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Hematology > Exam 1 > Flashcards

Exam 1 Flashcards

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1
Q

What is the function of blood

A

transports oxygen, CO2, glucose, proteins, lipids, moves waste to liver and kidneys

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2
Q

What are the alternative names for
RBCs
WBCs
platelets

A

RBC- erythrocyte
WBC-leukocyte
platelets- thrombocytes

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3
Q

Describe the shape, size, interior and exterior characteristics of RBCs

A

biconcave, anucleate, red cells filled with hemoglobin,

7-8 um in diameter

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4
Q

Describe the zone of pallor of RBCs

A

1/3 of the center of the cell, usually looks white

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5
Q

What is anemia

A

loss of O2 carrying capacity, because of low RBC count or low hemoglobin concentration

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6
Q

What is polycythemia

A

high RBC count that leads to hyperviscosity

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7
Q

How are hemoglobin levels determined

A

whole blood + Drabkin’s reagent turns HGB into cyanmethemoglobin, absorbance of color is measured in spectrometer at 540nm

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8
Q

What is the hematocrit test

A

ratio of volume of packed RBCs compared to volume of whole blood
also call packed cell volume

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9
Q

How is a manual hematocrit test performed, what is the normal result

A

blood is placed in a capillary tube, centrifuged, the column is measured where RBC height is divided by the total length of the column
the normal ratio is 50%

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10
Q

What is an MCV

A

mean cell volume- measures RBC size

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11
Q

What is an MCH

A

mean cell hemoglobin- measures mass of HGB per cell

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12
Q

What is an MCHC

A

mean cell hemoglobin concentration: measures RBC staining intensity and size of central pallor

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13
Q

What is the RDW

A

RBC distribution width- measures how varies RBCs are in size

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14
Q

What is it called when a person has an abnormal RDW

A

anisocytosis-really varied RBC sizes

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15
Q

What tests are included in a CBC

A

RBC count, Hemoglobin, hematocrit, MCV, MCH, MCHC and RBC morphology

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16
Q

What are reticulocytes

A

large immature RBCs released from BM, might indicate RBC anemia or BM issues

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17
Q

What is the difference between Reticulocytes and RBCs

A

they are filled with RNA,

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18
Q

What is the function of WBCs

A

protecting the body from infection and injury

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19
Q

What is a manual WBC count

A

1:20 dilution with diluent: dilute acid solution

acid makes RBC rupture

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20
Q

How are RBCs manually counted

A

whole blood + .85% normal saline, 1:200 dilution
maintains morphology of RBCs
mixture placed in hemacytometer
RBC counted

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21
Q

what is leukopenia, leukocytosis and leukemia

A

luekopenia- low WBC count
leukocytosis- high WBC count
Leukemia-uncontrolled proliferation of malignant cancerous WBCs

