Brainscape's Knowledge GenomeTM


Top Flashcards (Certified)
All Flashcards

Low Yield Semmelweis > Hematology - From Slides > Flashcards

Hematology - From Slides Flashcards

1
Q

How many red blood cells I have in the body?

Use

Volume and Normal RBC Count

A

Volume: 5L

RBC Normal Count: 5 T/L or milion per microliter

5x5x10^12 = 25 x10^12

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

What is the number of RBC lost in a day? hour? second?

Normal amount in the body: 25 x10^12

RBC Lifespan:120 days

(*Therefore this the amount produced as well)

A

Day: 25 x10^12 / 120 = 2 x 10^11 / day

Hour: 2 x 10^11 / 24 = 10^10 /hr

Second: 10^10/ 3,600 = 3x10^6 /s

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

What is the number of WBC lost in a day? hour? second? Relative to RBC

What is the number of Platlets lost in a day? hour? second? Relative to RBC

Number is not nesscesery!

How is it possible?

A

Similar to RBC!

RBC lifespan is higher, Accumulate more but the turnover is the same - Equilibrium!

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

Two ways of checking the bone marrow?

Location and Aim

A
  • Bone Marrow Aspiration - Sternum, Static Check
  • Bone Marrow Biopsy - Crista Ilia, Function Check
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

What is the differential blood count of WBCs?

A

Neutrophills - 45-70%

Monocytes - 2-8%

Eosinophills - 0-4%

Lymphocytes - 25-45%

Basophills - 0-2%

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

What is the Normal WBC blood count?

A

4-10 G/L

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

What is the Normal PLT blood count?

A

150-400 G/L

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

“Tornochi Principle” - As cells are differentiating:

  • Cell Size
  • Nuclear/Cytoplasmic Ratio
  • Nuclear Chromatin Density
  • Basophilia of Cell
  • Number of Nucleoli
A
  • Cell Size: ↓
  • Nuclear/Cytoplasmic Ratio : ↓
  • Nuclear Chromatin Density: ↑
  • Basophilia of Cell: ↓
  • Number of Nucleoli:↓
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

Definition of Blast Cells:

A

The earliest, Non-Stem cells, precursor that is easilly recognizable with microscope.

(“Tornochi Principle”)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

Granulocyte Lineage

Which cell is larger Promyelocyte or Myeloblast?

Which cell is more potent Promyelocyte or Myeloblast?

A

Promyelocyte - Larger

Myeloblast - More Potent

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

Granulocyte Lineage

Which cell has only eosinophillic kind of granules Promyelocyte or Myelocyte?

A

Promyelocyte - Only Eosinophillic

Myelocyte - Both kinds

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

Granulocyte Lineage

Which cell has a oval shape nucleus?

Which cell shows the first kidney shape nucleus?

What is the outcome of a Metamyelocyte?

A

Myelocyte - Oval Shape

Metamyelocyte (aka Juvenile)- first show kidney shape

Metamyelocyte turns to Band cell

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

Granulocyte Lineage

What is the first kind of cell that is normal to see sometimes out of the Bone Marrow?

A

Metamyelocyte

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

What is a Left Shift in Granulocyte distribution?

What are the causes?

A

High relative amount of Juvenile and Band cells presence in the blood.

Caused as a response to Infection or by Leukemia

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

What is a Right Shift in Granulocyte distribution?

What are the causes?

A

High relative amount of Hypersegmented Neutrophills (5 segements nucleus, Overmature) presence in the blood.

caused by suppression of bone marrow activity, as a hematological sign specific for pernicious anemia and radiation sickness.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

Proerythroblasts and Erythroblasts

What is the most dominant visible change in their progression?

also called?

A

Pronormoblasts and Erythroblasts

Becoming more Eosinophilic

More Hb and Less DNA content as it differentiates

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

Erythroid lineage

What are the names of the subtypes of the normoblast progression?

A

Pronormoblast

↓

Basophillic Normoblast

↓

Intermediate (aka Polychromatophillic) Normoblast

↓

Eosinophilic Normoblast (aka Acidophilic/Orthochromatic)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

Erythroid lineage

Eosinophilic Normoblast (aka Acidophilic/Orthochromatic) - what will be the outcome of this cell (Next step)?

and after that one..?

A

Reticulocyte

becomes a Mature RBC

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

Erythroid lineage

What types of the Erythroid lineage cells are present in:

1) The bone marrow
2) Periphery

A

Erythroid lineage

Bone Marrow - All cell steps

Periphery - Reticulocytes and RBCs

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

Erythroid lineage

What is the significance of elevated amount of Reticulocytes?

