AABHemOnline2.1.24 Flashcards
(279 cards)
1
Q
1,5,8-13 what group
A
fibrinogenFibrinogen group – factors 1, 5, 8, and 13. This group is called the fibrinogen group because thrombin activates all of these factors including fibrinogen. Maybe it should have been called the thrombin
2
Q
Group not vit k dep, consumed in coagulation, not in serum1,5,8-13
A
fibrinogen group
3
Q
2,7-9,10 what grop
A
Prothrombin
4
Q
Which grp is vit K dependent…What factors…
A
prothrombin2,7-9,10
5
Q
HMWK, PK11,12 what groupAll of these factors are involved in the initial phase of the intrinsic system activation.
A
contact group
6
Q
Group that is not vit K dep, activates instrinsic pathway, includes HMWK, 11,12
A
contact group
7
Q
Intrinsic and common tested with what test
A
APTT
8
Q
factors in intrisic pathway
A
8,9-11,12
9
Q
Factors in extrinsic pathyway
A
7, 3(TF)
10
Q
Extrinsic and common pathway tested with
A
PT/INR
11
Q
factors in common pathway
A
1,2,5,10
12
Q
factor not part of coag pathways and doesn’t affect testing
A
13
13
Q
what does PT/PTT test for
A
crosslinked fibrin clot
14
Q
I
A
fibrinogen
15
Q
II
A
Prothrombin
16
Q
III
A
Tissue thromboplastin, TF
17
Q
IV
A
calcium
18
Q
V
A
labile
19
Q
VII
A
stable
20
Q
VIII
A
antihemophiliac A
21
Q
IX
A
antihemophiliac B
22
Q
XI
A
anti hemophiliac C
23
Q
X
A
Stuart Prower
24
Q
XII
A
Hageman
25
XIII
fibrin stabilizing
26
inactive form of plasmin
plasminogen
27
fibrinolysis is breakdown of fibrin by act of
plasmin
28
insoluble fibrin breaks down to
D-dimer
29
soluble fibrin breaks down to
FDPs
30
Thromboplastin (TF, Ca) used in
PT
31
ISI is used to calculate the INR for the...
PT
32
Test that monitors wafarin/coumadin
PT
33
Two methods for PT, PTT, TT
optical and electromechanical
34
PT ref range
10-13sec
35
Increased PT associated with factors...
7 extrinsic1,2,5,10 common
36
Activated partial thromboplastin reagent in aPTT is a
phospholipid
37
Two reagents in aPTT
activated partial thromboplastin/phospholipid and CaCL
38
PTT range
30-36sec
39
Increased aPTT associated with factors...and also this....
8,9,11,12 intrinsic1,2,5,10 commoninhibitor
40
Test that tests amt of time it takes for fibrinogen to convert to fibrin
thrombin time
41
Thrombin reagent used in these two tests
TT, fibrinogen
42
TT ref
10-15 secSimilar to PT
43
increased TT due to
A/hypo/dys-fibrinogenemiaHeparinFDPsThrombolytic therapy
44
Test that tests fibrin clot formation by using Thrombin and plotting clot times w/1:10 std dilution
fibrinogen
45
In testing fibrinogen, concentration is.... .... to clotting timeref range
inversely proportional to clotting time, longer time means less fibrinogen200-400mg/dL
46
Increased fibrinogen in these 3
inflammationpregobirth CTRL
47
decreased fibrinogen in these 3
DICliver dysfuctionhypofibrinogemia
48
Test that differentiates factor def from lupus inhibitor using 1:2 dilution of PT plasmsa to normal pooled plasma running PT/APTT
mixing study
49
If PT/PTT is correct in a mixing study, this indicates a...follow up with a ... ...
factor deffactor assay
50
If PT/PTT is not corrected with mixing study,indicated an....
inhibitor
51
Factor assay normal range
50-100% activity
52
Test where you do PT,APTT and get std curve from dilutions; times are converted to % activity
factor assay
53
Factory assay should be...
linear
54
Nonlinear in a factor assay indicates
inhibitor
55
Test which uses monoclonal ab to detect fragments
D dimer
56
D dimer ref
<=0.50mg/mL
57
Increased Ddimer in these 4
DIC, DVTPulmonary embolismArterial thromboembolism
58
Test that tests for soluble fibrinogen, FDP with latex agglutination
FDP/FSP/fibrin monomer
59
Most common coagulation disorder, autosomal dominant disease
vWD
60
vWD lacks
F8:vWD
61
vWD:PTT...PFA100/PLT agg...
