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MLT Ch. 2 Hematology
Flashcards made directly from the Success! in Clinical Laboratory Science book
| Question | Answer |
|---|---|
| What is the first type of cell produced by the developing embryo? | Erythrocyte |
| What percentage of tissue located in the bone marrow cavities of adults is fat? | 50% |
| What kind of stem cells possess self-renewal ability, produce progenitor cells committed to a single cell lineage, and are morphologically unrecognizable/ | pluripotent hematopoietic stem cells |
| In an adult, what are the two best areas for obtaining active bone marrow by aspiration? | posterior iliac crest, and sternum |
| What is the normal ratio of myeloid to erythroid precursors in the bone marrow (M:E ratio)? | 4:1 |
| The following accurately describes what growth factors: Bind to target cell receptors to express activity, May promote or suppress cell death, and can stimulate or inhibit cell proliferation? | hematopoietic growth factors |
| In the third month of gestation what is the primary site of hematopoiesis? | Liver |
| The mechanism that relays information about tissue oxygen levels to erythropoietin-producing sites is located in the | kidney |
| Antigen-independent lymphopoiesis occurs in primary lymphoid tissue located in the | thymus and bone marrow |
| Programmed cell death is called | apoptosis |
| in what area of the bone arrow does hematopoiesis take place? | cords |
| bone marrow cellularity refers to the ratio of | hematopoietic tissue to adipose tissue |
| interleukins and colony stimulating factors are cytokines produced by | monocytes and T lymphocytes |
| What is the approximate total blood volume in an adult? | 6L |
| The myeloid progenitor cell can produce cells committed to | granulocytic, erythrocytic, monocytic, or megakaryocytic lineages |
| The largest hematopoietic cells in normal bone marrow are the | megakaryocytes |
| As most blood cell lines mature, what would be one of the characteristics? | nucleus to cytoplasm ratio (N:C) decreases |
| What describes thrombopoietin (TPO) | It is a hormone produced by the liver that stimulates megakaryopoeisis |
| when the hepatic phase of fetal life is reactivated in an adult, hematopoiesis can be termed | myeloid metaplasia or extramedullary |
| what is the average lifespan of a red blood cell? | 120 days |
| the Na+ -K+ cation pump is an important mechanism in keeping the red blood cell intact. its function is to maintain a high level of | intracellular K+ |
| what is the structure of the hemoglobin molecule? | four heme groups four globin chains |
| what is the process known as culling? | removal of abnormal red cells by the spleen |
| hemoglobin forms that are incapable of oxygen transport include | carboxyhemoglobin and methemoglobin |
| the majority of iron found in an adult is a constituent of | hemoglobin |
| a senescent red blood cell is one that has | lived its life span |
| what red cell morphologic abnormality is described by the term poikilocytosis | deviations from the normal shape |
| Howell-Jolly bodies are composed of | DNA |
| when spherocytes are reported, what is observed on the peripheral blood smear? | RBCs without central pallor |
| red cells found in lead poisoning characteristically exhibit coarse granules composed of ---?--- that are reported as ---?--- | aggregated ribosomes; basophilic stippling |
| rouleaux of red blood cells when seen in the monolayer of a blood smear is characteristic of | multiple myeloma |
| What is true about iron absorption regarding erythropoietic activity? | absorption increases when erythropoietic activity increases |
| what term describes a mature red blood cell that contains iron granules or deposits? | siderocyte |
| What is one of the reasons you can have a "shift to the left" in the oxygen dissociation curve of hemoglobin | decreased oxygen release |
| What are some of the things that characterize erythropoietin (EPO)? | It transforms the CFU-E into the earliest recognizable RBC precursor, it increases the rate of red blood cell production by the bone marrow, and it shortens the maturation time of developing erythroid precursors |
| what is one factor that will result in an immediate increase in oxygen delivery to the tissues? | increased hemoglobin binding of 2,3-BPG |
