Anemias

Question 1

Neutrophilia Causes

Answer 1

Bacterial infection (most common)
Some viral and fungal infections
Chronic Inflammation
Smoking, exercise, stress

Question 2

Leukemoid Reaction vs. CML

Answer 2

Leukemoid Reaction: WBC <50, left shift, normal RBC, normal platelets, LAP increased, philadelphia chromosome absent

CML: WBC >50, left shift, low RBC, varying platelets, LAP decreased, philadelphia chromosome present

Question 3

Neutropenia

Range, conditions

Answer 3

Absolute neutrophil count <1.5 x 10^3/uL

Decreased bone marrow production: aplastic anemia
Increased cell loss: anemia, chemotherapy

Question 4

Pelger Huet Causes

Answer 4

Leukemia or myelodysplastic syndromes

Question 5

Hypersegmented Neutrophils

causes

Answer 5

Megaloblastic anemia, B12, folate deficiency

Question 6

Dohle Bodies

Answer 6

Severe infections, burns, cancer, toxic drugs

Question 7

Toxic Granulation

Answer 7

Bacterial infections

Question 8

Alder-Reilly

Answer 8

Normal function, large granules

Question 9

Chediak-Higashi

Symptom, diff, inclusions

Answer 9

Early death, recurrent infections, neutropenia, thrombocytopenia, blue-green bodies

Question 10

May-Hegglin

Inclusions? Smear?

Answer 10

Inclusions that look like Dohle bodies
Giant platelets, low platelet count, bleeding

Question 11

Chronic Granulomatous Disease

Answer 11

Respiratory burst oxidase system, cannot generate oxygen to kill microorganisms

Form granulomas around pathogens in tissue

Question 12

Reticulocytes

What are they, stain qualities,

Answer 12

Immature red blood cells with increased RNA
On wright stain, polychromatophilic cells
On new methylene blue supravital stain, blue granules

Question 13

Reticulocyte Smear Procedure

Answer 13

1:1 ratio of blood to new methylene blue
Incubate for 15 minutes at room temperature in the stain

Question 14

Miller Disc Formula

Answer 14

% retic = (# retics counted x 100) / (# RBCs counted x 9)

Count at least 112 RBCs, should have 5-7 RBCs in little square

Question 15

RPI and Corrections

If pt HCT <45%

Answer 15

(% retic count / maturation time) x (patient HCT/45)

Question 16

RPI Interpretation

Answer 16

<2.0: decreased production, Fe deficiency, aplastic anemia
>2.0: increased destruction, hemolytic anemia

Question 16

Absolute Retic Count Formula

Answer 16

(% retic x RBC should be given) / 100

Question 16

Sickle Cell Trait vs. Disease

Which is worse?

Answer 16

Sickle cell trait has one copy of mutation, not as many symptoms unless under low oxygen tension

Question 16

High Pressure Liquid Chromatography (HPLC)

What does it do, patient population

Answer 16

Separates and quantifies hemoglobin

Newborn screening

Done before electrophoresis

Question 17

Sickle Quick

Screens for, procedure, interpret, bad for

Answer 17

Screens SS disease and AS trait

RBCs lysed and hgb released, HgS is insoluble, will form turbid suspension in phosphate buffer

False positive in HbC Harlem or low hemoglobin

Bad test for babies, false negative from HgF

Question 18

Electrophoresis

What does it do, order for alkaline and acid, traveling trends

Answer 18

Identifies hemoglobin proteins based on electrical charges

Alkaline: CSFA
CEO, SDG travel together
H and Barts faster than A (won’t show up)

Acid Citrate: FASC
ADGEO travel together