PTT increasedPFA100/PLT agg abnormal
62
Condition thats recessive sexlinked; hemorragic;F8 def with normal PLT function
Hemophilia A
63
Hemophilia A:PTT..PLT func...
PTT increasedPLT func normal
64
What do vWD and Hemophilia A have in common...How do you diff between vWD and Hemophilia A:
Both have F8 def and have increased PTTOnly vWD has abnormal PLT function
65
Recessive, sexlinked F9 def
Hemophilia B
66
autosomal recessive F11 def
Hemophilia C
67
Def that is part of common pathway where both PT and PTT is increased
fibrinogen def
68
Term when fibrinogen levels are below analytical range
A-fibrinogenemia
69
Term where fibrinogen is <200
Hypo-fibrinogenemia
70
Term where amt of fibrinogen is normal but PT/PTT are increased
Dys-fibrinogenemia
71
Factor def where all tests will be normal because it's not part of coag pathway
F13 def
72
5M urea solubility test uses urea to dissolve clot, which def is tested using this...positive...
F13positive is clot dissolves
73
Def thats part of intrinsic, theres no history of bleeding and only the PTT is abnormal
F12 def
74
Disorde where theres formation of microthrombi followed by systemic fibrinolysis
Disseminated Intravascular coagulation
75
DIC:PLT ct, fibrinogen..BT, PT, APTT..FSP/Ddimer...
PLT ct, fibrinogen: decreased, all used upBT, PT, APTT: decreased, coag factors used upFSP/Ddimer...pos
76
In Liver disease, all but...are decreased
all but F8
77
In vit K def, what factors are decreased
2,7,9,10 vit k dependent
78
What diff liver from vit k def
F8
79
Lupus anticoagulant seen in...ab against aPTT is...
SLEantiphospholipid ab
80
Lupus anticoag:PTT...rest are...mixing study...
PTT is increased but rest are normalmixing study isn't corrected
81
Hemotopoetic order
HSC, MPP, Common, CFU
82
Where does hemotopoeisis begin
yolk sac
83
order of hemotopoiesis organs
yolk sac, liver, spleen, BM
84
Medullary/BM/red marrow production of cells in adults in ...bones of ... and ...
flat bones of illiac crest and sternum
85
extramedullary production of cells in adult are... and ....
liver and spleen
86
Pronormoblast is called
Proerthyroblast
87
What cell comes after Pronormoblast/Proerthythroblast
Basophlic normoblast/erythroblast
88
Polychromotaphilic normoblast is also
Polychromotaphilic erythroblast
89
Orthochromatic normoblast also
Orthochromatic erthythoblast
90
Retic is also
Polychromatic ertythrocyte
91
RBC also
ertythrocyte
92
RBC:1.)Pro, 2.)Basophilic, 3.)Polychromatophilic 4.)Orthochromatic..../.....
normoblast/erythroblast
93
Last nucleated red cell, NRBC called these two
orthochromatic normoblast, erythroblast
94
RBC5.)Retic or6.)RBC or
5.)polychromatic erythrocyte6.)erythrocyte
95
Retic called
polychromatic erythrocyte
96
Myeloid cell with red, azurphilic primary granules
Promyeloctye
97
Myeloid with 50% nucleus and specific granules
myelocyte
98
Lymphoid cell that one large prominent nucleoli
prolymphocyte
99
1.)Megakaryoblast2.)Promegakaryocyte3.)Megakaryocyte4.)PLT
...
100
Largest cell in BM, can make 1000 PLTs
Megakaryocyte
101
Diff between mono and promono
chromatin is finer/lacy in promono
102
Hmg:2...2...chains4......ring with...
2 alpha, 2 beta4 heme grpsprotoporphyrin ring w/iron
103
3 embroyonic hmg
Gower 1,2,Portland
104
2 zeta, 2 epsilon
gower 1
105
2 zeta, 2 gamma
Portland
106
2 alpha, 2 epsilon
Gower 2
107
Gower 1: zeta,epsilonGower2:alpha, epsilonPortland:zeta,gamma
....
