Exam Practicum C

Question 1

Define hematocrit

Answer 1

Measurement that represents % of RBCs in whole blood. It’s spun down to separate different cellular components of whole blood in capillary tube.

Question 2

Describe Buffy coat

Answer 2

Thin, light colored layer formed between packed RBCs and plasma after centrifugation. It is composed of WBCs and platelets

Question 3

Describe polychromasia

Answer 3

Presence of young RBCs called r eticulocytes in peripheral blood that exhibit bluish tint when stained with Wright’s stain. Observed frequently in hemolytic anemias during periods of increased demand for RBC production

Question 4

Purpose of EPO?

Answer 4

Cytokine responsible for stimulating erythropoiesis. Produced in the peritubular cells of kidneys in response to hypoxia. EPO acts on. Erythroid progenitor cells in the bone marrow, promoting proliferation, differentiation, and maturation into RBCs.

Question 5

What are the growth factors and cytokines that influence erythropoiesis?

Answer 5

EPO, IL-3, and GM-CSF

Question 6

How does IL-3 influence erythropoiesis?

Answer 6

Stimulates growth and differentiation of multiple hematopoietic cell lineages, including erythroid progenitor cells. It plays a supportive role in erythropoiesis by promoting the survival and proliferation of erythroid precursors.

Question 7

How does GM-CSF help the body with erythropoiesis?

Answer 7

Stimulates the production and differentiation of multiple blood cell types, including RBCs. It acts on erythroid progenitor cells, promoting their maturation and proliferation.

Question 8

What is iron deficiency anemia?

Answer 8

Impaired RBC production due to insufficient iron levels from poor dietary intake, chronic blood loss, or impaired absorption

Question 9

What would lab results look like for iron. deficiency anemia?

Answer 9

Low hemoglobin, hematocrit, serum iron, ferritin, and increased TIBC

Question 10

What would peripheral blood smear look like in iron deficiency anemia?

Answer 10

Microcytic and hypochromic RBCs

Question 11

Describe anemia from vitamin B12/B9 deficiency

Answer 11

Decrease intrinsic factor of B12/B9 leads to insufficient RBCs and poor quality RBCs. These RBCs die. Sooner.

Question 12

Describe pernicious anemia

Answer 12

Insufficient RBC production due to antibodies targeting parietal cells.

Question 13

What do labs for Vitamin B12 / B9 deficiency anemia look. Like?

Answer 13

Low Hgb, HCT, increased MCV, and decreased B12

Question 14

What do peripheral blood smears look like from a patient with vitamin B12/B9 deficiency anemia or pernicious anemia?

Answer 14

Macrocyclic RBCs, hyper-segmented neutrophils

Question 15

Describe hemolytic anemia

Answer 15

Increased destruction of RBCs, whether by mechanical issues (heart valve, repeated impact), autoimmune, or chemically induced.

Question 16

What do labs look like in hemolytic anemia?

Answer 16

Decreased hgb, HCT, increased LDH, relics, and indirect bilirubin

Question 17

What would a peripheral blood smear look like in a patient with hemolytic anemia?

Answer 17

Polychromasia, spherocytes, and relics

Question 18

Describe aplastic anemia

Answer 18

Pancytopenia due to bone marrow failure

Question 19

Describe labs of a patient with aplastic anemia

Answer 19

Low hgb, HCT, and retic count

Question 20

What would peripheral blood smear look like from a patient with aplastic anemia?

Answer 20

Panocytopenia

Question 21

What kind of hemoglobin affects sickle cell patients?

Answer 21

Hgb S

Question 22

What is the appropriate course. Of action to be taken when numerous nRBCs are present?

Answer 22

Evaluate bone marrow. Do a corrected WBC count calculation. Grade peripheral blood smear

Question 23

What conditions will have increased retic in peripheral blood smears?

Answer 23

Hemolytic anemias, blood loss, or hemorrhage

Question 24

What conditions will have decreased retics in peripheral blood smears?

Answer 24

Aplastic anemia / bone marrow failure, chronic kidney disease (due to decrease EPO from liver), iron deficiency anemia, B12 or folate deficiency, and of course in in healthy adults.

Question 25

What kind of RBC is associated with myeloid metaplasia?

Answer 25

Teardrop cells (dacrocytes) are prominent in patients with myelofibrosis

Question 26

Spherocytes is associated with what condition?

Answer 26

hemolytic anemia, jaundice, or splenomegaly

Question 27

Cold agglutinins is associated with what condition?

Answer 27

Hemolytic anemia, acrocyanosis, or raynaud's phenomenon

Question 28

Elliptocytosis is associated with what condition?

Answer 28

Hemolytic anemia, or jaundice

Question 29

A patient with alcohol abuse would have what kind of labs? What organ in his body could be dysfunctional?

Answer 29

Liver disease Lab: decrease clotting factors and potentially be anemic.

Question 30

What causes sickle cell to farm?

Answer 30

A single base - pair point mutation in beta globin gene resulting in valine switched for glutamic acid.

Question 31

What is spleenic sequestration in sickle cell patients?

Answer 31

Excessive amount of blood becomes trapped in the spleen causing a dangerous drop in the circulating blood volume.

Question 32

What is vaso-occlusive crisis in sickle cell patients?

Answer 32

Occurs

Question 33

Patients with iron deficiency anemia will have what kind of labs?

Answer 33

Decreased Hgb, Hct, MCV, serum iron, and ferritin. Increased TIBC and FEP

Question 34

Patients with sideroblastic anemia will have what kind of labs?

Answer 34

Variable anemia, increased serum ferritin, serum iron, and iron stores in BM. Normal or decreased TIBC

Question 35

Describe sideroblastic anemia.

Answer 35

Ineffective erythropoiesis and impaired iron utilization in the mitochondria of developing RBCs. Leads to iron accumulation in mitochondria, forming ringed sideroblasts.

Question 36

What would the peripheral blood smear look like in a patient with B12 / Folate deficiency?

Answer 36

Macrocytic ovalocytes, aniso, poikilo, and hypersegmented neutrophils

Question 37

Describe Hgb C disease.

Answer 37

Hb C disease where Hb C instead of Hb A is present. Hb C forms crystals within RBCs leading to their distortion and the formation of target cells.

Question 38

What would blood smear look like from a patient with Hgb C disease?

Answer 38

Target cells and Hb C crystals may be present

Question 39

What could cause a patient to develop aplastic anemia?

Answer 39

Failure of BM (acquired or transplanted), autoimmune reactions, infections, medications, radiation, chemotherapy, and exposure to toxins

Question 40

RBCs of a patient hemolyzes when exposed to oxidative stress. Some RBCs have heinz bodies, what could this patient have?

Answer 40

G6PD deficiency. Its an inherited enzyme deficiency that affects RBCs ability to handle oxidative stress, like breaking down peroxide into water. Avoid fava beans, certain medications, and infections. Cells undergo hemolysis due to accumulation of ROS.

Question 41

How can a patient develop myelophthisic anemia?

Answer 41

Occurs when bone marrow is infiltrated or replaced by non-hematopoietic cells, such as tumor cells, fibrosis, or granulomas. This disrupts normal hematopoiesis, leading to anemia and the release of immature or abnormal cells into blood.

Question 42

What would labs look like in a patient with lead poisoning?

Answer 42

Microcytic, RBCs with basophilic stippling, increased FEP, and anemia