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106 MLT > Chapter 11 quiz > Flashcards

Chapter 11 quiz Flashcards

1
Q

Processing and testing the specimen
When a preserved specimen stands for a time, the components settle into three distinct layers:

A

Top layer: plasma
Middle layer: buffy coat, a grayish-white cellular layer composed of WBCs and platelets
Bottom layer: RBCs

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2
Q

Each anticoagulant prevents the coagulation of whole blood in a specific manner.

A

Anticoagulants
EDTA (lavender top)
EDTA is that it removes ionized calcium through the process of chelation.
Heparin (green top) a substance that inactivates the blood-clotting factor thrombin.
Sodium citrate (light blue top)
Sodium citrate removes calcium from the coagulation system by precipitating it into an unusable form.

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3
Q

Anticoagulants

A

Anticoagulants
EDTA (lavender top)
EDTA -removes ionized calcium through the process of chelation.
Heparin (green top)
Heparin acts as an antithrombin, or substance that inactivates the blood-clotting factor thrombin.
Sodium citrate (light blue top)
Sodium citrate removes calcium from the coagulation system by precipitating it into an unusable form.

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4
Q

Anticoagulants

A

Anticoagulants
EDTA (lavender top)

Heparin (green top)

Sodium citrate (light blue top)

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5
Q

Anticoagulants
EDTA (lavender top)

A

The mode of action of EDTA is that it removes ionized calcium through the process of chelation.

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6
Q

Heparin (green top)

A

Heparin acts as an antithrombin, or substance that inactivates the blood-clotting factor thrombin.

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7
Q

Sodium citrate (light blue top)

A

Sodium citrate removes calcium from the coagulation system by precipitating it into an unusable form.

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8
Q

Laboratory tests performed in the hematology laboratory include the following:

The RBC indices of mean corpuscular volume (MCV), mean corpuscular hemoglobin (MCH), and mean corpuscular hemoglobin concentration (MCHC) are now a standard part of a routine automated CBC.

A

Counting the number or concentration of cells
Determining the relative distribution of various types of cells

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9
Q

Measuring biochemical abnormalities of the blood
Tests basic to the evaluation and follow-up of a patient
Complete blood count

A

CBC): Hemoglobin (Hb), hematocrit (Hct), RBC count with morphology, WBC count with differential, and platelet estimate

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10
Q

The RBC indices of
mean corpuscular volume (MCV),
mean corpuscular hemoglobin (MCH), and
mean corpuscular hemoglobin concentration (MCHC) are now a standard part of a routine automated CBC.

A

ean corpuscular volume (MCV),
mean corpuscular hemoglobin (MCH), and
mean corpuscular hemoglobin concentration (MCHC) are now a standard part of a routine automated CBC.

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11
Q

The RBC indices of a standard part of a routine automated CBC.

A

mean corpuscular volume (MCV),
mean corpuscular hemoglobin (MCH), and
mean corpuscular hemoglobin concentration (MCHC) are now a standard part of a routine automated CBC.

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12
Q

List the three layer are formed when whole blood is spun down?

A

Plasma ( 55% of a total blood)
Buffy Coat leukocytes & platelets (<1% of total blood)
Erythrocytes (45% of blood)

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13
Q

describe the percent % of blood each layer
Plasma
Buffy Coat leukocytes & platelets
Erythrocytes

A

Plasma ( 55% of a total blood)
Buffy Coat leukocytes & platelets (<1% of total blood)
Erythrocytes (45% of blood)

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14
Q

55% of a total blood
Buffy Coat LeuKocytes & platelets
Erythrocytes

A

Plasma ( 55% of a total blood)
Buffy Coat leukocytes & platelets (<1% of total blood)
Erythrocytes (45% of blood)

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15
Q

circulating blood is divided as follows:

A

45% cells
red blood cells
white blood cells
platelets
55% plasma

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16
Q

Define the term hematopoiesis

A

blood cell production

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17
Q

Describe hemoglobin synthesis and normal and abnormal types of hemoglobin

A
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18
Q

Identify the types of mature leukocytes found in circulating blood, and describe the characteristics of each.

A
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19
Q

Describe the process of maturation and functional differences between subsets of lymphocytes.