How can we recognize them?

A

Can tell us about over or under- production of RBCs

More oval than RBCs with network of ribosomal RNA aka Substancia Reticulofilamentosa (not by Giemsa)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

Erythroid lineage

Normal Precentage of Reticulocytes

A

1% in Total RBC Count

but absolute measurement is more Important per individual

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

What is the difference in the amount of WBC and PLT to RBCs?

A

RBC/WBC - 10^3 (Tera to Giga)

RBC/PLT - 10 (Tera to 100 Gigas)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

Anemia

What are the Major parameters to check for it?

A

RBC

Hb

Ht

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

Anemia

What is MCV?

A

MCV= Ht/RBC

Mean corpuscular volume (MCV) is a laboratory value that measures the average size and volume of a red blood cell.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
**_Anemia_** What is MCH?
**_MCH= Hb/RBC_** The mean corpuscular hemoglobin , or "mean cell hemoglobin" (MCH), is the average mass of hemoglobin (Hb) per red blood cell (RBC) in a sample of blood.
26
**_Anemia_** What is MCHC?
**_MCHC= MCH/MCV (actually Hb/Ht)_** The mean corpuscular hemoglobin concentration is a measure of the concentration of haemoglobin in a given volume of packed red blood cell. Because normally Ht is aroud 50% the MCHC is **Normally twice as the Hb.**
27
**_Anemia_** What are the implications of a changes of MCH and MCV in anemia?
**_MCH_ - Hyper/Normo/Hypo-Chromatic Anemia** **_MCV_ - Micro/Normo/Macro-Cytic Anemia**
28
What is the key findings in **Iron Deficiency Anemia** (IDA)?
**Microcytic** - MCV↓ **Hypochromic** - MCH↓ (MCHC is low)
29
What is the key findings in **Megaloblastic Anemia** (Normally from B12/Folate Deficiency)?
**Macrocytic** - MCV↑ **Hyperchromic** - MCH↑ (MCHC is Normal)
30
**_Anemia_** What is the absolute measurment value of anisocytosis?
**_RDW - Red cell Distribution Width_** RDW=MCV/Standard Deviation
31
**_Anemia - Tests Significance_** Se LDH Se Bi (Indirect) Se Haptoglobulin Coombs Test
LDH and Bi - (Uncojugated) ↑ - Hemolytic Coombs Test - Autoantibodies
32
What is the Reticulocyte Index?
_**RI = [Reticulocyte(%) \* Ht] / [Correction Factor \*Norm Ht]**_ -The correction factor is based on the abillity of the Bone marrow to release the reticulocytes **depending on the Severity of anemia by the Ht.**
33
**_RBC with Basophilic Stippling_** What does this indicate?
Lead Poisning
34
**_RBC - Eliptocytes_** What does this indicate?
Megaloblastic Anemia
35
**_RBC - Schistocytes_** What does this indicate?
Fibrin Fibrills in the blood stream
36
**_RBC - Howell Jolly Bodies_** What does this indicate?
Megaloblastic Anemia or Splenectomy
37
**_RBC - Spherocytes_** What does this indicate?
Heredetery or by Immune Hemolytic Anemia
38
**_RBC - Target Cells_** What does this indicate?
Thalassemia
39
**_RBCs - Echinocytes (Burr cells)_** What does this indicate?
Altered lipid in cell membrane Artifact Uremia Piruvate‐kinase deficiency Aged transfused RBC
40
**_RBC - Anulocytes_** What does this indicate?
IDA
41
**_RBC - Which parasites can live in it?_**
Plasmodium Genus - Malaria
42
**_Transferrin_** What is the meaning of the TIBC and what else will relate to this in it?
**Transferrin Saturation** is the relative iron binding capacity **TIBC** is the absulote actuall total Iron Binding capacity
43
What is the initial change in IDA?
**Serum Ferritin** ↓ - Reflects the Storage of Iron in the body.
44
AML, MPN, MDS are all examples for :
**Malignant Myeloid Groups of Disroders**
45
Neutrophills\>7.5 G/l with Elevation of Band cells this is defined as -
**Neutrophillia caused by infection - Left Shift**
46
Eosinophills\>0.5 G/l
**Eosinophillia**
47
**Leukomoid Reaction**
Infection causing left shift ddx from leukemia by markers
48
