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Study for Final Ret

Review of missed and past questions from exams.

QuestionAnswer
MCV Formula (Hct x 10)/ RBC
MCH Formula (Hgb x 10)/ RBC
MCHC formula (Hgb x 100)/Hct
What increases osmotic fragility? osmotic fragility is increased by an increased internal pressure (or a higher ratio of internal fluid to surface area). This is seen in conditions like spherocytosis.
What decreases osmotic fragility? a decreased internal pressure (or lower ratio of internal volume to surface area). This is seen in conditions like sickle cell anemia.
What erythrocytic inclusions can be seen in wright stains? Basophilic stippling, siderotic granules (pappenheimer bodies), Howell-Jolly Bodies, polychromasia.
What erythrocytic inclusion requires a supravital stain to be visualized since it cannot be seen with write stain? Heinz bodies cannot be seen in wright stains only with supravital stain.
What is a codocyte? A target cell (codo - coda which looks like half a target)
What is a dacrocyte? A teardrop cell.
What is the genetic cause of Hemoglobin C? Lysine switched with glutamic acid at the 6th position on the beta chain (ly for glu on 6 beta)
What is the genetic cause of Hemoglobin S? valine subbed for glutamic acide at the 6th position on the beta chain (val for glu on 6 beta)
What does Crawl slow fast Accelerate mean? The order and speed of the proteins on hemoglobin electrophoresis (alkaline electrophoresis) from slowest to fastest Hemoglobins C, S, F, A.
What does ACE Of Clubs mean? What migrates with A2 hemoglobin. A2, C, E, OArab, and CHarlem
What does Sad Dog Gets Loved mean? What migrates with Hgb S: S, D, G, and Lepore
What are the three types of sickle crises Aplastic, Hemolytic, and painful/vaso-occlusive
Sickle crisis associated w/ infectionsthat cause temporary suspension of erythropoiesis resulting from overworked marrow due to continuous stimuli to make new RBCs, recognized by Retic decrease, spontaneously resolves w/in 5-10 days Aplastic crisis
Sickle crisis most often in 5 mo-2 yr olds, caused by acute splenic sequestration; shows decrease in HH & platelets and increase in retics; s/s include jaundice, sudden weakness, rapid pulse, pallor, enlarged spleen; hypovolemia, shock & death may result Hemolytic Crisis
sickle crisis results in sever pain; cause= occlusion of small BVs re: adhesion of sickled cells to endothelium from tissue dmg & necrosis; lasts <1 wk maybe longer; tx by rehydration, pain rx, antibiotic tx for infection; may result in autosplenomegaly Vaso-Occlusive crisis
What might indicate autosplenectomy or loss of spleen function due to surgery or pathology? Howell-Jolly Bodies
What are common in Hgb C smears ? numerous codocytes, occasional microspherocytes and schistocytes, HgbC crystals ("bar of gold") commonly after splenectomy, increased retic
What disease shows hypersegmented neutrophils, macrocytic erythrocyte results, pancytpenia. megaloblastic anemia
Would the MCV be increased or decreased w/ 80 NRBC/100 WBC & increased polychromasia? Why? Increased because the polychromatic and nucleated reds would be larger cells than normal and would increase the MCV value.
Dohle bodies are associated with? May Hegglin Anomaly
Auer rods are seen in what types of leukemias? Acute leukemias associated with myeloid lineage.
Which chronic leukemia is associated with basophilia? Chronic Myelogenous Leukemia
What are the platelets in essential thrombocythemia like? increased in number and functionally abnormal
What enzyme deficiency is associated w/ a moderate to severe hemolytic anemia after exposure to certain drugs and characterized by red cell inclusions formed by denatured Hgb? G6PD deficiency
what is the morphologic abnormality characteristically found in thalassemias? codocytes
Is the total iron binding capacity increased or decreased in ringed sideroblasts in bone marrow? decreased
What is typically found in chronic leukemias at onset? elevated leukocyte count
What is the expected blast count in bone marrow for chronic leukemia, myelodysplastic syndromes, and myeloproliferative disorders? <20% of nonerythroid marrow nucleated cells would be blasts
What is the expected blast count in bone marrow for acute leukemias? more than 20% of nonerythroid marrow nucleated cells would be blasts
what test is used to confirm the type of hemoglobinopathy? hemoglobin electrophoresis
What is the significance of howell-Jolly bodies in sickle cell anemia? the spleen becomes nonfunctional and cannot remove the DNA remnants from the erythrocytes leaving Howell-Jolly Bodies in the cells.
What is the lifespan of a neutrophil? 6-10 hours
In which stage of red cell maturation does hemoglobin first form. Recognized as gray-blue cytoplasm polychromatic normoblast
What red cell inclusion is often indicative of hemoglobin denaturation? Heinz Bodies (cannot be seen with Wright's stain)
What is the largest hematopoietic cell found in the bone marrow? megakaryocytes
increased RDW would correlate with what on the peripheral smear? anisocytosis
What protein is responsible for transport of hemoglobin dimers resulting from intravascular hemolysis? Haptoglobin
Are epsilon and zeta chains present in normal adult hemoglobin? No, alpha, beta, gamma, and delta are normally in adult hemoglobin.
