Hematology 1 Lecture Finals

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.