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Hematology
AAB Study Exam
| Question | Answer |
|---|---|
| What is the composition of whole blood? | Plasma (55%) RBC's (45%) WBC/PLT (1%) |
| What is pancytopenia? | Reduction of all blood cell types including RBC (anemia), WBC (leukopenia), and platelets (thrombopenia). |
| What is hemostasis and which cell is primarily involved? | Hemostasis is also known as clotting. The major cell involved is platelets. |
| What stain is used to visualize retics? | Supravital stain |
| What portion of a retic is stained? | The residual ribosomal RNA |
| What is the normal range for retics in a normal adult? | 0.5 to 1.7% |
| Roleaux | Result of possible multiple myeloma, elevated fibrinogen or globulins in plasma. Looks like a stack of coins. |
| Which organs are part of the hematopoietic system? | The spleen, red marrow, liver, lymphnodes, and thymus. |
| What can polychromasia indicate? | Either that a treatment for anemia is working or that there is increased hemolysis of the RBC's. |
| Describe polychromasia. | Polychromatic cells are also referred to a retics. They are immature blood cells that are released into the blood stream. Usually occurs following acute or chronic hemorrhage, hemolysis, or as a regenerative rbc process. |
| Microcytes | Diameter of rbc is < 6um, MCV < 80 fL, caused by hb synthesis defect or IDA, thalassemia |
| Macrocytes | 9um or larger, MCv > 100 fL, caused by liver disease, post-splenectomy, megaloblastic conditions |
| What type of RBC's does the Osmotic fragility test for? | Spherocytes, they lyse faster than normal RBC's in hypotonic solns |
| What are common reasons to perform a sed rate? | To see if there is an inflammatory process taking place, multiple myeloma, PID, Lupus, RA, kidney disease. |
| What is the normal reference range for sed rate? | 0 to 20 mm/hr |
| Auer rods are only seen in which cell line? | Myeloloid |
| How do you calculate MCV? | hct/RBC x 10 |
| how do you calculate MCH? | hgb/rbc x 10 |
| How do you calculate MCHC? | hgb/hct x 100 |
| Basophilic stippling can indicate | lead poisoning; congenital dyserythropoetic anemia; thalassemia alpha and beta (among others) |
| What is the osmotic fragility test for? | Shows the presence of spherocytes; hereditary spherocytosis, and hemolytic anemias are more fragile (also increased in old blood) |
| What is the RBC count, the indices and the typical RBC morphology of thalassemia? | increased RBC (erythroid hyperplasia); micro/hypo; target cells, basophilic stippling |
| What is the cause of siderocytes/sideroblasts? | Sideroblastic anemia; there is a disturbed or missing enzyme in the heme synthesis pathway; this leads to iron accumulation within mitochondria, which eventually rupture and deposit the iron into the cell |
| What condition causes increased Heinz bodies? | Glucose 6 Phosphate deficiencty (G6PD) |
| What are Heinz bodies made of? | denatured hemoglobin |
| What is basophillic stippling composed of? | RNA and ribosomes |
| What does Prussian blue stain? | Iron deposits |
| What is anemia in sickle cell caused by? | extravascular hemolysis (cells taken out by spleen) |
| What happens to the blood in alcoholism? | can cause stomatocytes and/or ecchinocytes |
| What are four states that can lead to target cells? | thalassemia; liver disease; hemoglobin C disorders; splenectomy |
| Congenital red cell aplasia is called . . | Diamond Blackfan |
| Congenital aplastic anemia is called . . . | Fanconi's anemia |
| What is G6PD? | glucose 6 phosphate dehydrogenase deficiencty; the most common erythorcyte enzyme disorder |
| Fluid portion of blood | 1. Plasma- contains fibrinogen; 2. Serum- contains no fibrinogen (used to form clot) |
| Excess EDTA | Shrinkage of RBC's; Decreased hematocrit; Decreased ESR; Degenerated WBC; Increase MCHC; Platelet swell and break up causing an increased count |
| in lavender/Purple top test must be performed within how mant hours of collection | 2 Hours; After 6 hours RBC's swell and WBC's show vacuolization and pyknotic nucleus (dark RBC nucleus) |
| Blue Top | Containd Sodium CItrate 9:1; Choice for caogulation studies; Maintains stability of the coagulation factors ( Factor V- Proaccelerin, Factor VIII- Antihemophilic A) Maintains functional abilities of platelets: ( Used for CBC if platelet clumps in EDT |
| Blue Top | Test plasma within 2 hours of collection otherwise freeze or refrigerate; 9:1 Ratio is critical (no short draws) |
| Adjusting anti-coagulant in blue top | Adjust amount of anticaogulant on patients with HCT above 55% ( high HCT means less plasma, less plasma needs less anticoagulant); citrate= (100 -HCT/595 -HCT) x amt of blood |
| Green Top | Contains heparin; Prevents coagulation by: 1. Interacting with anti-thrombin, 2. Inhibiting thrombin; Causes WBC and platelet clumping; Used in special hematology and chemistry |
| Gray Top | Contains( 1.Sodium Fluorde- preserves glucose and alcohol, 2. Potassium Oxalate- anticoagulant, binds calcium); For glucose and alcohol testing |
| Red Top | Contains no anticaogulant; Used for most chemistry tests |
| Tiger Top | aka " Marble top"; COntains no anticoagulant; Has silica gel at the bottom for serum and clot separation |
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