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Hematolgy > Lecture final > Flashcards

Lecture final Flashcards

1
Q

what test is the most reliable assessment of the effective erythroid activity of the bone marrow?

A

retic count

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2
Q

what conditions (including parasitc infections) produce a macrocyitic/normochromic picture?

A

pernicious anemia
liver disease
folate deficiency
B12 deficiency

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3
Q

what conditions produce a microcytic/hypochromic blood picture?

A 
thalassemia
iron deficiency
sideroblastic anemia
Lead poisoning
hookworm infection
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4
Q

what are the typical findings in pernicious anemia?

A

oval macrocytes
shift to the right
BM WBC precursors, giant band and metas

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5
Q

what is the schilling test and what body fluid is used for the test?

A

indirect measure of intrinsic factor (pernicious anemia)

urine

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6
Q

what are macropolycytes?

A

large cells with 5-7 lobes in nucleus. larger than hypersegs

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7
Q

what portion of the red blood cell is damaged leading to the formation of burr cells and thorn cells?

A

membrane

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8
Q

what are the distinguishing characteristics of hereditary ovalocytosis?

A

ovalocytes

Normal Hgb and normal cental palor

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9
Q

what is the most unusual and significant finding in patients suffering for AIHA?

A

positive direct coobs test (DAT)

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10
Q

what poikilogyte is associated with ABO HDN?

A

spherocytes (not normal)

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11
Q

what poikilocyte is associated with extramedullary hematopoiesis?

A

tear drop cells

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12
Q

what are the lab finding is PCH?

A

positive DAT
positive Donath Landsteiner
syptoms after exposure to cold

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13
Q

what are the hemoglobin electrophoresis results in sickle cells anemia?

A

Has Hgb S and F

No Hgb A

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14
Q

hat hemoglobin is insoluble in reducing agents such as sodium dithionite and sodium meatbisulfate?

A

Hgb S

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15
Q

which beta chain of the Hgb molecule is abnormal in Hgb C disease, sickle cell anemia and thalassemia major?

A

beta chain

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16
Q

what does the PBS of a patient with sickle cells trait usually look like?

A

occcasional target cells otherwise normal

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17
Q

what does the PBS of a patient with IDA show?

A

pale, microcytic/hypochromic cells

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18
Q

what are the serum iron and TIBC results in IDA?

A

decreased iron increased TIBC

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19
Q

what is the specific cause of thalassemia?

A

decreased rate of synthesis of either slpha or beta chains. inherited not normal

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20
Q

what is another name for homozygous alpha thalassemia?

A

barts disease

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21
Q

what is another name for heterozygous alpha thalassemia?

A

Hgb H disease

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22
Q

what cause relative polycythemia?

A

stress
dehydration
severe burns
not increased erythropoeiten

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23
Q

what are the typical lab findings in acute leukemia?

A

anemia
thrombocytopenia
young cells

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24
Q

what has auer rods and a positive peroxidase stain?

A

AML

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25
Q

what has a positive periodic acid-Schiff stain

A

ALL

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26
Q

what has a positive chloroacetate esterase stain?

A

AMML

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27
Q

what has a prescence of myelomonocytes?

A

AMML (Naeglis)

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28
Q

what has a presence of the philadelphia chromosome?

A

CML

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29
Q

what has hypermature lymphs and smudge cells?

A

CLL

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30
Q

what has extreme thrombocytosis?

A

CML

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31
Q

what has increased incidence of bleeding disorders

A

APL

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32
Q

what leukemia is most frequently seen in patients over the age of 50?

A

CLL

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33
Q

whay type of cells might be expected to be found in the bone marrow of a leukemic patient?

A

small cells in PBS
acute=blasts
CML=all stage of granulocytes (except IM)

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34
Q

what is the “end stage” of DiGuglielmo’s syndrome?

A

AML (arythro Leukemia)

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35
Q

what condition would be described as acute granuocytopenia?

A

agranulocytosis/neutropenia

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36
Q

what are the lab findings in Hodgkins disease?

A

increase EOS
decreased lymphs
increased monos
Reed sternberg cell

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37
Q

what are the lab findings in multiple myeloma?

A 
occasional plasma cell
bence jones protein
rouleaux
increased sed rate
high protein
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38
Q

what is the L.E factor?

A

anti-nucleoprotein IgG antibody

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39
Q

how is a downey cell described?

A

a typical lymph in IM scalloping around RBC

blue at the edges aka reactive lymph

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40
Q

what disease is indicated by a positive ANA

A

SLE (lupus)

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41
Q

with what conditions is a decreased LAP associated?

A

CML
AML
increased leukomoid reactions

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42
Q

what are the causes of bleeding?

A 
trama
decreased clotting factor synthesis
DIC
increased utilization of clotting factors
genetic defects
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43
Q

what is the immediate response to vessel injury?

A

vasocontriction

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44
Q

what comprises the initial plug in the wall of an injured vessel?

A

platelets

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45
Q

what is meant by platelet adhesion?

A

sticks to surfaces

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46
Q

what is meant by platelet aggregation?

A

platelets stick to each other

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47
Q

which platelet factor is most important in the clotting process?

A

factor 3

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48
Q

what factor is fibrinogen?

A

I

49
Q

what factor is prothrombin?

A

II

50
Q

what factor is tissue thromboplastin?

A

III

51
Q

what factor is Ca?

A

IIII

52
Q

what factor is the labile factor?

A

V

53
Q

what if the anti-hemophiliac factor?

A

VIII

54
Q

what are the christmas factors?