How can B and T Lymphocytes be distinguished? monoclonal antibody reactions to surface and cytoplasmic antigens
How can metamyelocytes be differentiated from other stages of granulocyte maturation? the indentation of the nucleus
granulocytes that fail to divide beyond the band or two-lobed stage are indicative of what anomaly? pelger-huet anomaly
what is the principle defict in chronic granulomatous disease? oxidative respiratory burst
Abnormal mucopolysaccharide metabolism is characteristic of what anomaly? Alder-Reilly anomally
qualitative and quantitative neutrophil changes can include what? hyposegmentation (pseudo-pelger huet), toxic granulation, and neutrophilia.
Giant lysosomal granules are charateristic of what anomaly? Chediak-Higashi syndrome
What are microcytes and hypochromia most often associated with? Iron-deficiency Anemia
excessive extravascular red cell destruction is associated with bilirubinemia
Excessive extravascular red cell destruction is associated with hemoglobinemia and hemoglobinuria (which are related to eachother) and bilirubinemia
what does total iron binding capacity represent? the amount of iron that transferrin can bind
Impaired DNA synthesis is characteristic of what type of anemia? Megaloblastic anemia.
What is the leading cause of folate deficiency? insufficient dietary intake.
Does a ringed sideroblasts in the bone marrow correlate with an increased or decreased TIBC? decreased
Paroxysmal cold hemoglobinuria has an antibody that shows specificity to what antigen? P antigens
An acquired red cell membrane defect that results in increased sensitivity to complement binding? Paroxysmal Nocturnal Hemoglobinuria
The anemia found in chronic renal failure is primarily caused by what? inadequate erythropoietin synthesis
when iron use exceeds absorption, what occurs first? the iron stores are depleted
which hemoglobin fraction comprises the majority of hemoglobin found in RBCs of patients with sickle cell trait? HgbS
What deficiency is the cause of pernicious anemia? intrinsic factor deficiency due to gastric parietal cell atrophy
alpha thalassemia with sickle cell anemia has what kind of clinical manifestation? typically less severe than sickle cell alone, Hgb F is present which is thought to reduce the sickling severity.
Does an excessive anticoagulation of whole blood specimen lead to a falsely increased or decreased rate? falsely decreased
Massive splenomegaly, mild anemia, slightly elevated WBC count, Normal LAP, teardrop erythrocytes, agranular macrothrombocytes. What might this indicate? idiopathic myelofibrosis
Increased red cell mass, blood pancytosis, increased blood viscosity, and no increase in erythropoietin level implies what type of myeloproliferative disorder? polycythemia vera
normal hgb and wbc, increased megakaryocytes in the BM, frequent bleeding and clotting, along with increased number of platelets that are functionally abnormal implies what type of myeloproliferative disorder? essential thrombocythemia
A striking feature of CML is that there is a presence of what types of granulocytes? there is a presence of granulocytes at different stages of development
Most CML patients are diagnosed in which stage? chronic phase
Which phase of CML carries the worst prognosis and is not normally responsive to tx? Blast crisis
the cells in CLL are morphologically identical to small lymphocytic lymphoma cells
the poorest prognosis of CLL is associated w/ what features? anemia and thrombocytopenia
What immunophenotype is characteristic of B cell CLL? neg TdT; Pos B cell antigens CD19, 20, and 23; pos surface immunoglobulin; pos t cell antigen CD5
what genetic abnormality is associated with AML M3? t(15;17)
inv(16) is associated with what type of leukemia? AMML with marrow eosinophilia
TdT is a marker for what type of blasts? lymphoblasts
AML M5a contains a majority of what type of cells? monoblasts
AML M5b contains a majority of what type of cells? promonocytes
Macrophages with "wrinkled" cytoplasm due to an accumulation of glucocerebroside is characteristic of what Lipid storage disease cell? gaucher's cells
what is seen in the urine of multiple myeloma IgG light chains
what is the potential cure for myelodysplastic syndrome? allogenic stem cell transplant
what is the deficiency in niemann-pick disease? sphingomyelinase
macrophages with a cytoplasm filled with uniformly sized lipid droplets is characteristic of what type of cell? niemann-pick cells
Lymphocytes with alder-reilly bodies are seen in what type of lipid storage disease mucopolysaccharide disorders
Hexosaminidase A is deficient in what lipid storage disorder? Tay Sachs
Atypical lymphs with large vacuoles are seen, but not diagnostic of what lipid storage disorder? Tay Sachs
Plasma cell counts of 80% appearing in sheets is indicative of what? Multiple Myeloma
Created by: wulfmannwarrior