1 Flashcards
(165 cards)
1
Q
From the Greek word “haima” (blood) and “logos” (study/science)
A
Hematology
2
Q
Red liquid circulating in the heart, vein, arteries and capillaries.
A
Blood
3
Q
Give 6 functions of blood.
A
- Respiratory
- Nutritional
- Excretory
- Buffering action
- Maintenance of body temp
- Transport of hormones
- Defense mechanism
4
Q
Also known as respiratory pugments.
A
Hemoglobin
5
Q
Give 3 waste products of blood.
A
Creatinine, Blood Urea Nitrogen, Blood Uric Acid
6
Q
What is the normal blood pH?
A
7.35-7.45
7
Q
What are the liquid portion of blood?
A
Plasma (unclotted)
Serum (clotted)
8
Q
Give other names of RBC.
A
Erythrocyte
Erythroplastids
Akaryocyte
9
Q
Give other names of WBC.
A
Leukocyte
Leukoplastids
10
Q
Give the granular WBC.
A
Basophil
Eosinophil
Neutrophil
11
Q
Give the agranular WBC.
A
Lynphocyte
Monocyte
12
Q
Other names of platelets.
A
Thronbocytes
Thromboplastids
13
Q
What is the specific gravity of blood?
A
1.055
14
Q
This method is used only when small quantities of blood are required.
A
Skin puncture
15
Q
What are the effects of squeezing or milking the site of skin puncture?
A
Hemolysis
Excess tissue fluid
16
Q
What is the recommended depth of skin puncture in small children and infants?
A
< 2mm
17
Q
What is the recommendes depth of skin puncture in adults?
A
2mm - 2.5mm
18
Q
Why do we discard the 1st drop of blood in skin puncture?
A
To discard excess tissue fluid
To discard dead epidermal cells
To facilitate free flow of blood
19
Q
Can warming the puncture site can increase the bloodflow? If so, what is the required temperature of a warm cloth and for how long?
A
Yes, 40 -42 deg celcius for 2 - 5mins
20
Q
What is the order of draw for skin puncture?
A
Tube for blood gas analysis
Slides
EDTA microcollection tubes (filled first before other microcollection tube to ensure adequate volume and accurate result)
Other microcollection tubes with anti coagulant
Serum micro collection tubes
21
Q
What is the best puncture site for children and infants?
A
Plantar surface (heel portion) medial side (in line with big toe) and lateral side
22
Q
Puncture site for adults and older children using the skin puncture method.
A
Hand, palmar surface of non dominant hand. 3rd or 4th finger (distal portion)
23
Q
What are the 3 major veins for venipuncture?
A
Cephalic vein (thumb side), Basilic vein (pinky finger), Median Cubital Vein (connects cephalic and median vein)
24
Q
Why is it that the median vein is the site of choice in venipuncture?
A
Because it is well anchored.
25
What is the angle of the needle in venipuncture?
15 degrees
26
What are the effects of prolonged tourniquet application?
Hemolysis
Hemoconcentration
Shortened coagulation time (PT & APTT)
27
What is the distance of the tourniquet on the puncture site and how long should the tourniquet applied in the arm?
3-4 inches (7.5-10cm), < 1min
28
The phlebotomist can only puncture the patient ___
No more than 2.
29
What is the most common needle length and what is the standard bore size?
1 & 1.5 inches, 21G
30
What are the common cause of hemolysis?
Prolonged tourniquet application
Moisture or contamination of tube
Small sized needle
Excessive agitation
Frothing of blood sample
31
Additives that inhibit the use of glucose by the red cells
Antiglycolytic agents
32
Normal value of RBC.
Male: 4.6-6
Female: 4-5.40
33
Normal value of hemoglobin.
Male 14-18 d/dL (140-180)
| Female 12-15 g/dL (120-150)
34
Normal value of hematocrit
Male 40-54 % (.40-.54 L/L)
| Frmale: 35-49 % (.35-49 L/L)
35
Normal value of MCV
| Mean cell volume
80-100 fL
36
Normal value of MCH
| Mean cell hemoglobin
26-32 pg
37
Normal value of MCHC
| Mean cell hemoglobin concentration
32-36 g/dL
38
Normal value of RDW
11.5-14.5 %
39
Normal value of WBC
Male 4.5-11.5
| Female 4.5-11.5
40
Normal value of platelet
150-450
41
It is the process of blood cell production that includes cell renewal, proliferation, differentiation, and maturation.
Hematopoeisis
42
What are the 3 phases of hematopoeisis
```
Mesoblastic phase (yolk sac phase)
Hepatic phase
Medullary phase (myeloid phase)
```
43
It is a phase in the hematopoeisis that is characterized by the development of primitive erythroblasts that produce measurable amounts of hemoglobin, including portland, Gower 1, and Gower 2. This phase does not contribute significantly to definitive hematopoeisis and it occurs intravascularly of within a developing vessel.