| periods of intense erythropoietin activity cause premature release of marrow reticulocytes into the blood, what is true about these early reticulocytes? | they circulate longer than usual before reaching maturity, they may be termed shift or stress reticulocytes, and they may show diffuse basophilia with Wright's stain |
| Which of the following inclusions is only visible with supravital staining? | heinz bodies |
| the presence of schistocytes on the peripheral blood smear is commonly associated with | increased red cell destruction |
| what may be a sign of accelerated bone marrow erythropoiesis | nucleated red cells in the peripheral circulation |
| microcytic, hypochromic red cells are most often associated with impaired | hemoglobin synthesis |
| when acanthocytes are found on the blood smear, it is usually the result of | altered membrane lipids |
| which erythrocyte metabolic pathway generates adenosine triphosphate (ATP) via glycolosis | Embden-Meyerhof |
| what red blood cell precursor is the last stage to undergo mitosis | polychromatophilic normoblast |
| the major adult hemoglobin requires the synthesis of alpha-globin chains and | beta-globin chains |
| defective nuclear maturation commonly results in the production of red cells that are | macrocytic |
| the major storage form of iron is | ferritin |
| excessive extravascular red cell destruction is associated with | bilirubinemia |
| which protein is primarily responsible for transport of hemoglobin dimers resulting from intravascular hemolysis | haptoglobin |
| the morphologic abnormality characteristically found in hemoglobinopathies is | codocytes |
| where do the early and late stages of heme synthesis occur | in mitochondria |
| spectrin is a protein that occupies a major role in | red cell membrane structure |
| what is the function of reduced glutathione (GSH) in the red blood cell | neutralizes intracellular oxidants that accumulate |
| what does measuring the total iron binding capacity (TIBC) represent? | amount of iron that transferrin can bind |
| serum ferritin is a good indicator of the amount of | storage iron |
| fetal hemoglobin differs from adult hemoglobin in that hemoglobin F | resists elution from red cells with acid solutions |
| impaired DNA metabolism is a characteristic of | megaloblastic anemia |
| what is associated with glucose-6-phosphate dehydrogenase (G6PD) deficiency? | G6PD gene is located on the X chromosome |
| what are some facts about variant hemoglobin E, alpha2beta2 26 Glu->Lys? | there are two small alpha chains, Hemoglobin E is the second most common hemoglobin variant known, and glutamic acid is normally found at position 26 of the beta chain |
| pica is most commonly associated with what condition? | iron deficiency |
| The leading cause of folate deficiency is | dietary insufficiency |
| What are some facts about sickle cell syndromes? | apslenism may result from repeated sickling crises in the homozygous state, heterozygous persons may be partly protected from infection by falciparum malaria, and trait conditions are generally asymptomatic with no sickle cell formation |
| shistocytes can be found in patients with microangiopathic hemolytic anemia (MAHA) what conditions could be responsible for this type of red cell destruction? | Disseminated intravascular coagulation (DIC), Hemolytic uremic syndrome (HUS), Thrombotic thrombocytopenic purpura (TTP) |
| What are some blood findings that would correlate with the presence of ringed sideroblasts in the bone marrow? | pappenheimer bodies, basophilic stippling, and increased percent transferrin saturation |
| what is usually associated with marked reticulocytosis? | four days after a major hemorrhage, drug-induced autoimmune hemolytic anemia, sickle cell anema |
| hereditary stomatocytosis is manifested physiologically by changes in | membrane cation permeability |
| in addition to an increase in red blood cells what would be a characteristic of polycythemia vera? | increased platelets, increased granulocytes, increased erythropoietin level |
| what are some characteristics of aplastic anemia? | bone marrow hypoplasia, absolute reticulocytopenia, blood findings of pancytopenia |
| what values would you expect to obtain on hemoglobin and hematocrit determinations done immediately after a major hemorrhage, if hemoglobin and hematocrit vanlues were normal prior to the hemorrhage? | both normal |