108
Hmg F chains
2 alpha2 gamma
109
Adult Hmg and %
A 97-98A2 2-3F 1
110
polypedtide chain that is only seen in embryonic
epsilon
111
polypeptide chain thats in both fetal and adult, curve will have sharp incline before birth and be dominant in adult
alpha (hmg A,F)
112
Chain with curve that rises early before birth then decreases after birth
gamma
113
chain with curve at minimal rise until right after birth into adult
gamma
114
chain with curve thats the lowest and in adults
delta
115
Type of EDTA used in hematoloby
Di-potassium
116
anticoag in Coagulation, ratio
3.2% citrated plasma1:9
117
Cell ct calculation
#cells x DIL x 10/#sqmm
118
Cause of granular slides, decreased RBC/HCTincreased MCV/MCHC
cold agg
119
Hmg concentration uses this method
cyan methmg
120
Cyan methmg measures all hmg except
Sulf-hmg
121
3 things that falsely affect Hmg
lipemiaincreased WBCHmg S/C
122
Average size of cellvolume/cell
MCV
123
MCV NV, calculation
80-100fLHCT/RBC x 10
124
Microcytic valueMacrocytic...
<80fL>100mL
125
Average hmg/cell
MCH
126
MCHNV, calculation
28-34pgHmg/RBC x 10
127
Hmg concentration/cell
MCHC
128
MCHC NV, calculation
32-36 g/dL, %Hmg/HCT x 100
129
hypochromic....hyperchromic...
<32>36 %
130
degree of anisocytosis
RDW
131
RDW NV, aniso
12-15>15
132
NRBCs falsey increase...correction calculation...
WBCsWBC x 100/nrbc +100
133
Besides NRBCS, what two things increase WBC
lrg PLTlyse resistant RBC
134
Fragmented RBCs falsely increase....
PLTS
135
increased angle makes a ...smeardecreased angle makes a ... smear
increased angle=thickerdecreased =thinner
136
small drop or big angle could cause a
short smear
137
big drop, sml angle could cause a
long smear
138
crenated smear due to
not dried throughly
139
Wright, Giesma are what kind of stains
Romanowsky
140
Two reagents in Romanowsky stain
Azure BEosin Y
141
Azure B is....stains....Eosin Y is...stains...
Azure B is basic, stains acidEosin Y is acidic, stains basic
142
Buffer to acidic, not enough staining, too much rinsing leads to
excessive pink and light staining
143
Buffer too alkaline, prolonged staining, not rinsing well leads to
excessive blue and dark staining
144
ESRWM
W: 0-20M: 0-15
145
4 causes of increased ESR
inflammationincreased plasma proteinsrouleauxRA
146
Retic ct:dye used...disc...NV...
NMBMiller disc0.5-1.5%
147
Corrected retic ct calculation
Retic ct x PT HCT/45%
148
RPI:uses PT HCT, normal HCT, Retic ct and is over 2 days
PT HCT/45% x retic ct/2 days
149
screen for HmgS, uses EDTA, Dithionite, doesn't differentiate
Solubility test
150
Hmg S is insoluble in... ...Pos solubility test versus neg
Hmg S insoluble in sodium dithionitePos: turbidNeg=transparent
151
Stain used in hmg electrophoresis to visualize bands...meansured with...
Ponceau staindensitometer
152
Cellulose 8.6 migration from slow/cathod to fast/anode
C, S, F, Acrawl, slow, fast, accelarated
153
Slowest/cathode to fastest/anode in citrate 6.2
-FASC+
154
Citrate 6.2 slow/cathode to fast/anode migration
F, A, S, C
155
Stain catalyzes oxidation of substance by H2O2-enzyme in primary granules-specific for granulocytes-diff AML from ALL
MPOmyeloperoxidase
156
Stains phospholipids, neutral fats, sterol-primary, secondary granules-brown/black-AML vs ALL
Sudan Black BSBB
157
Enzyme hydrolyze ester linkages and frees nahthol-diazonium salt causes insoluble pigment-myelogenous cells line-AML vs ALL
Naphtyl AS-D Chloroacetate esteraseThe aim of this stain is to demonstrate the presence of granulocytes. Granulocyte lysozomes contain a rather specific hydrolase that can use the Naphtol AS-D Chloroacetate as substrate. The liberated naphtol reacts with the diazonium salt "Fast Red Violet LB", forming red depots.