Mesoblastic phase
| Yolk sac phase
44
The first fully developed organ in the fetus that becomes the major site of T-cell production
Thymus
45
What is the anticoagulant in gray top (Sodium flouride)?)
Potassium Oxalate
46
What is the anticoagulant in gray top (lithium iodoacetate)?
Lithium heparin
47
It converts fibrin ti fibrin clot.
Thrombin
48
What is the additive in Gold top tube?
Thixotropic gel
49
This additive chelates calcium and is mostly used in most hematologic tests.
EDTA (Ethylenediaminetetraacetic acid)
50
CBC's and reticulocyte counts can be performed on blood stored at room temp for how many hours?
4 hours
51
WBC count, hematocrit and platelet counts can be determined at 4 deg. Celsius up to how many hours?
24 hours
52
ESR should set up within how many hours if stored at room temp?
2 hours
53
ESR should set up within how many hours if specimen is refrigerated?
6 hours
54
Bloodsmears should set up within how many hours after blood collection?
2 hours
55
What is the optimal concentration of EDTA?
1.5mg per ml of blood
56
This is the anticoagulant choice for Osmotic Fragility Test and blood gas analysis.
Heparin
57
What is the optimal concentration of Heparin?
15-20 units per ml of blood
58
What are the three hepain formulation?
1. Ammonium heparin
2. Sodium heparin
3. Lithium heparin
59
Why is it that heparin is not a choice of anticoagulant in hematologic tests?
Because heparin causes cellular clumping (especially platelets), which leads to pseudoleukocytosis (falsely increase WBC) and pseudothrombocytopenia (falsely decrese platelets).
60
Why should we not use heparin in blood smears?
Because it causes morphologic distortion of platelets and leukocytes.
61
What is the critical ratio of sodium citrate and blood?
1:9
62
What is the concentration of sodium citrate that is used in coagulation tests?
3.2%
63
Give the order of draw in Syringe method.
```
B- blood culture tube (yellow)
C- citrate (light blue)
R- Red
H- Heparin (green)
E- EDTA (lavander/purple)
S- sodium chloride (gray)
```
64
This anti coagulant prevents phagocytosis, neutralizes some antibiotics, prevent complement activation and is used for blood culture.
SPS (Sodium polyanethol sulfonate)
65
This anti coagulant is mostly used in blood bank, paternity testing, HLA testing and DNA testing.
ACD- Acid Citrate Dextrose
66
This additive is used for lead determination.
Tan top
67
What is the anti coagulant of tan top tube?
K2 EDTA
68
This additive is used for trace element determination, nutritional chemistry and toxicology.
Royal blue top (ag: K2 EDTA)
69
This additive is used for molecular diagnostic test
White top tube (K2 EDTA with gel)
70
This additive is used foe westergren ESR
Black top (3.8% Sodium Citrate)
71
This additives preserves glucose in 3 days and is used for glucose and alcohol determination.
Gray top (Sodium fluoride)
72
This additive preserves glucose in 1 day/24 hours and is used for glucose and alcohol determination.
Gray top (Lithium iodoacetate)
73
Responsible for the RBC production
EPO
74
Where is EPO produced?
Kidney
75
It is a female hormone that indirectly inhibits erythropoeisis.
Estrogen (Estrogen - kidney)
76
It is a male hormone that indirectly stimulates erythropoeisis.
Testosterone (Testosterone to kidney, then kidney will stimulate erythropoeisis)
77
This hormone directly stimulates erythropoeisis in bone marrow
Growth hormone
78
This is the first stage of hemoglobin synthesis in erythropoeisis.
Rubricyte, Polychromatic Normoblast, Polychromatic erythroblast
79
This is the last stage of hemoblobin synthesis in erythropoeisis.
Reticulocyte
80
This is the last stage with nucleus in erythropoeisis.
Metarubricyte, Orthocromatic normoblast, orthochromatic erythroblast
81
Increased in number in cells with variation in size.
Anisicytosis
82
What is the normal value of MCV?
80-100 fL
83
What are the 3 ways to detect anisocytosis?
1. using the nucleus of a small lymphocyte
2. Using the MCV value
3. Using the RDW value
84
What is the formula of MCV?
MCV= (HCT /RBC) x 10
85
What is the referennce range of RDW?
11.5 % -14.5 %
86
It is a calculated index (from RBC histogram) given by hematology analyzers to help identify anisocytosis
RDW (Red cell Distribution Width)
87
General term for variation in coloration.
Anisochromia
88
What is the normal size of the central pallor of the RBC?
1/3 the diameter.
89
Give 3 conditions that may picture anisochromia.
