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Hematology 1 > (P) Week 2: Bone marrow and Lymphoid Organs Part 2 > Flashcards

(P) Week 2: Bone marrow and Lymphoid Organs Part 2 Flashcards

1
Q

this is where the lymph fluid collected from tissues flows

A

lymph nodes

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2
Q

when blood flows into the capillaries, ________ leaks through them which now circulates into the lymphatic vessels

A

plasma

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3
Q

_________ filters plasma from the lymph fluid before it is returned to the general circulation

A

lymph nodes

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4
Q

what are the three layers of the lymph nodes

A

cortex, paracortex, and medulla

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5
Q

this is the germinal center of the lymph nodes where activated B-cells lie

A

cortex

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6
Q

this is the layer of the lymph node that contains t-cells and macrophages

A

paracortex

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7
Q

what does the medulla contain?

A

b-cells and plasma cells

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8
Q

what is the sample used for:

diagnosing leukemia
assess marrow function
assess iron storage
to rule out other hematological diseases

A

bone marrow

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9
Q

T or F

you may not collect bone marrow samples when there’s a quantitative issue with the platelet

A

F (you may because there’s only a problem with platelet amount)

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10
Q

T or F

Qualitatve platelet issues disqualifies a patient for a bone marrow collection procedure

A

T

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11
Q

T or F

Spleen problems is a ground for rejection for a bone marrow collection procedure

A

F (liver problems)

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12
Q

T or F
Hemophilia A and B is a contraindication to collect bone marrow

A

T

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13
Q

T or F

Vitamin C deficiency is a contraindication to collect bone marrow

A

F (vit K)

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14
Q

Enumerate the prothrombin group clotting factors that are dependent on vitamin K

A

CL 2,7,9, and 10

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15
Q

Bone Marrow specimen

Place in zenker’s fluid,
buffer-neutral formalin
and B5 fixative

A

Bone marrow core biopsy

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16
Q

how much Bone marrow aspirate must be collected

A

1-3 mL

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17
Q

this is done when there is difficulty in aspirating a sufficient amount of bone marrow aspirate

A

dry tap

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18
Q

what are the acceptable preparations of bone marrow aspirate to be submitted to a doctor upon routine staining

A

direct films and crush preparations

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19
Q

Bone Marrow specimen

Stained with either
* Romanowsky stain
* Wright-Giemsa stain
* Prussian blue stain

A

Bone Marrow aspirate

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20
Q

what anticoagulant is used in bone marrow samples?

A

EDTA

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21
Q

enumerate the process of re-clotting the bone marrow aspirate in an EDTA tube

A
  • 0.15 M of calcium chloride
    *place in fixative ex. Zenker’s formalin
  • submit to the histotech lab for tissue processing
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22
Q

instrument used to bore a hole into the bone for bone marrow collection

A

trephine biopsy needle

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23
Q

anticoagulant used for bone marrow specimens that will be undergoing routine examination

A

EDTA

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24
Q

anticoagulant used for bone marrow specimens that will be undergoing special examination

A

heparin

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25
Q

what are the 2 kinds of leukemia under special stains for blood and bone marrow

A

acute myelogenous leukemia (AML)
acute lymphoid leukemia (ALL)

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26
Q

What are the stain results for AML?
peroxidase =
sudan black b (SBB) =
tDT =

A

peroxidase = +
sudan black b (SBB) = +
tDT = -

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27
Q

What are the stain results for ALL?
peroxidase =
sudan black b (SBB) =
tDT =

A

peroxidase = -
sudan black b (SBB) = -
tDT = +

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28
Q

type of esterase stain that stains monocytes, monoblasts, promonocytes, and megakaryocytes

A

non-specific

29
Q

type of esterase stain that stains all immature granulocytes and granulocytes

A

specific

30
Q

type of esterase stain that differentiates granulocytic and non-granulocytic leukemia

A

specific

31
Q

non specific esterase stain is divided into

A

alpha-napthyl-butyrate
alpha-napthyl-acetate

32
Q

other name for specific esterase stain

A

ASD-chloroacetate esterase

33
Q

granulocytic or non-granulocytic leukemia

monoblasts, promonocytes, and monocytes

will become macrophage

A

non-granulocytic

34
Q

granulocytic or non-granulocytic leukemia

myeloblasts, promyelocytes, etc

A

granulocytic

35
Q

how many types of acute myeloid leukemia are there?

