Hemotology-Anatomy

Question 1

A girl presents with anaphylaxis after ingesting peanut butter. What substances are released when mast cells degranulate?

Answer 1

Histamine, heparin, eosinophilic chemotactic factors

Question 2

How would you describe a smear that shows (A) an increased number of RBCs and (B) numerous immature RBCSs.

Answer 2

Smear shows (A) erythrocytosis/polycythemia (increased number of cells) and (B) reticulocytosis (increased immature cells/proliferation)

Question 3

A patient presents with sore throat, fever, and lymphadenopathy. Labs reveal an increase in neutrophil count. What does this reflect?

Answer 3

Bacterial infection causes an increase in neutrophils

Question 4

Name the three types of mature cells into which T cells differentiate.

Answer 4

Cytotoxic T cells, helper T cells, and regulatory T cells

Question 5

Granulocytes and mononuclear cells are what kind of blood cells?

Answer 5

Leukocytes (leuk = white and cyte = cell)

Question 6

You note that a patient’s bone marrow shows a monoclonal proliferation of plasma cells. What is the diagnosis?

Answer 6

Multiple myeloma

Question 7

What are the three types of lymphocytes?

Answer 7

B and T cells. which mediate adaptive immunity, and NK cells. which are part of the innate immune response

Question 8

What are dendritic cells in the skin called?

Answer 8

Langerhans cells

Question 9

B lymphocytes are part of the ____ (cell-mediated/humoral) immune response.

Answer 9

Humoral

Question 10

A patient is noted to have an increased amount of basophils on blood smear. What is a diagnosis to consider?

Answer 10

Myeloproliferative disease, especially CML (basophils also mediate allergic reactions—isolated basophilia is uncommon)

Question 11

A man comes to the ED with a head laceration. What role do platelets play immediately after an injury like this?

Answer 11

A man comes to the ED with a head laceration. What role do platelets play immediately after an injury like this?

Question 12

Name three types of granulocytes.

Answer 12

Basophils, eosinophils, and neutrophils

Question 13

Eosinophils are phagocytic cells, particularly in the presence of what?

Answer 13

Antigen-antibody complexes

Question 14

Which cytokine causes activation of macrophages?

Answer 14

γ-interferon

Question 15

Which major histocompatibility complex and CD molecules are expressed by cytotoxic T cells?

Answer 15

Major histocompatibility complex I and CD8 (MHC × CD = 8, and MHC I × CD8 = 8)

Question 16

Would you expect to find monocytes in a tissue biopsy?

Answer 16

No (monocytes are found in the blood, not the tissue [when they enter tissue, they differentiate into macrophages])

Question 17

After maturation, where do B lymphocytes migrate to from the bone marrow?

Answer 17

Peripheral lymphoid tissue (lymph node follicles, white pulp of spleen, other unencapsulated lymphoid tissue)

Question 18

____ cells produce a large amount of antibodies that are specific for an antigen.

Answer 18

Plasma

Question 19

Name two types of mononuclear cells.

Answer 19

Lymphocytes and monocytes

Question 20

What medication could prevent exacerbation of asthma (by preventing the release of inflammatory compounds from mast cells)?

Answer 20

Cromolyn sodium, which stabilizes mast cell membranes and prevents degranulation

Question 21

Monocytes differentiate into ____ in tissues.

Answer 21

Macrophages

Question 22

What two types of granules do platelets contain?

Answer 22

Dense granules and α granules

Question 23

What molecule do erythrocytes depend on exclusively for energy?

Answer 23

Glucose, with 90% used in glycolysis and remaining 10% in HMP shunt

Question 24

Which major histocompatibility complex and CD molecules are expressed by helper T cells?

Answer 24

Major histocompatibility complex II and CD4 (MHC × CD = 8, and MHC II × CD4 = 8)

Question 25

Under the microscope, you note a neutrophil with several granules. What organelle are you looking at?

Answer 25

Lysosome

Question 26

How do eosinophils and mast cells interact during an allergic reaction?

Answer 26

Eosinophils produce histaminase and arylsulfatase to limit the inflammatory reaction from mast cell degranulation

Question 27

What is the origin of the word monocyte?

Answer 27

Mono = one (nucleus); cyte = cell

Question 28

What role does the erythrocyte play in acid-base physiology?

Answer 28

Erythrocytes carry carbon dioxide from the periphery to the lungs for elimination

Question 29

T lymphocytes mediate the ____ (cellular/humoral) immune response.

Answer 29

Cellular

Question 30

What are the contents of small granules in neutrophils?

Answer 30

ALP, collagenase, lysozyme, lactoferrin

Question 31

What is the response of a B cell after encountering an antigen?

Answer 31

B cells differentiate into plasma cells and secrete antibodies and memory cells

Question 32

Macrophages can be identified by labeling \_\_\_\_, a cell surface marker.

Answer 32

CD14

Question 33

What are the contents of the dense granules of platelets?

Answer 33

Adenosine diphosphate, calcium

Question 34

What is the main function of leukocytes?

Answer 34

To defend against infection

Question 35

Mast cells are involved in type ____ (I/II/III/IV) hypersensitivity reactions.

Answer 35

I (mast cells mediate allergic reactions in local tissues)

Question 36

A boy presents with an itchy butt. What type of white blood cells will defend the boy against the infection he likely has?