158
Esterase in mons/macrophages, distinguishes AMML vs AMLmyelomon vs mono
alpha naphyl esterase
159
Stains glycogen, magenta-mature granulocytes, monos are posdistinguishing acute lymphocytic leukemia (ALL) and nonlymphocytic leukemia
PASperiodic acid schiff Periodic Acid Schiff (PAS) support distinguishing acute lymphocytic leukemia (ALL) and nonlymphocytic leukemiaThe periodic acid-Schiff (PAS) staining procedure is most commonly used in the histology laboratory to detect glycogen deposits in the liver when glycogen storage disease is suspected.
160
Distinguished CML from leukomoid-enzyme is in secondary granules of PMNs-scored
Leukocyte ALP
161
LAP score NV...Leukomoid, severe bacterial LAP...vsCML LAP...
NV 13-130Leukomoid/bacterial increasedCML decreasedPatients with leukemoid leukocytosis show very high LAP score due to high cytoplasmic alkaline phosphatase activity. On the other hand, in patients with CML, the neutrophils show a very weak reaction to the alkaline phosphatase staining (low LAP score).
162
TdT
Terminal Deoxynucleotidyl Transferase
163
TdT diff...from...
ALL from lymphoma
164
Stain that is nonvital, stains iron in BM
Prussian blue
165
Prussian blue increased iron staining in these 3, decreased in 1
increased in sidero,hemachromatosis, hemosiderosisdecreased in IDA
166
BM aspirate take from... ...in adults
illiac crest
167
Light scatter at 90 degree is...scattershows...
side, granularity
168
Light scatter at 180 degrees is...scattershows...
forwardparticle size
169
Stain uses acid elution, citrate phosphate buffer; eluates all hmg except F...F resist acid elution and are...
Kleihauer Betkepink
170
Test that denatures A but F are resistant
alkali denature HmgF
171
Denatured hmg inclusions of RBC; supravital stain using NMB
Heinz body
172
Test using buffered NaCl with increasing hypotonic slns; amt of hemolysis measures spectrophotometrically
Osmotic fragility test
173
osmotic fragility test:NV...increased fragility...seen in...
NV 50%fragility <50%spherocytosis
174
Screen for PNH, using low ionic strength sln
sugar H2O
175
Test for PCH, antiP
Donath Landsteiner
176
Intra or extravascular hmg degrationbiliverdin, bili-albumin, bili diglucurondie, urobilinogen, stercobili
extravascular
177
intra or extravascular hmg degrationfree hmg, haptoglobin, methmg, urine hemosideran, heme/Fe, hemopexin
Intravascular
178
Hmg in ferrous state, Fe3+
oxyhmg
179
hmg oxidized to ferric state Fe2+
methmg
180
hmg with carbon monoxide
carboxy hmg
181
hmg and CO2
Deoxy
182
RBC NV:size, MCV..
7-8 microns, 80-100 fL
183
Microcyte...macrocyte...microns, MCV...
