Hematology Flashcards by c k

hematopoiesis

blood making

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erythropoiesis

RBC making

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hemolysis

RBC destructioin

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hemostasis

arrest of bleeing

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thrombosis

formation of pathological blood clots

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Basic shape and composition of erythrocyte?

biconcave disc lacking nucleus and lacking mitochondria with lots of hemoglobin

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five types of white blood cells?

basophils
neutrophils
eosinophils
monocytes
lymphocytes

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leukemia vs lymphma?

leukemia is a cancer in the bone marrow and blood

lymphoma is a cancer in the lymph nodes or other lymphoid tissue, predominately outside the bone marrow

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acute leukemia vs chronic?

acute: the cells are immature in their degree of differentiation and the clinical course is usually rapidly progressive w/o intervention
chronic: cells are more mature in their differentiation and the disease follows a more indolent clinical course

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lymphoid vs myeloid leukemia

lymphoid - arising from lymphocytic lineage

myeloid - arising from one of the other cell types in the marrow

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platelets

origin
function

platelets are the cellular component of the blood responsible for hemostasis

small cells produced from large polyploid cells in the bone marrow called megakaryocytes

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Define the components of peripheral blood that are measured when a CBC is requested (7)

hemoglobin
hematocrit
RBC count
Mean corpuscular volume (MCV)
White blood cell count
platelet count 
Mean Platelet volume

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Define the values that are typically calculated when a CBC is requested (6)

Hematocrit
Mean corpuscular volume (MCV)
Mean corpuscular hemoglobin Mean corpuscular hemoglobin concentration
Red cell distribution width
Absolute counts of leukocytes (if applicable)

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Hematocrit

Ratio of volume of erythrocytes to that of the whole blood

RBC/Whole blood

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How to calculate hematocrit?

RBC volume / Total Volume
or
RBC x MCV

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MCV what does it tell you and how do we calculate it?

Mean corpuscular volume - i.e. average volume of RBCs

Calculated from hematocrit and red cell count

MCV = Hct / RBC

Note that 10^-15 L = fL

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Red cell distribution width

measure in variation of size of red cells

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Mean Corpuscular Hemoglobin
what is it?
how do you calculate it?

content (weight) of Hgb of average red cell

calculated from Hgb concentration and red cell count

MCH = Hgb / RBC

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MCHC
What is it
what does it tell you

average concentration of Hgb in a given volume of packed red cells

Calculated from Hgb concentration and Hct

MCHC = Hgb / Hct

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Who show’s the strongest fluorescence in flow cytometry?

immature and activated cells, due to their high RNA content

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how does fluorescence of reticulocytes change as they mature?

decreases because RNA content decreases during maturation process

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when is a differential performed?

when requested

when flagged by the analyzer and certain conditions are met

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How is the differential performed?

Make a blood film (wedge/cover glass/spinner)
Air-dry and fix with methanol
Stain with a Wright-Giemsa

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Normal Peripheral Blood Components (3)

RBCs
WBCs
Platelets

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Diff =

(Diff% x WBC) / 100

HCT% =

RBC x MCV

Scattergrams differentiate cells based on (2)

fluorescence and size

How to we count red cells?

Blood passes through an aperture through which current flows - creating a change in voltage - pulse - Pulse size is proportional to cell size Histogram created for number of events vs cell size Note that we always want single file

How to we measure hemoglobin ?

Measure change in absorbance following oxidation reaction and compare it to some standard (Beers law) Cyanide methode Sodium lauryl sulfide method

How do we count platelets?

Same as RBCs, just change the range size of the instrument - note that we always want single file

why might we have a spuriously low platelet count?

If they clump together - machine wont count as platelets

Distribution width from histogram?

the spread is the range

What is derived from the mean height of the voltage pulses formed during the red cell count?

MCV

What is calculated from Hgb concentration and red cell count?

