Hematology Rotation Final Flashcards

1
Q

Myeloblasts are MPO (pos/neg)

A

POS

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2
Q

MPO positive for?

A

Myeloblasts

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3
Q

True/False: PLT estimate with differential is not necessary if there was no PLT flag.

A

FALSE
Always do PLT estimate with manual differential

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4
Q

T/F: HJ and Pappenheimer bodies are stained with Wright

A

True

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5
Q

HLL is tartrate resistant T/F

A

TRUE

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6
Q

T/F: Methanol is used as a fixative

A

True

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7
Q

What cells are CD3+

A

All T cells

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8
Q

What cells are CD4+

A

T helper cells

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9
Q

What cells are CD8+

A

Cytotoxic T cells/suppressor cells

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10
Q

What cells are CD19+

A

B cells

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11
Q

What cells are CD34+

A

Blasts

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12
Q

What cells are CD45+

A

WBCs (Grans, monos, lymphs)

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13
Q

What cells are CD56+

A

NK cells

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14
Q

What is basophilic stippling made of?

A

RNA

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15
Q

What are pappenheimer bodies made of?

A

Iron

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16
Q

What are Howell-Jolly bodies made of?

A

DNA

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17
Q

What are Heinz bodies made of and what stain must you use to see them?

A

denatured hemoglobin; new methylene blue

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18
Q

What deficiency leads to pernicious anemia?

A

Vitamin B12

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19
Q

Oxalo acetate buffer lyses ______ in phase platelet counting.

A

RBCs

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20
Q

Atypical/reactive lymphs are indicative of? What do they look like?

A

Viral infection
- irregular nucleus, basophilic cytoplasm that take the shape of the surrounding RBCs, large

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21
Q

What RBC morphology are you expected to see in a patient with myelofibrosis?

A

Tear drop cells

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22
Q

What can cause eosinophilia?

A

Parasitic infection
Allergic rxn
Hodgkin’s Lymphoma

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23
Q

TRAP positive = ?

A

Hairy cell leukemia

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24
Q

What is expected to be seen in the peripheral smear of someone with pernicious anemia?

A

Hypersegmented neutrophils
Oval macrocytes
HJ bodies

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25
Q

Anisocytosis?

A

Differing size of cells

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26
Q

Poikilocytosis

A

Differing shape of cells

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27
Q

Transudate appearance

A

straw yellow, clear, no clots

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28
Q

Exudate appearance

A

red/pink/green/yellow, cloudy, clotted

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29
Q

Disease processes that elevate ESR?

A

anemia and leukemia

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30
Q

95% of CML patients have what?

A

Philadelphia chromosome

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31
Q

Which sysmex indices reports in percent?

A

MCHC

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32
Q

What does PLT clumping indicate?

A

Elevated WBC count

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33
Q

What should be done to fix PLT clumping?

A

Redraw in sodium citrate tube, compare with EDTA tube results

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34
Q

What is the blue reticulum found inside of reticulocytes?

A

RNA

35
Q

What is the order of RBC maturation?

A

Pronormoblast
Basophilic normoblast
Polychromatic normoblast
Orthochromatic normoblast
Reticulocyte
Erythrocyte

36
Q

Which stage of the RBC is the last go undergo mitosis?

A

Polychromatic normoblast

37
Q

Which stage of the RBC is the last to have a nucleus?

A

Orthochromatic normoblast

38
Q

Reference range for MCHC

A

29-37.5

39
Q

What does an increased MCHC indiciate?

A

Spherocytes in peripheral smear, cold agglutinins, hemolyzed/icteric/lipemic
Abnormal electrolytes

40
Q

What to do if MCHC <29?

A

Check chem results to see if they are abnormal or normal.
If abnormal, run 1:5 dilution.

41
Q

What to do if MCHC >37.5?

A

Turbidity flag
Warm in water bath
If still high, 1:5 dilution
If still high, spun crit

42
Q

How to calculate absolute eosinophils

A

eos x WBC / 100

43
Q

Forward vs side scatter

A

Forward: size of cell
Side: complexity/granularity

44
Q

What is the pink slide for in hematology?

A

PLT <100

45
Q

What to do if MCV delta flags?