Sideroblastic anemia, (hypo and normochromic cells)
After transfusion with normal cells (hypochromic anemia)
After iron therapy for IDA
90
This cell is pale, central pallor is less than 1/3 of diameter and is usually microcytic
Hypochromic Cells
91
GRADING OF HYPOCHROMIA:
| Area of central pallor is 3/4 of diameter.
3+
92
GRADING OF HYPOCHROMIA:
| Area of central pallor is 1/2 of diameter.
1+
93
GRADING OF HYPOCHROMIA:
| Area of central pallor is thin rim of hemoglobin.
4+
94
GRADING OF HYPOCHROMIA:
| Area of central pallor is 2/3 of diameter.
2+
95
It has a large clear central pallor and is also known as thin rim of Hgb, Ghost cells and Pessary Cells,
Anulocyte
96
In what condition can we observe anulocyte?
IDA
97
This term refers to the RBC's lack of central pallor even though they lie in a desirable area for evaluation
Hyperchromic cells
98
In what parameter can we say that true hyperchromia occurs?
when MCHC is high
99
Larger than normal red cells with bluish tinge (Wright's Stain) causes by residual RNA
Polychromatophilic erythrocytes
100
Increased number of red cells with variation in shape
Poikilocytosis
101
RBC's with irregular spiculated surface and is usually associated with Abetalipoproteinemia, McLeod Syndrome, and PK def.
Acanthocyte (Spur Cell)
102
Elongated RBC with a slit-like central pallor and is associated with Rh Null Syndrome, Alcoholism, Hereditary Stomatocytosis, Electrolyte imbalance, severe liver disease.
Stomatocyte (Mouth Cells)
103
Almost Spherical in shape, lacks the central pallor and is associated with Hereditary Spherocytosis, Hemolytic anemia, burns, ABO HDN.
Spherocyte
NOTE: spherocyte may be wrongly reported if one examines the feathered edge of the blood film because the RBC in the said area lack central pallor.
104
Folded RBCs that is associated with Hgb SC disease
Biscuit cell
105
Bipolar or central distribution of Hgb that is associated with sickle cell anemia
Bronze elliptocyte
106
RBCs which show a centrally stained area with a thin outer rim of Hgb that is associated with Thalassemia (aka. hhereditary leptocytosis)
Leptocyte (mexican hat cell, platycyte, codocyte, bulls eye cell, target cell)
107
Sickle or crescent shapeed rbcs that is associated with sickle cell anemia andHgb SC disease
Drepanocyte (sickle cill, miniscocyte)
108
This form of sickle cell when reoxygenated thhey tend to fragment.
ISC irreversible sickle cell
109
This form of sickle cell when reoxygeenated they return to the original biconcave disk shape
Oat-shape cells
110
Fragmented RBCs tthat is associated with DIC, uremia patientts with artificial heart valve
Schistocyte (schizocyte)
111
Pear shaped or tear drop shaped RBCs and is associated with Primary myeloid fibrosis, pernicious anemia.
Dacryocyte (tear drop cell)
112
Oval-shaped RBCs that is associated with hereditary elliptocytosis
Ovalocytes
| Elliptocytes- more oval than ovalocytes, are cigar-shaped
113
RBCs with regularly spiculated surface (pointed at tips) that is associated with uremia, PK disease
Burr cells
114
RBCs with regularly spiculated surface (rounded tips) that is associated with Bile acid abnormalities
Echinocyte (crenated rbc)
115
THis cell is as large as leukocytes, pale pink staining ghost of the red cell (membrane remaining after the contents have been released) and it is seen in malaria and in other conditions causing overt hemolysis
Semilunar bodies
116
RBC inclusion bodies that has denatured and precipitated Hgb and is associated with G6PD, favism (sensitive to fava bean) and drug induced hemolytic anemias
Heinz bodies
Supravital Stains: YES
Wright's Stain: NO
117
RBC inclusion bodies that has microtubules rings remaining from a mitotic spindle and is associated with Lead poisoning, pernicius anemia and cases of abnormal erythropoeisis.
Cabot Rings
Wright stain : Reddish-Violet
118
RBC inclusion bodies that has remnants of nuclear chromatin (DNA) that is associated with Megaloblastic anemia and after splenectomy
Howell-Jolly bodies
Supravital Stains: New Methylene blue
Wright's Stain: Reddish-blue or purple
Feulgen rxn (+) POSITIVE (histochem stain for DNA)
119
RBC inclusion bodies that has intraerythrocytic collection of iron and is associated with sideroblastic anemias
Siderotic granules (aka pappenheimer bodies)
Iron stain: Perl's Rgt
Supravital stain: New methylene blue
Wright's stain: dark staining dots
120
RBC inclusion bodies that has aggregated RNA and is associated with Lead poisoning (plumbism), Arsenic poisoning, Pyrimidine-5'- nucleotidase deficiency.