| results from a 1-day-old infant include a hemoglobin of 20.1g/dL, a hematocrit of 60%, MCV of 110.2fL, and 4 nucleated red cells/100 WBCs. How should these results be interpreted? | no further testing is indicated |
| red blood cells with a single elongated projection are known as---?--- and may be seen in ---?--- | dacryocytes;myelofibrosis |
| a patient with nomocytic, normochromic anemia secondary to small cell carcinoma may be exhibiting an anemia designated as | myelophthisic |
| idopathic aplatic anemia is best defined as a form of anemia that | has no identifiable cause |
| What is the name of one of the true red blood cell aplasias? | Damond-Blackfan anemia |
| what are some of the causes of absolute secondary erythrocytosis? | defective cardiac or pulonary function, high-altitude adjustment, hemoglobins with increased oxygen affinity |
| a cellulose acetate hemoglobin electrophoresis (alkaline pH), performed on the blood of a stillborn infant, revealed a single band that migrated farther toward the anode that did the Hb A control. what is the most likely composition of the hemoglobin? | four gamma chains |
| the most likely cause of a stillbirth with four gamma chains is | hydrops fetalis |
| what two conditions shows similar cbc and blood smear findings? | folic acid and vitamin B12 deficiencies |
| what are some conditions associated with the presence of schistocytes and spherocytes? | clostridial septicemia, prosthetic heart valves, and severe thermal burns |
| a 30 year old woman who has been vomiting for 3 days has a hemoglobin of 19 g/dL, and a hematocrit of 54%. her results suggest the presence of | relative polycythemia |
| an excessive accumulation of iron in body tissues is called | hemochromatosis |
| abetalipoproteinemia is characterized by mild anemia and numerous ---?--- on the peripheral blood smear | acanthocytes |
| what is the most common cause of iron deficiency | bleeding |
| what are some characteristics of beta-thalassemia major? | transfusion-dependent anemis, iron chelation therapy is necessary, common in persons of Mediterranean ancestry |
| in the anemia of chronic disease, what are the usual serum iron and transferrin levels? | serum iron decreased, transferrin decreased |
| in children the most important effect of lead poisoning is on the | neurological system |
| on what is the classification of sickle cell trait versus sickle cell disease based? | percentage of hemoglobin S on electrophoresis |
| which of the following is the most appropriate treatment for sickle cell anemia? hydroxyurea, supportive therapy, hyperbaric oxygen, or iron | supportive therapy |
| which of the values can be used to indicate the presence of a hemolytic anemia? hemoglobin level, hematocrit level, erythrocyte count. retociulocyte count. | reticulocyte count |
| a pre-operative 20 year old female has mild microcytic anemia, with target cells and stippled red cells observed on the blood smear, her hemoglobin A2 level is quantified at 5%, what do these findings suggest? | heterozygous beta-thalassemia |
| what causes the hemolytic process in glucose-6-dehydrogenase deficiency following oxidant exposure | precipitation of denatured hemoglobin |
| in clinically severe hereditary spherocytosis what might be found post-spenectomy | rise in thr red cell count and hemoglobin level, increased number of Howell-Jolly bodies, transient elevation in the platelet count |
| what laboratory results would be consistent with accelerated red cell destruction | increased serum bilirubin, increased plasma hemoglobin, increased serum lactate dehydrogenase (LD) |
| acquired hemolytic anemias are usually due to | extracorpuscular factors |
| the antibody associated with paroxysmal cold hemoglobinuria shows specificity for | P antigens |
| a 69 year old male is admitted with pallor, mild tachycardia, and difficulty walking because of numbness in the extremities. CBC shows; hemoglobin 7.8 g/dL, MCV 118.5 fL. Differential shows hypersegmented neutrophils. the findings are most suggestive of | anemia due to the lack of Vitamin B12 |
| a clinical laboratory scientist examined a Wright's stained smear and saw what appeared to be small, dark-staining granules in the mature erythrocyes. A second smear was stained with Prussian blue and was positive - what would you expect to be abnormal? | serum ferritin level |
| hemoglobinopathies are characterized by | production of structurally abnormal hemoglobin variants |
