BOC Hematology

In order for hemoglobin to combine reversibly with oxygen, the iron must be

In the ferrous state

Which description fis the Donath Landsteiner antibody

IgG biphasic hemolysin

(Specific) secondary granules pf the neutrophilic granulocyte

Appear first at the myelocyte stage

Pluripotent hematopoietic stem cells are capable of producing

Lymphoid and myeloid stem cells

Auer rods are characterized by

Fused primary granules

Which is a characteristic of cellular changes as megakaryoblasts mature into megakaryocytes in the bone marrow

Nuclear division without cytoplasmic maturation

True statement of megakaryocytes in bone marrow

An average 5-10 should be found in each low power field (10x)

After the removal of red blood cells from the circulation hemoglobin is broken down in

Iron, heme, globin

Which cells are involved in inmediate hypersensitivity reactions

Basophils

A Wright Stained peripheral blood smear reveals blue, ring shaped inclusions with red chromatin dots in several of red blood cells. These inclusions are consistent with

Malarial parasites

HGB 11.5 g/dL

HCT 34%

MCV 89 fL

MCH 29pg

MCHC 29%

Normocytic, hypochromic erythrocytes

Multiple myeloma

Roleaux

Automated hematology analyzers calculate the hematocrit using which following

MCV and RBC

Analogy: MCV = HCT/RBC x 10

A false elevation in a manual hematocrit (microhematocrit) determination may result from

Trapped plasma

Increased MCHC

Spherocytes

Amount hemoglobin in red blood cells

MCH

RDW-CV and RDW-SD provide

Index of distribution of rbc volumes

MCV 55fL

MCHC 25%

MCH 17pg

Microcytic, hypochromic

Calculate MCV

RBC 2.00 × 10^6 uL

HCT. 24%

HGB 6.8 g/dL

Retic 0.8%

MCV = HCT/RBC x 10

24/ 2 × 10=120 fL

MCH formula

HGB/RBC x 10

MCH calculation

HCT 20%

RBC 2.4 × 10^6 uL

HGB 5 g/dL

5/2.4 × 10=20.833 > 21pg

MCHC

HGB/HCT x 100

MCV formula

HCT/RBC x 10

The calculated erythrocyte indices on adult man are

MCV= 89fL

MCH: 29pg

MCHC: 38%

The calculations have been rechecked; erythrocytes on the peripheral blood smear appear normocytic and normochromic with no abnormal forms. The next stop is:

Repeat hemoglobin and hematocrit

B

Alpha es lo mas que hay en adultos 95-98% y aumenta a medida que creces porque de bebé tienes mas HgF

D

Increases after 30 week of gestation so aumenta a medida que uno crece (pensemos)

C

Gamma se desarrolla en liver y BM (elevada) y luego va disminuyendo después que naces

Pernicious anemia is

Macrocytic (B12 defiency)

Hemolysis in Paroxymal Nocturnal Hemoglobinuria (PNH) is:

Caused by a red cell membrane

Associated to idiopathic hematomachrosis

Iron overload in tissue

A patient with policytemia vera is most likely to develop deficiency of

Iron

DAT can help to distinguish

Inherited shperocytosis from acquired spherocytosis

Anemia of chronic inflammation is characterized by:

Decreased serum iron levels

Factors common involved in causing anemia in patients with chronic renal disease include:

Inadecuate erythropoiesis

The hypoproliferative red cell population in bone marrow of uremic patients its caused by:

Decreased levels of circulating erythropoietin

Anemia of chronic inflammation

Iron levels decreased

TIBC decreased

Severy hypochromic microcytic anemia patient with history of chronical bleeding.

Which result set would be expected in this case?

Serum iron decreased

TIBC increased

Storage iron decreased

Which is the most closely associated with iron deficiency anemia

Chronic blood loss

Defect in thalassemia:

Quantitative deficiency in RNA result in decreased globin chain production

20 yrs old African American has peripheral blood changes suggesting thalassemia minor. The quantitative A2 level is normal, but the HbF level is 5% (normal <2%) This is most consistent with:

Delta- beta thalassemia minor

TIP» Si es major es 100% HbF

Anemia secondary to uremia and chronic renal disease characteristically is:

Normocytic, normochromic

Laboratory findings consistent with hemolytic anemia:

Increased serum lactate dehydrogenase (L D)

Increased catabolism of heme

Deficiency of this enzyme associated with moderate-severe hemolytic anemia after exposure to certain drugs and with cell inclusions of hemoglobin denature