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22
Q

What are the functions of neutrophils

A

phagocytic, mostly towards bacteria, immune response

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23
Q

What other name do neutrophils have

A

segmented, polymorphonuclear neutrophils

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24
Q

Describe the structure of neutrophils

A

pink/ lavender cytoplasm filled with bactericidal substances

multilobed nucleus

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25
What is neutrophilia, neutropenia?
neutrophilia- too many WBCs usually sign of bacterial infection neutropenia- decreased WBCs, could be due to viral infection or some medication
26
What is a band neutrophil and what does it look like
less mature neutrophils, non segmented, has C shape, no lobes
27
What is left shift
increased bands due to a bacterial infection
28
What does a eosinophil look like and what are its functions
round, bright orange- red cytoplasmic granules that are filled with proteins that help with immune regulation functions with allegeric rxns or parasitic infection
29
What is the structure of basophils
dark purple cytoplasmic granules that cover the nucleus, granules have histamines and other proteins
30
What is the structure of lymphocytes? | What is their function
round, large nuclei, larger than RBCs, non granular cytoplasm mostly immune response functions
31
What is lymphocytosis? Lymphopenia?
lymphocytosis- high lymphocytes, indicates viral infection | lymphopenia- decreased lymphs, drug therapy or immunodeficiency
32
What are monocytes and what is their function?
immature macrophages, that pass through blood from the bone marrow to a target tissue, phagocytize, immune response APC
33
What are the physical characteristics of monocytes
larger than other WBCs, blue-gray cytoplasm with fine azure granules, ground glass appearance, nucleus folded
34
What is monocytosis
increased monocytes, could be associated with inflammation or certain infections
35
What is the function of platelets
help maintain blood vessels, repair vessel wall, adhere, aggregate, secrete to trigger clot formation. Controls hemostasis
36
What are the physical characteristics of platelets
2-4 um in diameter | round or oval, anucleate, slightly granular
37
What can occur if platelets become uncontrolled?
deep vein thrombosis, pulmonary embolism, heart attacks, strokes, peripheral artery disease, miscarriage
38
How is platelet function tested?
MPV- mean platelet volume with a manual or automated platelet count
39
What is thrombocytosis? thrombocytopenia?
thrombocytosis- too many platelets, could be due to inflammation, trauma, internal bleeding thrombocytopenia- low platelets, could be easy bruising and uncontrolled hemorrhage
40
Practice Ch1 slide 23
A RBC B Neutrophil C Band D Eosinophil E basophil F lymph G monocyte H platelet
41
``` Put the following cells in order of most to least common Monocytes eosinophil neutrophil lymphocyte basophil ```
``` neutrophil lymphocyte monocyte eosinophil basophil ```
42
Define Quality Control QC
control and monitoring of the testing process to ensure that results are valid and reproducible
43
Define Quality Assurance QA
a broader term that encompasses preanalytical, analytical and postanalytical variables
44
ID the QA as pre, post or analytical - legible forms - abnormal result flagging - accurate result transcription - delivery of specimen
- pre - post - post - pre
45
What does variance show
the deviation of each data point from its expected value
46
Practice standard deviation formula
SD=
47
Practice variance formula
sigma ^2=
48
What does the standard deviation measure
dispersion, the distance between all data points and the mean
49
What is the Coefficient of variance formula
CV=100xSD/mean
50
What does the CV measure?
the normal expression of the SD | lower values are a good thing
51
What is the confidence interval
95.5% 2SD +- the mean any points outside of this range are "abnormal"
52
practice Ch2 slide 16
Variance SD=0.126 95.5 CI = 7.878-8.13 CV= 1.54%
53
How is accuracy tested
reagent-instrument system does a reference assay for comparison to new reagent system
54
How is precision measured
SD or CV%
55
Label graphs on Ch2 slide 27
A- accurate and precise B- inaccurate, precise C-accurate, imprecise D- inaccurate, imprecise
56
Define linearity
the ability to generate results proportional to the calculated concentration
57
What if an assay results a value above linearity?
the sample must be diluted and re-assayed
58
What is an example of a process that is done in the lab to ensure quality control?
lot to lot comparisons | old and new assays are compared
59
Define analytical specificity
The ability to identify interfering substances versus the substance of interest. Like if there is lipemia or hemolysis
60
Define analytical sensitivity
the lowest value that can be found by a test, the higher the sensitivity the better, a high specificity indicates we can detect things in very small amounts
61
What is the purpose of the Levy Jennings chart
displays data points compared with mean and limits
62
What westgard rule indicates there is a trend
7T- at least 7 control values that are going in a consistent direction
63
Define a delta check
a way to monitor if the difference between two results that happened one after the other is flagged. 20% SD
