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Hematology 1
| Question | Answer |
|---|---|
| the blood is __% of the body weight | 7-8 |
| the blood has __% of plasma | 55 |
| The blood has __% formed elements | 45 |
| the layers of the centrifuged blood | fatty-plasma-buffy-rbc |
| lacks fibrinogen group | serum |
| contains all coagulation factor | plasma |
| the average human possesses how many liters of blood | 5-6L |
| the mode of action of this anticoagulant is that it removes ionized calcium through a process referred to as chelation | EDTA |
| EDTA is the anticoagulant of choice in | hematology |
| Disodium salt is also known as | versene |
| tri-potassium salt is also known as | sequestrene |
| recommended by the International Council for Standardization in Hematology (ICSH) and CLSI as the anticoagulant of choice for blood cell counting and sizing because they produce less shrinkage of RBCs and less of an increase in cell volume on standing. | K2 EDTA |
| the process of destroying pathogenic microorganisms in inanimate objects | disinfection |
| destruction of all forms of microbial life including spores | sterilization |
| appropriate disinfectant is __ with a ration of __ | household bleach / sodium hypochlorite , 1:10 |
| this may occur using EDTA. Platelets adhere around neutrophils, forming a ring of satellite effect. | platelet satellitosis |
| what anticoagulant you should use to correct platelet satellitosis? | sodium citrate |
| anticoagulant of choice in coagulation studies | sodium citrate |
| ratio of BLOOD to ANTICOAGULANT | 9:1 |
| in sodium citrate, it preserves what clotting factor | factor 5 and 8 |
| BLOOD to ANTICOAGULANT ratio in Standard Westergren | 4:1 |
| sodium citrate is used in concentration of | 3.2% |
| Standard Westergren is used in concentration of | 3.8% |
| natural anticoagulant | heparin |
| inhibits coagulation by inactivation of thrombin | heparin |
| Anticoagulant for Osmotic Fragility Test, and LAP test | heparin |
| anticoagulant used for preserving glucose | sodium fluoride |
| inhibitor of glycolysis | sodium fluoride |
| Can also be used in determination of lactic and blood alcohol | sodium fluoride |
| 3 major ways for collecting blood | skin puncture, venipuncture, winged blood collection (butterfly) |
| tourniquet should be applied ___ above the venipuncture site | 3-4 inches |
| tourniquet application should not be longer than | 1 min |
| most common means of collecting blood | ETS |
| the most common needle size for adult venipuncture | 21 gauge, 1 inch |
| advantage of using a 1 inch needle | provides better control |
| most common skin cleanser | 70% isopropyl alcohol |
| preferred concentration of anticoagulant in EDTA | 1-2 mg/ml or 1.5mg/ml |
| how many inversions for light blue top tube | 3-4 |
| skin puncture should not be more than __ deep | 2mm |
| false increase in capillary blood | WBC and Glucose |
| false decrease in capillary lood | rbc, hct, hb, plt |
| the most common complication encountered in obtaining a blood specimen. leakage of a small amount of blood in the tissue around the puncture site. | ecchymosis or bruising |
| leakage of a large amount of blood around the puncture site causes the area to rapidly swell. | hematoma |
| comprised of heme and 4 globin chains | hemoglobin |
| nv of hb at birth | 15-20 g/dL |
| nv of hb adult women | 12-16 g/dL |
| nv of hb men | 13-18 g/dL |
| wedge smear angle | 30-45 degree |
| cover slip area | 22mm x 22mm |
| wedge smear drop of blood | 2-3mm |
| the distance of the drop of blood to the end of the slide | 0.5 inch or 1 cm |
| if patient has increase hct (polycythemia vera) the angle of the spreader must be | lowered to 25 degree angle |
| if patient has decrease hct (anemia) the angle of the spreader must be | higher than 45 degree angle |
| romanowsky stain contains | methelyne blue and eosin b or y |
| is a continuous, regulated process of blood cell production that includes cell renewal, proliferation, differentiation, and maturation | hematopoiesis |
