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hematology > rotation questions test > Flashcards

rotation questions test Flashcards

1
Q

normal values for wbc

A

5000-10,000

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2
Q

normal values for RBC

A

male- 4.7-6.1 million/cc

female- 4.2-5.4 million/cc

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3
Q

normal values for hgb

A

male 14-18 g/dl

female 12-16 g/dl

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4
Q

normal values for hct

A

males 42-52%

female-37-47%

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5
Q

normal values for platelets

A

150,000-400,000

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6
Q

normal values for retics

A

0.5-2%

avg 1

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7
Q

normal values for esr

A

male 0-15 mm/hr

female 0-20 mm/hr

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8
Q

what quick QC calculation can be used to check the accuracy of the RBC parameter as they are obtained from an automated counter

A

rbc x 3 = hgb

hgb X 3 = hct

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9
Q

factors which can increase ESR

A 
pregnancy 
alcoholism
cirrhosis
hepatitis
multiple myeloma
anemia
tilted tube
specimen too warm
infections
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10
Q

factors which can decrease ESR

A

sickle cell anemia
polycythemia
delay in preforming test
spherocytosis

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11
Q

what is the chief use of the osmotic fragility test

A

spherocytosis

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12
Q

what test is best to use to differentiate between homozygous and heterozygous sickle cell disease

A

hgb electrophoresis

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13
Q

how are retics stained

A

supravital stains

new methylene blue or brilliant cresyl blue

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14
Q

what is the use of the reticulocyte test to the doctor

A

used for monitoring anemia

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15
Q

in what conditions would one expect to see increased retic count

A

anemia
splenectomy
hemorrhage

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16
Q

in what conditions would one expect to see decreased reticulocyte count

A

aplastic anemia
bone marrow suppression
ineffective erythropoesis

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17
Q

what is the proper procedure for hct

A

blood is collected in heparin tube, seal one end, spin in microhct centrifuge to obtain packed cells, use macromethod of wintrobe or micromethod

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18
Q

what happens to the value if micro hct are spun too long

A

hemolysis- falsely decreased

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19
Q

what happens to the value if micro hct is not spun enough

A

cells will not pack - falsely increased

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20
Q

MCV

A

indicates RBC size
less than 80- microcytic
80-100 - normal
>100 macrocytic

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21
Q

MCHC

A

indicates degree of hypochromia

less than 32% increased hypochromia

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22
Q

with what conditions are burr cells associated

A

renal failure

kidney disease

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23
Q

in what condition is basophilic stippling freq. seen?

A

lead poisoning

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24
Q

with what condition are heinz bodies most closely associated

A

G6PD deficiency

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25
Q

how are basophillic stippling and recticulum differentiated

A

BS- romanowsky

retics- NMB

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26
Q

what is the best specimen to use for blood smears for RBC morphology

A

whole blood from EDTA tube

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27
Q

how can you adjust the color of wrights stain smear

A

adjust the pH

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28
Q

what is the most prominent feature in a blood smear from a patient with ABO HDN

A

spherocytes

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29
Q

how to calculate MCV

A

(hct/RBC) X 10

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30
Q

normal values for MCV

A

male 80-94

female- 81-99

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31
Q

how to calculate MCH

A

(hgb/RBC) X 10

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32
Q

normal values MCH

A

27-31 pico

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33
Q

how to calculate MCHC

A

(hgb/hct) X 100

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34
Q

normal values MCHC

A

32-36%

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35
Q

MCV increased

MCHC normal

A 
macrocytic-normochromic
liver disease
b12 deficiency
folate deficiency
pernicious anemia
alocholism
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36
Q

MCV decreased

MCHC decreased

A 
microcytic- hypochromic
iron deficiency anemia
sideroblastic anemia
thalassemia
lead poisioning
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37
Q

MCV normal

MCHC normal

A

normocytic- normochromic

aplastic anemia

38
Q

what is the appearance of the blood smear in IDA

A

small cells
lacking central pallor
serum iron decreased
TIBC increased

39
Q

folic acid deficiency

A

large cells
normal central pallor
PA no neurological symptoms

40
Q

what are the causes of aplastic anemia and what are the blood findings

A 
marrow suppression 
failure of replacement
exposure to chemicals, radiation
pancytopenia
normo-normo
41
Q

what is a common characteristic of all hemolytic anemia

A

increased RBC destruction

42
Q

what is an unusual finding that is the means of differentiating AIHA from other hemolytic anemias

A

positive DAT

43
Q

what information is included in a CBC differential

A

RBC morphology
platelet estimation
diff of WBC

44
Q

what is the most common WBC in a diff

A

seg

45
Q

what is the most common WBC in children

A

lymph

46
Q

what is the least common WBC

A

baso

47
Q

what is the largest WBC

A

mono

48
Q

what are other names for NRBCS

A

blast cells
rubricytes
prorubricytes
metarubricytes

49
Q

is a plasma cell likely to be found in the PBS

A

no, normally about 1% of nucleated cells in bone marrow

50
Q

what is the meaning of the term shift to the left

A

increase in immature granulocytes - blast, pro, myelo, meta, band

51
Q

what is a shift to the right

A

increase in mature granulocytes- seg, hyper seg

52
Q

how is a dx of hereditary elliptocytosis made

A

examining the PBS
atleast 25%
osmotic frag.