64
What should you do if a delta check occurs
investigate, look for intervention, transfusion, changes in patient
65
Practice drawing the chart in Ch2 slide 43
TP vs TN vs FP vs FN
66
What is the formula for PPV? NPV?
positive predictive value TP/TP+FPx 100 Negative predictive value TN/TN+FNx 100
67
What does the PPV and NPV tell us?
PPV- probability that those who have a condition will get a positive result NPV-probability that those who do not have a condition will get a negative result both demonstrate the efficacy of a test
68
What is the function of the plasma membrane
a physical barrier, establishes selective permeability, maintains electrochemical gradient, receptors for signaling,
69
What is the function of the nucleus
controls cell division and functions, contains genetic code
70
What is the function of a nucleolus
synthesizes ribosomal RNA and assembles ribosome subunits
71
What is the function of ribosomes
to synthesize proteins
72
What is the function of the RER
rough endoplasmic reticulum- synthesizes membrane bound and secreted molecules, has ribosomes on exterior
73
What is the function of the smooth ER
synthesizes phospholipids and steroids, detoxifies drugs, stores Ca
74
What is the function of the Golgi apparatus
modifies and packages macromols for other organelles and for secretion
75
What is the function of the mitochondria
ATP production through aerobic respiration/ oxidative phosphorylation
76
What is the function of lysosomes
has hydrolytic enzymes that degrade/ recycle unwanted material
77
What is the function of microfilaments
supports the cytoskeleton and motility
78
What is the function of intermediate filaments
provides a strong structural support to cell
79
What is the function of microtubules
maintains cell shape, helps with cell and organelle motility, mitosis
80
What is the function of the centrosome
has centrioles that form mitotic spindle fibers during mitosis
81
What are clusters of differentiation
CD is the term for blood cell antigens, each are assigned a system
82
What is the cell membrane composed of
phospholipids and cholesterol arranged in a hydrophilic and hydrophobic layer
83
What is the inner layer of the cell membrane made of
phosphatidylserine and phosphatidylethanolamine
84
What is the outer layer of the cell membrane made of
sphingomyelin and phosphatidylcholine
85
What can you find attached to a cell outer membrane
carbs liked to membrane proteins and phospholipids
86
What is glycocalyx
carbs on the outside of cells made of glycoproteins and glycolipids
87
What is a cell nucleus composed of
chromatin, nuclear envelope, nucleoli
88
Name the levels of folding of chromatin
nucleosomes: DNA wrapped around histones chromatin fibers supercoiled chromatin fibers
89
What is hetero and euchromatin?
hetero- inactive, tightly coiled | eu-active, loosely coiled
90
What is the name of the internal structure within the golgi apparatus
sacs called cisternae
91
What is the name of the internal structure in the mitochondria
infoldings called cristae
92
True or False, the mitochondria is capable of self replication
True it has its own DNA and RNA
93
Put the following in order of thickest to thinnest microfilaments microtubules intermediate filaments
microfil inter microtub
94
Practice labelling Ch 3 slide 31
``` A- microfilaments B glycogen aggregates C golgi complex D centriole E microtubule F vacuole G mitochondria H lysosome I heterochromatin J euchromatin K nucleolus L RER M nuclear pore N nuclear envelope ```
95
What structure protects the BM?
stromal cells- special endothelial cells
96
What do stromal cells do
secrete growth factors that regulate proliferation and differentiation of precursor blood cells
97
What are the 4 stages of the cell cycle
Gap 1- cell growth and synthesis S- DNA synthesis- DNA replication occurs Gap 2- tetraploid DNA is checked for damage or mistakes M- Mitosis- disivion of chromosomes into 2 daughter cells G0- quiescence- cell not in cycle
98
What is the purpose of the cell cycle
replicate DNA and distribute identical chromosome copies to daughter cells
99
What are the stages of mitosis
``` prophase prometaphase metaphase anaphase telophase cytokinesis ```
100
What are the checkpoints that occur in the cell
G1, S, G2 and metaphase checkpoints
101
What regulates the cell cycle?
cyclin and cyclin dependent kinases (CDK)
102
What is necrosis? What is apoptosis?
necrosis- pathological, happens because of injury to cells | apoptosis-self inflicted cell death
103
Would toxins cause necrosis or apoptosis??
necrosis
104
Would a viral infection cause necrosis or apoptosis?
apopotosis
105
If a cell is swelling this indicates _____ If a cell nucleus condenses and becomes fragmented this indicates ____ If a cell leaks and this leads to inflammation it indicates _____
necrosis apoptosis necrosis
106
If a cell shrinks this indicates ____ If a cell plasma membrane is ruptured this indicates___ If a cell nucleus randomly breaks and lysis If a plasma membrane is intact but loses phospholipids slowly this is ____
apoptosis necrosis necrosis apoptosis
107
Which stages of the cell cycle make up interphase?
G1, S and G2
108
``` Where does hematopoiesis occur when humans are 20th day of life 3rd month of life 8th month of life adulthood ```