A
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20
Q

Distinguish the cellular characteristics in the formation of thrombocytes.

A
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21
Q

Discuss the mode and applications for the three types of anticoagulants used for hematology assays.

A
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22
Q

Assess at least three types of unsuitable blood specimens and the effect of each on test result.

A
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23
Q

Hemoglobin determination

A
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24
Q

Microhematocrit determination

A
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25
Q

Describe the calculations and applications of a reticulocyte count.

A
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26
Q

Describe the application of the erythrocyte sedimentation rate (ESR).

A
27
Q

Calculate the red blood cell indices. Explain the application of the red cell distribution width (RDW)

A
28
Q

Identify and describe morphologic alterations of size, shape, color, and inclusions in erythrocytes.

A
29
Q

Compare the three categories of anemia, based on morphology.

A

q

30
Q

Identify and describe leukocytes alterations.

A
31
Q

blood cell production is

A

hematopoiesis

32
Q

Erythrocytes:
Erythrocytes function and maturation:
1. Main function:
2. oxygen is transported in a:
3. the concentration of Hb in the blood is
4. to combine with the transport oxygen the Hb molecule must have a certain combination of
5. the red blood cell (RBC) begins as
6.as cell matures in the bone marrow,

A
  1. Main function: to carry oxygen to the cells of the body.
  2. chemical combination with hemoglobin(Hb).
  3. measure of its capacity to carry oxygen.
  4. heme (which contains iron) and globin.
    5.a nucleated cell within the bone marrow.
  5. its diameter decreases, and the nucleus become denser and smaller, and is finally released from the cell (extruded) to become a biconcave disk.
33
Q

Erythrocytes define:

A

a red blood cell that (in humans) is typically a biconcave disc without a nucleus. Erythrocytes contain the pigment hemoglobin, which imparts the red color to blood, and transport oxygen and carbon dioxide to and from the tissues.

34
Q

clinical hematology procedures:
LABORATORY TESTS PERFORMED IN THE HEMATOLOGY LABORATORY INCLUDE THE FOLLOWING:

A
  1. counting the number or concentration of cells.
    2.Determining the relative distribution of cells.
    3.measuring bio - chemical abnormalities of the blood.
35
Q

Test basic to the evaluation and follow - up of a patient

A
  1. complete blood count (CBC): Hemoglobin (Hb), hematocrit (Hct), RBC count with morphology, WBC count with differential, and platelet estimate.
  2. The RBC indices of mean corpuscular volume (MCV), mean corpuscular hemoglobin (MCH), and mean corpuscular hemoglobin concentration (MCHC) are now a standard part of a routine automated CBC.
36
Q

Thrombocytes
Platelet (thrombocyte) maturation and function
1. Produced in the bone marrow
2. They act as plugs around the opening of a
3. Platelets do not have a nucleus and are not actually:
4. Mature platelets are small, colorless bodies
5. Platelets are general round or ovoid -
6.platelets have a colorless to pale -

A

1.platelets are an essential part of the blood - clothing mechanism.
2.wound and release factors necessary for blood clot formation.
3. actually cells; they are portions of cytoplasm pinched off from megakaryocytes and released into the bloodstream.
4. 1.5 to 4 micrometers in diameter.
5. although they may have projections called pseudopods.
6. blue background substance containing centrally located, purplish red granules.

37
Q

Leukocytes
(Reporting leukocytes result)
1. Total count
2.relative count
3. Absolute count

A

1.(A). The total leukocytes in the circulating blood vary by age.
(B). Can fluctuate with circadian rhythms.
2.(A) In the differential leukocyte count, cells are identified while examining and counting 100 WBCs in a systematic manner, with results reported in relative numbers or percentages.
3. (A) the absolute count is a more accurate measure. The absolute cell count count by decimal units) by the total WBC count per liter.