| These cells are present in the first few hours after an ovum is fertilized. | totipotential stem cell |
| the most versatile type of stem cell, can develop into any human cell type, including development from embryo into fetus. | totipotential stem cell |
| These cells are present several days after fertilization. it can develop into any cell type, except they cannot develop into a fetus. | Pluripotent stem cells |
| These cells are derived from pluripotent stem cells. They can be found in adults, but they are limited to specific types of cells to form tissues | multipotential stem cell |
| Begins around 19th day of embryonic development after fertilization. | mesoblastic phase (yolk sac phase) |
| formation of primitive erythroblast | mesoblastic phase (yolk sac phase) |
| what are the three embryogenic hemoglobins | gower I, gower II, portland |
| begins at 5th to 7th week of gestation | hepatic phase |
| lymphoid cells begin to appear | hepatic phase |
| major site of hematopoiesis in hepatic phase until 1-2 weeks after birth` | liver |
| detectable levels of Hb f, Hb A and Hb A2 may be present in this stage | hepatic stage |
| globin chain of Hb F | 2alpha, 2 gamma |
| Stage for the beginning of definitive hematopoiesis | hepatic stage |
| medullary phase starts at __ of fetal development | 5th month |
| measurable levels of Hb A, A2 and fetal Hb | Medullary phase (Myeloid) |
| Hb A globin chain combination | 2 alpha, 2 beta |
| Hb A2 globin chain combination | 2 alpha, 2 delta |
| site of adult hematopoiesis | bone marrow, spleen, kidney, liver, lymph nodes, thymus |
| normal HbA concentration in adults | 92-95% |
| normal HbA2 concentration in adults | 2-3% |
| normal HbF concentration in adults | 1-2% |
| Hematopoietically active marrow consisting of the developing blood cells and their progenitors | red marrow |
| Hematopoietically inactive marrow composed primarily of adipocytes (fat cells), with undifferentiated mesenchymal cells and macrophages | yellow marrow |
| the process of replacing the red marrow by the yellow marrow is called | retrogression |
| tissue basophil | mast cell |
| capable of extramedullary hematopoiesis | liver |
| two most common erythrocytic maturation stages with fried egg app. | polychromatic and orthochromic normoblast |
| the largest cell in the bone marrow | megakaryocyte |
| the most predominant cell in the bone marrow | metamyelocyte |
| largest cell in the peripheral blood | monocyte |
| largest lymphoid organ in the body | spleen |
| spleen stores how many percent of platelets | 30 |
| graveyard of RBC | spleen |
| Cord of billroth | red pulp |
| removal of mature or senescent RBC through phagocytosis that leads to eventual degradation of cell organelles | culling |
| removal of cell inclusions. | pitting |
| A process by which erythroid precursor cells differentiate to become mature RBC. | erythropoiesis |
| the primary regulator of erythropoiesis | erythropoietin |
| normal M:E ratio | 3:1 |
| all blood cells are derived from a single pluripotential stem cell | monophyletic theory |
| suggests that each of the blood cell lineage is derived from its own unique stem cell | polyphyletic theory |
| RNA and Protein synthesis, presynthetic stage | G1 |
| cell division | mitosis |
| chromosome condense | prophase |
| centrosomes move to opposite poles | prometaphase |
| sister chromatids segregate | anaphase |
| chromatids move to opposite poles, cell divides | telophase |
| glycoproteins that regulate the proliferation, differentiation, and maturation of hematopoietic precursor cell | cytokines |
| dendritic cell precursor | monocyte |
| macrophage precursor | monocyte |
| In differentiating mature from immature RBCs, the emphasis should be in | chromatin pattern |
| RBC: globin production begins in this rbc developmental stage | pronormoblast / rubriblast |
| RBC: DETECTABLE level of hemoglobin | Basophilic normoblast / prorubricyte |
