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HEMA 1: LEC > Overview Part 2 > Flashcards

Overview Part 2 Flashcards

1
Q

A______ is performed on automated blood cell analyzers and includes the RBC, WBC, and platelet measurements

A

complete blood count (CBC)

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2
Q

No matter who collects, the ______ is responsible for the integrity of the specimen and ensures that it is submitted in the appropriate anticoagulant and tube and is free of clots and hemolysis

A

medical laboratory professional

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3
Q

red-tinted plasma indicating RBC damage

A

Hemolysis

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4
Q

The specimen must be of sufficient____, because “short draws” result in incorrect anticoagulant-to-blood ratios.

A

volume

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5
Q

The specimen must be tested or prepared for storage within the appropriate time frame to ensure accurate analysis and must be accurately registered in the work list, a process known as…

A

specimen accession

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6
Q

may be automated, relying on bar code or radio-frequency identification technology, thus reducing instances of identification error.

A

Accession

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7
Q

Although all laboratory scientists and technicians are equipped to perform visual RBC, WBC, and platelet counts using dilution pipettes, hemacytometers, and microscopes, most laboratories employ______ to generate the CBC.

A

automated blood cell analyzers

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8
Q

Many blood cell analyzers also provide comments on RBC, WBC, and platelet______.

When one of the results from the blood cell analyzer is abnormal, the instrument provides an indication of this, sometimes called a_____.

A

morphology

flag

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9
Q

In case of a flag, a________ is performed

A

“reflex” blood film examination

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10
Q

The_______ is a specialized, demanding, and fundamental CBC activity.

Nevertheless, if all blood cell analyzer results are within reference intervals, the it is usually omitted from the CBC.

How-ever, physicians may request it on the basis of clinical suspicion even when the analyzer results fall within their respective reference intervals.

A

blood film examination

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11
Q

To accomplish a blood film examination, the microscopist prepares a “______” blood film on a glass microscope slide, allows it to dry, and fixes and stains it using Wright or Wright-Giemsa stain

A

wedge-prep

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12
Q

Blood film examination

The microscopist visually performs an estimate of the WBC count (objective and examination???) and platelet count (objective and examination???) for comparison with their respective analyzer counts, and investigates discrepancies.

A

with the 40X or 50x objective at 400X or 500X magnification

with the 100× oil immersion objective at 1000% mag-nification

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13
Q

Blood film examination

Next, the microscopist svstematicallv reviews, identifies, and tabulates 100 (or more) WBCs to determine their percent distribution. This process is referred to as determining the…

A

WBC differential (“diff”)

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14
Q

True or False

The WBC differential relies on the microscopist’s skill, visual acuity, and integrity, and it provides extensive diagnostic in-formation.

A

True

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15
Q

Blood film examination

Finally the microscopist examines the morphology of WBCs, RBCs, and platelets by light microscopy for abnormalities of shape, diameter, color, or inclusions using ______magnification.

A

1000×

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16
Q

Visual recognition systems such as the_______ automate the WBC, RBC and platelet morphology assessment and WBC differential processes, but the medical laboratory professional or the hematopathologist is the final arbiter for all cell identification.

A

Cellavision DM96

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17
Q

Results of the CBC, including all automated blood cell analysis and blood film examination parameters and interpretive comments, are provided in paper or digital formats for physician review with______ results highlighted.

A

abnormal

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18
Q

Because they are structural and do not flow in the bloodstream,________, the endodermal cells that form the inner surface of the blood vessel, are seldom studied in the hematology laboratory

A

endothelial cells

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19
Q

are important in maintaining normal blood flow, in tethering (decelerating) platelets during times of injury, and in enabling WBCs to escape from the vessel to the surrounding tissue when needed

A

endothelial cells

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20
Q

______are a key component of hemostasis, as previously described;

_______is the second component

A

Platelets

plasma coagulation

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21
Q

The _______employs a complex sequence of plasma proteins, some enzymes, and some enzyme cofactors to produce clot formation after blood vessel injury.

Another six to eight enzymes exert control over the coagulation mechanism, and a third system of enzymes and cofactors digests clots to restore vessel patency, a process called______.

