Western Lab Quiz 2 Flashcards
1
Q
- High Density lipoproteins (HDL)…
Select one:
A. are found mainly in animal and vegetable fats that are solid at room temperature.
B. deliver cholesterol to cells throughout the body.
C. return cholesterol to the liver, where it is converted into bile salts for elimination.
D. regulates the body’s production of cholesterol based on the amount of saturated fat that is consumed.
A
- C
2
Q
2. What lab value should be monitored in a patient with thrombophlebitis who is undergoing treatment with oral anticoagulant therapy with warfarin (Coumadin)? Select one: A. PTT/aPTT B. Hemoglobin (Hgb) C. platelet count D. Hematocrit (Hct) E. PT/INR
A
- E
Partial thromboplastin time (PTT) is a blood test that looks at how long it takes for blood to clot. It can help tell if you have a bleeding problem or if your blood does not clot properly. Aka: aPTT Activated partial thromboplastin time
Prothrombin time (PT) is a blood test that measures the time it takes for the liquid portion (plasma) of your blood to clot. Formal name: Prothrombin Time and International Normalized Ratio
3
Q
- The physician orders blood coagulation tests to evaluate a patient’s blood-clotting ability. Which test is used to determine a patient’s response to heparin therapy?
Select one:
A. Partial thromboplastin time (PTT/aPTT)
B. Platelet count
C. Bleeding time (BT)
D. Prothrombin time (PT)
A
- A
Heparin is used to prevent blood clots from forming in people who have certain medical conditions or who are undergoing certain medical procedures that increase the chance that clots will form.
Partial thromboplastin time (PTT) is a blood test that looks at how long it takes for blood to clot. It can help tell if you have a bleeding problem or if your blood does not clot properly. Aka: aPTT Activated partial thromboplastin time
4
Q
- A 23-year-old female aeronautical engineer complains of a rash on her ankles and shins, and easy bruising for 10 days. The rash is not itchy or painful. She denies recent contact with new soaps or detergents. The bruises occur on her arms and sides, unrelated to trauma.
On further questioning, she reports nosebleeds, gum bleeding with flossing, and an unusually heavy menses two weeks ago. On physical exam, she has no lymphadenopathy or hepatosplenomegaly. Her stool is Guaiac positive. This is a close up of her rash:
The physician ordered CBC, Peripheral blood smear and PT, aPTT. The results are as following:
CBC:
Patient; Normal
WBC (x 103/ml): 6.0; 4.3-10
Hemoglobin (gm/dl): 13.1; 12-16
Hematocrit (%): 39; 38-50
RBC (x 106/ml): 4.7; 4.2-5.4
MCV (fL): 86; 78-96 (Mean Cell Volume) average RBC
Platelet Count (x 103/ml): 3; 150-450
MPV (fl): 14; 7.2-11.1 (Mean Platelet Volume)
Peripheral Blood Smear: Remarkable for low count of platelets, slightly increased in size indicating quick turnover in bone marrow. MPV is the average volume of platelets and is measured in fL (femtoliters).
PT = 11.6 seconds (normal 10.4 - 12.8 seconds)
aPTT = 32 seconds (normal 24 - 34 seconds)
What is the likely diagnosis?
Select one:
A. Systemic lupus erythematosus (SLE-autoimmune disorder of connective tissue)
B. Hepatitis (inflammation of liver)
C. Aplastic anemia (anemia due to bone marrow failure)
D. Acute leukemia (malignant increase of white blood cells)
E. Autoimmune thrombocytopenia
A
- E
Thrombocytopenia is any disorder in which there is an abnormally low amount of platelets. Platelets are parts of the blood that help blood to clot. This condition is sometimes associated with abnormal bleeding.
