1. Hematology

Question 1

Identify the cellular components of whole blood

Answer 1

Erythrocytes -RBCs
Leukocytes – WBCs
Thrombocytes – platelets

Question 2

Pancytopenia

Answer 2

a decrease in all cell lines (ex. RBC, WBC, and PLTs)

Question 3

Polycythemia/ Anemia

Answer 3

increased RBCs

Decrease in RBCs

Question 4

Thrombocytosis / Thrombocytopenia

Answer 4

increase in plateletes

decrease in platelets

Question 5

Leukocytosis / penia

Answer 5

increase WBCs / decrease

Question 6

Leukemoid reaction

Answer 6

temporary leukocytosis

Question 7

Neutropenia

Answer 7

dec neutrophils

Question 8

Medullary myeloid hematopoiesis

Answer 8

production of myeloid cells in the bone marrow

Question 9

Extramedullary hematopoiesis

Answer 9

production of blood cells outside of bone marrow

Question 10

o Prenatal hematopoiesis vs post natal

Answer 10

 Mainly produced in the yolk sac until the liver (and spleen) and then the bone marrow can take over

post natal Tibia and femur until ~ 25 y.o. then the vertebra, sternum, and ribs

Question 11

Lymphopoesis

Answer 11

production of lymphocytes

T-cells are produced in the bone marrow but mature in the thymus

B-cells are produced and mature in the bone marrow

NK cells are produced and mature in the bone marrow

Question 12

Erythropoietin (EPO

Answer 12

hormone produced by the kidney to stimulate production of RBCs

Question 13

Distinguish an erythrocyte from other cell lines in the blood, discuss erythrocyte production and state the purpose of the Red Blood Cell

Answer 13

Most abundant blood cells type in the body

Biconcave

Lifespan = 120 days

Purpose: gas transport/oxygen transport

Question 14

Discuss the Red Blood Cell components including Hemoglobin, Iron, porphyrin

Answer 14

Hemoglobin
 Heme – iron portion
 Globin – protein

Iron – carries oxygen and can be stored and reused for erythropoiesis when RBCs are broken down

Porphyrin – bind iron

Question 15

Explain the process of what happens when a Red Blood Cell breaks down

Answer 15

o RBC breakdown byproducts:
 Heme –> bilirubin
 Iron –> recycled
 Globin –> amino acids

Question 16

Discuss the role of leukocytes in the blood and identify their purpose

Answer 16

Purpose: fight infection and remove debris

Question 17

Identify the 5 types of Leukocytes and discuss their role in immune response and time in circulation

Answer 17

Neutrophil – (8-12 hours)
 Bacterial infection

Monocyte (blood: 3 days, tissues: 2-3 mos) 
	Phagocytes 
	Immune response 
	Chronic infection 
	Viral infection 
	Resident macrophages 
o	Eosinophil (8 hrs – days)
	Parasitic infections 
	Allergic response  

Basophil (8 hrs – days)
 Allergic reaction

Lymphocyte (days to mos to years)
 Immunity
 Viral infection

Question 18

Thrombocytes

Answer 18

Produced by megakaryocytes that live for 5-9 days

purpose: coagulation

Question 19

Demonstrate ability to input labs into the ‘X’

Answer 19

Hbg
WBC Plt
HCT

Question 20

Differentiate between Complete Blood Count (CBC) and CBC with differential

Answer 20

A complete blood count or CBC is a blood test that measures many different parts and features of your blood, i
A CBC test measures the total number of white cells in your blood.

A test called a CBC with differential also measures the number of each type of these white blood cells.

Question 21

Identify the Red Blood Cell indices and their role in diagnosing anemia

Answer 21

Mean corpuscular volume (MCV) – RBC size
 Macrocytosis
 Normocytosis
 Microcytosis

Mean corpuscular hemoglobin (MCH) – mean content of Hgb per RBC

Mean corpuscular hemoglobin concentration (MCHC) – mean content of total Hgb

Red cell distribution width (RDW) – variation in RBC size
 Anisocytosis

Question 22

Define mild neutropenia, moderate neutropenia and severe neutropenia.

