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Credits to Mir Clifford Elvina's notes, including our last quiz to serve as a review for finals.
High Power Objective (HPO)
What objective can be used for WBC count estimate?
Slower
Refrigerated ESR can caused __ sedimentation rate.
Acidified Serum Test (Ham Test)
Which of the following laboratory tests would be best to confirm PNH?
Flow cytometry for FLAER binding, CD24 on granulocytes, and CD14 on monocytes.
Flow cytometry for detection of eosin-5'-maleimide binding on erythrocytes
Osmotic fragility test
Acidified serum test (Ham test)
Low Power Objective (LPO)
What objective can be used in the general assessment of the smear?
Megaloblastic Anemia
Bronze Skin Diabetes is the most common among patients with
Thrombocytosis & Leukocytosis
Macroscopic examination of the smear shows blue specks at feathery edge. This indicates:
Faster
Identify the rate of sedimentation if the following condition (Westergren was used), inflammation
Point Mutation
The most common mutation causing hemoglobinopathies is
Create a smear from a purple top tube after 1 hour.
In the collection of samples for peripheral smear which of the following is not applicable?
Create a smear from a green top tube immediately after collection
Create smear at the bedside using blood without anticoagulant
Create a smear from a purple top tube after 1 hour
Collect blood for PBS using a tube with K2EDTA
Oil Immersion Objective (OIO)
What objective can be used for relative differential count?
Recollect blood using a light blue top
In the presence of PLATELET SATELLITISM, which of the following is the best remedy?
Recollect blood using a light blue top
Recollect blood using EDTA and invert it properly
Recollect blood using a gray top tube
Recollect blood using a green top tube
Automated Winthrobe Method
It is an ESR method that is sensitive and can be performed within approximately 70 minutes.
Oil Immersion Objective (OIO)
What objective can be used for platelet count?
Presence of sickling cells macroscopically
A positive results for Sodium Metabisulfite Test is
None of the above
What objective can be used for absolute differential count?
None of the above
Low Power Objective (LPO)
All of the Above
Oil Immersion Objective (OIO)
High Power Objective (HPO)
A mutated RBC membrane protein affecting horizontal protein interactions
The altered shape of the spherocyte in HS is due to
120 Days
A normal erythrocytes has an average life span of
Megaloblastic Anemia
It is the defect in DNA synthesis that results in abnormal nuclear maturation characterized with asynchronous maturation of nucleus and cytoplasm
Faster
Titling the ESR tube may caused __ sedimentation rate.
Osmotic Fragility Test
Screening Test for Hereditary Spherocytosis: This Occurs after the body has a forceful contact with hard surfaces seen among marathon runners, tennis players (Hemolytic Disease of The Newborn: March Hemoglobinuria; Hemolytic Transfusion Reaction, Autoimmune Hemolytic Disease)
Presence of Ring Sideroblast
Hallmark of sideroblastic anemia
Dilution of the blood
The correction factor, 1.1 is needed because
Macrophage mediated
RBC destruction that occurs when macrophages ingest and destroy RBCs is termed
Polymyalgia rheumatica
ESR can be used in the diagnosis of
Grainy appearance
What will be the macroscopic appearance of the smear if the patient has cold hemagglutinin
Abetalipoproteinemia
Acanthocytes are found in association with
It should be tongue or bullet shape
All of the following is a characteristic of a good smear except:
The film is two thirds to three fourths the length of the slide
When the slide is held up to the light, the thin portion of the film has a “rainbow” appearance.
The film is smooth without irregularities, holes, or streaks
It should be tongue or bullet shape
Increased osmotic fragility, positive DAT result
Which one of the following sets of results is consistent with HS?
Decreased osmotic fragility, positive DAT result
Increased osmotic fragility, negative DAT result
Increased osmotic fragility, positive DAT result
Decreased osmotic fragility, negative DAT result
1:label
The drop of blood should be __ cm away from the __ of the slide
Autohemolysis test
Screening Test for Hereditary Spherocytosis (HS)
Sideroblastic Anemia
It is caused by blocks in the protoporphyrin pathway resulting in defective hemoglobin synthesis and iron overload
Decrease the angle of the spreader slide
The blood smear made on a patient with polycythemia vera is too short. What should be done to correct this problem?
Cannot be determined
A recollected blood for CBC was done using heparin had a platelet count of 155x10^9/L what is the corrected count
Increased MCHC
In HS, a characteristic abnormality in the CBC results is:
90mm/hr
The expected ESR of temporal arteritis is
3 months
A normal erythrocytes has an average life span of
Faster
Identify the rate of sedimentation if the following condition (Westergren was used), hemolyzed specimens
Presence of Turbidity
A positive results for Sodium Dithionite Test is
Faster
Identify the rate of sedimentation if the following condition (Westergren was used), increased anticoagulant
Slower
Identify the rate of sedimentation if the following condition (Westergren was used), dehydration
Pyruvate kinase deficiency
The most common defect or deficiency in the anaerobic glycolytic pathway that causes chronic HNSHA is
Methylene blue and eosin
The components of Wright's stain include:
Hemolysis
What is the term used for Increased Destruction of RBCs?
Acute Hemolytic Anemia
Rapid hemolysis upon exposure to a particular trigger/substance/condition or environment
Chronic Hemolytic Anemia
Underlying hemolytic anemia that can go undetected but has an increasing burden over time.