| Membrane loss and red cell trapping occur in the splenic microcirculation in hereditary ---?--- | spherocytosis |
| A characteristic oval shape occurs in the mature erythrocytes in hereditary ---?--- | elliptocytosis |
| What are some disorders commonly linked to the development of anemia of chronic disease | persistent infections, noninfectious inflammatory disorders, malignancy |
| What are some characteristics about hemoglobin C disease? | Tharget cells are frequently seen on the peripheral smears, red cells may contain bar-shaped intracellular crystals, the disorder is less severe than sickle cell disease |
| Increased sickling that occludes the vessels is associated with what kind of red blood cells? | sickle cells |
| a bone marrow M:E ratio of 4:1 would be an expected finding for | Aplastic anemia |
| an elderly man with a 10 year hx of CLL presented with jaundice and fatigue that attributed to a recent 3 gram drop in his hB. Many spherocytes and polychromatophillic RBCs were found on his Wright's smear, what type of immune hemolytic anemia is likely | secondary warm autoimmune hemolytic anemia |
| a moderately anemic patient with suspected pernicious anemia (PA) shows intrinsic factor antibodies and a low cobalamin level. what diagnosis would support this diagnosis? | Gastric atrophy and achlorhydria, oval macrocytes and Howell-Jolly bodies, and elevated serum lactate dehydrogenase (LD) and bilirubin |
| a cellulose acetate electrophoresis revealed a large band of hemoglobin in the hemoglobin S position. This band is quantified at 95%. The peripheral smear revealed 70% target cells, and the solubility test was neg. Based on this, what is the hemoglobin? | Hemoglobin D |
| A previously healthy man experiences weakness and hemoglobinuria after taking the antimalarial agent primaquine. This hemolytic attack most likely occurred because of a deficiency of | Glucose-6-phosphate dehydrogenase |
| What condition is an acquired red cell membrane defect that results in increased sensitivity to complement binding | paroxysmal nocturnal hemoglobinuria |
| Lead intoxication, isoniazid treatment for tuberculosis, and acute alcohol ingestion are associated with what acquired reversible anemia | sideroblastic anemia |
| What statements relate to relative anemia of pregnancy | it is normocytic and normochromic, it does not produce an oxygen deficit for the fetus, and it is associated with an increase in plasma volume |
| the anemia found in chronic renal failure is most likely caused by | loss of erythopoietin synthesis |
| What are some characteristics about aplastic anemia | it is a stem cell, disorder, there is a risk of life-threatening infection, there are frequent bleeding complications |
| The fish tapeworm Diphylobothrium latum is associated with the development of | macrocytic anemia |
| an increase in erythropoietin is not a normal compensating mechanism in what condition | renal tumors |
| Thalassemias are the result of a | Quantitative defect in globin-chain synthesis |
| what are characteristics of iron-deficiency anemia | increased serum transferrin, decreased transferrin saturation, decreased ferritin |
| clinical manifestations of a homozygous mutation involving the beta-globin gene will most likely appear | by 6 months of age |
| the hemolysis associated with infection by malaria organisms is due to the | release of merozoites from erythrocytes |
| a tech received a 5 mL EDTA tube that contained a 0.5mL of anticoagulated blood. A smear was made with Wright's stain. when viewed the majority of cells appeared to have evenly distributed, blunt spicules on the surface. what is the interpretation? | crenated cells caused by the incorrect blood to anticoagulant ratio |
| when iron use exceeds absorption, what then happens first? | iron stores are depleted |
| the major mechanism responsible for the anemia of chronic disease is | impaired release of storage iron |
| What are some characteristics of the idiopathic type of sideroblastic anemia | it is refractory to treatment, the blocks in heme synthesis are unknown, it is a subtype of myelodysplastic syndromes |
| thinning of bones and deformation of facial bone structure seen in homozygous beta-thalassemia is a | result of hyperplastic marrow activity |