Answer 22

Mild neutropenia: >1,000 ANC & <1,500 cells/microL

Moderate neutropenia: >500 ANC & <1,000 cells/microL

Severe neutropenia: ANC & cells/microL <500

Question 23

Bone Marrow Biopsy techniques and its diagnostic use in patients

Answer 23

Indications:
Patient specific determination

Pancytopenia

Abnormal cells in circulation
• Anemia
• Malignancy
• Concern for immature cells

Question 24

Recall contraindications to Bone Marrow examination.

Answer 24

Hemophilia

Severe DIC

Severe bleeding disorders

Question 25

Discuss the value of a Reticulocyte count and indications for ordering

Answer 25

A reticulocyte count is an indication of erythropoiesis Causes of reticulocytosis:  Decreased RBC survival  Increased production d/t accelerated loss  Recent replacement of deficient nutrient

Question 26

Interpret the results from Reticulocyte study

Answer 26

Reticulocyte count: 0.5-2% normal Reticulocyte index (RPI) – 2.0 – 3.0

Question 27

Discuss the value of an erythrocyte Sedimentation Rate (ESR) and indications for ordering

Answer 27

nonspecific measure of inflammation

Question 28

Discuss the role of Hemoglobin electrophoresis

Answer 28

Tests the contents of the RBCs against a known band for the various Hgb types

Question 29

Identify symptoms of anemia that are common in clinical presentation

Answer 29

``` o Fatigue/dizziness/weakness o Syncope o Pallor o Jaundice o Dyspnea o Palpitations/chest pain/MI ```

Question 30

the difference between Microcytic, Macrocytic and Normocytic anemias and the importance of MCV lab value in determining

Answer 30

o Microcytic: <80 fL o Normocytic: 80 – 100 fL o Macroctic: >100 fL

Question 31

Identify Vitamin K dependent factors in the clotting cascade

Answer 31

o 2, 7, 9 ,10 2 + 7 = 9 + 1 = 10

Question 32

Identify the role of PT and PTT in coagulation

Answer 32

PT and PTT prevent coagulation

Question 33

Discuss the role of D-Dimer in diagnosing a patient with a clot or bleeding

Answer 33

A D-dimer will indicate thrombosis with thrombolysis because it is measuring terminal fibrin degradation products

Question 34

• Discuss the blood bank transfusion process

Answer 34

Blood collection -> testing for infectious disease -> blood component preparation -> ID of proper components for treatment -> Assessment of compatibility between donor and recipient -> transfusion -> evaluation for adverse reaction

Question 35

Identify the antigens on a Red Blood Cell

Answer 35

A, B, AB, and O

Question 36

Recall the Blood Bank (Immunohematology) labs tests and indications

Answer 36

``` o ABO group o Antibody screen o Type and screen o Crossmatch o Transfusion o Coombs test ```

Question 37

Explain the process of Type and Screen and how it related to blood transfusions

Answer 37

o Forward typing: detecting antigens on RBC  Add antibodies to different tubes containing patient’s RBCs and look for clumping o Reverse typing: to detect antibodies in serum which can bind to RBC antigens  Add patient’s serum to tubes containing antibodies and look for clumping

Question 38

Packed RBCs

Answer 38

```  Hemorrhage  Anemia  Severe thalassemia  Hemolytic disease of the newborn  Sickle cell ```

Question 39

Platelets

Answer 39

 Thrombocytopenia  Invasive surgery  Massive transfusion  DIC

Question 40

Fresh frozen plasma (FFP)

Answer 40

 Prevent coagulopathy in trauma  Correct coagulopathy before surgery  Correct coagulopathy/bleeding  DIC

Question 41

State the risks of blood transfusions

Answer 41

``` o Hemolytic transfusion reaction o Leukoagglutin reaction o Hypersensitive reaction o Bacterial contamination o Infectious disease o Transfusion GVHD o Transfusion related acute lung injury ```