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ASCP hem & coag

QuestionAnswer
t(15;17) Acute promyelocytic leukemia /M3 Females w/ sudden onset of bleeding// DIC Retinoic acid receptor alpha gene Retinoic acid= complete remission
t(9;22) CML Philadelphia chromosome// flower garden/// decreased LAP score
t(8;21) AML/ M2 Adults, dysmeylopoiesis, psuedo pelger huet Myeloblastic anemia w/o maturation
11q23 AML/M5 Schilling type Monoblastic young adults & children
t(16;16) AML myelomonocytic M4 Eo variation
CD 10, CD19, CD22, CD24 ALL B cell precursors
CD2,CD4, CD5, CD8 ALL T cell precursors
CD 19, CD20, CD23, CD5 CLL
CD103, CD11c, CD25, TRAP Hairy cell leukemia
Waldenstrom's macroglobulinemia Malignancy of the lymphoplasmacytoid cells which manufacture IgM
WBC scatter plot: A: top left, B middle, C right, D bottom left A:monocytes B:neutrophils C: Eosinophils D: lymphocytes
Why is the WBC count increased when the PB is analyzed automatically in a sickle cell anemia patient? Sickled RBC's are resistant to lysis so are counted among the WBC population
What reagents are used in the PT test? Thromboplastin and calcium replace the tissue thromboplastin and calcium necessary in vivo to activate factors VII and VIIa. this ultimately generates thrombin from pro thrombin via the coagulation cascade
Which ratio of coagulant to blood is correct for coagulation procedures? 1:9
The anticoagulant of choice for most routine coagulation studies is... Sodium citrate
Which results would be expected for the prothrombin time PT and activated partial thromboplastin time APTT in a patient with polycythemia? Both prolonged: The blood in a polycythemia patient contain so little plasma that access anticoagulant remains in is available to buy in to reagent calcium thereby resulting in a prolongation of the PT and aPTT
Which test would be abnormal in a e patient with Stewart power factor (factor X) deficiency? Stewart power factor (factor X)!is involved in the common pathway of the coagulation cascade therefore it's deficiency prolongs both PT in aPTT
Normal Hgb A, F, A2
Sickle cell trait hgb A: 50-70%, S: 20-40%, A2,F
Sickle cell anemia Hgb S, F, A2
Hgb AC trait C,A, A2, F
Hgb SC disease C,S, F A2
Beta thalassemia minor Hgb A2, A in equal parts F small
Beta thalassemia majior Lg F, md A2, small A
Which clotting factor is not measured by PT and APTT test? Factor XIII (fibrin stabilizing factor) It creates covalent bonds between fibrin monomers formed during the coagulation process to produce a stable fibrin clot.
What happens in the absence of factor 13 The hydrogen bonded fiber in a polymers are soluble and 5M urea or in 1% monochloroacetic acid
A modification of which procedure can be used to measure measure fibrinogen? Thrombin time. Fibrinogen can be quantitatively measured by a modification of thrombin time by diluting the plasma since of thrombin clotting time of diluted plasma is inversely proportional to the concentration of fibrinogen. (th clause method)
Vitamin K is necessary for activation of which clotting factors Factors II,VII, IX and X It is required for Corboxylatiin of glutamate residues of these coagulation factors
Is vitamin K enhanced by heprin therapy No
Distribution 30% spleen, 70% peripheral blood Reference ranges for platelets are 150,000 to 400,000/ mm3 the lifespan is 9 to 12 days
What does the PFA test do A test to see if platelets properly adhere an aggregate at the injury site. Basically checks if platelets are working correctly It takes the place of the historical bleeding time test
What does thrombin do? Cleves peptides off of the fibrinogen molecules to form fibrin which polymerizes to form insoluble fibrin strands. thrombin also activates factor 13 which cross-links the fibrin strands at the D region . (birth of the D dimer)
Other function is of thrombin are Feeds back to protonate factors V & VIII recruits and aggregates platelets turns on endothelial cell thrombomodulin (receptor/ activator for protein C and protein S system) to in activate factors V and VIII.
INR : International normalized ratio reference ranges under 13 seconds therapeutic goal is 2.0 to 3.5 INR( patient result/ mean of ref range)^ISI
APTT Screen for intrinsic and common pathways measures all factors except for VII & XIII monitors heparin therapy. Reagents: activator (Kaolin, celite, or ellagic acid), PLT phospholipid, cacl2
APTT reference range 20 to 40 seconds therapeutic goal is 1.5 to 2.5 times normal or use heparin response curve
Fibrinogen assay Quantitative measure of factor I (fibrinogen) reference ranges : 200 to 400 mg/dl
PT prothrombin time Screen for extrinsic and common pathways Measures factors I, II, V, VII, and X Monitors oral anticoagulants (warfarin Coumadin) Reagents: tissue thromboplastin and CACL2 sensitive to vitamin k factors INR
PT time reference range < 13 seconds therapeutic reference range: 2.0 to 3.5
Von Willebrand's disease Wimpy Willy normal platelets decreased factor VIII decreased vWF
Bernard-Soulier Super Bernie giant platelets
Reptile lease time Snake venom enzyme. Test similar to thrombin time but is not inhibited by heparin (good to use on patients on heparin) reference range: 18 to 22 seconds
Abnormal ristocetin induced aggregation Bernard- Soulier & von Willebrand
Hemophilia A Inherited disorder deficiency of factor VIIII, sex linked recessive (men) spontaneous bleeding into joints, treat with commercial factor VIIII
Hemophilia B Inherited disorder deficiency and factor IX, sex linked recessive ( men) clinically identical; hemophilia A treat with factor IX concentrates
Hemophilia C Inherited disorder, deficiency in factor XI Incomplete Autosomal recessive, wide ranging clinical severity, high incidence in Ashkenazi Jews, only contact factor associated with bleeding
Von Willebrand disease Inherited disorder, primary { 1*}defect in the von Willebrand factor, vWF factor Binds platelets via the glycoprotein 1B/V/IX receptor. 2*: deficiency a factor VIII, Autosomal dominant abnormal PFA test treat with cryoprecipitate
Factor XIII DEFICIENCY Inherited disorder, Autosomal recessive, not detected by common coagulation test, poor wound healing, detected with the 5M urea test
Inherited disorders coagulation Hemophilia A, hemophilia B, hemophilia C, von Willebrand disease, factor XIII deficiency
Intrinsic pathway Pk, hk, XII, XI, IV, VIII
Extrinsic III, VII, TF
COMMON patheay X, V, II, I II: prothrombin I: fibrinogen
What is required to activate Protien C and become fully functional? Streptokinase
Created by: Hdickerson79