Answer 36

Eosinophils, which defend against helminthic infections, such as pinworm

Question 37

How do erythrocytes facilitate transport of carbon dioxide away from the peripheral tissues?

Answer 37

Membrane has chloride-bicarbonate antiport allowing bicarbonate export from RBCs & transport of CO2 to the lungs for elimination

Question 38

What roles do macrophages have?

Answer 38

Phagocytose bacteria, cellular debris, and senescent RBCs, and scavenge damaged cells and tissue

Question 39

What costimulatory molecule present on B cells is required to activate T cells?

Answer 39

CD28

Question 40

What are the contents of the α granules of platelets?

Answer 40

Von Willebrand factor, fibrinogen

Question 41

Mast cells resemble ____ structurally and functionally.

Answer 41

Basophils

Question 42

What major histocompatibility complex do B cells possess on the cell surface?

Answer 42

Major histocompatibility complex II, which allows B cells to act as antigen-presenting cells

Question 43

What are the contents of the large granules in neutrophils?

Answer 43

Proteinases, acid phosphatase, myeloperoxidase, β-glucuronidase

Question 44

How many leukocytes are normally found per cubic milliliter (cells/mm3) of blood?

Answer 44

4000 to 10,000 cells/mm3

Question 45

Name five diagnoses to consider in a patient discovered to have eosinophilia.

Answer 45

Neoplasm, asthma, allergic reaction, collagen vascular disease, parasites (NAACP)

Question 46

From highest to lowest, how would you rank the following according to percent: basophils, eosinophils, lymphocytes, monocytes, neutrophils

Answer 46

Granulocytes = basophils, eosinophils, and neutrophils, and mononuclear cells = lymphocytes and monocytes

Question 47

A patient's blood smear shows numerous cells w/bilobate nucleus and large eosinophilic uniform-sized granules. What do you consider?

Answer 47

Eosinophilia in neoplasm, asthma, allergic reaction, collagen vascular disease, parasites (NAACP)

Question 48

What is the predominant type of lymphocyte found in the circulation?

Answer 48

T cells, which make up approximately 80% of circulating lymphocytes

Question 49

How would you describe a peripheral blood smear showing red blood cells of varying sizes and shapes?

Answer 49

Smear exhibits anisocytosis (varying sizes) and poikilocytosis (varying shapes)

Question 50

Small granules are ____ (more/less) numerous in neutrophils

Answer 50

More

Question 51

Patients with TB and sarcoidosis have granulomas. What is an important component to its formation?

Answer 51

Macrophages

Question 52

Where in the body would you typically find the most platelets at any one time (and about what fraction)?

Answer 52

Approximately one third of the platelet pool is stored in the spleen

Question 53

What is the root of the word eosinophil?

Answer 53

Eosin= a dye, philic= loving

Question 54

A peripheral blood smear shows multiple neutrophils with nuclei of six, seven, and even eight lobes. What lab tests are needed?

Answer 54

Vitamin B12 and folate tests (hypersegmented polys [neutrophils] are present in deficiencies of either vitamin)

Question 55

A woman taking aspirin is undergoing surgery. How long before surgery must she discontinue aspirin?

Answer 55

At least 8–10 days before surgery (this is the lifespan of a platelet)

Question 56

In a test, you separate granulocytes from mononuclear cells and study the cell groups separately. What cell types are found in each group?

Answer 56

Granulocytes = basophils, eosinophils, and neutrophils, and mononuclear cells = lymphocytes and monocytes

Question 57

The life span of an erythrocyte is ____ days.

Answer 57

120

Question 58

What is the root of the word macrophage?

Answer 58

Macro= large; phage= eater

Question 59

A patient with sarcoidosis is found to have numerous granulomas on bronchoscopy. Which type of leukocyte is important to its formation?

Answer 59

Macrophages are important in granuloma formation

Question 60

Erythrocytes are ____ (nucleated/anucleated).

Answer 60

Anucleated

Question 61

A patient with HIV wants to be treated. What is the primary target of HIV?

Answer 61

CD4+ helper T cells

Question 62

A 78-year-old woman has depression, weakness, and leg paresthesia. Blood smear shows hypersegmented polys. What is a possible diagnosis?

Answer 62

Vitamin B12 deficiency (folate deficiency can cause similar symptoms, but only B12 causes neurologic symptoms)

Question 63

On the skin of a patient, you see small red lesions that do not blanch with pressure. Name two possible etiologies of these lesions.

Answer 63

These are petechiae, which can be caused by a low platelet count (thrombocytopenia) or dysfunctional platelets

Question 64

A 65-year-old woman with CML has blood drawn. What would you expect on the reports?

Answer 64

High number of band cells (immature PMNs), which reflects increased myeloid proliferation

Question 65

In primary hemostasis, von Willebrand factor must be released and bind to what erythrocyte receptor?

Answer 65

Glycoprotein Ib

Question 66

What do small granules in neutrophils contain vs. larger granules?

Answer 66

Small granules = ALP, collagenase, lysozyme, lactoferrin, & large granules = proteinase, acid phosphatase, myeloperoxidase, β-glucuronidase

Question 67

In the formation of a stable thrombus, fibrinogen binds platelets together via what receptor?

Answer 67

Glycoprotein IIb/IIIa