A

X XI

55
Q

what factors are hageman factors?

A

XII

56
Q

what factor is hemophilia A?

A

VIII

57
Q

what factore is hemophilia B?

A

IX

58
Q

what is the stuart power factor?

A

X

59
Q

what factor is plasma thromboplastin?

A

XI

60
Q

what factor is the hagemans factor?

A

XII

61
Q

intrinsic factors

A

1,2,,5,8,9,10,11,12

62
Q

extrinsic factors

A

1, 2, 5, 7, 10

63
Q

factors in common

A

1, 2 ,5, 10

64
Q

vitamin K dependant factors

A

2, 7, 9, 10

65
Q

liver factors

A

everything but 8

66
Q

labile factors

A

5, 8

67
Q

adsorbed plasma factors

A

5, 8, 11, 12

68
Q

aged serum factors

A

7, 9, 10, 11, 12

69
Q

factors that lac enzymatically active form

A

5, 8

70
Q

component of thromboplastin

A

activated factor x
platelet factor III
Ca ions
factor 5

71
Q

end result of stage 1

A

plasma thromboplastin

72
Q

end result of stage II

A

thrombin

73
Q

end result of stage III

A

fibrin

74
Q

substance which initiates the extrinsic system

A

tissue factor 3

not contained in the blood until injury occurs

75
Q

substance which initiates the intrinsic system

A

platelet factor 3
plasma factor 12
contact with exposed colagen

76
Q

precursor of thrombin

A

prothrombin

77
Q

substance which converts fibrinogen to fibrin

A

thrombin

78
Q

activated substance responsible for clot lysis

A

plasmin (activated)

79
Q

final end products of th breakdown of fibrin and of fibrinogen

A

frag, E

2 D frag.

80
Q

components which are depleted in DIC

A

1, 5, 8, platelets

81
Q

factor deficiency that would be incompatible with life

A

IV Ca

82
Q

principle of the coagulyzer (orMLA)

A

change in optical density cuts the timer off

83
Q

principle of the fibrometer

A

completion of electrical circut due to formation of a clot

84
Q

principle and normal value for duke

A

ear

1-3 mins

85
Q

principle and normal value for ivy

A

forearm

1-7 mins

86
Q

principle for tourniquet test

A

capillary fragility

87
Q

principle and normal value for thrombin time

A

measure of availability of fibrinogen

15-20 secs (factor 1)

88
Q

what is the principle of the Lee-White clotting time?

A

monitoring heparin therapy

detects intrinsic defects

89
Q

what is the principle of prothrombin consumption test?

A

meausres amount of prothrombin remaining in serum after clotting

90
Q

normal values for fibrinogen

A

200-400 mg/dl

91
Q

factors which influence clot retention

A

platelet factor 6

normal fibrin normal hct (thrombosthenin 6)

92
Q

what deficiency is PT especially sensitive to?

A

deficiency of factor 7

93
Q

what abnormalities could be indicated by and increased PTT?

A

liver disease

hemophilia A and B

94
Q

what is the principle of plasma recalcification time?

A

amount of time required for clot to form in plasma

95
Q

what factor is stypven time most useful for?

A

russels viper venom -factor 7

96
Q

what does euglobulin lysis measure?

A

fibrinolysis

97
Q

thrombo wellco test especially normal values

A

if agglutination occurs in 1:5 dilution but not in 1:20

FDP >10>40 in both >40

98
Q

what factor does 5 M urea test detect?

A

factor 13

99
Q

tests useful in the diagnosis of DIC

A

bleeding time, abnormal PT/PTT, fibrinolysis, factors 1, 5, 8 platelets

100
Q

effect of asprin in testing

A

increased BT

abnormal glass bead test

101
Q

characteristics and lab results for hemophilia A

A

deficincy of 8
sex linked
recessive
increased PTT

102
Q

characteristic and lab results for hemophilia B

A

christmas disease
factor 9
increased PTT

103
Q

characteristics and lab findings of vonwillebrands disease

A

increased PTT
abnormal bleeding time
factor 8 def.

104
Q

characteristics and lab findings of ITP

A

due to anti-platelets Ab
increased bleeding time
decreased platelets
pinpoint hemorrhages

105
Q

characteristics and lab findings of glanzmanns thrombasthenia

A

defect in platelet aggrigation

abnormal platelet funcion

106
Q

what is the characteristic of hereditary telangiectasia

A

vascular defect

107
Q

what is parahemophilia

A

factor 5 def.

108
Q

what is the mode of action of coumadin?

A

anti-vitamin k

109
Q

what is the mode of action of heparin?

A

netralized/inactivates thrombin

110
Q

what test is used to monitor coumadin

A

PT

111
Q

what test is used to monitor heparin

A

PTT

112
Q

what level must be reached for a clotting factor to cause and abnormality

A

30-40% abnormal

50-150% normal

113
Q

what is anti-thrombin III

A

heparin cofactor needs anti-thrombin to be bound, wouldnt work without it

114
Q

name a test that will distinguish between primary and secondary fibrinolysis

A

d dimer

115
Q

what factors are removed when plasma is adsorbed?

A

vitamin k dependent

factors 2, 7, 9, 10

116
Q

what reagents can be used to prepare adsorbed plasma?

A

barium sulfate

aluminum hydroxide

117
Q

irreversible aggregation of platelets

1st is reversible 2cnd is not

A

viscous metamorphosis

118
Q

what plasminogen activators are now being used to treat heart attack and stroke victims

A

tPA
tissue plasminogen activator
urokinase

Hematolgy (7 decks)

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