**Granulocytopenia:** General Causes (3)
**Granulocytopenia:** * **Decreased granulocytopoiesis (aplasia)** * **​Maturation problem** * **Increased loss of granulocytes**
49
**Granulocyte count of Granulocytopenia** * **neutrophilic granulocyte count \> 1 G/l :** * **0.5 G/l \< count \< 1 G/l :** * **count \< 0.5 G/l :**
**Granulocyte count of Granulocytopenia** * neutrophilic granulocyte count \> 1 G/l – **no symptoms or mild infections** * 0.5 G/l \< count \< 1 G/l – **increased risk for infections** * count \< 0.5 G/l – **severe bacterial and fungal infections, sepsis**
50
Major cause of Agranulocytosis
**Drugs**
51
**_Leukemia_** * What is the difference between Acute and Chronic ?
**_Leukemia_** * Acute - Death without treatment in a few weeks, Undifferentiated white blood cells * Chronic - Death without treatment in a few years, Differentiated white blood cells * Both are Malignant
52
**_Leukemia_** * What is a Proliferative Advantage?
**_Leukemia_** * Ineffective inhibition of Proliferation in Malignant WBC due to genetic mutation. "Anti-Social WBC". * This causing Chronic Leukemia
53
**_Leukemia_** * What is a Maturation Inhibition?
**_Leukemia_** * Differentiation is halted in Malignant WBC due to very high rate of genetic mutation - Causing Acute Leukemia from Chronic Leukemia.
54
**_Acute Myeloid Leukemia_** * What is a the precentage of Blast cells in Blood and Bone marrow?
**_Acute Myeloid Leukemia_** * **Blood \> 20%** * **Bone marrow \>** **20%**
55
**_Acute Myeloid Leukemia_** * **WHO Classification: By Pathomechanism (4 types)**
**_Acute Myeloid Leukemia_** * AML with **reccurent genetic defects** * AML **from MDS/MPN** * **Therapy Induced** AML * **Mixed** phenotype (M+L) and **NOS** (Non-otherwise specified)
56
**_Acute Myeloid Leukemia_** * **Key Symptomes**
**_Acute Myeloid Leukemia_** * Hepatosplenomegaly with lymphadenopathy * Infections * Bleeding tendency * Anemia * Weight loss * DIC / Leukemic Thrombi * Osteomyelofibrosis * Auer rod in WBC
57
**_Acute Myeloid Leukemia_** * **Diagnosis**
**Acute Myeloid Leukemia** * **Hiatus Leukemicus** - In preipheral blood * Bone marrow - **Blast level \> 20%** * Genetic Abnormalties **- Lamda/Kappa Ratio** * **Reciprocal Translocation** * **Immnuophenotyping**
58
**_Myeloproliferative Neoplasms_** * Unique Features
**_Myeloproliferative Neoplasms_** * **Differentiated cells in periphery** * **Fibrosis** * **Progression to AML is common**
59
**_Myeloproliferative Neoplasms_** * CML is differentiated from other MPN by - * What is the detection method?
**_Myeloproliferative Neoplasms_** * **Philadelphia Chromosome Positvity :** **9:22 chromosomal translocation - ABL-BCR** * **Abl-BCR gene is detected by FISH**
60
**_Myeloproliferative Neoplasms_** * What are the different forms of Ph Negative MPNs? * What is the common mechanism of Mutation?
**_Myeloproliferative Neoplasms_** * **Polycythemia vera (PV)** * **Essential thrombocytemia (ET)** * **Idiopathic myelofibrosis (IMF)** * **Other less common forms** * **​**Caused by different **JAK mutations**
61
**_Chronic Myeloid Leukemia_** * What is the normal and CML M:E ratio?
**_Chronic Myeloid Leukemia_** * **_​_**Normal - **2:1** * CML - **30:1**
62
**_Polycythemia vera_** Single base pair mutation?
**_Polycythemia vera_** **JAK2** (vast majority of cases)
63
**_Polycythemia vera_** DDX
**_Polycythemia vera_** Polyglobulemia? 1. **EPO↑**: Doping, Paraneoplastic, Altitude, Lung/Heart Disease (Mostly COPD), Hemoglobinopathies. 2. **Plasma Volume↓**
64
**_Myelofibrosis and ET_** 3 common Mutations?
**_Myelofibrosis and ET_** **JAK2, CALR, MPL**
65
**_Essential Thrombocythemia_** DDX
**_Essential Thrombocythemia_** MDS, IMF, PV, CML, Bleeding
66
What is the Ph- MPN that is most likely to develop to AML?
## Footnote **Myelofibrosis**
67
**_MDS_** Classification? (5)
**_MDS_** * SLD: Single lineage dysplasia (Refractory Anemia) * RS: Ring Sideroblasts * 5q- : Mononuclear megakaryocytes * MLD: Multilineage dysplasia * EB: Excess Blasts
68