G6PD

Patient with G6PD deficiency are least likely to have hemolytic episodes in which of the following situations:

Spontaneously

Characteristics of autoimmune hemolytic anemia

DAT +

(abnormal production of antibodies)

Pernicious anemia

Macrocytosis and Pancytopenia

Macrocytosis and pancytopenia

Vitamin B12 deficiency

Folic acid deficincy anemia characteristic:

Macrocytic

Megaloblastic asynchronous development in bone marrow indicates:

Impaired DNA synthesis

Associated with megaloblastic anemia

Neutropenia and thrombocytopenia

Characteristic features of iron metabolism in patients with anemia of chronic inflammation

Serum iron decreased

Transferrin saturation decreased

TIBC normal or decreased

Characteristic of morphologic feature of Hemoglobin C

Target cells

Thalassemia are characterized by:

Deceased rate of globin chains

Thalassemia minor

Laboratory findings in hereditary spherocytosis:

Decreased RBC band 3 protein

Which of the types of policytemia vera a severly burned patient most likelt have:

Relative polycythemia associated with dehydration

Lead poisoning

Basophilic stippling

Pernicious anemia white blood cell feature

Hypersegmentation

Parameter abnormal in hereditary spherocytosis

MCHC

Protein defective in hereditary elliptocytosis

Spectrin

Most common mechanism in hereditary stomatocytosus

Abnormal Na/K permeability

Basic mechanism associated with sideroblastic anemia:

Enzymatic defect in heme synthesis causes iron accumulation

Individuals with Fanconi anemia characteristically show:

Increased HbF

Fanconi is a autosomal recessive disorder of normocytic anemia

Features: short stature, microcephaly, and hyperpigmentation

Abnormal rcb morphonoly in Pyruvate Kynase Deficiency

Echinocytes (Burr cells)

Hemoglobin D y G

Ambas migran con HbS en alkaline gel

Hemoglobinopathiy results from delta and beta gene

HbLepore

Consistent with heterozygous beta thalassemia

Increased red blood cell count

Hereditary persistence of fetal hemoblogin HPFH is due to a loss of expression of globin chain:

Gamma

Anti-I

Cold agglutinin disease

Most common presentation of paroxymal cold hemoglobinuria

Children with viral illnes

Anemia of hospitalized patients

Anemia of chronic inflammation

Increased red cell mas into 99 percentile

Serum erythropoeitin level below range

Which of following criteria confirm a diagnosis of polycytemia vera?

JAK2 V617F mutation

Spherocytes and policromasia

HDN and ABO incompatibility

Polycytemia vera M:E ratio

4:1

A patient has a tumor that concentrates erythropoietin. He most likely to have which of the following types of polycytemia?

Polycytemia associated with renal disease

Which type of polycythemia is most often associated with lung disease

Polycythemia, secondary to hypoxia

How does BM respond to anemic distress

Expand production, release RBC prematurely

Which of following conditions contribute lethargy, abdominal pain and hemoglobinuria in G6PD deficiency patients

Ingesting fava beans

The most likely cause of macrocytes that accompanies primary myelofibrosis is:

Folid acid deficiency

Giant, vacuoled, multinucleated erythroid precursors are present in which following:

Erythroleukemia

Significant feature in dyserythropoiesis

Megaloblastoid erythropoiesis

M: E ratio in erythroleukemia

Low

Autoimmune hemolytic anemia is a complication of:

CLL

Total granulocyte count 7.5 × 10³ uL is termed:

Absolute neutrophilic leukocytosis

Elevation of total white blood cells count above 11.0 × 10³ uL is termed:

Leukocytosis

Elevation of lymphocyte percentage above 45% is termed:

Relative lymphocytosis

Relative are %

Absolute are numbers

The mechanism causing catecholamine- induced neutrophilia includes:

A shift in granulocytes from the marginating pool to the circulating pool

What accounts for the smudge cells in CLL

Artifact due to fragile cells

M:E ratio in chronic myelocytic leukemia

Variable

Infectious mononucleosis

Abnormalities in erythroleukemia

Megaloblastoid development

Neutropenia is associated with:

Viral infection

Neutrophilic Leukemoid reaction

Dwarf micromegakaryocytes may found in the peripheral blood of patients with:

Primary myelofibrosis

Pseudo pelger huët anomaly associated with:

Chronic myeloid leukemia

High levels of basohips are seen in which leukemia

CML

Hypercellular Bone Marrow with an M:E 6:1 is most commonly due to :

Granulocytic hyperplasia

Primary myelofibrosis