UAMS Hematology Exam 1

RES includes what 5 organs?

Spleen, liver, thymus, bone marrow, lymph nodes

What does RES stand for?

Reticuloendothelial system

Where is the primary site of hematopoiesis?

Bone marrow

What is the ratio for yellow and red bone marrow?

50:50

Where is bone marrow located?

proximal ends of long bones, sternum, iliac pelvic crest

Where is the best location to obtain bone marrow?

iliac pelvic crest

Where do megakaryocytes lie in the bone marrow?

close to the endothelial cells for easy release

Where do erythrocytic cells lie in the bone marrow?

close to the endothelial cells in a "bunch of grapes" formation

Where do leukocytes lie in the bone marrow?

they begin in the core and slowly make their way to the cord lining

Which organ is involved in RBC circulation?

spleen

Which granulocyte is the last to undergo mitosis?

myelocyte

What is margination?

the accumulation and adhesion of leukocytes to the epithelial cells of blood vessel walls at the site of injury in early stages of inflammation

What is diapedesis?

the outward passage of White Blood Cells through intact vessel walls.

Erythrocyte maturation sequence

1. Pronormoblast / Rubriblast

2. Basophilic Normoblast / Prorubricyte

3. Polychromatic Normoblast / Rubricyte

4. Orthochromic Normoblast / Metarubricyte

5. Polychromatic Erythrocyte / Reticulocyte

6. Erythrocyte

Immature cells

large, high N:C, fine nucleus

Mature cells

smaller, low N:C, condensed nucleus

Where do you count WBC's on a hemacytometer?

4 large corner squares

Where do you count RBC's on a hemacytometer?

4 small corner squares of the middle large square

Where do you count PLT's on a hemacytometer?

entire large center square

What percent of RBC's are removed daily from circulation?

1%

What element is reused in our cells?

iron

When should peripheral blood smears be made?

preferably within 3-4 hours

What happens if a peripheral blood smear is made after 5-6 hours?

echinocytes and pyknotic cells

What is erythroid hyperplasia?

increase in the formation of RBCs

What is intramedullary hemolysis?

cell destruction occurring inside the bone marrow

What is extramedullary hematopoiesis?

cell formation occurring outside the bone marrow

What is the first cell to not have nucleoli?

myelocyte

If greater than how many NRBCs should you correct the WBC count?

5

Polychromasia is observed in what stain?

Wright's Geisma stain

Reticulocytes are observed in what stain?

New Methylene Blue stain

Reference range for neutrophils

50-70%

Reference range for lymphocytes

18-42%

Reference range for monocytes

2-11%

Reference range for bands

up to 5%

Reference range for eosinophils

up to 3%

Reference range for basophils

up to 2%

Reference range for RBC

4.2-6 x 10^6/ul

Reference range for WBC

3-10.6 x 10^3

Reference range for PLT

150-450 x 10^3

What does the sweep flow vacuum do?

causes cells to pass through the instrument aperture

What happens to RBC's nucleus as it matures?

becomes smaller, condenses, eventually extruded from the cell

What does a left shift indicate?

infection or leukemia

What makes male's RBC count higher?

testosterone

B lymphocytes convert into plasma cells and produce what?

antibodies

What is the life span of RBCs?

120 days

WBC maturation sequence

1. Myeloblast

2. Promyelocyte

3. Myelocyte

4. Metamyelocyte

5. Non-segmented neutrophil (band)

6. Segmented neutrophil

What must RBCs be able to do to escape macrophages in the spleen?

deform

What is the calculation for correcting WBC count for NRBC?

WBC x 100 / NRBC + 100

What is the calculation for the total WBC count from a hemacytometer?

cells counted x dilution factor x depth factor / area counted

What is used in the Coulter Principle?

cell impedance

Counts on a hemacytometer must agree within what percent?

10%

Which cell is the 1st to have nonspecific / primary granules?

promyelocyte

Which cell is the 1st to have specific / secondary granules?

myelocyte

Which WBC is involved in immunity?

lymphocyte

Which WBC is involved in parasitic infections and allergies?

eosinophils

Which WBC is involved as phagocytosis and known as "scavengers"?

monocytes

Which granulocytic WBC is involved in phagocytosis?

neutrophil

Which WBC has IgE receptors and aid eosinophils?

basophils

What does it mean if your slide is too blue and how do you fix this?

too alkaline and decrease stain time or increase buffer

What does it mean if your slide is too pink and how do you fix this?

too acidic and increase stain time or decrease buffer

What is the most immature cell in the bone marrow?

pluripotential stem cell

Can pluripotential stem cells be differentiated?

no

What stimulates the production of erythrocytes?

EPO

Where is EPO produced?

kidneys

What stimulates the production of platelets?

thrombopoietin

What stimulates the production of WBCs?

interleukins

What organ filters RBCs?

spleen

What is culling?

when the spleen destroys a RBC because it is old

RBCs deform to prevent what?

hemolysis

What is leukocytosis?

an increase in WBCs

What can leukocytosis indicate?

bacterial infection, leukemia

What is leukopenia?

a decrease in WBCs

What can leukopenia indicate?

viral infection, chemotherapy

What would a large increase in myeloblasts indicate?

leukemia

What organ is involved in immunity and inflammation?

lymph nodes

Myeloblast characteristics

nucleus: round or oval with abundant, unclumped light purple chromatin

cytoplasm: sparse, blue-gray

nucleoli: 2-5

granules: none present

Promyelocyte characteristics

nucleus: round or oval, slight chromatin clumping

cytoplasm: more evident than blast

nucleoli: 1-2, beginning to fade

granules: large non-specific, red to purple

Myelocyte characteristics

nucleus: round or oval, chromatin getting coarser

cytoplasm: clearing observed near nucleus, may observe dawn of neutophilia

nucleoli: none present

granules: primary & secondary granules

Metamyelocyte characteristics

nucleus: kidney bean shaped, chromatin getting coarser, stains darker

granules: secondary granules, more pink

Neutrophilic band characteristics

nucleus: horse-shoe or C shaped, chromatin very clumped, pyknotic ends

cytoplasm: abundant, pink

granules: secondary granules

Segmented neutrophil characteristics

nucleus: pinched into segments connected with a fine filament, 3-5 lobes, chromatin coarse,

cytoplasm: abundant, pink

granules: secondary granules