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MTAP 2 - HEMATOLOGY > 3RD HEMA - Part 3 > Flashcards

3RD HEMA - Part 3 Flashcards

(60 cards)

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1
Q

● Clinical syndrome resembling leukemia (Confused with CML)
● Not a disease, a description only

A

LEUKEMOID REACTION (LR)

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2
Q

● WBC ct.: >__ X 109/L (with neutrophilia and a marked left
shift [presence of immature neutrophilic forms])

A

(50) LEUKEMOID REACTION (LR)

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3
Q

● Excessive leukocytic response in the peripheral blood

A

LEUKEMOID REACTION (LR)

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4
Q

most frequently refers to neutrophils, but the increased
count may be due to an increase in other types of WBCs

A

LEUKEMOID REACTION (LR)

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5
Q

Generally used to distinguish LR from CML

A

LEUKOCYTE (NEUTROPHIL) ALKALINE PHOSPHATASE (LAP/NAP) TEST

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6
Q

Principle: ↑ LAP activity can be observed in neutrophils that have undergone normal growth.

A

LEUKOCYTE (NEUTROPHIL) ALKALINE PHOSPHATASE
(LAP/NAP) TEST

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7
Q

Principle: Hydrolysis of sodium alpha naphthyl phosphate by alkaline phosphatase produces a colored precipitate with a diazotized amine

A

KAPLOW’S METHOD

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8
Q

KAPLOW’S METHOD

: Fixative

A

Methanol and formalin

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9
Q

KAPLOW’S METHOD

Buffer:

A

Propanediole

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10
Q

KAPLOW’S METHOD

Substrate:

A

Sodium alpha naphthyl phosphate

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11
Q

mount in a mounting
solution like

A

Glycerol

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12
Q

KAPLOW’S METHOD

Initial stain:

A

Brentamine-fast garnet salt

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13
Q

KAPLOW’S METHOD

Counterstain:

A

Aqueous Mayer’s hematoxylin

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14
Q

No reddish brown to black precipitate

A

0

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15
Q

Moderately diffused reddish brown to black precipitate

A

2+

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16
Q

Slightly diffused reddish brown to black precipitate

A

1+

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17
Q

Very heavily diffused reddish brown to black precipitate

A

4+

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18
Q

Heavily diffused reddish brown to black precipitate

A

3+

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19
Q

Normal Kaplow’s (LAP) Score =

A

15 to 100

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20
Q

Decreased LAP score

A

Chronic myelogenous
leukemia (CML)

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21
Q

Normal or increased LAP score

A

Leukemoid reaction (LR)

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22
Q

Examples Of Cases With Increased Kaplow’s (Lap) Score

-Characteristics As Having
Leukemoid Reaction (Lr)

(4)

A
  1. Third trimester of pregnancy
  2. Polycythemia vera
  3. Infections
  4. Intoxication
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23
Q

Examples Of Cases With
Decreased Kaplow’s (Lap) Score

(4)

A
  1. CML
  2. Paroxysmal Nocturnal Hemoglobinuria
  3. Sideroblastic anemia
  4. Myelodysplastic syndrome
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24
Q

CML or LEUKEMOID REACTION

Leukocyte in the peripheral blood: Blasts/Promyelocytes

A

CML

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25
CML or LEUKEMOID REACTION Toxic granulation: Absent
CML
26
CML or LEUKEMOID REACTION Leukocyte in the peripheral blood: Usually Myelocytes
LEUKEMOID REACTION
27
CML or LEUKEMOID REACTION Toxic granulation: Present
LEUKEMOID REACTION
28
CML or LEUKEMOID REACTION Eosinophils/Basophils: increased (↑)
CML
29
CML or LEUKEMOID REACTION Eosinophils/Basophils: Decreased (↓)
LEUKEMOID REACTION
30
CML or LEUKEMOID REACTION LAP: Decreased (↓)
CML
31
CML or LEUKEMOID REACTION Splenomegaly: Usually prominent
CML
32
CML or LEUKEMOID REACTION LAP: Increased (↑)
LEUKEMOID REACTION
33
CML or LEUKEMOID REACTION Philadelphia chromosome (Ph1): Usually present
CML
34
CML or LEUKEMOID REACTION Philadelphia chromosome (Ph1): Absent
LEUKEMOID REACTION
35
CML or LEUKEMOID REACTION Splenomegaly: Mild (if present)
LEUKEMOID REACTION
36
CML or LEUKEMOID REACTION Platelet count: Normal
LEUKEMOID REACTION
37
CML or LEUKEMOID REACTION Platelet count: >600 or <50 X 109 /L
CML
38
Most common clinical application of flow cytometry: (2)
Diagnosis of Leukemias and Lymphomas
39
● Originally designed to evaluate physical properties of cells based on their ability to deflect light.
FLOW CYTOMETRY
40
- Measures physical antigenic, and functional properties of particles suspended in a fluid.
Flow cytometry
41
- Can describe antigen expression on many viable cells. Currently, ____ antigens can be detected at the same time on an individual cell. This is accomplished by the conjugation of monoclonal antibodies to a variety of fluorochromes that can be detected directly
17 antigens Flow cytometry
42
Most significant discovery that led to improvement of flow cytometry and its subsequent widespread application in clinical practice:
Development of Monoclonal Antibodies
43
Although the term flow cytometry suggests the measurement of a cell, this procedure is successfully applied to study other particles, including _____________, ______________, and __________.
Chromosomes, Microorganisms, and Proteins.
44
A flow cytometer is composed of
- Fluidics - Light source - Multiple detectors - Computer
45
Laser =
Light Amplified by Stimulated Emission of Radiation
46
The basic unit of all radiation:
Photon
47
Commonly analyzed specimen in Flow Cytometry (5)
● Bone marrow ● Peripheral blood ● Lymphoid tissue ● Body cavity fluids ● Solid tissue
48
● Must be processed within 24 to 48 hours from time of collection
For peripheral blood and bone marrow specimens
49
● Collected into a tube or container with an anticoagulant (preferably heparin) and are transported to a flow cytometry laboratory at room temperature.
For peripheral blood and bone marrow specimens
50
This method, called ____________ __________, created a central core of individually aligned cells surrounded by a sheath fluid.
hydrodynamic focusing
51
The detector located directly in line with the illuminating laser beam measures _____________ scatter (FS or FSC), which is proportional to particle __________ or _______.
The detector located directly in line with the illuminating laser beam measures forward scatter (FS or FSC), which is proportional to particle volume or size.
52
A photodetector positioned to the side measures _____ scatter (SS or SSC), which reflects surface __________ and _______ structures such as granules and vacuoles.
A photodetector positioned to the side measures side scatter (SS or SSC), which reflects surface complexity and internal structures such as granules and vacuoles.
53
● CD 34 ● CD117 ● Terminal deoxynucleotidyl transferase
Lineage
54
● CD 33 ● CD 13 ● CD 15 ● CD 14
Granulocytic/ Monocytic
55
● CD 71 ● Glycophorin A
Erythroid
56
● CD 41 ● CD 42 ● CD 61
Megakaryocytic
57
● CD 19 ● CD 20 ● CD 22 ● κ Light chain ● Λ Light chain
B lymphocytes
58
● CD 2 ● CD 3 ● CD 4 ● CD 5 ● CD 7 ● CD 8
T lymphocytes
59
__, __, and ___________ are displayed at the same time on the instrument screen and registered by the computer system.
FS, SS, and fluorescence
60
Counterstain for __ to __ minutes
10 to 15 minutes

MTAP 2 - HEMATOLOGY (5 decks)

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