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hematology
Hematology Rodak chapters 13,14,16,17, 21, 38
| Question | Answer |
|---|---|
| How are plts released into peripheral circulate from the bone marrow? | Megakaryocyte cytoplasmis fragments extend through the endothelial cells, lining the sinusoids, into blood and then shed platelets. |
| What significant immunologic conditions happen with age? | Functional decline of several organ systems. |
| All of the following stimulate megakaryocyte and platelet production except: a. interlukins b. erythropoietin c. thrombopoietin d. CSF-Meg | Erythropoietin (remember that erythropoietin stimulate and regulate the production of erythrocytes) |
| what does the reticuloyte count assess? | Erythropoietic activity |
| From where are additional platelets first derived when the circulating count decreases? | The 30% of mature cells that are stored in the spleen |
| When plts are activated, all of the following occur except: a. alpha granule contents are released b.change to spiny projections c. prostaglandin (eicosanoid synthesis) pathway is activated d.(ADP) release is inhibited | adenosine diphosphate (ADP) release is inhibited. |
| Which of the following is not a function of plt surface-connected canalicular (SCCS)? a. produces energy for the cell b. delivers granule contents to the surface c. connects the internal contents to the surface d. stores plasma coag factors | produces energy for the cell |
| What are two key features with dimond blackfan anemia? | Stem cells are deficient and erythropoietin resistant. |
| why are fat cells not seen in thin smear of bone marrow? | they rupture in aspiration |
| A bone marrow aspirate shows copious blue granulaes with the Prussian blue stain. | Iron Overload |
| What is an osteoblast? | The formation and remodeling of bone |
| What is an osteoclast | The re absorption of bone |
| Define ineffective erythropoesis. | progenitor cells are defective and destroyed before leaving the bone marrow |
| what cell type tends to be found in molded clusters? | Malignant cells |
| What bone marrow sample is best to determine M:E ratio, overall cellularity, and search for malignant cells | core biopsy |
| Why is prep work STAT when receiving Body fluids? | WBC begin to deteriorate 30 min after collection |
| What determines whether or not body fluids are diluted before counting? | The appearance of the fluid |
| The clinical consequences of panocytopenia? | Fatigue, infection, and bleeding |
| What is panocytopenia? | The reduction in the number of erythrocytes, luekocytes, and thrombocytes |
| How must synovial fluid be handled differently than other fluids? | Add hyaluronidase to overcome the viscous nature of fluid |
| the most consistent in peripheral blood finding in aplastic anemia | Marcrocytosis, thrombocytopenia, nutropenia |
| Bloody CSF in tube 1 and begins to clear as the tubes success indicate | traumatic tap |
| The most common anemia in the elderly | Iron deficiency and anemia chronic c disease. |
| What test is used along with MCV to morphologically classify anemias? | RDW |
| ferric nonheme iron in a RBC | Pappenheimer body |
| DNA in a RBC | Howell-Jolly body |
| Precipitated RNA in a RBC | Basophilic stippling |
| Denatured hemoglobin in a RBC | Heinz body |
| The Red cell histogram is wider than normal. Which of the following is true? a. RDW is decreased b. Most cells are larger than normal c. The coefficient of variation was calculated incorrectly d. Anisocytosis is present | Anisocytosis is present |
| Red cell inclusions often found in lead poisoning | basophilic stippling |
| Blood for iron studies should be drawn when | Should be drawn fasting in the morning |
| Megaloblastic anemias are caused by a defect in the synthesis of? | DNA |
| Which vitamins are required for the nuclear development of blood cells | B12 and Folate |
| Which of the following is true regarding hypersegmented neutrophils? | are an early, consistent, and specific finding in megaloblastic anemia |
| bone marrow failure causes pancytopenia in: | Both the bone marrow and peripheral blood |
| What id the treatment of choice for long-term survival for patients under 40 yrs of age with aplastic anemia | Hematopoietic stem cell transplant |
| Type II congenital dyserythropoetic anemia (CDA II) | Giant, multi nucleated red cells |
| Type I congenital dyserythropoetic anemia (CDA I) | Multi nucleated forms and intracellular bridges or nuclear strands between two erythroblasts |
| Type III congenital dyserythropoetic anemia (CDAIII) | Giant erythroblasts with 12 nuclei are characteristic features. |
| Normal bone marrow cells being replaced with malignant cells is called? | Myelophthisic anemia |
| Plt membrane surface | Glycocalyx |
| Glycocalyx absorbs proteins and transports them to storage organelles by? | endocytosis |
| Megakaryocyte progenitor that undergoes endomitosis is: | MKI |
| Diploid and participates in normal mitosis | BFU-Meg |
| Transitional polyploidy is established | LD-CFU-Meg |
| Growth factor produced in the kidney and induces growth and differentiation of committed Meg progenitors | TPO or Erythropoietin |