| what accurately describes cold autoimmune hemolytic anemia? | red cell agglutination in extremities induces Reynaud's phenomenon, it may occur secondary to Mycoplasma pneumonia, hemolysis is complement-mediated or via removal of coated cells |
| what anemia would have a high red cell distribution width (RDW) | sickle cell disease during crisis |
| What disorders would splenomegaly be a common finding | homozygous beta-thalassemia, hereditary spherocytosis, hemoglobin SC disease |
| functionally white blood cells are divided into | phagocytes, and immunocytes |
| what is the largest white blood cell normally found in the peripheral blood? | monocyte |
| what is the approximate amount of time a granulocyte spends in the circulation before migrating into the tissues | less than a day |
| what percentage of neutrophils in the peripheral blood constitutes the circulating pool | 50% |
| what is the major phagocytic cell involved in the initial defense against bacterial pathogens | neutrophil |
| what is the growth factor that is primarily responsible for regulating granulocyte and monocyte production | colony stimulating factor |
| what does the granulocyte mitotic pool in the bone marrow contain | myeloblasts and promyelocytes |
| a "shift to the left" when used to describe a cell population refers to | increased cells in the blood due to a redistribution of blood pools |
| what is a characteristic of agranulocytosis | decreased numbers of granulocytes |
| what are some characteristics of T lymphocytes | they secrete cytokines, the comprise majority of cells in the blood lymphocyte pool, they regulate the immune response |
| an adult has a total WBC count of 4.0x10^9/L. the differential count is as follows; neutrophils - 25%, bands 5%, lymphs 65%, and monocytes 5%. The absolute value reference range for lymphocytes 1.0-4.0x10^9/L. What is the determination for lymphocytes | there is a relative lymphocytosis |
| True or False, Auer rods are composed of fused primary granules | true |
| what factors can be associated with variations in the total white blood cell count? | age, exercise, and emotional stress |
| Would an absolute neutrophil count of 1.0x10^9/L be associated with risk of infection? | yes, neutropenia is associated with a risk of infection. the degree of neutropenia correlates with the infection risk from high susceptibility(<1.0x10^9/L) to great risk (<0.5x10^9/L). infection increases with the degree and duration of the neutropenia |
| What are some characteristics of basophils | morphologically, basophils resemble tissue mast cells; basophilic granules contain heparin and histamine, and the granules are water soluble. |
| the myelocyte is the most mature granulocyte precursor that can undergo | mitosis |
| production of primary granules ceases and production of secondary granules commences with what cell stage | myelocyte |
| what are some facts about eosinophils | they contain a type of peroxidase that is distinct from that of neutrophils, eosinophils are an important line of defense against parasites, major basic protein is a component of eosinophil granules |
| what is a characteristic of primary granules | coated with a phospholipid membrane |
| what are indicators of a neutrophillic response to tissue damage or inflammatory stimuli | toxic granules and Dohle bodies in the neutrophils |
| what is the term for cell movement through blood vessels to a tissue site | diapedesis |
| vasodilation and bronchoconstriction are the result of degranulation by which of the following blood cells | basophils |
| on what basis can B and T lymphocytes be distinguished | monoclonal antibody reactions to surface and cytoplasmic antigens |
| cells that produce immunoglobulins in response to antigenic stimulation are designated | plasma cells |
| what are some characteristics about neutrophils | they have surface receptors for IgG and complement components, the contain alkaline phosphatase and muramidase, they act in nonspecific phagocytosis and are destined to die |
| what are some characteristics that would help distinguish reactive lymphocytes from monocytes | a sharp indentation of the cytoplasmic margin by adjacent red blood cells, presence of large azurophilic granules, abundant, deeply basophilic cytoplasm |
| what can differentiate metamyelocytes from other stages of granulocyte maturation | indentation of nucleus |
| lymphocyte concentrations in the peripheral blood are greatest during what age interval | 1 to 4 years |