38
Q

Leukocytes
(Lymphocytes)
1. comprise about 34% of
2. Two sizes, large and small;
3. Described based
4.after antigenic stimulation, small lymphocytes can undergo transformation and are
5. Lymphocytosis, an increase in the

A
  1. leukocytes in normal adults.
  2. most are small.
  3. on sized and cytoplasmic granularity
  4. then called reactive, atypical, variant, or reticular lymphocytes.
  5. number of lymphocytes, is associated with viral infections.
39
Q

Leukocytes
(Lymphocyte maturation and function
Maturation)

A

Mature lymphocyte
Overall size
Small: 6 to 9 micrometers
Large: 17 to 20 micrometers
Nucleus to cytoplasm ratio
Small: 4:1 to 3:1
Large: 2:1
Nuclear characteristics: Round or oval
Cytoplasm characteristics: Light blue; few azurophilic granules may be present

40
Q

(Leukocytes)
Monocyte function and morphology

A

Monocyte function and morphology
1.Monocytes remain in the peripheral blood for hours to days after leaving the bone marrow.
2.They are motile, phagocytic cells, but they do not die after they engage in phagocytotic activity.
3.Function in the defense against microorganisms.
4.The largest of the normal leukocytes
Nucleus is large and usually indented.
5. Gray-blue cytoplasm with extremely fine and abundant azurophilic granules: “azure dust”

41
Q

(Leukocytes)
Monocyte maturation

A

Monocyte maturation
1.Produced mainly in bone marrow
2.The stages of development are monoblast, promonocyte, and monocyte.
3.Mature monocyte
4.Overall size: 12 to 18 micrometers
5. Nucleus to cytoplasm ratio: 2:1 to 1:1
6. Nuclear characteristics: Horseshoe-shaped, folded, lacelike chromatin
7.Cytoplasmic characteristics: Vacuoles common, blue-gray, abundant

42
Q

Normal leukocyte morphology
1.Basophils

A
  1. About the same size as neutrophils, basophils’ nuclei usually occupy a greater portion of the cell.
    2.Irregularly shaped nucleus
  2. Cytoplasm is usually colorless; it contains a number of deeply stained, coarse, round, or angular basophilic granules.
  3. Note that tissue basophils, also called mast cells, are similar but not identical to basophilic granulocytes.
  4. Basophil counts
  5. Basophilia, an increase in the number of basophils, occurs in chronic myelogenous leukemia and other conditions.
43
Q

Leukocytes
(Normal Leukocytes Morphology)
1. Eosinophil
2.Eosinophilia
3.Eosinopenia

A

Eosinophils
Slightly larger than neutrophils, usually with a bilobed nucleus.
Cytoplasm is usually colorless, but crowded with spherical acidophilic granules, which stain red-orange.
Eosinophil counts
2. increase in the number of eosinophils above normal, is associated with a wide variety of conditions, but especially with allergic reactions and drug reactions.
3. decreased number of eosinophils, is seen with hyperadrenalism.

44
Q

Normal leukocyte morphology
1. Band neutrophils -
2.Neutrophil counts
3. neutrophilia
4.Neutropenia

A

1.The band neutrophil is a younger form of the mature neutrophil.
Band neutrophils resemble segmented cells except for the shape of the nucleus. An increase in their numbers is significant.

2.Generally, an increased WBC count (leukocytosis) results from an increase in the absolute number of neutrophils present in the blood, called neutrophilia;
3. neutrophilia; it is usually accompanied by a shift to the left.
4. is a decrease in the absolute neutrophil count.

45
Q

Normal leukocyte morphology
1. Segmented neutrophils

A

1.The most numerous of the granulocytes, neutrophils make up about 59% of the leukocytes in peripheral blood, with a range of 35% to 71%.
2.The usually lobular nucleus forms a relatively small part of the cell.
3.The nuclear chromatin is coarse and clumped and stains deep purple. The nuclear membrane is distinct, and no nucleoli are visible.
4.The abundant cytoplasm is colorless or faintly pink and contains a large number of very small, often indiscrete, lilac-specific neutrophilic granules distributed irregularly throughout it.

46
Q

Characteristics of basophils
1.Basophils
2.The granules contain histamine, heparin or
3.If the same events are triggered by

A

Characteristics of basophils
1.Basophils occur in very low numbers in normal peripheral blood. Their life span in blood is similar to that of neutrophils and eosinophils.
2.The granules contain histamine, heparin or a heparinlike substance, and peroxidase. The rapid release of mediators from immunoglobulin E (IgE)–primed basophils and mast cells activated by exposure to parasite-associated antigens is thought to contribute significantly to the local inflammation associated with IgE-dependent immune responses to parasites.
3.If the same events are triggered by antigens from pollen, food, drugs, or insect venom, the result is a disorder of immediate hypersensitivity.

