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Hematology > Exam I > Flashcards

Exam I Flashcards

(55 cards)

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1
Q

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

A

cell membrane

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2
Q

Where is the main site of hematopoiesis in the fetus? In the adult?

A

liver; bone marrow

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3
Q

What is the major site of extramedullary hematopoiesis?

A

spleen

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4
Q

What three major criteria are used to identify blood cells?

A

cytoplasm, nucleus, and cell size

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5
Q

How is bone marrow cellularity determined?

A

number of nucleated cells is compared to the total amount of cells and fat present

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6
Q

What is the normal M:E ratio?

A

2:1 - 5:1 (average 3:1)

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7
Q

How does a doctor use a bone marrow exam?

A

aid in making definitive diagnosis, patient management/treatment evaluation, assessment of iron stores, special stains

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8
Q

What is the dualistic theory of blood cell origin?

A

granulocytes originate from non-granular marrow precursors, and lymphocytes originate from lymphoid tissue

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9
Q

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

A

rubriblast, prorubricyte, rubricyte, metarubricyte, reticulocyte, erythrocyte

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10
Q

What is the average life span of a RBC?

A

100-120 days

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11
Q

What is erythropoietin, where is it produced, and how is its secretion stimulated?

A

mucoprotein formed by the kidneys capable of maintaining a normal RBC mass by stimulation of the bone marrow due to tissue hypoxia

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12
Q

Define apoferritin.

A

protein that allows iron in the ferrous state to be absorbed by the small intestine

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13
Q

Define ferritin.

A

submicroscopic storage form of iron in the tissues found principally in the reticuloendothelial cells of the liver, spleen, and bone marrow

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14
Q

Define hemosiderin.

A

iron containing pigment derived from hemoglobin upon disintegration of RBCs (one method of iron storage); can be seen microscopically

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15
Q

What is asynchrony?

A

nuclear and cytoplasmic development are mismatched

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16
Q

What is karyorrhexis?

A

necrotic stage with fragmentation of the nucleus, whereby chromatin is distributed irregularly throughout the cytoplasm

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17
Q

How does the RBC count vary for physiological reasons and what are some conditions that cause this?

A

decreased due to anemia, bleeding, or hypoplasia of the bone marrow; increased due to decreased oxygen or plasma volume, dehydration, high altitude, or pulmonary and cardiac disease

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18
Q

What are the characteristics of a good RBC diluent?

A

isotonic to prevent cell lysis and crenation, and contains a fixative to preserve cell shape and prevent clumping

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19
Q

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

A

on each side of the slide, count cells in the four corners and the central smaller square of the larger central 5x5 square, disregarding any cells that touch the bottom and right-hand sides; average the two sides together and multiply by 10,000

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20
Q

What pathway provides most of the energy for a mature RBC?

A

Emden-Meyerhof glycolytic pathway (glycolysis)

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21
Q

What pathway functions to protect hemoglobin from oxidation?

A

hexose monophosphate (HMP) shunt

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22
Q

In order to function as an oxygen carrier, what oxidation state must the iron in hemoglobin be in?

A

Fe2+

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23
Q

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

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A

hemoglobin and HCl are combined in a Sahli tube and allowed up to an hour to develop; converted to acid hematin