| RBC: this stage is the LAST STAGE capable of mitosis | polychromatic normoblast / rubricyte |
| RBC: 1st stage where hemoglobin synthesis is visible | polychromatic normoblast / rubricyte |
| RBC: the nucleus is ejected in this stage | orthochromic normoblast / metarubricyte |
| erythrocyte biconcave disc measuring | 7-8um |
| last stage of hemoglobin production | reticulocyte |
| stain used in reticulocyte | new methelyne blue |
| Embden-Meyerhof pathway generates __ of RBC ATP | 90% |
| common enzyme deficient in EMP | pyruvate kinase |
| how many ATP molecules are formed in the EMP | 2 |
| most common inherited enzyme deficiency and is associated with Heinz bodies | G6PD |
| what pathway has the deficiency of GPD | Hexose monophosphate pathway |
| reduced glutathione reduces __ to water | peroxidases |
| NADPH reduces the Ferric iron to the ferrous state in the presence of methemoglobin reductase | methemoglobin reductase pathway |
| other name for methemoglobin reductase | cytochrome B5 reductase |
| generates 2,3 diphosphoglycerate | Luebering - Rapoport shunt |
| shape of the curve | sigmoid |
| Demonstration the relationship between blood pH and oxygen affinity of Hb. | bohr effect |
| RBC destruction in extravascular hemolysis | 90% |
| function is to transport oxygen from the lungs to tissues and transport carbon dioxide from the tissues to the lungs for exhalation | hemoglobin |
| how many amino acids are present in alpha and zeta chains | 141 |
| one gram of hemoglobin can carry __ ml of oxygen | 1.34 |
| one gram of hemoglobin can carry a constant __mg of Iron | 3.47 |
| chromosome 11 globin production | gamma beta delta epsilon |
| chromosome 16 globin production | alpha zeta |
| it is the master regulatory hormone of systemic iron metabolism. | hepcidin |
| affinity for carbon monoxide is 200x greater than for oxygen and unable to transport oxygen | carboxyhemoglobin |
| color for carboxyhemoglobin | cherry red |
| carboxyhemoglobin is formed by combination of hemoglobin with | carbon monoxide |
| can cause chocolate brown discoloration of the blood | methemoglobin / hemiglobin |
| this type of hemoglobin is irreversible | sulfhemoglobin |
| cannot be measure by cyanmethemoglobin method | sulfhemoglobin |
| what is the discoloration of the blood in sulfhemoglobin | mauve-lavender / green |
| reagent used in acid hematin (sahli's method) | 0.1 N HCl |
| most common method in automated machine | cyanmethemoglobin method (modified drabkin's) |
| absorbance of cyanmeth | 540 nm |
| shortens the reaction time in cyanmeth method | dihydrogen potassium phosphate |
| cyanmeth: converts ferric to ferrous | potassium ferricyanide |
| cyanmeth: donates cyanide to hemoglobin | potassium cyanide |
| cyanmeth: improves RBC lysis | Non-ionic detergent |
| platelet count that can cause interference in cyanmeth method | >700 x 10^9 / L |
| wbc count that can cause interference in cyanmeth method | >20 x 10^9 / L |
| the SG of the copper sulfate solution is | 1.053 |
| in copper sulfate method, the drop of blood should be added from a height of about | 1cm |
| in copper sulfate method, if the HB is equal or more than ___ the donor is accepted | 12.5 g/dl |
| in copper sulfate method, if the drop of blood will sink within __ the donor is accepted | 15 seconds |
| variation of cell size | anisocytosis |
| increase in heterogenous population of cell | RDW |
| normocytic size | 6-8um |
| normal MCV | 80-100fl |
| variation of hemoglobin content | anisochromia |
| normal MCHC | 32-36% |
| variation in RBC shape | poikilocytosis |
| associated conditions are: abetalipoproteinemia and McLeod syndrome | acanthocyte / spur cells/ thorn cells |
| anemia associated with renal insufficiency (uremia) and pyruvate kinase deficiency | echinocyte |
| can be used to differentiate thalassemia and IDA | target cell |
| gerbich null dse ( Ge: -2, -3, -4) | elliptocyte |
| schistocyte with hornlike proections | keratocytes |
| myeloid fibrosis with myeloid metaplasia myelopthisic anemia | dacrocyte |