| what is true about macrophages | they are mature tissue forms of blood monocytes, they serve as antigen-presenting cells to the immune system, and they remove damaged or dying cells and cellular debris |
| antigen-dependent lymphopoiesis occurs in secondary lymphoid tissue located in the | spleen and lymph nodes |
| what is produced by neutrophils during the respiratory burst | hydroxyl radicals (OH-), hydrogen peroxide (H2O2), and superoxide anion (O2-) |
| in patients with infectious mononucleosis which blood cells are infected by the causative agent? | B lymphocytes |
| what does a hairy cell contain | tartrate-resistant acid phosphatase |
| based on the WHO classification system B cell ALL (FAB type L3) and ---?--- represent different clinical presentations of the same disease entity | Burkitt lymphoma |
| the presence of both immature neutrophils and nucleated erythrocytes in the peripheral blood is most accurately called a | leukoerythroblastic reaction |
| in which anomaly is a failure of granulocytes to divide beyond the band or two-lobed stage observed | Pelger-Huet |
| What are some cases where eosinophils would be increased | allergic disorders, skin disorders, parasitic infection |
| What is the principal defect in chronic granulomatous disease (CGD) | oxidative respiratory burst |
| A patient with normal hemoglobin and WBC count values, a persistently elevated platele count (over 1000x10^9/L), increased marrow megakaryocytes, and a history of frequent bleeding and clotting episodes most likely has | essential thrombocythemia |
| an adult patient with massive splenomegaly has mild anemia, a slightly elevated WBC count, and a LAP score of 170. The smear shows teardrop erythrocytes and leukoerythroblastosis, these findings are most consistent with | idiopathis meylofibrosis |
| the most common type of chronic lymphocytic leukemia (CLL) in the United States involves the | B cell |
| what would be a characteristic finding of Waldenstrom disease | increased IgM and blood hyperviscosity |
| a Gaucher cell is best described as a macrophage with | "wrinkled" cytoplasm due to an accumulation of glucocerebroside |
| the presence of giant binucleated Reed-Sternberg cells with prominent nucleoli suggest a diagnosis of ---?--- disease rather than other lymphoproliferative disorders | Hodgkin disease |
| in a patient with fever of unknown origin, what lab findings would be consistent with an inflammatory process | increased C-reactive protein, increased fibrinogen level, increased erythrocyte sedimentation rate |
| the presence of the chromosomal abnormality t(15;17) and a high incidence of disseminated intravascular coagulation (DIC) is diagnostic of | Acute promyelocytic leukemia (FAB type M3) |
| what is commonly found in acute myelogenous leukemias | neutropenia, thrombocytopenia, hepatosplenomegaly |
| A child has acute lympholastic leukemia that is precursor B cell type and CALLA positive, Analysis by flow cytometry would likely show cells that immunophenotype for | CD10, CD19 |
| What disorders are classified as a myeloproliferative disorder | polycythemia vera, essential thrombocythemia, chronic myelogenous leukemia |
| What gene mutation correlates with the t(9;22) that is present in Philadelphia chromosome positive chronic meyelogenous leukemia | BCR/ABL |
| What correctly describes the WHO classification of hematopoietic neoplasms | acute leukemia is defined as the presence of at least 20% bone marrow blasts; it groups lymphoid disorders into B cell, T/NK cell, and hodgkin lymphoma;diagnostic criteria include morphologic , cytochemical, immunologic,cytogenetic, and molecular features |
| What medical findings would be helpful in distinguishing a chronic myelogenous leukemia (CML) from a neutrophilic leukemoid reaction | leukocyte alkaline phosphatase score, presence of marked splenomegaly, neutrophils with Dohle bodies and toxic granulation |
| what is a typical finding in chronic leukemias at onset | elevated leukocyte count |
| In what condition would a LAP score of 10 most likely be found | Chronic myelogenous leukemia |
| What conditions are associated with neutrophilia | Staphylococcal pneumonia, crushing injury, neoplasms (tumors) |
| in what conditions would an absolute monocytosis be seen? | tuberculosis, recovery stage of of acute bacterial infection, collagen disorders |
| coarse PAS positivity may be found in the leukemic cells of | Acute lymphoblastic leukemia (FAB type L1) |