A

coagulation system

fibrinolysis

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22
Q

The medical laboratory professional focuses especially on blood specimen integrity for the______, because minor blood specimen defects, including clots, hemolysis, lipe-mia, plasma bilirubin, and short draws, render the specimen useless

A

coagulation laboratory

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23
Q

High-volume coagulation tests suited to the acute care facility include the:

A

platelet count and MPV

prothrombin time and partial thromboplastin time (or activated partial thromboplastin time)

thrombin time (or thrombin clotting time)

fibrinogen assay

D-dimer assay

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24
Q

_______ and ______ are particularly high-volume assays used in screening pro-files.

These tests assess each portion of the coagulation pathway for deficiencies and are used to monitor anticoagulant therapy

A

The prothrombin time and partial thromboplastin time

25
Q

Another 30 to 40 moderate-volume assays, mostly clot-based, are available in________ facilities.

The _______ coagulation laboratory with its interpretive complexities attracts advanced medical laboratory scientists with specialized knowledge and communication skills.

A

specialized or tertiary care facilities

26
Q

Advanced hematology procedures

Besides performing the CBC, the hematology laboratory provides: (4)

Performing these tests may require advanced preparation or particular dedication by medical laboratory scientists with a desire to specialize.

A

bone marrow examinations

flow cytometry immunopheno-typing

cytogenetic analysis

molecular diagnosis assays

27
Q

______ and ______ specimens are collected and stained to analyze nucleated cells that are the immature precursors to blood cells

A

Bone marrow aspirates and biopsy

28
Q

Cells of the_______ are precursors to RBCs

A

erythroid series

29
Q

mature to form bands and neutrophils, eosinophils, and basophils

A

myeloid series cells

30
Q

myeloid series cells mature to form…

A

bands and neutrophils, eosinophils, and basophils

31
Q

produce platelets

A

megakaryocytes

32
Q

Medical laboratory scientists, clinical pathologists, and hematologists review Wright-stained aspirate smears for morphologic abnormalities, high or low bone marrow cell concentration, and inappropriate cell line distributions.

For instance, an increase in the______ may indicate bone marrow compensation for excessive RBC destruction or blood loss

A

erythroid cell line

33
Q

The biopsy specimen, enhanced by ________staining, may reveal abnormalities in bone marrow architecture indicating leukemia, bone marrow failure, or one of a host of additional hematologic disorders.

A

hematoxylin and eosin (H&E)

34
Q

Results of examination of bone marrow aspirates and biopsy specimens are compared with____ results generated from the peripheral blood to correlate findings and develop pattern-based diagnoses.

A

CBC

35
Q

In the bone marrow laboratory,_____ stains may occasionally be employed to differentiate abnormal myeloid, erythroid, and lymphoid cells.

A

cytochemical stains

36
Q

Cytochemical stains include

A

myeloperoxidase

Sudan black B

nonspecific and specific esterase

periodic acid-Schiff

tartrate-resistant acid phosphatase

alkaline phosphatase

37
Q

Since 1980, however,________ methods have enabled identification of cell lines by detecting lineage-specific antigens on the surface or in the cytoplasm of leukemia and lymphoma cells.

A

immunostaining

38
Q

An example of______ is a visible dye that is bound to antibodies to CD42b, a membrane protein that is present in the megakaryocytic lineage and may be diagnostic for megakaryo-blastic leukemia

A

immunostaining

39
Q

________may be:

quantitative, such as _______that have grown from the original Coulter principle, or

qualitative, including_____ that have migrated from research applications to the clinical laboratory

A

Flow cytometers

clinical flow cytometers

laser-based instruments

40
Q

_______ are automated clinical blood cell analyzers that generate the quantitative parameters of the CBC through application of electrical impedance and laser or light beam interruption.

Qualitative _______ are mechanically simpler but technically more demanding.

A

Clinical flow cytometer

laser-based flow cytometers

41
Q

True or False

Both qualitative and quantitative flow cytometers are employed to analyze cell populations by measuring the effects of individual cells on laser light, such as forward-angle fluorescent light scatter and right-angle fluorescent light scatter, and by immunophenotyping for cell membrane epitopes using monoclonal antibodies labeled with fluorescent dyes.

