HEMATOLOGY

Question 1

Reticulocyte Count

Answer 1

Increases during rapid blood loss or hemolytic diseases where RBCs are destroyed prematurely

Question 2

Low Reticulocyte count Indicate 3 conditions

Answer 2

1. Decreased production of RBCs by the bone marrow which can be caused by aplastic anemia, etc.
2. Exposure to radiation • Chronic infection •
3. Certain meds that damage bone marrow

Question 3

• MCV –

Answer 3

Mean Corpuscular Volume

Question 4

• MCH –

Answer 4

Mean Corpuscular Hemoglobin

Question 5

• MCHC -

Answer 5

Mean Corpuscular Hemoglobin Concentration

Question 6

• RDW –

Answer 6

Red Cell Distribution Width

Question 7

Mean Corpuscular Volume MCV

Answer 7

average volume of red cells in a specimen.

Question 8

Differentiates microcytic or macrocytic anemia • Low MVC = • Normal MVC = • High MVC =

Answer 8

microcytic anemia normocytic macrocytic anemia

Question 9

Microcytic causes (TIA)

Answer 9

Thalassemmia Iron deficiency Anemia of chronic renal disease

Question 10

Macrocytic causes are BAC-DRAMHypo)

Answer 10

B12 folate deficiency

Alcohol use

Chronic liver disease

Drugs

Reticulocytosis

Aplastic anemia

Myelodysplastic

Hypothyroidism

Question 11

Mean Corpuscular Hemoglobin (MCH)

Answer 11

• Measure of the average MASS of hemoglobin contained by a rbc

Question 12

Low MCH =

Answer 12

microcytic anemias;

Question 13

High MCH =s

Answer 13

macrocytic anemia

Question 14

Normal MCH

Answer 14

• Normal: 27 - 31 picograms/cell

Question 15

Mean Corpuscular Hemoglobin Concentration (MCHC)

Answer 15

• Measure of the concentration of hemoglobin in a given volume of RBCs

Question 16

Normal MCHC

Answer 16

• 32-36 g/dL

Question 17

Low MCHC

Answer 17

(hypochromic) in microcytic anemias

Question 18

Normal MCHC

Answer 18

(normochromic) in macrocytic anemias (due to larger cell size)

Question 19

High MCHC (hyperchromic) in

Answer 19

spherocytosis, sickle cell and Hb C ds. w/ splenomegaly

Question 20

Red Cell Distribution Width RDW

Answer 20

• Shows the difference in size between the smallest and largest red blood cells in a sample.

Question 21

RDW normal

Answer 21

Normal range is ~ 12-15% variation in size

Question 22

RDW average red cells are

Answer 22

6–8 micrometers

Question 23

Questions during exam: meds that affect blood are Dont forget: ______ May need to question ________

Answer 23

• Medications list • Meds that affect the blood (ex. ASA, NSAIDS, Warfarin, Pentoxifylline, erythropoietin, neupogen, etc.) • Don’t forget HERBAL/VITAMINS/ SUPPLEMENTS • May need to question FAMILY HISTORY

Question 24

Symptoms of Anemia Depend on HCDR

Answer 24

• Hgb level • Decrease in O2 carrying capacity of blood • Change in total blood volume • Rate at which these change

Question 25

The concentration of DISSOLVED oxygen in the blood (CdO2) is \_\_\_\_\_\_\_\_\_\_\_\_\_. This is known as the \_\_\_\_\_\_\_\_

Answer 25

directly proportional to the partial pressure of oxygen (PO2) in the gas. This is known as Henry's Law.

Question 26

The solubility coefficient of oxygen in blood (aO2) =

Answer 26

0.0031 mL / mmHg of oxygen / dL of blood.

Question 27

CdO2 = Constant is

Answer 27

aO2 x PO2 (aO2 = 0.0031 mL O2/ mmHg O2 / dL blood) aO2 0.0031

Question 28

• What would the concentration of dissolved oxygen be in the blood when the partial pressure of oxygen in the alveolar gas is 100 mmHg?

Answer 28

15 mL O2

Question 29

Causes of Prolongation PTc

Answer 29

• Normal: INR 0.8-1.2 • Normal: PT 12-14 se

Question 30

PT/INR evaluates how well together.

