(P) Week 2: Bone marrow and Lymphoid Organs Part 2 Flashcards by Nathalie Grace Castillo

this is where the lymph fluid collected from tissues flows

lymph nodes

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

plasma

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

lymph nodes

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what are the three layers of the lymph nodes

cortex, paracortex, and medulla

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

cortex

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

paracortex

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what does the medulla contain?

b-cells and plasma cells

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what is the sample used for:

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

bone marrow

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T or F

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

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

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T or F

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

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T or F

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

F (liver problems)

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

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T or F

Vitamin C deficiency is a contraindication to collect bone marrow

F (vit K)

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

CL 2,7,9, and 10

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Bone Marrow specimen

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

Bone marrow core biopsy

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how much Bone marrow aspirate must be collected

1-3 mL

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

dry tap

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

direct films and crush preparations

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Bone Marrow specimen

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

Bone Marrow aspirate

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what anticoagulant is used in bone marrow samples?

EDTA

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

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

trephine biopsy needle

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

EDTA

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

heparin

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

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

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

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

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

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

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

non-specific

type of esterase stain that stains all immature granulocytes and granulocytes

specific

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

specific

non specific esterase stain is divided into

alpha-napthyl-butyrate alpha-napthyl-acetate

other name for specific esterase stain

ASD-chloroacetate esterase

granulocytic or non-granulocytic leukemia monoblasts, promonocytes, and monocytes ## Footnote will become macrophage

non-granulocytic

granulocytic or non-granulocytic leukemia myeloblasts, promyelocytes, etc

granulocytic

how many types of acute myeloid leukemia are there?

8 (0-7)

how many types of acute myeloid leukemia can esterase differentiate

5 (M1-M5)

these are all purely granulocytic specific esterase = + non-specific esterase = -

M1, M2, M3

combined granulocytic and non-granulocytic specific esterase = + non-specific esterase = +

purely non-granulocytic specific esterase = - non-specific esterase = +

Used to differentiate leukemoid reactions from leukemia

Leukocyte alkaline phosphatase (LAP)

High LAP reactions indicate

leukemoid

0 to decreased (-) LAP reaction

leukemia

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

Tartrate-Resistant Acid Phosphatase (TRAP)

This stains iron

pearl's / Prussian blue stain

rubricytes or immature RBCs with excess amounts of iron

Sideroblasts

mature RBCs that got into the general circulation with excess iron

Siderocytes

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

pappenheimer bodies

Used to diagnose chronic granulomatous disease

Nitroblue Tetrazolium Stain (NBT)

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

chronic granulomatous disease

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

NADPH oxidase

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

blue-black formazan

Nitroblue Tetrazolium Stain (NBT) no staining indicates

abnormal phagocytes

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

macroscopic cellular study

Normal values for fat and buffy coat in macroscopic cellular study

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

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

normocellular

conditions that manifest ___________ Aplastic anemia Bone marrow failure Fanconi syndrome Myelofibrosis

hypocellularity

what do you call congenital myelofibrosis?

Myelofibrosis with Myeloid Metaplasia (MMM)

what do you call myelofibrosis if the cause is unknown?

Idiopathic Myelofibrosis

conditions that manifest ___________: Leukemia (chronic or acute) Polycythemia vera Leukemoid reactions (severe cases) Megaloblastic anemia

hypercellularity

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

Low power 100x

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

High Power (500X to 1000X Magnification)

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

erythroleukemia (aka AML M6)

when myeloids overpower the erythroids in number, it presents

granulocytic leukemia or chronic myelogenous leukemia

How many metamegakaryocytes are normally found in every LPO?

2-10

Osteoclasts VS Metamegakaryocytes have separated nuclei and do not have cytoplasmic granules

Osteoclasts

Osteoclasts VS Metamegakaryocytes have fused nuclei with cytoplasmic granules

Metamegakaryocytes

Osteoblasts VS Plasma cells have perinuclear halos near the nucleus

Plasma cells

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?

Sol.: simply divide the higher number with the lower number (60%/40%= 1.5) 1.5:1

If see this card gib nath a kith

thanks mwah