20th- yolk sac 3rd- liver 8th- BM adult- BM
109
Where else do adults have hematopoietic tissue
the BM, lymph nodes, spleen, liver, thymus
110
What cells develop in the BM? and the lymphoid tissue?
BM- RBCs, myeloid cells, megakaryocytes, lymphoid cells | Lymphoid cells- in lymphoid tissue
111
What are the primary lymphoid tissues? and the secondary?
1ary-BM, thymus | 2ndary- spleen, lymph nodes, MALT
112
What is MALT
mucosa associated lymphoid tissue- this is where lymphoid cells respond to antigens
113
Red marrow is ____ composed of _____ | Yellow marrow is ____ composed of _____
red- active, developing blood cells | yellow- inactive, fat cells
114
What is an adipocyte? what is its function
large cell with fat vacuoles, regulate volume of marrow, secrete cytokines and growth factors
115
What are endothelial cells and what are their functions
broad flat cells that form a layer on the surface of arteries/ veins/ vascular sinuses
116
What are macrophages and what is their function
phagocytosis, secrete cytokines and regulate hematopoiesis
117
What are osteoblasts? and osteoclasts
blast- bone forming | clast- bone resorbing
118
What is the function of reticular adventitial cells
secrete extracellular matrix to anchor developing cells in bone, regulate HSCs and progenitor cell survival and differentiation
119
As we age we experience more _____ which means our ____ marrow is replaced with more ___ marrow
retrogression, red, yellow
120
Describe the structure of the liver
2 lobes, kupffer cells- special macrophage that remove old cells from blood
121
What are the functions of the liver in adults
protein synthesis and degradation, coagulation factor synthesis, card and lipid metabolism, drug and toxin clearance, iron recycling and storage, HGB degradation
122
What is extramedullary hematopoiesis?
a response from the liver to infectious agents, hematopoiesis outside of BM
123
What disease can cause extramedullary hematopoiesis
diseases of Kupffer cells that have enzyme deficiencies,
124
What is the function of the spleen
blood filtration, not essential for life
125
Define culling and pitting, what organ performs this?
Removal of abnormal RBCs by the spleen culling- cells phagocytized pitting- hole punching RBCs removes damaged things on surface and allows it back into circulation for a while longer
126
Where does blood enter the spleen through?
the central splenic artery
127
What is splenomegaly
enlarged spleen
128
What is a splenectomy
removal of spleen, can be done if RBCs are being destroyed too much
129
What is hypersplenism
enlarge of the spleen, causing pancytopenia, all cells are low
130
Where are the lymph nodes located,
along the lymphatic capillaries, all over body some superficial others deep
131
What is lymph? what is its function
fluid portion of blood that escapes into connective tissue, lymphocyte proliferation, specific immune response, filters debris, bacteria, particulate matter that enters the lymph node
132
Afferent lymphatic vessels carry circulating lymph ___ the lymph nodes Efferent lymphatic vessels carry circulating lymph ____ the lymph nodes
into, out of
133
What is the function of the thymus
T cell maturation, has a waiting and holding zome for T cells to differentiate and go into circulation
134
The thymus contains ___% of mature T cells in the body
15%
135
What other cells are present in the thymus
B cells, eosinophils, neutrophils, myeloid cells
136
What is the name of the stem cell that is the progenitor for myeloid cells
CFU-GEMM or CFU S | colony forming, granulocyte, erythrocyte, monocyte, megakaryocyte
137
What abilities do HSC have
self renewal, pluripotent, control of hematopoietic system
138
What are the two major types of hematopoietic progenitor cells
non committed- become progenitors | committed- become lymphoid or myeloid lineage
139
What are the 3 possible fates of HSCs
self renewal differentiation apoptosis
140
What morphological changes occur to a cell as it matures
decreases in volume, decreases in N:C ratio
141
what morphological changes do maturing cells have in their nucleus
loss of nucleoli, smaller diameter, condensation of chromatin, could change in shape
142
What morphological changes do cells have in their cytoplasm as they mature
decreased basophilia increase in proportion of cytoplasm sometimes granules
143
What are the hematopoietic growth factors?
cytokines, CSF- colony stimulating factor, KIT signals nucleus of HSCs and stimulates their proliferation
144
Describe the process of erythropoeisis
CFU-GEMM-> BFU-E burst forming unit --> CFU-E-> erythropoietin-> pronormoblasts
145
Where is red and yellow marrow in children? and adulthood?
children- mostly Red, all over | adults- equal parts red and yellow, changes into yellow in long bones, stays red in axial skeleton
146
A range of results that defines the upper and lower limits of linearity
analytical measurement range
147
True of false: interphase is a stage of mitosis
False
148
What is the mesoblastic phase of hematopoiesis?
yolk sac phase- 19th day of gestation
149
What is the hepatic phase of hematopoiesis
5-weeks old- occurring in liver
150
What is the medullary phase of hematopoiesis
4th month- Bone marrow
151
True or False: The thymus increases in size as we age
false- it gets smaller

Hematology (4 decks)

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