**_Infectious Mononucleosis_** cause? and cell effected?
**_Infectious Mononucleosis_** EBV causes atypical B cells formation to be attacked by T cells
69
**_Infectious Mononucleosis_** Associasion with
**_Infectious Mononucleosis_** Burkitts/Hodgkin/B Lymphoma Nasolaryngelal Carcinoma
70
**_Infectious Mononucleosis_** Diagnosis and DDX
**_Infectious Mononucleosis_** DDX: Lymphoma 1. increased lymphocytes (12‐18 G/L) 2. presence of at least 10% atypical lymphocytes on peripheral smear 3. a positive serologic test for Epstein-Barr virus (Paul‐Bunnel antibody) .
71
**_Infectious Mononucleosis_**
**_Infectious Mononucleosis_** Downy Cells
72
**_ALL and AML_** ddx - Incidence as a function of Age
**_ALL and AML_** A**M**L mostly in elderly ("**M**evogarim") A**L**L mosly in children ("**L**o-mevogarim")
73
**_CLL_** * Prevelance? * Is it common in children? which age?
**_CLL_** * The most common leukemia! * Not in Children (at all)! 60-80~
74
**_CLL_** * Prognosis? * Treatment?
**_CLL_** * Many years (more than 10 years) * Treatment could resolve the disease with significant side effects * Thearpy should start later than other cancers - same effectivity less time with side effects
75
**_CLL_** * Lymph node Equivalent?
**_CLL_** * **Small lymphicytic Lymphoma** (SLL) * Same immunophenotype and cytogenetics but in SLL there is solid tissue disease.
76
**_CLL_** * Lymphocyte count suggestive of CLL? * What is the effectivity of these lymphocytes in inflammation?
**_CLL_** * The absolute lymphocyte count is **_\> 5 G/L_** and may be up to 300 G/L - Diagnosis! * Very low effectivity - **_Monoclonal Lymphocytes!_** (Not specific for infection)
77
**_CLL_** * What are the surface markers for CLL?
**_CLL_** * **_CD5+, CD19+ together !_** (B and T cell mixed markers) * **_CD23+_** - **Mental** cell lymphoma will have a **negative** value **_CD23 -_** ! (ddx) * **_CD52+_** - Prognostic Marker
78
**_CLL_** * Typical Cells seen in CLL (not diagnostic)
**_CLL_** * Smudge Cells * Gumprecht bodies
79
What are the B-Symptoms?
**_B symptoms_** * Fever * Night sweats * Weight loss
80
**_Monoclomal Gammopathies_** Kinds?
**_Monoclomal Gammopathies_** * MGUS (Bengin - "Undetermined Significance") * Multiple Myeloma * Smoldering Myeloma * Plasmacytoma
81
**_Monoclomal Gammopathies_** Immunofixation result?
**_Monoclomal Gammopathies_** * Kappa to Lambda ratio is not 50%
82
**_Monoclomal Gammopathies_** Parameter in blood?
**_Monoclomal Gammopathies_** * Monoclonal immunoglobulins * aka Paraprotein or M-Protein
83
**_MGUS_** What is the meaning of the diagnosis?
**_MGUS_** * This is a **_premalignant_** state! * Will progress to Multiple Myeloma - 20% in 15 years * Can be prevented!
84
**_Plasmacytoma_** * Where does the Plasma cells reside?
**_Plasmacytoma_** * Peripheral Plasma cell tumor
85
**_Multiple Myeloma_** * Where does the Plasma cells reside?
**_Multiple Myeloma_** * In the bone marrow, hence it is a Myeloma
86
**_Multiple Myeloma_** * Further state for progression of the disease?
**_Multiple Myeloma_** * Plasma cell Leukemia (out to peripheral blood) * It is an end stage not many patient reach
87
**_Multiple Myeloma_** * What is the 5 year survival rate?
**_Multiple Myeloma_** * 35%
88
**_Multiple Myeloma_** * Clinical Presentation : **CRAB**
**_Multiple Myeloma_** * Hyper**C**alcemia * **R**enal Insufficiency * **A**nemia * Lytic **B**one lesions
89
**_Multiple Myeloma_** * Lab tests results
**_Multiple Myeloma_** * ESR ↑↑ * M-Peak (also in MGUS) and Hyperproteinemia * Anemia
90
**_Smoldering Myeloma_** * Significant finding (+ddx from M.M)
**_Smoldering Myeloma_** * **Plasma cells in the Bone marrow _\>10%_** * **ddx: No clinical symptoms of Multiple Myeloma!**
91

Low Yield Semmelweis (37 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2025 Bold Learning Solutions. Terms and Conditions