47
Q

Mature basophil describe

A

1.Overall size: 10 to 16 micrometers
2.Nucleus to cytoplasm ratio: 1:1
3.Nuclear characteristics: Distinct lobes
4.Cytoplasmic characteristics: Blue-black gra

48
Q

Characteristics of eosinophils:
1.Eosinophils exist in
2.The function of eosinophils is
3.They do leave the peripheral blood when
4.They are active in

A

1.Eosinophils exist in the peripheral blood for less than 8 hours after release from the marrow and have a short survival time in the tissues.
2.The function of eosinophils is not completely understood.
3.They do leave the peripheral blood when adrenocorticosteroid hormones increase and proliferate in response to immunologic stimuli.
4.They are active in allergic reactions and certain parasitic infections, especially those involving parasitic invasion of the tissues.

49
Q

Mature eosinophil describe :

A

1.Overall size: 10 to 16 micrometers
2.Nucleus to cytoplasm ratio: 1:1
3.Nuclear characteristics: Distinct lobes
4.Cytoplasmic characteristics: Orange granules

50
Q

Characteristics of neutrophils
1.Metabolically, neutrophils are
2.The neutrophilic granules contain
3.The cells
4.Once in the tissues, the neutrophils destroy bacteria

A

Characteristics of neutrophils
1.Metabolically, neutrophils are very active and can carry out both anaerobic and aerobic glycolysis.
2.The neutrophilic granules contain several digestive enzymes that are able to destroy many types of bacteria.
3.The cells are capable of random locomotion and can be directed to an area of infection by the process of chemotaxis.
4.Once in the tissues, the neutrophils destroy bacteria by engulfing them and releasing digestive enzymes into the phagocytic vacuole thus formed.

51
Q

Segmented neutrophil describe

A

1.Overall size: 10 to 16 micrometers
2.Nucleus to cytoplasm ratio: 1:1
3.Nuclear characteristics: Distinct lobes
4.Cytoplasmic characteristics: Specific blue-pink granules

52
Q

Band

A

1.Overall size: 10 to 16 micrometers
2.Nucleus to cytoplasm ratio: 1:1
3.Nuclear characteristics: Elongated, curved
4.Cytoplasmic characteristics: Specific blue-pink granules

53
Q

Metamyelocyte

A

1.Overall size: 10 to 18 micrometers
2.Nucleus to cytoplasm ratio: 1:1
3.Nuclear characteristics: Indented
4.Cytoplasmic characteristics: Specific blue-pink granules

54
Q

Myelocyte

A

1.Overall size: 12 to 18 micrometers
2.Nucleus to cytoplasm ratio: 2:1 to 1:1
3.Nuclear characteristics: Oval or indented
4.Cytoplasmic characteristics: Specific blue-pink granules

55
Q

Promyelocyte

A

1.Overall size: 14 to 20 micrometers
2.Nucleus to cytoplasm ratio: 3:1
3.Nuclear characteristics: Oval or round shape, 1 to 5 nucleoli
4.Cytoplasmic characteristics: Heavy granulation

56
Q

1.Granulocytic leukocyte development
2.Myeloblast

A

1.Includes myeloblasts, promyelocytes, myelocytes, metamyelocytes, bands, segmented neutrophils, eosinophils and basophils.
2.Myeloblast
1.Overall size: 10 to 18 micrometers
2.Nucleus to cytoplasm ratio: 4:1
3.Nuclear characteristics: Oval or round shape, 1 to 5 nucleoli
4.Cytoplasmic characteristics: Auer rods can be present, no granules

57
Q

Granulocyte maturation and function

A

Granulocyte maturation and function
1.Neutrophils normally mature in the bone marrow in stages, from the youngest to the most mature: myeloblast, promyelocyte, myelocyte, metamyelocyte, band, and segmented neutrophils.
2.Cells of the neutrophil series are generally round with smooth margins or edges. As the cells mature, they become smaller.
4. Most immature cells have cytoplasm that stains dark blue and becomes light pink as the cells mature. As the cells mature from the myeloblast to the promyelocyte stage, nonspecific granules that stain blue to reddish purple appear in the cytoplasm.
5.Eventually, these nonspecific granules are replaced by specific neutrophilic granules.
6.Nuclear changes also occur as the cells mature.
7.Nucleoli may be apparent in the early forms but gradually disappear as the chromatin thickens and the cell matures.

