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MLT Ch. 2 Hematology
Success!`65-237
| Question | Answer |
|---|---|
| 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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jParette
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