Exam 1

Question 1

What controls the entrance and exit of substances into and out of blood cells?

Answer 1

cell membrane

Question 2

Where is the main site hematopoiesis in the fetus?

Answer 2

liver

Question 3

Where is the main site of hematopoiesis in the adult?

Answer 3

bone marrow (medullary)

Question 4

What is the major site of extra medullary hematopoiesis?

Answer 4

spleen

Question 5

What three major criteria are used to identify blood cells?

Answer 5

size, shape of the nucleus, appearance of the cytoplasm

Question 6

How is bone marrow cellularity determined?

Answer 6

number of nucleated blood cells to the total number of cells and fat

Question 7

What is the normal M:E ratio?

Answer 7

between 2:1 and 4:1, average 3:1

Question 8

How does a doctor use a bone marrow exam?

Answer 8

aids in making a definitive diagnosis, evaluation of treatment, and assessment of iron stores

Question 9

What is the dualistic theory of blood cell origin?

Answer 9

dual origin of white blood cells; granulocytes originate from non-granular marrow precursors and lymphocytes originate from lymphoid tissue

Question 10

What are the stages of RBC development from youngest to oldest?

Answer 10

Rubriblast > rubricyte > metarubricyte > reticulocyte > erythrocyte

Question 11

What is the average life of a RBC?

Answer 11

100-120 days

Question 12

What is erythropoietin?

Answer 12

mucoprotein capable of maintaining normal RBC mass

Question 13

Where is erythropoietin produced?

Answer 13

kidneys

Question 14

How is secretion of erythropoietin stimulated?

Answer 14

bone marrow is stimulated in response to tissue hypoxia

Question 15

Define apoferritin

Answer 15

protein that is necessary for absorption of iron to occur

Question 16

Define ferritin

Answer 16

submicroscopic iron

Question 17

Define hemosiderin

Answer 17

conglomeration of ferritin, which can be seen with a microscope

Question 18

Define transferrin

Answer 18

protein that transports iron

Question 19

What is asynchrony?

Answer 19

nuclear maturation lags behind the cytoplasm maturation

Question 20

What is karyorrhexis?

Answer 20

fragmentation of nuclear chromatin

Question 21

What are some conditions that cause RBC count to vary?

Answer 21

high altitudes, obstructive pulmonary disease, congestive heart failure

Question 22

What are the characteristics of a good RBC diluent?

Answer 22

isotonic, contain a fixative to preserve shape of the RBC, prevent clumping, and have proper specific gravity

Question 23

How do you calculate a RBC count when it is performed on a hemocytometer?

Answer 23

average of the two sides then multiplied by 10,000 because it is a 1:200 dilution

Question 24

What is the structure of normal hemoglobin A?

Answer 24

two alpha and two beta chains

Question 25

What pathway provides the most energy for a mature RBC?

Answer 25

Emden-Meyerhof Glycolytic Pathway

Question 26

What pathway functions to protect hemoglobin from oxidation?

Answer 26

Hexose-mannose phosphate shunt (HMP shunt)

Question 27

Iron in hemoglobin must be in what oxidation state to function as an oxygen carrier?

Answer 27

Fe2+

Question 28

What molecule is hemoglobin converted to in the Sahli method of hemoglobin determination?

Answer 28

acid hematin

Question 29

What is the most commonly used method for hemoglobin determination in the modern hematology lab?

Answer 29

Cyanmethemoglobin method

Question 30

What hemoglobin pigment cannot be converted to oxyhemoglobin?

Answer 30

sulfhemoglobin

Question 31

Which manual hematology procedure is the most reliable and reproducible?

Answer 31

hematocrit

Question 32

What test measures the percentage of the RBC volume of whole blood?

Answer 32

hematocrit

Question 33

How is the hematocrit test performed?

Answer 33

height of the RBC compared to the height of the cells and the plasma

Question 34

Two methods for performing hematocrit

Answer 34

Wintrobe and the micro method

Question 35

What method is preferred for performing hematocrit?

Answer 35

micro method

Question 36

Why is the micro method preferred over the Wintrobe method for finding the hematocrit?

Answer 36

simple and most reproducible, takes a small amount of blood and does not need any special equipment besides the centrifuge

Question 37

What test measures the "suspension stability" of RBCs?

Answer 37

erythrocyte sedimentation rate

Question 38

Name two methods used for the ESR

Answer 38

wintrobe-landesburg and Westergren method

Question 39

Which method used to find ESR uses saline?

Answer 39

Westergren

Question 40

Why is saline used in the Westergren method of calculating ESR?

Answer 40

believed to offset any effect of anemia

Question 41

What factors can cause an increased ESR?

Answer 41

abnormal amounts of fibrinogen or globulins, bacterial infections, multiple myeloma, macroglobulinemia

Question 42

What factors can cause a decreased ESR?

Answer 42

sickle cell anemia, spherocytosis, polycythemia

Question 43

equation for MCV

Answer 43

(Hct / RBC) * 10

Question 44

equation of MCH

Answer 44

(Hgb / RBC) * 10

Question 45

equation for MCHC

Answer 45

(Hgb / Hct) * 100

Question 46

What is the rule of three?

Answer 46

three times the RBC is the hemoglobin and three times the hemoglobin is the hematocrit

Question 47

What test is the most reliable assessment of the effective erythroid activity of the bone marrow?

Answer 47

reticulocyte count

Question 48

What is the normal reticulocyte count for an adult?

Answer 48

about 1%

Question 49

What stains are used for a reticulocyte count?

Answer 49

supravital stains: new methylene blue, and brilliant crassly blue

Question 50

How are reticulocytes observed on a wright's stained smear?

Answer 50

polychromatophilic

Question 51

What reagent is used for the sickle cell solubility test?

Answer 51

sodium dithionite

Question 52

What reagent is used for the slide test?

Answer 52

sodium metabisulfite

Question 53

How is the solubility test read?

Answer 53

tube is held one inch from the lined reader scale

Question 54

What constitutes a negative solubility test?

Answer 54

if the lines can be seen

Question 55

How is the slide test read?

Answer 55

checking for the appearance of sickle cells or "holly-leaf' forms under the microscope

Question 56

What is the reagent used in the osmotic fragility test?

Answer 56

saline

Question 57

How is the osmotic fragility test read?

Answer 57

read the color of the supernatant on the spectrophotometer

Question 58

What conditions cause an increased osmotic fragility?

Answer 58

some acquired hemolytic anemias, spherocytosis

Question 59

What conditions cause a decreased osmotic fragility?

Answer 59

target cells, thalassemia, Hgb C, sickle cell anemia

Question 60

What type of RBCs are placed into the structure category?

Answer 60

Howell-Jolly bodies, cabot rings, basophilic stippling, Heinz bodies, Pappenheimer bodies

Question 61

What type of RBCs are placed into the size category?

Answer 61

macrocytes, anisocytes, microcytes

Question 62

What type of RBCs are placed into the shape category?

Answer 62

sickle cell anemia, schistocytes, ovalocytes, elliptocytes, blister cells

Question 63

What are the different categories that RBCs can be placed into based on color?

Answer 63

hypochromia and polychromia

Question 64

What is the chemical composition of basophilic stippling?

Answer 64

RNA

Question 65

What is the chemical composition of Heinz bodies?

Answer 65

denatured hemoglobin

Question 66

What is the chemical composition of Howell-Jolly bodies?

Answer 66

DNA

Question 67

What is the chemical composition of Pappenheimer bodies?

Answer 67

Iron

Question 68

Which abnormal RBC can be counted as a reticulocyte?

Answer 68

basophilic stippling