MCH

flow cytometry forward scatter tells us about?

cell size

flow cytometry side scatter light tells us about

internal cell information

flow cytometry side fluorescence tells us about

type and quantity of nucleic acid and intracellular organelles

flow cytometry yields scattergram plot with what measures?

signal scatter vs. signal fluorescence - indicates cell type

what do we use to quantify reticulocyte?

flow cytometry - fluorecent label nucleic acids - more RNA = less mature / still making hemoglobin

How can we quantify nucleated red blood cells?

flow cytometry - label nuclei / scattergram

How can we measure platelet maturation?

flow cytometery

what provides automated differential?

scattergram

drawback of scattergram?

does not give you morphology - just size

what does a manual differential add?

Morphology of RBC, WBC, platelets, etc. Abnormal formed elements in peripheral blood Relative or absolute quantification of the different WBC populations

RBC

Round and smooth Central pallor Little variation in diameter Typically not touching

Too few platelets?

thrombocytopenia

too many platelets?

thrombocytosis

Acidophilic cytoplasm with fine granules | nucleus with clumped chromatin divided into 2-5 disctinct lobes linked by thin thilaments?

neutrophil

too few neutrophils

neutropenia

too many neutrophils

neutrophilia

most abundant white cell?

neutrophils

smaller with scant cytoplasm and round nucleus with dense chromatin - 10% may be larger with more abundant cytoplasm and less condensed chromatin small number may have abundant cytoplasm and prominent azurophilic granules

lymphocytes

most abundant white cell in children?

lymphocytes

lymphocytosis

too many lymphocytes

too few lymphocytes

lymphopenia

slightly larger than neutrophils bi-lobed nucleus spherical / large / course / reddish granules

eosinophils

too few eosinophils?

can't be documented by diff

fluxuation in eosinophil count?

count remains fairly constant

nucleus is obscured by course / purple / black granules

basophils

least abundant of wbc

basophil

too few basophil?

can't be documented by diff

largest cells in peripheral smear | irregular/lobular nucleus

monocytes

when thinking about leukocyte counts, are percentage or absolutes more valuable?

``` Absolutes e.g. 50% nueutrophils w/ WBC 500 = 250 50% nuetrophils 2/ WBC 8000 = 4000 very different ```

reference range | what is normal?

value typical of healthy individual value typical of individuals not at risk of disease desireable number

practical reference interval?

Mean +/- 2 SDs = central 95%

Practical reference interval absolute monocyte count lower bound

shift to 0.2

Is normal count always good?

No... as part of typical disease processes, certain tests are expected to be abnormal Failure to change can indicate an inability of the body to respond appropriately

Is abnormal always bad?

No... probability of all 16 measures being in reference range only 44%... More important to consider how far outside normal bound value is

WBC method

flow cytometry

RBC method

impedance transducer

HGB method

spectrophotometry

Hct method

Impedence transducer

PLT method (2)

Impedence transducer | flow cytometry

NRBC (nucleated) method

flow

Diff% method

flow

BA% method

flow

RET % method

flow

Heme progenitor cells method

flow

MCV method

RBC histogram

MCH method

RBC histogram

MPV method

Platelet histogram

MCV calculation

HCT/RBC x 10

MCH calculation

HGB/RBC x 10

MCHC calculation

HGB/HCT x100

Diff # calculation

Diff% x WBC / 100

Ret # calculation

Ret% x RBC / 100

do we need a cbc for pre-op

how can we use automated cell counter to determine if baby okay to birth?

lamellar bodies which contain surfactant would get counted as platelets in amniotic fluid

PRR

Recognize a foreign molecular structure that we humans do not have - Found on most cells in the body / on their surface or on inner membranes

Pathogen associated molecular pattern

foreign molecular structures recognized by innate immune system

Toll like receptor

A type of pattern recognition receptor (with homology to the Toll gene in the fruit fly - which control innate immunity in invertebrates) that recognizes foreign molecular structure that we humans due not have

What happens when TLR bind a foreign pattern?

signaling cascades are activated within teh cell that lead to the expression that cause or increase inflammation

damage associated molecular pattern

stress or damage indicator molecules express by body cells - recognized by innate immunity

Common foreign patterns recgonized by TLR

Lipopolysaccharide (part of cell wall of gram negative bacteria) Peptidoglycan (gram positive bacteria) double stranded RNA

Final transcription factor most commonly activated in inflammation

NF-kappaB

Hematology Flashcards

(95 cards)