micro <7, <80fLmacro>8, >100fL
184
Cell with irregular thorn projections/sml bulblike tips; altered lipid content
acanthocytes
185
another name for acanthocytes
spur
186
cell with bulls eye, increased membrane lipids; decreased hmg, seen in hmg-pathies
targets
187
another name for target
codocyte
188
crescent, pointed end cell; polymerises into rods of descreased O2 tension; inhibits rouleux
sickle cell
189
another name for sickle cell
drepanocyte
190
cell with regular projections, reversible/article or liver disease
echinocyte
191
another name for echinocyte
burr
192
cell pencil/cigar to oval; hereditary, IDA, thall
elliptocytes, ovalcytes
193
cell with ecentric vacuole...this cell bursts and becomes...seen in HA, heart vaulve hem
blister has ecentric vacuolehelmet burst blister
194
another name for helmet
keratocyte
195
cell due to mechanical damage, hemolyze or removed by spleen; fibrin formation caused; TTP,DIC, burns
shistocyte
196
cell with MCHC >36, lost biconcave/no CP; increased osmotic fragilityhereditary, ABO incompatibility
spherocytes
197
cell with slit like palor, reversibleartifact, increased lipidhereditary, alcoholic, rhnull,lead
stomatocyte
198
cell with RBCs inclusions that go thru spleen than elongated, seen in thall/myelofibrosis
tear drop
199
another name for tear drop
dacrocyte
200
RBC inclusion with blue black evenly distributed coarse to fine granules;seen in lead/thall/hmg-pathies
basophilic stippling
201
RBC inclusion red/violet figure 8; remnants of mitotic spindle fibers; severse anema
cabbot ring
202
RBc inclusion that's usually one dark purple spherical granule of DNA; post splenectomy, megablastic, HA
Howell jolly bodies
203
RBC inclusion in sml clusters of iron granules seen in wright or PB stain; sideroblastic, thall
Pappenheimer bodies
204
RBC inclusion that doesn't stain with wright, only NMB/supravital;round mass near cell membrane, aggregated denatured hmgG6PD def, drugs, post splenectomy
Heinz bodies
205
RBC disorder with amino substituion
Hmg-pathies
206
RBC disorder with decreased production of globin chain
Thall
207
RBC disorder with decreased RBC etc
anemia
208
Hmg-pathy where glutamic acid replaces valine in beta chain, 6th positionhomozygous
sickle cell disease
209
In sickle cell disease, what replaces what in the beta chain in the 6th position
glutamic acid replaces valine
210
Sickle cell disorder with many sickles, targets, and HJ bodies
Sickle cell disease, SS
211
Hmg-pathy heterozygous,glutamic acid replaces valine in beta chain;mostly targets
sickle cell trait
212
Hmg-pathy with targets, crytals that look like washington monuments; polychromatophilia
Hmg C disease
213
Hmg-pathy with glove like cells, sickle, targets
Hmg SC
214
Thallesemia also called Cooleys anemia, micro/hypo; targets, baso stipling,less A, more A2/F
Beta Thall major
215
Hmg disorder where >2% Hmg F; hypoxia
hereditary persistance HmgF
216
Anemia secondary to disease, iron therapy doesn't help; can be normo/normo to micro/hypo;storage iron/ferritin increases over time,iron/transferrin/hmg decrease
anemia of chronic
217
anemia with micro/hypobleeding, pregodecreased iron/ferritinincreased transferrin/TIBC
IDA
218
anemia thats micro/hypo, increased iron; pappenheimer bodies in wrights, siderocytes in PB, ringed sideroblasts in BM
siderblastic anemia
219
Cause of pernicious anemia due to def that affects DNA; macrocytes, hyperseg, megaloblastic
folic acid def
220
def that caused pernicious anemia due to lack of IF, can't absorb B12 for DNA;macro, hyperseg
Vit B12 def
221
anemia with pancytopenia, hypocellular BM; drugs/chemo
aplastic anemia
222
Membrane defect, enzyme defect, immune and nonimmune are all causes of
HA
223
membrane defect where mchc >36, increased osmotic fragility
hereditary spherocytosis
224
membrane defect causing hemolysis and occurs at night; testing with sugar H2O, sucrose, HAMs
PNHparoxymal nocturnal hmglobinuria
225
Ezyme def that causes HA, cant reduce iron from ferric to ferrous;-seen in antimalarial drugs/fava beans-Heinz bodies
G6PD def
226
Cold agglutin disease, paroxymal cold hmg, warm auto are all
auto immune HA
227
HDN, hemolytic trans rxn, delay trans rxn are all
alloimmune HA
228
HA where RBC/HCT is decreased,MCV/MCH/MCHC all increased