24
Q

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

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A

cyanmethemoglobin

25
What hemoglobin pigment CANNOT be converted to oxyhemoglobin?
sulfhemoglobin
26
Which manual hematology procedure is the most reliable and reproducible?
hematocrit
27
Define transferrin.
glycoprotein synthesized in the liver, with primary function being iron transport
28
What test measures the percentage of RBC volume of whole blood and how is it performed?
hematocrit determination; blood is collected in capillary tubes (filled 1/2-2/3), ends are sealed with clay and spun in a special centrifuge, and volume of packed RBCs is recorded
29
Name two methods for performing hematocrit determinations and indicate why one method is preferred over the other.
macromethod of Wintrobe and micromethod; latter preferred because it requires a smaller blood volume, takes less time, and is more reproducible
30
What test measures the "suspension stability" of RBCs?
erythrocyte sedimentation rate (ESR, sed rate)
31
Name two methods for ESR determination.
Wintrobe-Landesburg and Westergren
32
Which ESR method uses a saline dilution and why?
Westergren; theory that dilution offsets any effects of anemia, and makes the test more sensitive and easier to read
33
What factors can cause an increased ESR?
abnormal amounts of fibrinogen/proteins, anemia, pregnancy, infections, carcinoma, post-IM, alcoholism, cirrhosis, hepatitis, TB, multiple myeloma, macroglobinemia
34
What factors can cause a decreased ESR?
polycythemia, SCA, spherocytosis
35
If given the RBC, Hgb, and Hct counts, how would you calculate MCV? MCH? MCHC?
MCV = (Hct/RBC) x 10, MCH = (Hgb/RBC) x 10, MCHC = (Hgb/Hct) x 100
36
What is the Rule of Three?
approximately: 3 x RBC = Hgb, 3 x Hgb = Hct
37
What test is the most reliable assessment of the effective erythroid activity of the bone marrow?
reticulocyte count
38
What is the normal reticulocyte count? What stains are used for this procedure?
adult: 0.5-2% (~1%), newborn: 2.5-6%; new methylene blue, brilliant cresyl blue
39
How are reticulocytes observed on a Wright's stained smear?
polychromatophilic (blue) with no nucleus
40
What reagent is used for the sickle cell solubility test?
sodium dithionite
41
What reagent is used for the sickle cell slide test?
sodium metabisulfate
42
How are the sickle cell solubility and slide tests read?
solubility test is determined by tube turbidity (clear is =, turbid is +); slides are examined for the formation of sickle cells
43
What reagent is used for the osmotic fragility test?
saline (NaCl)
44
How is the osmotic fragility test read?
read color of supernatant with spectrophotometer; initial hemolysis determined by %NaCl at which hemolysis begins; complete hemolysis is %NaCl at which all cells lyse; use formula: %hemolysis = [(ODx - OD 0.85%)/(OD 0% - OD 0.85%)] x 100 to determine (x,y) points that are then plotted on a graph
45
What conditions cause an increased osmotic fragility?
acquired hemolytic anemias and hereditary spherocytosis
46
What conditions cause a decreased osmotic fragility?
SCA, iron deficiency anemia, thalassemia, following splenectomy, liver disease, Hgb C disease (essentially any disease that results in the formation of target cells)
47
Which terms relate to RBC variation in color?
normochromic, hypochromia, polychromatophilia (polychromasia)
48
Which terms relate to RBC variation in size?
normocyte, anisocytosis, macrocytosis, microcytosis
49
Which terms relate to RBC variation in shape?
poikilocytosis, ovalocytosis (elliptocytosis), spherocytes, sickle cell (drepanocyte), acanthocyte, Burr cell (echinoocyte), crenated (echinocyte), schistocyte, semi-lunar bodies (achromocyte), target cell (codocyte, leptocyte), tear drop cell (dacrocyte)
50
Which terms relate to RBC variation in structure?
basophilic stippling, Pappenheimer bodies, Howell-Jolly bodies, Cabot rings, malarial stippling, Maurer's dots, Rouleaux formation, stomatocyte, hemoglobin C crystals ("bar of gold"), hemoglobin SC crystals ("Washington monument", "bird"), blister cell (keratocyte), helmet cell (bite cell), envelope cell, Heinz bodies, nucleated RBC
51
What is the chemical composition of basophilic stippling?
RNA
52
What is the chemical composition of Heinz bodies?
denatured Hgb
53
What is the chemical composition of Howell-Jolly bodies?
nuclear chromatin fragments (DNA)
54
What is the chemical composition of Pappenheimer bodies?
iron
55
Which inclusion should be counted as reticulum in a reticulocyte count due to its composition?
basophilic stippling

Hematology (4 decks)

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