Answer 30

all of the coagulation factors in the extrinsic and common pathways of the coagulation cascade work

Question 31

Included in PT/INR are:

Answer 31

factors I (Fibrinogen), II (Prothrombin), V, VII and X

Question 32

Decrease in factor production or increase in factor destruction = prlonged PT

Answer 32

• Warfarin therapy • Vitamin K deficiency • Liver disease • DIC

Question 33

Causes of Prolongation of PTT Normal PTT –

Answer 33

25-35 secs

Question 34

What does PTT measure?

Answer 34

the integrity of the intrinsic system (Factors VIII, IX, XI, XII) and common clotting pathway

Question 35

Abnormalities leading to prolonged PTT (VHHLD)

Answer 35

• Heparin - binds to antithrombin • Very severe vitamin K deficiency • Hemophilia A, B, and C • Liver disease • DIC

Question 36

Fibrinogen Level  Synthesized by

Answer 36

the liver

Question 37

Fibrinogen Acute-phase reactant (APR =

Answer 37

proteins whose plasma concentrations increase in response to inflammation)

Question 38

Extrinsic

Answer 38

3, 7

Question 39

Fibrinogen Normal levels are

Answer 39

160-350 mg/dL

Question 40

Fibrinogen levels less than

Answer 40

 Levels \< 100 mg/dL may be inadequate to form clot

Question 41

Activated Clotting Time (ACT) Evaluate the

Answer 41

Evaluates the intrinsic and common pathways of coagulation

Question 42

Normal clotting time is

Answer 42

90-120 seconds

Question 43

Thromboelastography

Answer 43

 Test that rotates blood sample to initiate clot formation  Management of transfusion therapy in OR

Question 44

Thromboelastography Measures clot formation: R value

Answer 44

Reaction time in min before the first evidence of clot is detected (efficacy of coagulation factors & fibrin formation)

Question 45

Thromboelastography K value –

Answer 45

time from end of R until clot reaches 20mm tracing (speed of clot formation)

Question 46

Thromboelastography Alpha angle –

Answer 46

size of angle formed by tangent line from beginning of K until 20mm point (information similar to K - reflects speed of fibrin accumulation & crosslinking)

Question 47

Thromboelastography MA - Maximum amplitude –

Answer 47

greatest amplitude of tracing (reflection of maximum clot strength) 80% platelet function + 20% fibrin  Assesses platelet count/function +fibrinogen activity

Question 48

Thromboelastograph LY30 - Clot lysis index –

Answer 48

percentage of clot lysed after 30 min.

Question 49

TEG interpretation Prolonged R Time =

Answer 49

↓ clotting factors – treat w/ FFP

Question 50

TEG interpretation Low MA =

Answer 50

↓ platelets – give platelets

Question 51

TEG interpretation Prolonged K Time and/or low α angle =

Answer 51

↓ fibrinongen – treat w/ cryoprecipitate

Question 52

TEG interpretation High LY30 =

Answer 52

↑ fibrinolysis – treat w/ antifibrinolytics (aminocaproic acid)

Question 53

Hemophilia A

Answer 53

Factor VIII/antihemophiliac deficiency

Question 54

Hemophilia B

Answer 54

Factor IX/Christmas deficiency

Question 55

Hemophila C

Answer 55

Factor XI/Rosenthal deficiency)

Question 56

Fibrinogen deficiency

Answer 56

Factor I

Question 57

Prothrombin deficiency

Answer 57

Factor II

Question 58

Sickle cell

Answer 58

Hgb S is a variant Hgb produced by substitution of valine for glutamic acid in position 6 of the beta chain due to a defect on chromosome 11

Question 59

Premature Infant EBV

Answer 59

90-100 mL/kg

Question 60

Parturient EBV

Answer 60

100 mL/Kg

Question 61

Full-term Newborn Infant EBV

Answer 61

80-90 mL/kg

Question 62

Infant 3 mo – 3 yrs of age EBV

Answer 62

75-80 mL/kg

Question 63

Children \> 6 yrs EBV

Answer 63

•65-70 mL/kg

Question 64

Males EBV

Answer 64

75 mL/kg

Question 65

Females EBV

Answer 65

65 mL/kg

Question 66

Obese EBV

Answer 66

45-55 mL/kg

Question 67

ABL=

Answer 67

EBV x (Original Hct – target Hct)/Original Hct

Question 68

How much does one unit of platelets (250ml) raise the platelet count?

Answer 68

• 30,000-60,000/uL

Question 69

How much does 1 unit of PRC increase hematocrit?

Answer 69

1g hct 3%

Question 70

Identify the condition

Answer 70

Polycythermia Vera