5
Q
5. This cell fights against infection and is a/an: picture missing Select one: A. Neutrophil B. Monocyte C. Lymphocyte D. Eosinophil E. Basophil
A
- A
Basophils: Make heparin and histamine (two lobe segments, stain blue)
Eosinophils: Phagocytes for allergens (two lobe segments, stain red)
Neutrophils: Phagocytes that accumulate at site of infection (three segment lobes)
BEN, these WBC are granulocyte which have secretory granules in its cytoplasm. aka polymorphonuclear leukocytes (varying shapes of the nucleus, usually lobed into two or three segments
Lymphocytes: Make antibodies
Monocytes: Phagocytes that ingest debris and bacteria (one large nucleus)
LM, these WBC are Agranulocytes (mononuclear)
6
Q
6. A person with a hematocrit of 66 and hemoglobin of 22 is most likely to have the condition named: Select one: A. Polycythemia B. Anemia C. Infectious mononucleosis D. Leukemia
A
- A
Polycythemia: Abnormal increase in RBC count
Anemia: 10% or more decrease in RBC count
Infectious mononucleosis, or “mono”, is an infection usually caused by the Epstein-Barr virus. The virus spreads through saliva, which is why it’s sometimes called “kissing disease.” Mono occurs most often in teens and young adults.
Leukemia: Bone marrow is replaced by neoplastic tissue. Leukemia is cancer of the white blood cells. White blood cells help your body fight infection. Your blood cells form in your bone marrow. In leukemia, the bone marrow produces abnormal white blood cells. These cells crowd out the healthy blood cells, making it hard for blood to do its work (too many leucocytes accumulated in the body)
Hematocrit Hct: % of RBC in total volume of blood. Example: Normal 45%, Anemia 30%, Polycythemia 70%
Dehydration: plasma & Erythrocytes total is not full & hematocrit is at 70% of 3/4 full test sample
7
Q
- A 50-year-old white female seeks medical attention for easy fatigability that developed during the last 2 months. She also feels mildly short of breath with exertion such as walking up a flight of stairs, but she has no chest pain with exertion or at rest. She gives no history of bright red blood per rectum or black, tarry stools (melena), but she has had heavy menstrual periods for about a year. Her past medical history is relevant for anemia following her second pregnancy 8 years ago. She is on no prescribed medications. Family history is noncontributory.
Relevant physical examination was remarkable for pale conjunctiva. Rectal examination revealed no masses and heme negative brown stool was present.
Interpret her labs and select theright answer:
CBC; Patient Result; Normal Range
WBC: 8.2 X 103/μL; (4.8-10.8 X 103/μL)
Hgb: 8.0 g/dL; (12-15.6 g/dL)
Hct: 24%; (35-46%)
RBC: 4.0 X 106/μL; (3.8-5 X 106/μL)
MCV: 60 fL; (80-96.1 fL) Mean corpuscular volume
MCH: 20 pg; (27.5-33.2 pg) Mean corpuscular hemoglobin
MCHC: 33 g/L; (33.4-35.5 g/L) Mean corpuscular hemoglobin concentration
RDW: 16.5; (11.5-14.5) Red cell distribution width
Platelets: 500,000/μL; (150-400,000/μL)
Reticulocyte count: 3%; (0.5-1.7%). Reticulocytes are slightly immature red blood cells. A reticulocyte count is a blood test that measures the amount of these cells in the blood.
Select one:
A. Hemolytic anemia (short life span of RBCs)
B. Megaloblastic anemia (RBCs are large)
C. The platelet count is suggestive of a myeloproliferative disorder (overactive bone marrow).
D. Hypochromic, microcytic anemia with anisocytosis.
A
- D
Decrease in MCHC is known as hypochromic (think “less color” because of less hemoglobin) anemia. This is seen in iron-deficiency anemia and thalassemia.
Thalassemia: inherited blood disorders. If you have one, your body makes fewer healthy red blood cells and less hemoglobin. Hemoglobin is a protein that carries oxygen to the body. That leads to anemia. Thalassemias occur most often among people of Italian, Greek, Middle Eastern, Southern Asian, and African descent.
8
Q
8. A hematocrit value is normally about \_\_\_\_\_\_\_\_\_\_\_ the value of the hemoglobin. Select one: A. Three times B. One-third C. 700 times D. The same
A
- A
Hematocrit is the % of RBC in total volume of blood. Male 42-52%, Female 37-47%
Test tube is composed of (Plasma, leukocytes, platelets, erythrocytes). 45% (plasma), 55% (erythrocytes 44%, leukocytes, platelets 1%)
