F, A
(crawl, slow, fast, accelerated)
11
Q
pH 6.2 hgb electrophoresis
A
F, A/A2, S, C
12
Q
Methemoglobin
A
iron oxidized to ferric state, can’t bind 02 cyanosis, death,
Heinz bodies
13
Q
Sulfhemoglobin
A
sulf bound to heme, aquired from drugs/chem
cyanosis, cant be converted back
14
Q
carboxyhemoglobin
A
carbon bound, decreased O2 to tissues, affinity 200x greater
cherry red skin
15
Q
Macrocytes
A
megaloblastic, liver disease, retics, normal in newborns
16
Q
microcytes
A
IDA, thalassemia, ACI
17
Q
Elliptocytes/ovalocytes
A
membrane defect, HE
18
Q
Crenated cells
A
osmotic imbalance
19
Q
Burr cells (echinocytes)
A
membrane defect, uremia, PK def
20
Q
Acanthocytes
A
membrane defect, severe liver disease, abetalipoproteinemia
21
Q
Teardrops (dacryocytes)
A
myelofibrosis, thalassemias
22
Q
hypochromia
A
IDA, thalassemia
23
Q
Target cells
A
hgbop, thalassemia, liver disease
24
Q
Stomatocytes
A
HS, HS, thalassemia, RH null, alc cirrhosis
25
Rouleax
serum protein abnormality, MM macrogolbulinemia
26
Basophilic stipping
RNA aggregates, lead, abn hgb synth
27
HJ bodies
DNA remnents, pitted by spleen, post splenectomy, hemolytic anemias
28
Cabot rings
mitotic spindle, fragments, rapid blood regen, MBA, thal, splenectomy
29
pappenheimer
iron, faulty iron utilization, SBA, Post splen, thal, hemochromatosis
30
Reticulocytes
residual RNA
31
Heinz bodies
precipitated, oxidized hgb, G6PD, chemical injuries
32
Hemoglobinopathy
qualitative abnormality, abnormality in amino acid sequences
(ex. sickle cell, hgb c..etc)
33
Thalassemia
quantitative abnormality, under production of 1 or more globulin chains
(B-thal minor)
34
Folate Deficiency
n
m
h
impaires?
pan
increases?
nutritional deficiency, megaloblastic, HA, impaires DNA synth
pancytopenia, Increase LD
35
Vit B12 dEF
Megaloblastic, nutritional def, malab, parasites
pernicious anemia most common type
36
Sideroblastic anermia
defect in heme synth, dual RBC pop, rbc indicies normal, ringed sideroblasts
37
B-thal major
dec betal chain production,
micro hypo
38
B-thal minor
mild anemia, micro hypo,
39
Anemia of chronic inflammation
Micro hypo, AFR affect iron absorbtion, iron in bone marrow not released, 2nd most common
40
Promyelocyte
primary (nonspecific) granules
41
myelocyte
specific granules, last stage to divide
42
MPN/MPD
overproduction of 1 or more myelod cell lines, increased RBCs, 1 cell line dominant
(ex PV, CML)
43
myelodysplastic syndroms (MDS)
ineffective hematopoesis in 1 or more cell lines, hypercellular bone marrow
common in elderly
44
Myeloperoxidase
+ AML
= ALL
45
Sudan Black
+ AML
= ALL
46
Nap AS-D (specific esterase)
+ AML
= ALL
47
PAS
= AML
+ ALL
48
Multiple myeloma
plasma cells in marrow, norm/norm, rouleaux, M spike, bence jones, osteolytic lesions
49
Plasma cell leukemia
form of MM, plasma cells in peripheral, pancytopenia, monoclonal gamm
50
Walderstroms
malig Lymphs-plasma cells, increased IgM
51
Microhematocrit
screening for anemia
52
Osmotic fragility
increased in HS, decreased with target cells, SS, IDA
53
Donathan-landsteiner test
Paroxymal cold hgb, auto-P ab
54
Electrical impedance (coulter principle)
cell counting and size
55
Radio frequency
WBC differential
56
Opitcal light scatter (flow)
