1. sterile blood culture 2. Citrate (blue) 3. non additive (red) 4. Heparin (green) 5. EDTA (lavender) 6. Fluoride (gray)

HEMATOLOGY must memorize Flashcards by Jena Sy

Order of draw

sterile blood culture
Citrate (blue)
non additive (red)
Heparin (green)
EDTA (lavender)
Fluoride (gray)

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Routine gauge needle

20g

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which hematopoietic period is the 19th day of gestation?

Mesoblastic period

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Embryonic hemoglobins

Gower 1 = Zeta2 + Epsilon2
Portland = Zeta2 + Gamma2
Gower 2 = Alpha2 + Epsilon 2

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which hematopoietic period is the 3rd month of gestation?

Hepatic period

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Hemoglobin production includes what types of hemoglobin?

HbF = Alpha2 + Gamma2
HbA1 = Alpha2 + Beta2
HbA2 = Alpha2 + Gamma2

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which hematopoietic period is between the 5th and 6th month of gestation?

Myeloid period

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Reference range for hemoglobin on adults.
Male & female (g/dL)
Neonates (%)

Male: 13.5 - 18.0 g/dL

Female: 12.0 - 15.0 g/dL

Neonates: HbF = 60 - 80 %

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Reference range for Hematocrit %

Male: 40 - 54 %

Female: 35 - 49 %

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MCV reference range (fL)

80 -100 fL

*used to assess if Microcytic, Normocytic, or Macrocytic

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MCHC reference range (g/dL)

32- 36 g/dL

*used to assess if Hypochromic, or Normochormic

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RBC count reference range (x10^12/L)

Male: 4.20 - 6.00 x10^12/L

Female: 3.80 - 5.20 x10^12/L

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PLT reference range (x10^3/uL)

150 - 450 x10^3/uL

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Variation in RBC cell size

Anisocytosis

RBC = 6-8 um
MCV & RDW (reference)

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Macrocyte is caused by these anemia

Megaloblastic anemia (B12 def)
Non-megaloblastic anemia (BM failure)
Pernicious anemia (autoimmune)

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Microcytes cause by (TAILS)

T - Thalassemia
A - Anemia of Chronic Inflammation
I - Iron deficiency Anemia
L - Lead poisoning
S - Siderobalstic Anemia

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RBC Central Pallor normal reference

approx. 1/3 of the diameter

*determines color variation (MCHC)

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Abnormal variation in RBC shape

*common on severe anemia

Poikilocytosis

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RBC anomaly that has small, round, dense RBC with no central pallor

Spherocytes

Good to know:
- Hereditary spherocytosis
- Extensive burns (w/ schistocytes)

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RBC with slit-like area of central pallor

Stomatocytes

Good to know:
- RH null syndrome
- Alcoholism
- Hereditary stomacytosis
- Severe liver disease

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RBC anomalies in Mackloid syndrome and abetalipoproteinemia

Acanthocytes

*see RBC anomaly photos on Rodak’s Chapter 19 pg. 290 (5th ed)

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RBC with blunt or pointed, short projections

Burr cell (Echinocyte)

Good to know:
- Uremia
- Pyruvate kinase
deficiency

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RBC associated with primary myelofibrosis

Dacryocytes

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RBC associated with DIC and severe burn

Schistocytes

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Aka leptocyte,platycyte, codocyte, Mexican hat cell

Target cell Good to know: - Liver disease - Thalassemia - Hemoglobinopathies

2 RBC Inclusion Bodies not visible in wright stain

Heinz body Hb H *see RBC inclusion bodies table on Rodak's Chapter 19 pg. 289 (5th ed)

- Stack of coins - Elevated protein levels - Increase plasma fibrinogen

Rouleux Formation

Factor I

Fibrinogen

Factor II

Prothrombin

Factor III

Tissue Factor

Factor IV

Ionic calcium

Factor V

Labile factor

Factor VII

Stable factor

Factor VIII

Anti hemophilic factor

Factor VIII carrier

Von Willebrand Factor

Factor IX

Christmas Factor

Factor X

Stuart - Prower

Factor XI

Plasma Thromboplastin Antecedent (PTA)

Factor XII

Hageman Factor

Other name for Prekallikrein

Fletcher Factor

Other name for High Molecular Weight Kininogen (HMWK)

Fitzgerald Factor

Factor XIII

Fibrin Stabilizing Factor (FSF)

Factors in Intrinsic Pathway

9, 8, 11, 12 *APTT reference

Factors in Extrinsic Pathway

1, 3, 5, 7 *PT reference

Not seen in fresh serum

1, 5, 8, 13

Not seen in aged serum

1, 2, 5, 8, 13

Not seen in aged plasma

5 and 8

Not seen in adsorbed plasma

2, 7, 9, 10 *also Vitamin K dependent factors

Low HBG and HCT means?

Blood loss

How to differentiate chronic and acute blood loss?

Base on reticulocyte count low retic = acute high retic - chronic

which marrow is hematopoietically active?

Red marrow

which marrow is hematopoietically inactive?

