Must-Knows in Hematology Flashcards by Rochelle Lasac

Optimum concentration of EDTA

1.5 mg/mL

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Disodium Salt of EDTA

Versene

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Tripotassium salt of EDTA

Sequestrene

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Citrate ratio for coagulation studies

1:9

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Blood to Anticoagulant ratio

9:1

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Ratio of Black top - Blood to additive

4:1

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Contains citrate and used in Westergren ESR

Black top

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Potassium oxalate (Paul-Heller’s)

Shrink cells

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Ammonium oxalate (Wintrobe’s)

Swells cells

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Optimum concentration for heparin

15 to 20 U/mL

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Contains spray-dried K2EDTA; used in blood banking

Pink top

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Contains EDTA and gel; used for molecular diagnostics

White top

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Used in FDP studies

Soybean trypsin inhibitor

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Contains Sodium heparin and sodium EDTA; used for toxicology

Royal blue top

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Used for Lead Testing

Tan top tube

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Contains thrombin (clot activator)

Yellow/gray and orange

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Process that retains blood within the vascular system during periods of injury, localizes the reactions involved to the site of injury and repairs and reestablishes blood flow through the injured vessels

Hemostasis

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Involves platelets and blood vessels

Primary Hemostasis

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Involves coagulation factors

Secondary Hemostasis

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Deficiency of vWF, Abnormal results with ristocetin; normal with ECA

von Willebrand disease

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gp1b deficiency

Bernard-Soulier Syndrome

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Used to identify abnormal hemoglobins

Hemoglobin electrophoresis

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This uses ph 8.6 and cannot be used to identify HbS since Hemoglobin S co-migrates with HbD and HbG

Cellulose Acetate Hb Electrophoresis

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Uses ph 6-6.3 and can identify Hemoglobin S

Citrate agar Hb Electrophoresis

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Hemoglobin S Screening (+) sickling of cells

Sodium Metabisulfite Test

Hemoglobin S Screening (+) turbidity

Sodium dithionite test

Measure HbA2

Anion exchange microchromatography

What's the reagent used in Betke test?

NaOH (Sodium Hydroxide)

An Alkali denaturation test for hemoglobin

Betke Test

Reagent used in Singer Test

KOH

Screening for HbH Incubate at 50C for 2 hours

Heat Precipitation Test

Used to screen for Hemoglobin 17% solution

Isopropanol precipitation test

RBC membrane Components

Protein - 50% Lipid - 40% Carbohydrate - 10%

Enzyme which maintains cholesterol content of red cell membrane

LCAT

Increased cholesterol

Codocyte

Decreased cholesterol

Ovalocyte

This maintains biconcave shape of RBCs

Spectrin and actin Take note: Spectrin is the framework of RBC and a deficiency or a problem in spectrin causes hereditary spherocytosis

Supplies 90% of ATP; 2 ATP generated per lactic acid broken down

Embden-Meyerhof Pathway

10% of glycolysis Provides reduced glutathione to prevent denaturation of Hb

Hexose Monophosphate Pathway

Consist of denatured hemoglobin

Heinz bodies

Required to demonstrate reticulocytes, Heinz bodies and HbH

Supravital stains

Process of removing of inclusions in RBCs by the spleen

Pitting

This generates 2,3 DPG, which regulates the affinity of Hb for oxygen

Rapoport-Leubering pathway

Maintains hemoglobin iron in the ferrous state

Methemoglobin reductase pathway

Destruction of senescent/aged RBCs by the spleen

Culling

Destroys 90% of aged RBCs Happens within Reticuloendothelial System Complement is not activated

Extravascular lysis

Destroys 10% of aged RBCs; complement is activated within the blood vessel

Intravascular lysis

Major storage form of iron

Ferritin

Variation in size

Anisocytosis

Correlates with degree of anisocytosis; Normal 11.5-14.5%

Red Cell Distribution Width

80-100 fL; Seen in acute blood loss, hemolytic anemia; aplastic anemia

Normocytic RBC

It's a form of Congenital aplastic anemia

Fanconi's Anemia

Congenital pure red cell aplasia

Diamond Blackfan

Panic values (values that needs to be reported immediately) for hematocrit

<14%, >60%

Iron content determination methods of hemoglobin

Kennedy Wong

Amount of iron in hemoglobin

3.47 mg/mL

It contain the enzyme LAP and glycoside alkaline phosphatase

Neutrophil

Panic values of WBCs

<2000, >50000

It is also associated with mycosis fungoides

Pautier's abcess

Hematocrit (automated method) in the presence of cryoglobulin, cryofibrinogen

Increase

Hematocrit (automated method) in the presence of giant platelets

Increase

Hematocrit (automated method) in high wbc

Increase

Hematocrit (automated method) in hyperglycemia >600 mg/dL

Increase

Hematocrit (automated method) in autoagglutination

Decrease

Hematocrit (automated method) in clotted samples

Decrease

Hematocrit (automated method) with hemolysis in vitro

Decrease

Hematocrit (automated method) in the presence of microcytic red cells

Decrease

Hematocrit level requiring anticoagulant correction in coagulation studies

55%

This is the ESR method requiring correction

Wintrobe

ESR method NOT requiring correction

Westergen

Corrected when nRBCs are present

WBC count

Corrected in patients with lower hematocrit

Reticulocyte count

Wavelength at which hemoglobin determination is read

540 nm

It is the cytogenetic abnormality in fab M2

t(8q;21q)

It is the cytogenetic abnormality in M3

t(15;17)

It is the cytogenetic abnormality in M5a

t(9;11)

It is the cytogenetic abnormality in CML

t(9q;22q)

Length of the clay plug

4-6 mm

Length of tube to be filled with blood in the microhematocrit method

5 cm

This is also known as parahemophilia

Owren

Deficient in parahemophilia or Owren's Disease

Factor V

Stains eosinophilic component of eosinophilic leukemia

Cyanide resistant peroxidase

Poor separation of RBC from plasma layer due to increased number of reticulocytes

Stratified sedimentation

This causes darker staining of reticulocytes

High FBS

This causes pale staining of reticulocytes

Heparin

This is the time when you expected the D-dimer becomes positive after the onset of DIC

4 hours

Dawn of neutrophilia

Myelocytes

Aggregates of 3-4 cells

Rouleaux: 1+

Aggregates of 5-10 cells

Rouleaux: 2+

Rouleaux: Only Few free RBCs

Rouleaux: 3+

Slight Polychromasia

1+ Polychromasia

2+ Polychromasia

10%

3+ Polychromasia

>11%

4+ Polychromasia

Effect of thin smear on PBS staining

Excessively red

Platelet count: markedly decreased

0-49,000

Platelet count: moderately decreased

50000-99000

Platelet count:100,000-149,000

Slightly decreased

Platelet count:150,000-199,000

Low normal

Platelet count: 200,000-400,000

Normal

Platelet count: 401,000-599,000

Slightly decreased

Platelet count: Moderately increased

600,000-800,000

Platelet count: >800,000

Markedly increased