A

True

42
Q

The ______ is indispensable to leukemia and lymphoma diagnosis.

A

qualitative flow cytometry laboratory

43
Q

a time-honored form of chromosome analysis, is employed in bone marrow aspirate examination to find gross genetic errors

A

Cytogenetics

44
Q

_______, a reciprocal translocation between chromosomes 9 and 22 that is diagnostic in chronic myeloid leukemia

_______, a translocation between chromosomes 15 and 17 diagnostic in acute promyelocytic leukemia.

A

Philadelphia chromosome

t(15;17)

45
Q

True or False

Cytogenetic analysis remains essential to the diagnosis and treatment of leukemia.

A

True

46
Q

the fastest-growing area of laboratory medicine, enhance and even replace some of the advanced hematologic methods.

A

Molecular diagnostic techniques

47
Q

Real-time polymerase chain reaction, microarray analysis, fluorescence in situ hybridization, and DNA sequencing systems are sensitive and specific methods that enable medical laboratory scientists to detect various chromosome translocations and gene mutations that confirm specific types of leukemia and lymphoma, establish their therapeutic profile and prognosis, and monitor the effectiveness of treatment.

A

Molecular diagnostic techniques

48
Q

The___________ phenotypically detects an inherited RBC enzyme deficiency causing episodic hemolytic anemia

A

glucose-6-phosphate dehydrogenase assay

49
Q

The _________and its follow-up tests,______ and ______ are used to detect and diagnose sickle cell anemia and other inherited qualitative hemoglobin abnormalities and thalassemias

A

sickle cell solubility screening assay

hemoglobin electrophoresis and high-performance liquid chromatography,

50
Q

One of the oldest hematology tests, the_______, detects inflammation and roughly estimates its intensity

A

erythrocyte sedimentation rate

51
Q

the medical laboratory professional reviews the cellular counts, distribution, and morphology in body fluids other than blood

These include: (5) in which RBCs and WBCs may be present in disease and in which malignant cells may be present that require specialized detection skills.

A

cerebrospinal fluid
synovial (joint) fluid
pericardial fluid
pleural fluid
peritoneal fluid

52
Q

Analysis of_______ is always performed with a rapid turnaround, because cells in these environments rapidly lose their integrity.

The conditions leading to a need for body fluid analysis are invariably acute.

A

nonblood body fluids

53
Q

Medical laboratory professionals employ particularly complex quality control systems in the hematology laboratory.

Because of the unavailability of weighed standards, the measurement of cells and biological systems defies chemical standardization and requires elaborate calibration, validation, matrix effect examination, linearity, and reference interval determinations.

An internal standard methodology known as the_______ also supports hematology laboratory applications.’

A

moving average

54
Q

Medical laboratory professionals in all disciplines compare methods through______ that produce clinical sensitivity, specificity, and positive and negative predictive values for each assay.

A

clinical efficacy calculations

55
Q

They must monitor specimen integrity and test ordering patterns and ensure the integrity and delivery of reports, including numerical and narrative statements and reference interval comparisons.

A

Medical laboratory professionals

56
Q

RBC Parameters

A
  1. RBC: Red Blood Cell count
  2. HGB: Hemoglobin
  3. HCT: Hematocrit
  4. MCV: Mean Corpuscular Volume
  5. MCH: Mean Corpuscular Hemoglobin
  6. MCHC: Mean Corpuscular Hemoglobin Concentration
  7. RDW: Red Cell Distribution Width
  8. RETIC: Reticulocyte Count
57
Q

WBC parameters

A
  1. WBC: White Blood Cell count
  2. NEUT: Neutrophil count (percentage and absolute)
  3. LYMPH: Lymphocyte count (percentage and absolute)
  4. MONO: Monocyte count (percentage and absolute)
  5. EO: Eosinophil count (percentage and absolute)
  6. BASO: Basophil count (percentage and absolute)
58
Q

Platelet parameters

A
  1. PLT: Platelet count
  2. MPV: Mean Platelet Volume

HEMA 1: LEC (12 decks)

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