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Study for Final Ret
Review of missed and past questions from exams.
| Question | Answer |
|---|---|
| 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 |
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wulfmannwarrior
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