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hematology

Hematology Rodak chapters 13,14,16,17, 21, 38

QuestionAnswer
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 ?
Created by: geebs28