A

Take to blood bank to see if they have a blood type on file or if recently transfused

46
Q

Transudate associated diseases

A

Systemic, outside body cavity (CHF)

47
Q

Exudate associated diseases

A

More cells, inside body cavity (Inflammation/malignancy)

48
Q

MSU crystals and associated disease

A

GOUT
Yellow horizontal, blue vertical
Needle-like crystals

49
Q

CPPD crystals and associated disease

A

PSEUDOGOUT
Blue horizontal, yellow vertical
Rhomboid/square crystals

50
Q

When would you make a cytospin for a body fluid?

A

WBC count CSF >5
WBC count >20 for other body fluids

51
Q

What disease is associated with urine eosinophils?

A

Interstitial nephritis

52
Q

Tech must count ____ cells in a bone marrow exam.

A

250

53
Q

High HCT associated with?

A

Polycythemia vera

54
Q

Low HCT associated with>

A

Anemia

55
Q

What will be seen in a peripheral smear for multiple myeloma patient?

A

Rouleaux and plasma cells

56
Q

What will be seen in a peripheral smear for a patient with myelofibroma?

A

Tear drop cells, shift to the left seeing immature granulocytes and nRBCs

57
Q

What will be seen in a peripheral smear for a patient with sickle cell anemia?

A

Sickle cells, schistocytes, target cells

58
Q

What will be seen in a peripheral smear for a patient with a thalassemia?

A

Hypochromic, microcytic RBCs, no immature cells, but LOTS of poikilocytosis (tear drops!!)

59
Q

What will be seen in a peripheral smear for a patient with IDA?

A

Microcytic, hypochromic RBCs
No poikilocytes (normal morphology)

60
Q

What will be seen in a peripheral smear for a patient with G6PD deficiency?

A

Blister cells

61
Q

What will be seen in a peripheral smear for a patient with sickle cell anemia, not in a current crisis?

A

Target cells

62
Q

What will be seen in a peripheral smear for a patient with megaloblastic anemia?

A

Oval macrocytes
Hypersegmented neutrophils
HJ bodies

63
Q

What will be seen in a peripheral smear for someone with CLL?

A

Smudge cells
Lots of lymphs

64
Q

What will be seen in a peripheral smear for someone with acute leukemia?

A

> 20% blasts
If auer rods present = AML
If no auer rods, cannot tell whether its AML or ALL

65
Q

Increased lymphocytes + reactive lymphs = ?

A

Viral infection

66
Q

Increased neutrophils with toxic granulation, dohle bodies, and vacuoles = ?

A

Bacterial infection

67
Q

Acute vs chronic leukemia
Myeloid vs lymphoid leukemia

A

Acute = >20% blasts
Chronic = more myelocytes

Myeloid = auer rods present
Lymphoid = most all lymphs

68
Q

What will you see in the peripheral smear of someone with Pelger-Huet Anomaly?

A

Neutrophils with 2 segments (eyeglasses)

69
Q

What will you see in the peripheral smear of someone with Hairy cell leukemia?

A

Cytoplasmic projections
Low WBC
TRAP positive

70
Q

What will you see in the peripheral smear of someone with hemoglobin C?

A

HGB C crystals (washington monument)
Target cells

71
Q

How to perform PLT estimate for unknown

A

Count 8-10 fields near feathered edge
Average and multiply by 1.5, add zeros

72
Q

What squares/how many are counted for a BF count?

A

Large middle square and four corner squares on each side of the hemacytometer making 10 squares total counted

73
Q

Mesothelial cells

A

Line serous cavities
May be seen in BF, normal in small amounts, have fried egg appearance with hairy edges
Include in 100 cell BF diff

74
Q

If the blood smear color is too pink, the stain is too….?

A

Acidic

75
Q

If the blood smear color is too blue, the stain is too….?

A

Basic

76
Q

Critical HGB

A

<7

77
Q

Critical HCT

A

> 55

78
Q

Critical WBC

A

> 50

79
Q

Critical PLT

A

<20

80
Q

What are the 3 principles of the Sysmex?

A

Hydrodynamic focusing
Flow cytometry
SLS-HGB

81
Q

A synovial fluid is yellow, has high viscosity, and the WBC count was ~1000. What classification does it fall under?

A

Group I noninflammatory

82
Q

A synovial fluid is yellow-green, with a 100,000 WBC count and a positive culture. What group does it fall under?

A

Group III septic

83
Q

A synovial fluid is red with a 5,000 WBC count. What group does it fall under?

A

Group IV hemorrhagic