A

8 (0-7)

36
Q

how many types of acute myeloid leukemia can esterase differentiate

A

5 (M1-M5)

37
Q

these are all purely granulocytic

specific esterase = +
non-specific esterase = -

A

M1, M2, M3

38
Q

combined granulocytic and non-granulocytic

specific esterase = +
non-specific esterase = +

A

M4

39
Q

purely non-granulocytic

specific esterase = -
non-specific esterase = +

A

M5

40
Q

Used to differentiate leukemoid reactions from leukemia

A

Leukocyte alkaline phosphatase (LAP)

41
Q

High LAP reactions indicate

A

leukemoid

42
Q

0 to decreased (-) LAP reaction

A

leukemia

43
Q

Used to diagnose and confirm hairy-cell leukemia (targets B cells)

A

Tartrate-Resistant Acid Phosphatase (TRAP)

44
Q

This stains iron

A

pearl’s / Prussian blue stain

45
Q

rubricytes or immature RBCs with excess amounts of iron

A

Sideroblasts

46
Q

mature RBCs that got into the general circulation with excess iron

A

Siderocytes

47
Q

RBC made up of aggregated granules aka _______________ are made up of iron, and therefore stained with Pearl’s stain

A

pappenheimer bodies

48
Q

Used to diagnose chronic granulomatous disease

A

Nitroblue Tetrazolium Stain (NBT)

49
Q

A condition wherein engulfed organisms cannot be killed off by the macrophage due to its impaired killing ability

A

chronic granulomatous disease

50
Q

There is a deficiency with the _________enzyme which makes the respiratory or oxidative bursting function of phagocytes defective in chronic granulomatous disease

A

NADPH oxidase

51
Q

Normal phagocytes should produce _________ (precipitates) with Nitroblue Tetrazolium Stain (NBT)

A

blue-black formazan

52
Q

Nitroblue Tetrazolium Stain (NBT)

no staining indicates

A

abnormal phagocytes

53
Q

study where in the bone marrow liquid is placed in an ESR tube and spun to determine the levels of fat and buffy coat on each layer

A

macroscopic cellular study

54
Q

Normal values for fat and buffy coat in macroscopic cellular study

A

Fat - 1-3%
Buffy Coat - 3-5% or 5-8%

55
Q

if the levels fall between the reference values, the patient is evaluated as ____________

A

normocellular

56
Q

conditions that manifest ___________

Aplastic anemia
Bone marrow failure
Fanconi syndrome
Myelofibrosis

A

hypocellularity

57
Q

what do you call congenital myelofibrosis?

A

Myelofibrosis with Myeloid Metaplasia (MMM)

58
Q

what do you call myelofibrosis if the cause is unknown?

A

Idiopathic Myelofibrosis

59
Q

conditions that manifest ___________:

Leukemia (chronic or acute)
Polycythemia vera
Leukemoid reactions (severe cases)
Megaloblastic anemia

A

hypercellularity

60
Q

magnification used to find

fat to marrow ratio (cellularity estimate)
tumor cells
megakaryocyte number estimates

A

Low power 100x

61
Q

magnification used for

differential count
myeloid: erythroid (M:E) ratio computation
identify abnormal distribution and maturation gaps of cells

A

High Power (500X to 1000X Magnification)

62
Q

a reversed M:E ratio (erythroids are more than the myeloids) presents in

A

erythroleukemia (aka AML M6)

63
Q

when myeloids overpower the erythroids in number, it presents

A

granulocytic leukemia or chronic myelogenous leukemia

64
Q

How many metamegakaryocytes are normally found in every LPO?

A

2-10

65
Q

Osteoclasts VS Metamegakaryocytes

have separated nuclei and do not have cytoplasmic granules

A

Osteoclasts

66
Q

Osteoclasts VS Metamegakaryocytes

have fused nuclei with cytoplasmic granules

A

Metamegakaryocytes

67
Q

Osteoblasts VS Plasma cells

have perinuclear halos near the nucleus

A

Plasma cells

68
Q

In the bone marrow biopsy specimen, the RBC precursors were estimated to account for 40% of the cells in the marrow, and the other 60% were granulocyte precursors. What is the M:E ratio?

A

Sol.: simply divide the higher number with the lower number (60%/40%= 1.5)

1.5:1

69
Q

If see this card gib nath a kith

A

thanks mwah

Hematology 1 (14 decks)

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