| What is among the diagnostic criteria used for classifying the myelodysplastic syndromes | unexplained anemia refractory to treatment, hypogranular and hyposegmented neutrophils, abnormal platelet size and granulation |
| Naphthol AS-D chloroacetate esterase (specific) is usually positive in ___?___ cells, and alpha-naphthyl acetate esterase (nonspecific) is useful for identifying blast cells of ___?___ lineage | granulocytic; monocytic |
| the familial disorder featuring psuedo-Dohle bodies, thrombocytopenia, and large platelets is called | May-Hegglin anomaly |
| Alder-Reilly anomaly is an abnormality of | Mucopolysaccharide metabolism |
| What is the initial laboratory technique for the diagnosis of monoclonal gammopathies | serum and urine protein electrophoresis |
| What are some true statements about Hodgkin disease | peak incidence occurs in young adults, staging determines extent of disease and treatment course, almost a 2:1 male predominance over females is a characteristic |
| Blast cells that are CD14 and CD33 positive, Sudan black B positive, specific esterase positive, and of acute leukemia is most consistent with the immunophenotyping and cytochemical staining results | Acute myelomonocytic leukemia |
| What type of leukemia is associated with the best prognosis for a cure | Acute lymphocytic leukemia in children |
| A bone marrow with 90% cellularity and myeloid:erythroid (M:E) ratio of 10:1 is most characteristic of | Chronic myelogenous leukemia |
| A 60-year-old patient presents with extreme fatigue. Her blood and bone marrow finding are as follows: severe anemia with dual RBC poplulation 2% marrow blasts, and numerous ringed sideroblasts. This information is most consistent with | Refractory anemia with ringed sideroblasts (RARS) |
| What is a mechanism by which neutropenia may be produced? | Hypersplenism, marrow injury or replacement, drug-induced antibodies |
| what are some characteristic findings in polycythemia vera | blood pancytosis, increased red cell mass, increased blood viscosity |
| in what disorder is significant basophilia most commonly seen | Chronic myelogenous leukemia |
| Acute erythroleukemia (FAB type M6) is characterized by increased | marrow erythroblasts and multinucleated red cells |
| myeloid metaplasia refers to | extramedullary hematopoiesis |
| Lymphadenopathy is the most common presenting symptom in what type of lymphoma | non-Hodgkin types |
| What combination of reagents is used to measure hemoglobin | potassium ferricyanide and potassium cyanide |
| The slowest-moving hemoglobin(s) on an alkaline electrophoresis at pH 8.6 is (are) | A2, C, E, and O |
| a patient with suspected sickle cell trait as negative solubility test results, but hemoglobin electrophoresis at pH 8.6 shows an apparent A-S pattern, what is the most likely explanation | Patient has hemoglobin AD or AG and both procedures are correct |
| What are some correct statements regarding the solubility test for Hemoglobin S? | hemoglobin S polymerizes when deoxygenated, testing performed on a 2 day old infant can result in a false negative result, the test is positive in hemoglobin C-harlem |
| What may be a reason for a falsely low ESR? | EDTA tube is clotted, EDTA tube is one-third full, EDTA specimen is 24 hours old |
| a platelet count is performed on an automated instrument from an EDTA sample. Smear eval reveals platelet clumps. the specimen is redrawn using a sodium citrate tube. a count of 300x10^9/L is obtained, what is the corrected platelet count to report | 330x10^9/L - The dilution factor of blood to anticoagulant in the sodium citrate is 9:1. To compensate for the 10% dilutional loss of platelets, the platelet count must be multiplied by 1.1 |
| To best preserve cellular morphology, differential smears from an EDTA specimen should me made no more than ___?___hour(s) after collection | 5 |
| the blood smear made on a patient with polycythemia vera is too short. What should be done to correct this problem | decrease the angle of the spreader slide |
| The components of Wright's stain include | methylene blue and eosin |
| what is the reason for red blood cells to be bright red and the WBC nuclei to be poorly stained when using Wright's stain | the stain or buffer is too acidic |