Yellow marrow

cells in bone marrow that secrete semifluid extracellular matrix

Stromal cells

Hematopoietic stem cell marker

CD34

CALLA marker (Common Acute Lymphoblastic Antigen)

CD10

Closest cells to mast cells

Basophils

+ color in sulfhemoglobinemia

Mauve lavender

+ color in methhemoglobinemia

Choco brown

+ color in deoxyhemoglobinemia

Dark red

+ color in carboxyhemoglobinemia

Cherry red

Positive instrumental errors

Bubbles Electrical Pulses Aperture plugs

Affected by side angle scatter

Cytoplasmic granularity

Affected by forward light scatter

Cell size

cells seen in G6PD

Bite cells

Hemoglobin associated with Clostridium perfringens

Sulfhemoglobin

Reagent used for RBC count

Drabkin's reagent

Enzyme that differentiates acute myelocytic and acute lymphoblastic

Peroxidase

Marker for T cells

CD2, CD3

Marker for B cells

CD19, CD20

Primary stimulus of erythropoiesis

Hypoxia

Erythropoietin is produced in

Kidney

Stain used for Reticulocytes with polychromasia

Romanowsky stain

Juvenile granulocyte not capable of mitosis *predominant WBC in BM

Metamyelocyte

Youngest cell in the series present in peripheral blood Resembles pelger-huet

Band cell AKA stab/staff

NK cells marker

CD16, CD56

Bone forming cells? confused with?

Osteoblasts confused with plasma cells

Bone destroying cells? confused with?

Osteoclasts confused with megakaryocytes

Sequence of erythropoiesis

CFU-E Proerythroblast (Rubriblast 8:1) Basophilic erythroblast (Prorubricyte 6:1) Polychromatic erythroblast (Rubricyte 4:1) Orthochromic erythroblast (Metarubricyte 1:2) Reticulocyte Mature RBC

Sequence of granulopoiesis

CFU-GM Myeloblast (4:1) Promyelocyte (3:1) Myelocyte (1:1) Metamyelocyte (no mitosis, WBC in BM) Band (in PBS, resemble pelger-huet) ---------------------------------- Neutrophil Eosinophil Basophil

Colors of granulocytic myelocytes (earliest recognizable) Neutrophil myelocyte

Rose pink graules

Colors of granulocytic myelocytes (earliest recognizable) Eosinophil myelocyte

Orange-red granules

Colors of granulocytic myelocytes (earliest recognizable) Basophil myelocyte

dark purple

sequence of monopoiesis

monoblast promonocyte monocyte

sequence of lymphopoiesis

lymphoblast prolymphocyte lymphocyte

Largest cell in Peripheral Blood

Monocyte

Life span of T lymphocyte

4-10 yrs

Life span of B lymphocyte

3-4 days

Sequence of Thrombopoiesis

Megakaryoblast (10:1) Promegakaryocyte (4:1 to 7:1) Granular and mature megakaryocyte (<1:1) Metamegakaryocyte Platelet/Thrombocyte (8-11 days)

Largest cell in BM

Megakaryocyte

Major pathway in glycolysis

Embden-Meyerhoff pathway (Anaerobic glycolysis)

3 types of glycolysis diversion pathways (shunts)

Hexose monophosphate shunt Rapoport-Luebering pathway Methemoglobin reductase pathway

It is the removal of inclusion by the spleen

Pitting

It is the removal of senescent/aged RBCs by the spleen

Culling

Associated anemia in normo-normo (AHA)

Acute blood loss Hemolytic anemia Aplastic anemia

Associated anemia in micro-hypo (CCITS)

Chronic blood loss Chronic disease Iron Deficiency Anemia Thalassemia Sideroblastic anemia

Associated anemia in macro-normo (MN)

Megaloblastic anemia (B12/folate def) Nonmegaloblastic anemia (Liver disease, alcoholism)

Congenital aplastic anemia

Fanconi's anemia/syndrome

Acquired aplastic anemia

Radiation, chemicals, drugs

↓WBCs ↓RBCs ↓Retics ↓Plts

Pancytopenia

It differentiates Iron Deficiency Anemia from other micro-hypo anemia

TIBC (Total Iron Binding Capacity) high in IDA

GRADING: Area of palor is 1/2 of cell diameter

GRADING: Area of palor is 2/3 of cell diameter

GRADING: Area of palor is 3/4 of cell diameter

GRADING: Area of palor is a thin rim of Hbg

Inclusions in megaloblastic anemia

Oval macrocytes Howell-jolly bodies Hypersegmented neutrophils Ineffective erythropoiesis

Microscopic: RBCs gray (or blue) WBC too dark Eosinophil: Gray

Stains/buffers too basic (most common) Inadequate Rinsing Heparinized blood specimen

STAINING: Microscopic: RBCs too pale (red) WBC barely visible

Too acidic stain (mc) Over rinsing Inadequate buffering

Red cell grading of positive and negative

Sickle cell Basophilic stippling Pappenheimer Howell-jolly

examples of myeloproliferative disorder

Chronic myelogous leukemia (CML) Myelofibrosis Polycythemia vera Essential thrombocythemia

Number of WBC in peripheral blood? Leukemic leukemia

> 15,000 WBC/uL

no. of WBC in peripheral blood? Subleukemic leukemia

<15,000 WBC/uL with immature cells

no. of WBC in peripheral blood? Aleukemic leukemia

<15,000 WBC/uL without immature cells

+AML , -ALL

Myeloperoxiase and Sudan Black

-AML, +AML (marker for immature lymphocyte)

Terminal Deoxyribonucleotidyl Transferase

Normal All blood cells except erythroblast (PAS +)

Periodic Acid-Schiff Stain

+Granulocyte, - Monocyte

Naphthol AS-D Chloroacetate Esterase

-Granulocyte, +Monocyte

Alpha-Naphthyl Acetate Esterase

+Hairy cell leukemia and T cell Leukemia, - non T cell Leukemia

Acid Phosphatase (Tartrate Resistant AP)

Basophils and mast cells recognition

Toluidine Blue

HEMATOLOGY must memorize Flashcards

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