| howell jolly bodies positive reaction | fuelgen reaction, wright's stain, supravital stain |
| precipitation of ribosomes and DNA | basophilic stippling |
| figure of eight, infinity | cabot rings |
| to confirm true roleaux formation, drop __ | saline |
| BEST diluting fluid of RBC | Dacies or Formol citrate |
| RBC counting diluting fluid | gower, eagle, NSS, Toison, Strong, Bethel, Hayem, Dacie |
| volume of packed RBCs that occupies a given volume of whole blood | Hematocrit |
| normal hematocrit at birth | 45-60% |
| normal female hematocrit | 36-48% |
| normal hematocrit male | 40-55% |
| microhematocrit tube is __mm long | 75 |
| microhematocrit tube has an internal bore of ___mm | 1.2 |
| microhematocrit tube can hold __ml of blood | 0.5 |
| microhematocrit centrifuge RFC and min | 10,000-15,000 RCF for 5 mins |
| increased ammount of trapped plasma is found in | macrocytic anemia, spherocytosis, thalassemia, hypochromic anemia, sickle cell anemia |
| the space between the top of the platform and the cover glass | 0.1 mm |
| the volume of one entire platform is | 0.9uL |
| the volume of one large square is | 0.1 uL |
| the volume of each 25 smaller squares is | 0.004 uL |
| the volume of five small squares | 0.02 uL |
| white count diluting fluid | 2% acetic acid, 1% HCl, Turk's diluting fluid |
| leukocyte count should be performed within __ hours of dilution | 3 |
| in WBC count, allow the dilution to sit for how many minutes | 10 |
| type of Granulocyte that has 2-5 lobes | Segmented |
| type of granulocyte that has elongated, curved, sausage shaped nucleus | Band |
| secondary granule contains | major basic protein |
| nucleus dark purple with only two lobes, contains large, spherical granules that stain orange-pink | eosinophil |
| overlying granules, bilobed nucleus. has acidic components | Basophil |
| nucleus: kidney, horseshoe shaped. cytoplasm: ground glass appearance | monocyte |
| cytoplasm stains robin's egg blue | lymphocyte |
| absolute count id preferred | over relative |
| normal MCH value | 28-32 pg |
| RDW reference range | 11.5-14.5% |
| normal platelet count range | 150,000-400,000/ uL |
| reference method in platelet count | Phase microscopy / Brecher Conkrite |
| in brecher conkrite, whole blood is diluted with | 1% ammonium oxalate |
| used to assess the erythropoietic activity of the bone marrow | Reticulocyte count |
| normal value of Reticulocyte | 0.5-1.5% |
| to improve accuracy in reticulocyte count, have another laboratorian count the other smear; values should agree within what percent | 20% |
| sources of error in Reticulocyte count | Heinz bodies, Hb H, Howell-Jolly |
| if a refrigerated sample is used for ESR, the result will be | increased |
| the single most important factor in determining ESR | Plasma composition |
| more preferred method in ESR | westergren |
| specimen in westergren | sodium citrate whole blood |
| ESR: in the first 10 mins rouleaux formation occurs and sedimentation rate is high | lag phase |
| ESR: sedimentation occurs for a period of approximately 40 mins at a more rapid and constant rate | decantation rate |
| ESR: occurs at the last 10 mins, RBCs accumulate at the bottom of the tube | slow sedimentation |
| eosinophil count normal value | 50-350 x 10^6/L |
| sickle cell trait and sickle cell anemia are caused by | hemoglobin S |
| Sickle cell trait HbA% | 60 |
| sickle cell anemia HbA% | 0 |
| sickle cell test: deoxygenates hemoglobin | sodium metabisulfite method |
| sickle cell test: red blood cells immediately lyse in the presence of | saponin |
| sickle cell test: in the reduced state, form liquid crystals and yield a turbid appearance | sodium dithionite test/ solubility test |
| sickle cell test: Hb A and Hb S reagents contain monoclonal antibodies (IgG), which specifically binds to amino acids at or near the sixth position of the globin chain | Hemocard Hb A and S Procedure |
| positive for Hb A and Hb S is indicative of | sickle cell trait |
| positive for Hb S only is indicative of | sickle cell anemia |