| if 60 reticulocytes are counted in 1000 red blood cells, what is the reticulocyte count? | 6.0% - the formula for calculating a reticulocyte cout in percent is (# of reticulocytes counted/total number of RBCs counted)*100. So (60/1000)*100=6.0% |
| using a 6.0% reticulocyte count and a RBC count of 300x10^12/L, the calculated absolute reticulocyte count reported in SI units is | 180X10^9/L -The formula used to calculate the absolute reticulocyte count is (retic %*RBC(10^12/L)/100)*1000 Multiplication by 100 is done to report the results in SI units of 10^9/L. So (6.0*3.0)/100*1000=180x10^9/L |
| Sudan black B stain is a stain for | Lipids |
| The following numbers were obtained in evaluating leukocyte alkaline phosphatase (LAP) activity in neutrophils. What is the score? (0)15, (1)20, (2)30,(3)20,(4)15 | 200 - A LAP score is determined by first multiplying the number of cells found by the degree of positivity (i.e., 20*1=20) . These numbers are then added together to obtain a final score. In this example 0+20+60+60+60 = 200 |
| Perl's Prussian blue is a stain used to detect | iron |
| What kind of red cell inclusions stain with both Perl's Prussian blue and Wright's stain | Pappenheimer bodies |
| What is the depth between the counting platform and the coverslip on a hemacytometer | 0.10 mm |
| A WBC count is performed on a hemacytometer using a 1:20 dilution. 308 cells are seen in a total area of 8mm^2. What is the WBC count? | 7.7X10^9/L - The standard formula for hemacytometer counts expressed in mm^2 is (total number cells counted*dilution factor)/(area counted*depth). In this instance (308*20)/(8m^2*0.10 mm)= 3160/0.8mm^3=7700/mm^3=7.7X10^9/L |
| Lipemia, a presence of a cold agglutinin, or an instrument sampling or mixing error can result in a falsely ___?___ MCHC on an automated instrument? | falsely high |
| what is the principle of automated impedance cell counters | interruption of an electrical current by cells |
| a clinically significant difference between two electronic cell counts is indicated when the standard deviation is greater than | +2.0 |
| side angle scatter in a laser based cell counting system is used to measure | cytoplasmic granularity |
| the hemoglobin A2 quantification using anion exchange chromatography will be valid in | Beta-thalasemia minor |
| what disorders would be associated with an increased osmotic fragility and a decreased surface area-to-volume ratio | hereditary spherocytosis, warm autoimmune hemolytic anemia burn victims |
| a clotted EDTA tube can be used to perform a(n) | solubility test for hemoglobin S |
| the test value range that includes 95% of the normal population is the | reference interval |
| to establish a standard curve for reading hemoglobin concentration | certified standards are used |
| what could be a source of error when measuring hemoglobin by the cyanmethemoglobin method | white blood cell count that exceeds linearity limits, lipemic plasma, scratched or dirty hemoglobin measuring cell |
| what are some true statements about microhematocrits | a tube less than half full causes falsely low results, hemolysis causes falsely low results, trapped plasma causes falsely high results |
| to evaluate normal platelet numbers in an appropriate area of a blood smear, approximately how many platelets should be observed per oil immersion field | 8-20 |
| what are some true statements about manual reticulocyte counts | new methylene blue, a supravital stain, is used; RBC inclusions can result in falsely elevated counts; an erythrocyte must at least 4 blue particles to be counted as a reticulocyte |
| when are automated cell counters required to have a calibration check performed | after replacement of any major part |
| Which of the following tests could be performed on a hemolyzed blood sample? Hemoglobin only; hemoglobin and platelet count; RBC count and hematocrit; no results would be reportable | hemoglobin only |
| for which of the following procedures would heparin be a recommended anticoagulant? platelet count; coagulation tests; smear-based red cell morphology; osmotic fragility | osmotic fragility |
| platelets appear dark against a light background using what microscopy | phase microscopy |
| what is the quality control term used to describe the reproducibility of a test | accuracy |
| ----ALL OTHER QUESTIONS IN CHAPTER 2 ARE BASED ON PHOTOGRAPHS OR CASE STUDIES. PLEASE REFER TO CHAPTER 2 FOR THESE--- |
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