| This acts with TPO to induce early differentiation of stem cells | IL-3 |
| Acts in the presence of TPO to enhance the later phenomena of endomitosis, Meg maturation and plt release | IL-6 and IL-11 |
| Synthesizes and stimulates plt production in chemo-induced thrombocytopenia | IL-11 |
| What plt organelle sequesters ionic calcium and binds a series of enzymes of the eicosanoid pathway? | Dense Tubular system (DTS) |
| Controls cellular activation | G-Protien |
| Twists spongelike and enables plts to store glycocalyx | SCCS |
| what plt membrane receptor binds fibrinogen and supports plt aggregation? | GP IIb/ IIIa |
| What is the plt membrane receptor that is the adhesion receptor? | GP Ib/ IX/ V |
| What plt membrane receptor binds directly to collagen of vascular matrix | GP Ia/IIa |
| What plt membrane phospholipid flips from the inner surface to the plasma surface on activation and serves as the assembly point for coag factors? | Phosphatidylserine |
| What is the name of eicosanoid metabolite produced from endothelial cells that suppresses plt activation? | Prostacyclin |
| What binds membrane reseptors TP alpha or TP beta? | TXA2 |
| What allows Phospholipid #2 carbon to bind to unsaturated fatty acids | Arachidonic acid |
| What converts arachidonic acid to prostaglandin | cycto oxygenase |
| What molecule is stored in plt delta granules (dense bodies)? | Serotonin |
| What plasma protein is essential to plt adhesion? | VWF |
| What adhesion doesn't secrete granule contents of CAMS? | P-selection |
| Reticulated plts can be enumerated in peripheral blood to detect...? | Increased plt production in response to need |
| Plt adhesion refers to plts...what? | Sticking to surfaces such as subendothelial collagen |
| The prefered site for bone marrow biopsy in an adult is the? | Anterior or posterior iliac crest |
| The aspirate should be examined under low power to assess all of the following except: a. # of megakaryocytes b. cellularity c. Presence of tumor cells d. Morphology of abnormal cells | Morphology of abnormal cells (remember the Bone Marrow ASPIRATE is used for the abnormal cell morphology) |
| Normal M:E ratio | 1.5:1 to 3.3:1 |
| Most normoblasts in the normal marrow are? | polychromatic and orthochromatic normoblasts |
| Cells occasionally seen in the bone marrow that are responsible for the formation of bone are? | Osteoblasts |
| The largest cell found in a normal bone marrow aspirate is the ? | Megakaryocyte |
| All of the following are indications for a bone marrow evaluation except: a. pancytopenia b. Blast detection in blood smear c. Anemia w/ low serum iron and low ferritin d. Staging hodgkins lymphoma | Anemia w/ low serum iron and low ferritin |
| RBC precursors were estimated to account for 40% of cells in the marrow, the other 60% were granulocyte precursors. The M:E ratio would be? | M:E ratio = 1.5:1 |
| Bone marrow should large cells w/ multiple nuclei noted. They were close to the endosteum. The nuclei were evenly spaced through the cell. What is it? | Osteoclats |
| What is the advantage of the core biopsy vs the aspirate? | The core biopsy permits assessment of the architecture and cellular arrangement |
| Cells normally seen in CSF, serious and synovial fluids..? | neutrophils |
| "Fried egg" appearance | mesothelial cells |
| Idioplastic anemia is due to? | Unknown cause |
| The pathophysiologic mechanism in acquired, idiosyncratic aplastic anemia is? | Destruction of stem cells by autoimmune t cells |
| The most consistant peripheral blood findings in SEVERE aplastic anemia are? | Macrocytosis, thrombocytopenia, and neutropenia |
| The treatment for severe aplastic anemia for young adults <40 is? | Stem cell transplant from an HLA-identical sibling |
| Test most useful in differentiating FANCONI anemia from other causes of panocytopenia? | diepoxybutane-induced chromosome breakage |
| Mutation in genes that code for the telomerase complex may induce bone marrow failure | Resistance of stem cells to normal apoptosis, Autoimmune reaction against telomeres in stem cells, and decreased production of hemapoietic growth factor |
| Diamond blackfan is different from inherited aplastic anemia because... | Only erythropoesis is affected |
| what anemia should be suspected in a patient with refactory anemia, hemociderosis, and multinuclearity of erythrocyte precursors in the bone marrow? | CDA |
| The pathophysiology of anemia of chronic renal disease is mainly due to? | Inadequate production of erythropoietin |
| Complete blood count values for children (3-12) differ from those of adults by? | ? |
| Physiologic anemia of infancy results from | ? |
| Morphology of lymphs of healthy children is? | ? |
| When aging the hemoglobin level of elderly adults..? | ? |
| What are the most common anemias in elderly population | ? |
| Iron deficiency is recognized in an elderly pt the cause is? | ? |
| Which of the following conditions is least likely in an elderly pt | ? |
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geebs28
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