| a screening test for paroxysmal nocturnal hemoglobinuria | Sugar water screening test |
| gold standard for PNH | flow cytometry |
| confirmatory test for PNH | sucrose hemolysis test |
| specimen for sugar water screening test and sucrose hemolysis test | citrated blood |
| a test to measure the ability of the red cell to take up fluid without lysing | osmotic fragility test |
| OFT result in hemolytic anemia and spherocytosis | increase |
| reticulocytes have a __ OFT, while older cells are more fragile | Lower |
| OFT: in sanford method, what is used as a diluent | 0.5% saline |
| sanford method initial hemolysis at | tube 22 |
| sanford method complete hemolysis at | tube 17 |
| a test occasionally abnormal in hemophilia and Vit. K disorders | capillary fragility test |
| lee and white coagulation time normal value | 5-15mins |
| stains siderotic granules, pappenheimer bodies and hemosiderin | prussian blue reaction |
| perl's reagent composition | potassium ferricyanide-HCl |
| leukocyte ALP stains ALP present in | neutrophils |
| polycythemia vera leukocyte ALP result | increased |
| CML leukocyte ALP result | decreased |
| leukocyte alkaline phosphatase normal value | 30-185 |
| recommended specimen for leukocyte ALP | fresh capillary blood |
| stains peroxidases present in granulocytes and monocytes | myeloperoxidase stain |
| used to diffrentiate AML and monocytic leukemia from ALL | myeloperoxidase stain |
| stains lipid present in granulocytes and monocytes | sudan Black B |
| used to differentiate AML and myelomonocytic leukemias from ALL | sudan black B |
| stains mucoproteins, glycoproteins and hmw carbs | periodic acid schiff stain |
| stain used to help in diagnosis of DiGuglielmo's syndrome | PAS stain |
| in PAS stain, L1 and L2 produce what pattern | block pattern |
| used to differentiate granulocytic cells from monocytic cells | chloroacetate esterase |
| helpful in diagnosing hairy-cell leukemia | tartrate-resistant ACP / ACP 5 |
| used for recognition if mast cells and tissue s | toluidine blue |
| screening procedure for the detection of CGD (negative) | nitroblue tetrazolium neutrophil reduction test |
| present in 90% cases of ALL. used to differentiate AML from ALL | terminal deoxyribonucleotidyl transferase |
| occurs in the mitochondria and cytoplasm of bone marrow RBC precursors | heme |
| begins with condensation of glycine and succinyl coenzyme A, catalyzed by ___ to form aminolevulinic acid | aminolevulinic acid synthase |
| neutrophil maturation: appearance of primary granule | promycelocyte |
| neutrophil maturation: appearance of secondary granule | neutrophilic myelocyte |
| neutrophil maturation: last stage capable of mitosis | neutrophilic myelocyte |
| neutrophil maturation: nucleus is slightly indented D shaped | neutrophilic myelocyte |
| neutrophil maturation: nucleus is kidney shaped, juvenile cells | neutrophilic myelocyte |
| protein that binds iron to prevent bacterial growth. secreted by neutrophil | lactoferrin |
| WBC: curved nucleus / sausage shaped | neutrophilic band |
| it contain histamin, heparin, and chondroitin sulfate | basophilic granules |
| maturation if months to years | lymphocyte |
| life span 9-10 days | neutrophil |
| appearance of platelet in wright stain wedge smear | circular |
| primary hormone influencing platelet maturation | thrombopoietin |
| platelet: the stage where demarcating system first appears (steininger) | promegakaryocyte |
| platelet: nucleus is irregularly shaped | promegakaryocyte |
| where does the proplatelet process appear? | megakaryocyte |
| megakaryocyte lineage commited progenitors: most mature, endomitosis | LD-CFU-MEG |
| platelet structure: where glycoproteins gpIb and gpIIbIIIa are found | glycocalyx |
| platelet structure: contractile elements | thrombosthenin / actomyosin |
| platelet structure: retains platelet | microtubules |
| positive Gaucher's Disease | PAS |
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