53
Q

what are the distinguishing characteristics of hodgkins

A

slow relentless progression
leukemoid rxc with eos
reed-sternberg cells

54
Q

what are the normal features of a smear from a new born that would be considered abnormal in an adult

A

NRBC
polychromasia
young WBC

55
Q

how would you describe a downy type ATL as it appears on a wrights stain smear

A 
eccentric nucleus 
dense chromatin 
may have vacuoles 
abundant smooth cytoplasm 
scallops RBC HUGS THEM
ballerina skirt
56
Q

at what stage of development does diff of granules of a granulocyte take place

A

myelocyte

57
Q

how is the metas diff from myelo

A

kidney bean shape - meta

58
Q

procedure for preforming total eos count

A

whole blood is diluted with staining solution
use max light
count entire ruled area of both sides on low power
calculation is total # cells X 10 / 1.8 mm cubed

neaubauer hemocytometer

59
Q

with what conditions are increased eos count assocaited

A

parasites
allergies
skin disorders
splenectomy

60
Q

normal value for CSF cell count

A

adults 0-5
0 RBCs
neonates 0-30
0 RBC

61
Q

what test is the best measure of the erythroid activity of the bone marrow

A

retic count

62
Q

what conditions cannot be absolutely diagnosed without a bone marrow aspirate

A 
myeloproliferative disorders
aplastic anemia
lymphoma
tumors
leukemia
pernicious anemia
63
Q

what is the chief use of the LAP

A

diff leukemoid rxc from CML

64
Q

why is it necessary to correct a WBC count if more than five NRBC are present and how is the correction made

A

false increase of WBC count

LOOK IN NOTES

65
Q

incidence of leukemia in various age groups

A

chronic - old

acute- young

66
Q

what is a typical picture in the pBS in acute leukemia

A

severe normo-normo anemia
decreased RBC
thrombocytopenia
increased immatures

67
Q

at the time of DX which leukemia freq presents with greatly increased platelet count

A

CML

68
Q

blood picture

AML

A 
large number myeloblasts
scattered segs
no intermediate cells
severe N/N anemia
polychromasia
NRBC
thrombocytopenia
large bizarre platelets
69
Q

BP

ALL

A

> 60% lympho blasts
severe N/N
thrombocytopenia

70
Q

BP CML

A 
increased leukocytosis
increased all stages granulocytes
increased eos
increased baso
increased platelets at first later decreases
N/N
71
Q

BP CLL

A

60-95% small mature lymphs
increased smudge cells
icnreased eos
all stages granulocytes

72
Q

hodgkins

A 
not terribly abnormal or specific
mild anemia
thrombocytopenia
leukocytosis
usually granulocytes, esp eos
decreased lymphs
73
Q

following spelnectomy

A 
pappenheimer bodies
howell jolly bodies
cabot rings
target cells
aniso/poik
increased platelets
74
Q

megaloblastic anemia

A 
normochormic RBC
aniso
poik
macro ovalocytes
pancytopenia
hyper segs 
right shift
75
Q

polycythemia vera

A 
N/N
may become micro-hypo
increased RBC
occasional NRBC
immature grans
baso stippling
increased eos and basos
large bizarre platelets and clumping
76
Q

myelofibrosis

A 
moder N/N
polychromasia
NRBC
aniso 
poik
WBC n-increased with left shift
plts increased at first later decreased LARGE BIZARRE
77
Q

DIC

A 
thrombocytopenia
micro platelets
leukocytosis
schistocytes
decreased retics
78
Q

AIHA

A 
N/N
macro- poly
spherocytes
NRBC
schistocytes
acanthocytes
burr cells
RBC being eaten by macrophages
WBC increased with left shift
79
Q

thalassemia major

A 
severe micro hypo
aniso 
poik
poly
many NRBC
RBC inclusions
increased WBC left shift
80
Q

thalassemia minor

A 
mild micro-hypo
polychromasia
target cells
occ NRBC
baso stip
81
Q

MULTIPLE MYELOMA

A 
N/N
rouleaux 
WBC normal to decreased
occasional plasma cells 
NRBCS
increased lymphs, eos, immature granulocytes
82
Q

infectious mono

A

slight leukocytes
ATL
rare to few immature lymphs

83
Q

how do you do an indirect plt count and how do you report out this

A

count plts in 5 fields on high power and times it by 4
AD
INC
DEC

84
Q

how are PNH and PCH dx and diff

A

PCH- extrinsic D-L antibody extracorpuscular defect
dx by DL test
PNH- intrinsic acquired sensitive to complement
dx by HAMMS test or sugar water test

85
Q

which layer of the blood is used to make an LE prep

A

buffy coat

86
Q

which group of disorders is classified by using the FAB system of classification

A

acut leukemias

87
Q

what is the use of the KB technique

A

measures of fetal cells in maternal blood stream used for RH - mothers

88
Q

which age group has the highest values for the RBC paramteres

A

Newborns

89
Q

what is the coultier principle for cell counting

A

interruption of alight source as it passes through a flow cell

90
Q

how would you obtain a blood specimen from a patient who has IV solutions in both arms

A

go below the IV

hematology (9 decks)

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