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Review of missed and past questions from exams.

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Question
Answer
MCV Formula   (Hct x 10)/ RBC  
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MCH Formula   (Hgb x 10)/ RBC  
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MCHC formula   (Hgb x 100)/Hct  
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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.  
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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.  
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What erythrocytic inclusions can be seen in wright stains?   Basophilic stippling, siderotic granules (pappenheimer bodies), Howell-Jolly Bodies, polychromasia.  
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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.  
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What is a codocyte?   A target cell (codo - coda which looks like half a target)  
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What is a dacrocyte?   A teardrop cell.  
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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)  
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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)  
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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.  
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What does ACE Of Clubs mean?   What migrates with A2 hemoglobin. A2, C, E, OArab, and CHarlem  
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What does Sad Dog Gets Loved mean?   What migrates with Hgb S: S, D, G, and Lepore  
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What are the three types of sickle crises   Aplastic, Hemolytic, and painful/vaso-occlusive  
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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  
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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  
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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  
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What might indicate autosplenectomy or loss of spleen function due to surgery or pathology?   Howell-Jolly Bodies  
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What are common in Hgb C smears ?   numerous codocytes, occasional microspherocytes and schistocytes, HgbC crystals ("bar of gold") commonly after splenectomy, increased retic  
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What disease shows hypersegmented neutrophils, macrocytic erythrocyte results, pancytpenia.   megaloblastic anemia  
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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.  
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Dohle bodies are associated with?   May Hegglin Anomaly  
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Auer rods are seen in what types of leukemias?   Acute leukemias associated with myeloid lineage.  
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Which chronic leukemia is associated with basophilia?   Chronic Myelogenous Leukemia  
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What are the platelets in essential thrombocythemia like?   increased in number and functionally abnormal  
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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  
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what is the morphologic abnormality characteristically found in thalassemias?   codocytes  
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Is the total iron binding capacity increased or decreased in ringed sideroblasts in bone marrow?   decreased  
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What is typically found in chronic leukemias at onset?   elevated leukocyte count  
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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  
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What is the expected blast count in bone marrow for acute leukemias?   more than 20% of nonerythroid marrow nucleated cells would be blasts  
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what test is used to confirm the type of hemoglobinopathy?   hemoglobin electrophoresis  
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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.  
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What is the lifespan of a neutrophil?   6-10 hours  
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In which stage of red cell maturation does hemoglobin first form. Recognized as gray-blue cytoplasm   polychromatic normoblast  
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What red cell inclusion is often indicative of hemoglobin denaturation?   Heinz Bodies (cannot be seen with Wright's stain)  
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What is the largest hematopoietic cell found in the bone marrow?   megakaryocytes  
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increased RDW would correlate with what on the peripheral smear?   anisocytosis  
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What protein is responsible for transport of hemoglobin dimers resulting from intravascular hemolysis?   Haptoglobin  
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Are epsilon and zeta chains present in normal adult hemoglobin?   No, alpha, beta, gamma, and delta are normally in adult hemoglobin.  
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How can B and T Lymphocytes be distinguished?   monoclonal antibody reactions to surface and cytoplasmic antigens  
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How can metamyelocytes be differentiated from other stages of granulocyte maturation?   the indentation of the nucleus  
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granulocytes that fail to divide beyond the band or two-lobed stage are indicative of what anomaly?   pelger-huet anomaly  
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what is the principle defict in chronic granulomatous disease?   oxidative respiratory burst  
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Abnormal mucopolysaccharide metabolism is characteristic of what anomaly?   Alder-Reilly anomally  
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qualitative and quantitative neutrophil changes can include what?   hyposegmentation (pseudo-pelger huet), toxic granulation, and neutrophilia.  
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Giant lysosomal granules are charateristic of what anomaly?   Chediak-Higashi syndrome  
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What are microcytes and hypochromia most often associated with?   Iron-deficiency Anemia  
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excessive extravascular red cell destruction is associated with   bilirubinemia  
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Excessive extravascular red cell destruction is associated with   hemoglobinemia and hemoglobinuria (which are related to eachother) and bilirubinemia  
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what does total iron binding capacity represent?   the amount of iron that transferrin can bind  
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Impaired DNA synthesis is characteristic of what type of anemia?   Megaloblastic anemia.  
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What is the leading cause of folate deficiency?   insufficient dietary intake.  
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Does a ringed sideroblasts in the bone marrow correlate with an increased or decreased TIBC?   decreased  
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Paroxysmal cold hemoglobinuria has an antibody that shows specificity to what antigen?   P antigens  
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An acquired red cell membrane defect that results in increased sensitivity to complement binding?   Paroxysmal Nocturnal Hemoglobinuria  
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The anemia found in chronic renal failure is primarily caused by what?   inadequate erythropoietin synthesis  
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when iron use exceeds absorption, what occurs first?   the iron stores are depleted  
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which hemoglobin fraction comprises the majority of hemoglobin found in RBCs of patients with sickle cell trait?   HgbS  
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What deficiency is the cause of pernicious anemia?   intrinsic factor deficiency due to gastric parietal cell atrophy  
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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.  
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Does an excessive anticoagulation of whole blood specimen lead to a falsely increased or decreased rate?   falsely decreased  
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Massive splenomegaly, mild anemia, slightly elevated WBC count, Normal LAP, teardrop erythrocytes, agranular macrothrombocytes. What might this indicate?   idiopathic myelofibrosis  
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Increased red cell mass, blood pancytosis, increased blood viscosity, and no increase in erythropoietin level implies what type of myeloproliferative disorder?   polycythemia vera  
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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  
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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  
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Most CML patients are diagnosed in which stage?   chronic phase  
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Which phase of CML carries the worst prognosis and is not normally responsive to tx?   Blast crisis  
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the cells in CLL are morphologically identical to   small lymphocytic lymphoma cells  
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the poorest prognosis of CLL is associated w/ what features?   anemia and thrombocytopenia  
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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  
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what genetic abnormality is associated with AML M3?   t(15;17)  
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inv(16) is associated with what type of leukemia?   AMML with marrow eosinophilia  
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TdT is a marker for what type of blasts?   lymphoblasts  
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AML M5a contains a majority of what type of cells?   monoblasts  
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AML M5b contains a majority of what type of cells?   promonocytes  
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Macrophages with "wrinkled" cytoplasm due to an accumulation of glucocerebroside is characteristic of what Lipid storage disease cell?   gaucher's cells  
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what is seen in the urine of multiple myeloma   IgG light chains  
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what is the potential cure for myelodysplastic syndrome?   allogenic stem cell transplant  
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what is the deficiency in niemann-pick disease?   sphingomyelinase  
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macrophages with a cytoplasm filled with uniformly sized lipid droplets is characteristic of what type of cell?   niemann-pick cells  
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Lymphocytes with alder-reilly bodies are seen in what type of lipid storage disease   mucopolysaccharide disorders  
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Hexosaminidase A is deficient in what lipid storage disorder?   Tay Sachs  
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Atypical lymphs with large vacuoles are seen, but not diagnostic of what lipid storage disorder?   Tay Sachs  
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Plasma cell counts of 80% appearing in sheets is indicative of what?   Multiple Myeloma  
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