Basophilic stiplings (punctate basophilia)
Supravital stain: YES
Wright's stain: deep blue to purple
121
RBC inclusion bodies that has pricipitated Hb H and is associated with Hb Disease
Hb H (pitted golf ball)
122
abnormal Hgb composed of 4 beta globin chains
Hb H
123
Nucleated cells that function in body defense.
WBC
124
What is the normal value of WBC in newborn?
13.0 - 38.0 x109/L (133,000-38,000/mm3)
125
What is the predominant WBC in adult?
Neutrophil
126
What is the predominant WBC in children <4 years of age?
Lymphocyte
127
What is the most valuable and reliable criterion in determining WBC maturity?
Nuclear chromatin pattern
128
Give the WBC granulocytes.
Basophil
Eosinophil
Neutrophil
129
Give the WBC agranulocyte
Lymphocyte
| Monocyte
130
Give the WBC polymorphonuclear cells.
Basophil
Eosinophil
Neutrophils
131
Give the WBC mononuclear cells
MOnocyte
| Lymphocyte
132
Give the Phagocyte cells
Basophil
Eosinophhil
Neutrophil
Monocyte
133
Give the WBC immunocyte cell
Lymphocyte
134
Increase level of this WBC cell is associated with Asthma, Psoriasis, Scarlet fever, Parasitic infection (mostly helminthic except protozoan), trichinosis (T. spiralis may possibly produce the highest count)
Eosinophil
135
Earliest recognizable granulocytic precursor using the light microscope
Myeloblast
136
Last stage capable of mitosis and it is the stage of synthesis of the secondary granules aka specific granules
Myelocyte
137
Stage of synthesis of primary granules (non specificaka Azurophilic)
Promyelocyte
138
aka as juvenille cell -> young cell
| the first stage of nuclear indentation (nucleus is kidney bean shape) and its the most common cell in the bone marrow
Metamyelocyte
139
aka stab cell, staff cell
| Youngest granulocytic precursor to normally appear in PBS.
Band cell
140
Increased level of this is associated with bacterial infection (generally), appendicitis, Parasites (malaria, liver flukes)
Neutrophil
141
Decreased level of this cell is associated with ACTH administration
Eosinophil
142
The decreased level of this cell is associated with chemical toxicity (benzene), and nutritional deficiencies
Neutrophil
143
Aka extreme neutropenia (<0.5x109/L) and is associated drugs are amidopyrine and cephalosporin
Agranulocytosis
144
Decreased level of this cell is associated with Acute infection, stress and hyperthyroidism
Basophil
145
Increased level of this cell is associated with Immediate hypersensitvity reactions and hypothyroidism
Basophil
146
It is the final maturation stage of B-lymhocyte
Plasma cell
147
What is the most malignant disease of plasma cells?
Multiple myeloma
148
Increased lever of this cell is associated with Bordetella pertusis ifection, Toxoplasmosis and decreased level is associated with HIV infection (T lymphocytopenia)
Lymphocyte
149
It is the largest WBC cell and is associated with Tubercullosis, Syphilis, Protozoal and rickettsial infections (malaria, thypus) Sub acute Bacterial endocarditis and decreased level is associated with Aplastic anemia
Monocyte
150
What do we call the round discreet globules containing immuno globulins in cytoplasm of plasma cell?
Russel bodies
151
It is the most abundant cell in the body and some of its functions are:
Phagocytosis
Release Interleukin 1 (Stimulates T lymphocyte)
Produce transcobalamin II (the primary transport factor for Vit B12)
Macrophages
152
Name of macrophage in placenta.
Hoffbauer cell
153
Name of macrophage in bone
Osteoclast
154
Name of macrophage in spleen
Littoral cells/ Splenic MAcrophages
155
Name of macrophage in skin
Langerhans cell
156
Name of macrophage in brain
Microglial cells
157
Name of macrophage in kidney
Mesangial cell
158
Name of macrophage in lungs
Alveolar macrophages/ Dust cell
159
Name of macrophage in liver
Kupffer cell
160
It is the cancer of blood.
| Malignant neoplasm of the blood forming tissue of the bone marrow, spleen, and lymph system.
Leukemia
161
What is the of M:E ratio?
10:1
162
Type of anemia usually present in cases of acute leukemia:
Normocytic Normochromic
163
This cytochemical stain is used in differentiating AML and ALL, Positive stain rules our ALL.
Myeloperoxidase (MPO)
164
It is the only dse in which the MCHC is above the reference range
Hereditary spherocytosis
165
Confirmatory test for hereditary spherocytosis
OFT (increased OFT test)