58
Q

1.Variations in hemoglobin concentrations
2.Altitude: Normal Hb concentration is
3.There may be a slight decrease in hemoglobin
4.When the Hb value is
5.In anemia, circulating
6.Increase in Hb can be
7.Reference values: Male:
Female:

A

1.The reference (or normal) values for Hb in peripheral blood vary with the age and gender.
2.Altitude: Normal Hb concentration is higher at high altitudes than at sea level.
3.There may be a slight decrease in hemoglobin level after 50 years of age.
4.When the Hb value is below normal, the patient is said to be anemic.
5.In anemia, circulating erythrocytes may be deficient in number, in total Hb content per unit of blood volume, or both.
6.Increase in Hb can be seen in polycythemia and newborns.
7.Reference values: Male: 14.0 – 17.5 g/dL
Female: 12.3 – 15.3 g/dL

59
Q

Hemoglobin S amino acid sequence.
1.Hemoglobin S differs from
2.On this chain, valine (Val) is substituted for glutamic acid (Glu) at the

A

Fig. 11.11. Hemoglobin S amino acid sequence. 1.Hemoglobin S differs from hemoglobin A in one amino acid resides on the beta chain of the hemoglobin molecule.
2.On this chain, valine (Val) is substituted for glutamic acid (Glu) at the sixth position of the chain. (From Turgeon M: Clinical hematology, ed 5, Philadelphia, 2011, Lippincott Williams &

60
Q

Hemoglobin variants
1.Hb variants differ in the
2.Normal adult hemoglobin:
3.Hemoglobin F: the major form
4.Abnormal hemoglobin variants
5.Disorders where abnormal Hb plays an
6.Hemoglobin S:
7.Hemoglobin

A

Hemoglobin variants
1.Hb variants differ in the content and sequence of amino acids in the globin chains.
2.Normal adult hemoglobin: A and A2
3.Hemoglobin F: the major form found during intrauterine life and at birth
4.Abnormal hemoglobin variants
5.Disorders where abnormal Hb plays an important role pathologically are called hemoglobinopathies.
6.Hemoglobin S: sickle cell anemia or disease
7.Hemoglobin C

61
Q

Globin
1.The globin portion of the Hb molecule
2.Each of the four globin chains is
Hemoglobin function
1.Iron is essential for the primary function of the Hb molecule:
2.The molecule fully saturated with oxygen
3.Oxyhemoglobin carries oxygen from

A

Globin
1. is a protein substance that consists of four chains of amino acids (polypeptides).
2.Each of the four globin chains is attached to a heme portion to form a single Hb molecule.

Hemoglobin function
1.Iron is essential for the primary function of the Hb molecule: carrying oxygen to the tissues. If iron is lacking, anemia results because Hb is not formed in sufficient quantity.
2.The molecule fully saturated with oxygen (four oxygen molecules per Hb molecule) is called oxyhemoglobin.
3.Oxyhemoglobin carries oxygen from the lungs to the tissues of the body. Hb returning to the lungs with carbon dioxide from the tissues is known as reduced hemoglobin.

62
Q

Hemoglobin (Hb) synthesis, structure, and function
The heme (

A

Hemoglobin (Hb) synthesis, structure, and function
The heme (iron-containing) portion combines with globin (the protein portion) and forms an activated form of Hb that is ready to transport oxygen.
Each Hb molecule has four heme groups and a globin moiety, which is composed of four polypeptide chains.

63
Q

Reticulocyte (polychromatophilic RBC)
Per:

A

Reticulocyte (polychromatophilic RBC)
Per
cent in bone marrow: 1%
Hours in bone marrow: 48 to 72
Overall size: 8 to 10 micrometers
Nucleus to cytoplasm ratio: —
Nucleus: no nucleus
Cytoplasm: bluish hue
Reticulocytes differ morphologically from mature RBCs because they contain a fine basophilic reticulum or network of RNA, a cytoplasmic remnant that decreases as the cell matures.

106 MLT (9 decks)

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