Random Facts

Question 1

What are ring sideroblasts indicative of?

Answer 1

-indicative of MDS (myelodysplastic syndrome)

= erythroblasts w/ at least 1/3 of the nucleus encircled by at least 5 siderotic (iron containing) granules

Question 2

What are tear drop RBCs indicative of?

Answer 2

-indicative of myelofibrosis (bone marrow fibrosis)

Tear-drop RBC = dacrocytes

-seen in the fibrotic stage of PMF (primary myelofibrosis) or fibrotic stages of other MPN

Question 3

Location of red bone marrow

Answer 3

ribs, vertebrae, pelvis

-active marrow

Question 4

Location of yellow bone marrow

Answer 4

long bones of arms and legs

-inactive, contains adipocytes

Question 5

During which part of erythropoesis does expansion occur?

Answer 5

-in the C compartments

Not in the stem cells (quiescent)- important to protect from accumulation of genetic defects

Question 6

Differentiate osteoblastic and perisinusoidal niches

Answer 6

Niches of hematopoietic stem cells

(a) Osteoblastic/periarteriolar = quiescent stem cells, resistant to 5FU
(b) Perisinusoidal = cycling stem cells, killed by 5FU

Question 7

How long does it take RBC and WBC lineages to mature?

Answer 7

RBC lineage = 1 week maturation

WBC lineage = 2 week maturation

Question 8

Transcription factor crucial in developing erythroid and megakaryocyte lineages

Answer 8

FOG

Question 9

Normal value for WBC count

Answer 9

4.0-12.0 x 10^9 cells / L

Question 10

Normal value: Hgb

Answer 10

13.5-17.0 g/dL

Question 11

Normal value: Hct

Answer 11

Hematocrit: 39-51%

-the % of total blood volume composed of RBC

Question 12

Normal Value: MCV

Answer 12

= mean corpuscle volume (RBC size)

normal = 82.0-97.0 fL

Question 13

Normal platelet count

Answer 13

150-450 x 10^9 cells/ L

Question 14

Normal ANC value

Answer 14

ANC (absolute neutrophil count) = % neutrophils x total WBC count

ANC > 1.4 is normal

ANC automatically start empiric abx therapy

Question 15

What is the most common NHL subtype

Answer 15

Non-Hodgkin’s lymphoma has over 40 subtypes (so lots of types)

-most common subtype is DLBCL (diffuse large B cell lymphoma) which accounts for 25% of cases

Question 16

What are the three B-symptoms?

Answer 16

Fevers, night sweats, and weight loss

-indicative of lymphomas, most commonly Hodgkin’s over NHL

Question 17

How may drinking alcohol affect a pt w/ Hodgkin’s lymphoma

Answer 17

Alcohol induced LN pain

Question 18

What is the most common cause of anemia?

Answer 18

Iron deficiency anemia

Question 19

Composition of normal Hb

(a) HbF
(b) HbA
(c) HbA2

Answer 19

Normal Hb- all involve alpha and another dimer

(a) HbF (fetal) = alpha2gamma2
(b) HbA (adult) = alpha2beta2
(c) HbA2 = alpha2delta2

Question 20

What are target cells on peripheral blood smear?

(a) What conditions is it seen in?

Answer 20

Target cells = red cells w/ central staining of precipitated Hb seen in conditions of abnormal Hb

(a) Abnormal Hb => sickle cell, thalassemia, iron deficiency anemia

Question 21

Define hemolysis

Answer 21

Premature destruction of RBC (

Question 22

What plasma protein drops to undetectable levels in hemolysis?

Answer 22

Haptoglobin- binds free Hb in the blood

-hemolysis => extra Hb put out into the blood => Hb saturates the available haptoglobin => haptoglobin drops to undetectable levels in the blood

Question 23

Explain jaundice in some anemic pts?

Answer 23

Hb degradaition produces indirect bilirubin => jaundice

Question 24

What is the most potent platelet activator?

Answer 24

Thrombin

Question 25

Some ddx for generalized adenopathy

Answer 25

• lymphoma
• secondary syphilis
• EBV (mono)
• reactive hyperplasia due to HIV

Question 26

Some ddx for splenomegaly

Answer 26

• lymphoproliferative disease: associated w/ adenopathy as well
• infection: mono, CMV, HIV, parasitic
• myeloproliferative (MPN)
• hemolytic anemia