cold agg
229
Immune HA where cold auto anti-P, biphasic, complementpos DAT, Donath Landsteiner
PCHParoxymal cold hmg
230
HUS, TTP, DIC, plasmodium,babesiabartonella, clostridium can all cause
nonimune HA
231
conditon with increased RBC/erythropoeitin; all cells increased;
polycythemia vera
232
cell with 3-5 lobes, many secondary granules
neutrophil
233
cell with 2-3 lobes, eosin specific granules
Eos
234
cell with large dark granules with heparine and histamine
Baso
235
Largest cell in blood, horseshoe nucleus/convoluted; lacy chromatin, ground glass vacuoles
mono
236
cell nucleus size of RBC, nucleus 90% of cell, condensed chromatin, no nucleoli
lymph
237
cell with convoluted light blue, abundant cyto, azurophilic granules
large granular lymph
238
cell with ecentric nucleus, coarse chromatin; deep basophillic cyto w/halo of golgi apparatus
plasma cell
239
WBC inclusion that are stacks of rough endoplasmic reticulum; light blue, single/multiple;seen in severse bacterial infections
Dohle bodies
240
WBC inclusion that are large blue black primary nonspecific granules;bacterial infections and leukomoid rxns
toxic granulation
241
WBC inclusions that make clear spots in cyto; seen in bacterial and leukomoid rxn
cytoplasmic vacuolozation
242
WBC inclusion seen in AML, red/blue needle in cyto
auer rod
243
Two conditions with increased WBC, left shift, Dohle bodies, vacuolization and due to severe bacterial infections
reactive neutrophilialeukomoid rxn
244
LAP is... in leukomoid rxn
LAP is increased
245
anomoly with hyposegmented segs
pelger huet
246
anomoly with azurophilic granules resembling toxic granulation; mucopolyssaccharides
Alder-Reily anomaly
247
anomaly with membrane defect of lysosomes, giant abnormal granules;albinism/photophobia
Chediak-Higashi anomaly
248
Anomaly with dohle bodies, giant PLTs, but decreased PLTs
May Hegglin
249
Gaucher, Tay Sachs, Nieman Pick, Fabrys are all
lipid storage diseases w/enzyme def, decreased monos
250
caused by EBV, saliva;10% reactive lymphs, increased WBCs
infectious mononucleosis
251
virus spread thru saliva/transfusion;increased WBC, reactive lymphs, negative monospot
CMV
252
condition with increased lymphs, negative monospot seen mostly in kids <5yrs of age
infectious lymphoctytosis
253
Leukemia affects young, sudden, >20% blasts in BM or blood; can have auer rods;MPO/specific esterase pos
AML
254
MPO, SBB, specific esterase posPAS negwhat cell...
myeloblast
255
MPO, SBB, specific esterase negPAS poswhat cell
lymphoblast
256
AML classifications...M0M1M2
M0 minimallyM1 noM2 maturation
257
L1 is what leukemia
childhood, TdT
258
L2 is what leukemia
adult T cell
259
L3 is what leukemia
burkitts,EBV, CALLA, poor prognosis
260
Leukemia in 60yrs older etc, many small mature lymphs/soccer ball, smudge cells
CLL
261
Leukemia in 50yrs older, TRAP pos, mononuclear w/hairlike
hairy cell
262
leukemia in older males, large bizarre cells with cerebriform nuclei
Sezary
263
leukemia in older, myeloid, decreased LAP, many basophilsdry tap, Ph chromosome
CML
264
Lymphoma ass w/Reed Sternberg cell,elderly/males
Hodgkins lymphoma
265
PLTs:size...volume...live...NV...
2-4microns, 10fL7-10days150-450,000
266
Fragmented RBC affect on PLT
increase
267
clott/satellism affect on PLT
decrease
268
test that test PLT fnc, detects PLT plug, closure timedepends on PLT func, ct, activity
PFA 100
269
In PFA 100abnormal collagen/epi indicates
aspirin
270
In PFA 100 abnormal collagen/epi/ADP indicates
vWD
271
ADAMTS13 def seen in
TTP
272
due to ab made to heparin/PF4 complex, PLTs are sensitized and cleared by spleen, decreased PLTs
HITheparin induced thrombocytopenia
273
syndrome with giant PLTs, abnormal PLT aggregation with ristocetin
Bernard Soulier syndrome
274
Quantitative PLT disorder with decreased giant PLTs and Dohle like bodies
May Hegglin
275
PLT aggregation disorder w/ristocetin, glycoprotein 2b/3a defect
Glanzmanns thrombasthenia
276
PLT adhesion issue, abnormal ristocetin
vWD
277
Two PLT disorders that are abnormal with ristocetin...One that only aggregates with ristocetin...
abnormal ristocetin:-vWD, Bernard Soulieronly agg w/ristocetin:Glanzmanns
278
storage pool disease; no granules
gray PLT syndrome
279
most common PLT disorder, inhibits thromboxane A2
aspirin
