section 11

Question 1

identify indications for a bone marrow study

Answer 1

to confirm diagnosis or monitor effectiveness of treatment

Question 2

list the most common sites for bone marrow studies in adults and children

Answer 2

• children: hematopoietic bone marrow is in long bones and iliac crest
• adults: in ribs, pelvic bones, scalp and sternum
• collection for both from iliac crest

Question 3

define dry tap and causes

Answer 3

• aspirate doesn’t come out
• not going in far enough (not being in marrow)
• missing the angle of entry
• myelodisplastic syndromes or hairy cells

Question 4

describe 3 bone marrow preparations

Answer 4

• aspirate
• touch prep
• biopsy

Question 5

state the normal M/E ratio for adults

Answer 5

• 3:1 or 4:1

Question 6

define osteoblast

Answer 6

B for Bridge
bone forming cells resemble plasma cell

Question 7

define osteoclast

Answer 7

• bone breaker cells
• recycle bone component and reabsorb
• look like megakaryocytes

Question 8

how are bone marrow iron stores evaluated (stain and appearence)

Answer 8

• use of prussian blue stain
• iron loaded onto macros in bone marrow, 3-6 is standard
• macros w/ iron = nurse cells

Question 9

define siderocyte

Answer 9

non-nucleated RBC w/ iron granules

Question 10

define sideroblast

Answer 10

nucleated RBC with iron granules

Question 11

what is the term for a macrophage surrounded by RBCs in the bone marrow

Answer 11

nurse cell/ erythropoietic island

Question 12

what is a mast cell

Answer 12

bone marrow basophil from a separate stek cell line
- seen in chronic infections, autoimmune disease and systemic mastocytosis

Question 13

increased siderocytes or ringed sideroblasts is an indicator of what disorder

Answer 13

sideroblastic anemia
- iron cannot be incorporated into the RBC

Question 14

what cells are most numerous in bone marrow

Answer 14

bands and PMNs due to more mitotic divisions