Inherited Hemolytic Anemia
Factors that lead to hemolysis are hereditary.
Acquired Hemolytic Anemia
Factors that lead to hemolysis are due to exposure.
Intrinsic Hemolytic Anemia
Hemolytic factors are INHERITED.
Extrinsic Hemolytic Anemia
Hemolytic factors are ACQUIRED.
Fragmentation
Alternative name for Intravascular Hemolysis.
Macrophage Mediated
Alternative name for Extravascular Hemolysis.
Intravascular Hemolysis
Hemolysis occurs in blood vessels.
Extravascular Hemolysis
Hemolysis occurs outside the blood vessels.
Spleen
Where does Extravascular Hemolysis usually occur?
Spectrin
What is the most major cytoskeletal protein for maintaining cell shape, as well as the cytoskeletal protein of Red Cells?
Anchor assembled spectrin molecules to the lipid bilayer
What is the role of Ankyrin?
Transmembrane Proteins
What is the classification of Ankyrin and Actin?
Hereditary Spherocytosis
What is the most common hemolytic anemia caused by membrane defects?
Increased permeability to sodium leading to loss of membrane
What is the effect of Hereditary Spherocytosis (HS)?
Autosomal Dominant & Autosomal Recessive
What are the causes of Hereditary Spherocytosis?
Autosomal Dominant
Defective binding of Spectrin to Protein 4.1.
Autosomal Recessive
The Spectrin deficiency.
Osmotic Fragility Test
Confirmatory Test for HS.
Hereditary Elliptocytosis
What is the 2nd most common hemolytic anemia caused by membrane defects due to polarization of cholesterol at end of cell?
Hereditary Somatocytosis
What membrane defect causes abnormal permeability to both sodium & potassium, causing the RBC to swell?
Hereditary Hydrocytosis
Alternative name for Hereditary Stomatocytosis?
Hereditary Acanthocytosis
What membrane defect is caused by an increased cholesterol:lecithin ratio due to abnormal plasma lipid concentration?
Abetalipoproteinemia
Alternative name for Hereditary Acanthocytosis?
Absence of Serum ß-Lipoprotein
Distinguishable factors in Hereditary Acanthocytosis.
G6PD deficiency
What enzymopathy intrinsic defect causing hemolytic anemia is a sex-linked enzyme defect?
Orientals & Mediterranean
Group of people that G6PD is most severe at:
Fava Beans
What vegetable makes G6PD deficiency harmful?
Pyruvate Kinase Deficiency
What enzymopathy intrinsic defect causing hemolytic anemia is the most common enzyme deficiency in the Embden Meyerhof pathway?
Paroxysmal Nocturnal Hemoglobinuria
What enzymopathy intrinsic defect causing hemolytic anemia is related to RBC membrane having an increased sensitivity to complement binding?
Ham's and Sugar water test
Screening Test for Paroxysmal Nocturnal Hemoglobinuria?
Hereditary Pyropoikilocytosis (HPP)
What enzymopathy intrinsic defect causing hemolytic anemia is related to extreme red cell thermal sensitivity?
Normocytic, Normochromic anemia
What type of anemia does Extrinsic defects cause?
Accelerated destruction with reticulocytotic
Effect of Immune defects.
Warm Autoimmune Hemolytic Anemia (WAIHA)
Immune defect related to membrane loss and spherocytes due to coating of RBC with IgG & Complement.
Cold Autoimmune Hemolytic Anemia (CAIHA)
Immune defect related to membrane loss and spherocytes due to coating of RBC with IgM & Complement.
Paroxysmal Cold Hemoglobinuria
Immune defect that is Donath-Landsteiner test Positive.
Hemolytic Transfusion Reaction
Immune defect that is related to ABO incompatibility
Hemolytic Disease of the Newborn
Immune defect that is related to newborn Rh & ABO incompatibility.
Microangiopathic Hemolytic Anemia (MAHA)
Non-Immune defect that is related to liver disease/Disseminated intravascular coagulation.
March Hemoglobinuria
Non-Immune defect that is caused after forceful contact of the body with hard surfaces.
Infection by Plasmodium falciparum, Thermal burns such as 3rd degree burns, Venoms, & Mechanical trauma
Other causes of Non-Immune defects that leads to Hemolytic Anemias.
Fresh drop of capillary blood without Anticoagulation
What are Peripheral Blood Smears made of?
Best morphology of blood cells
What is the main advantage of PBS?
2-3 Hours
How long is the viability of blood sample for PBS?
EDTA
What tube is venous blood collected in?
Ethylenediaminetetraacetic acid
Full form of EDTA
Platelet Satellitosis
What is the term for the phenomenon wherein platelets aggregates/surrounds the neutrophil?
Falsely low platelet count
Effect of Platelet Satellitosis
Falsely low platelet count
Effect of Pseudothrombocytopenia
Light Blue Sodium Citrate top tube
What tube is used to prevent Pseudothrombocytopenia?
1.1
What is the correction factor of Light Blue top tube?
Manual Wedge Technique, Cover glass method, & Automated Smear Preparation
What are the 3 methods of Preparing a PBS?
Manual Wedge technique
What is the most convenient & commonly used method for preparing a PBS?
Cover slip technique
What method is commonly used for bone marrow smear preparation?
Erhlich's method & Beacom's method
2 methods of Cover Slip technique.
Note 
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