cell counting size and diff
57
Forwards scatter
volume/size of cell
58
Side scatter
complexity/internal structures, gating
59
Rule of three
RBC X 3 = hgb
Hgb X 3 = HCT
60
Primary Hemostasis
vasocontrisction
plt adhesion
plt aggregation
plt plug
61
Secondary hemostasis
coag factors to produce fibrin
XIII
62
Fibrinolysis
relase of TPa
plasminogen to plasmin
Fibrin to FDP
63
Bernard Soulier
lack of GP IB on plt w VWF, abn plt adhesion
giant plts, abn to ristocetin
64
Glanzmanns thrombastheina
def of GP IIB/IIIa, fibrinogen cant attach,
abn agregg w ADP, Epi and Collagen
65
Delta storage pool def
dense gran def
lack of ADP release
abn secondary agg with ADP and EPI
66
I
fibrinogen
converted to fibrin by thrombin
67
II
prothrombin, precoursor of thrombin
68
III
TFIII, released from vessle walls, not norm in blood
69
IV
Ca+, bound by sodium citrate
70
V
labile
71
VII
stable
72
VIII
hemophilia A, circulates with VWF, extremely labile
73
IX
christmas factor, hemophilia B
74
X
stuart factor
75
XI
hemophilia C, may or may not cause bleeding
76
XII
hageman, no bleedig, contact factor, not in vivo
77
XIII
fibrin stabilizing, poor wound healing
78
HMWK
fitzgerald, no bleeding, not part in vivo
79
PK
fletcher, thrombosis, not in vivo
80
Contact factors
PK, HMWK, XII, XI
81
Prothrombin group
II, VII, IX, X
82
Fibrinogen group
I, V, VIII, XIII
83
Common path
I, II, V, X
84
Extrinsic tenase complex
VIIa/Tf acts on X
85
Intrinsic complex
IXa/VIIIa acts on X
86
prothrombinase complex
Xa/Va acts on II
87
Vit K dependent factors
II, VII, IX, X
88
Affected by coumadin (warfarin)
II, VII, IX, X
all require vit K
89
consumed during clotting
I, II, V, VIII, XIII not present in serum
90
PT
extrinsic and common path
monitors coumadin (warfarin)
INR
91
APTT
intrinsic/common
UFH
92
Pt prolomged Aptt norm
VII
93
Pt norm
Aptt prolonged
HMWK, PK, XII, XI ,IX, VIII
94
both PT, APTT prolonged
X, I, II, V
95
Mixing studies
1:! mix of pt and normal plasma, if pt has a def it will be corrected with normal plasma, if not corrected, it is an inhibitor
96
ACT (activated clotting time)
cardiac care unit/surgery to monitor heparin
97
TT. (thrombin time)
measures fibringogen to fibrin, prolonged with hypo/dys fibrinogenemia, heparin FDPs
98
Reptilase time
using snake venom, prolonged with afibrinogenemia, not affected by heparin
99
XIII factor screening test
Cacl2 urea clot lysis, clot dissolves in 24hr
100
Anti Xa assay
LMWH, UFH, color inversely proportional to heparin concentration
101
VW disease
bleeding, abn w ristocetin, normal plts
increased APTT
most common inherited disorder
102
Hemophilia A
VIII, bleeding, norm PLts,
Inc APTT
dec VIII,
sex linked in males
103
Hemophilia B
IX, bleeding, sex linked
104
D-Dimer
lysis of fibrin by plasmin, marker for DIC, neg in primary fibrinolysis
105
FDP
plasmin on fibrin or fibrinogen, increased fibrinolytic activity, DIC
106
AT
plasma inhibitor, increased thrombosis w def
107
Protein C
coag inhibitor, inactivates Va, VIIIa, def = thrombosis
108
Protein S
cofactor for C
109
Factor V leiden
APC, V resistant to APC, thrombiosis, APTT/DRVVT
110
Lupus anticoagulants
thrombosis/abortion, phospholipids
111
HCT >555
prolonged times, anticoag must be reduced
