Hematology Exam 1 : Stains, cell bio, disorders of neuts, mono, reactive lymphs, RBC function and structure, bone marrow, Intro to Hematology

accurate diagnosis of the proper subtype classification and evaluation of the hematologic neoplasm

cell cytochemistry

what does LAP stand for?

Leukocyte alkaline phosphatase

Enzyme present in neutrophilic granules

LAP

reasons LAP is increased

Infection with neutrophilia

pregnancy last trimester

leukomoid reaction

polycythemia vera

aplastic anemia

multiple myeloma

obstructive jaundice

hodgkins' disease

reasons LAP is decreased

chronic myeloid leukemia (CML)

Paroxymal nocturnal hemoglobinuria

sickle cell anemia

hypophosphatasia

What does LAP differentiate between?

Leukomoid reaction vs CML

Describe the LAP procedure:

examine slide under 100x

count 100 neuts positive for LAP stain

grade each neut (1+-4+)

Calc LAP score / 100 neuts

What is the normal range for LAP score?

11-95

what does MPO stand for?

myeloperoxidase stain

Enzyme present in: neuts, eos, monos, primary granules, and effective microbial killing

MPO

MPO is absent in:

lymphocytes

Which stain is used for classification of acute leukemia that can show myeloblastic and myelomonocytic cells?

MPO

What does SBB stand for?

Sudan black b stain

What does SBB stain?

lipids (non enzyme)

sterols, phospholipids, and neutral fat

SBB is positive for this/these cells:

myelogenous cells and monocytes

SBB is negative for this/these cells:

lymphocytes

Useful stain for distinguishing between AML and ALL

SBB

what is specific esterase / chloroacetate esterase positive for?

myeloids

What is another name for nonspecific esterase stain?

double esterase

What does NSE stand for?

NSE

What is another name for specific esterase?

chloroacetate esterase

what does specific esterase stain?

granulocytic cells

What does NSE stain?

monocytes!!!, macrophages, megakaryocytes, and platelets

What stain distinguishes monoblastic leukemia from myeloblastic leukemia?

NSE with sodium fluoride

What does PAS stand for?

periodic acid schiff stain

What stain stains the cytoplasmic glycogen, glycoproteins, mucoproteins, and high molecular weight carbs?

PAS

What does PAS stain?

All blood cells

Describe the patterns from PAS

Granulocytes: diffused pattern

lymphocytes: granular pattern

ALL cells: block pattern

What is PAS negative for?

erythroid precursors, burkitt cells

What does TRAP stand for?

Tartarate resistant acid phophatase

What is the one major cell that TRAP stains strongly?

Hairy cells

What does TdT stand for?

Terminal deoxynucleotidyl transferase

What cells is the enzyme TdT present in?

pre-B and pre-T lymphoblast

What is a good stain to differentiate ALL from AML?

TdT

stain for reticulocytes?

methylene blue

Stain for heinz bodies

crystal violet

stain for eosinophils in urine?

hansel

stain for iron?

prussian blue

when do you have the highest amt of neuts during your life?

after birth - lowest by 6 months

surface/membrane receptors on neuts:

opsonic receptors, adhesion molecules, chemotactic receptors

what is myeloperoxidase responsible for?

pus

what are the azurophilic or nonspecific granules?

lyssozyme, myeloperoxidase, acid phophatase, protease

what specific granule is responsible for respiratory burst?

NADPHoxidase

If you have a lack of NADPHoxidase, what disease will you have?

Chronic granulomatus disease

What are the secondary granules?

lysozyme, NADPHoxidase, cytochrome b, lactoferrin

What are the contents of tertiary granules?

plasminogen activator, alkaline phosphatase, gelatinase

Which makes tighter bonds with their ligands: selectins or integrins?

integrins make stronger bonds than selectins

What cells are the first line of defense against infection, particularly bacterial and fungal infection through phagocytosis?

neuts

mode of migration: nondirectional, random migration or rolling along the vessel walls

locomotion

mode of migration: directional, repetitive wavelike migration towards the site of infection; morphological change with elongation and pseudopod fomation

chemotaxis

mode of migration: nondirectional acceleration of migration speed under the effect of chemoattractants

chemokinesis

what syndrome has giant lysosomal granules in granulocytes, monos, lymphs, plts, etc?

chediak-higashi

what does chediak higashi syndrome impair?

lysosomal enzyme release

What are the granules in alder reilly anomaly makde of?

precipitated mucopolysaccharide

when do you have the highest % of eos and when do you have the lowest?

highest: at night

lowest: in the morning

approx how many rbcs does an adult have in circulation?

20-30 trillion

Should oxyhemoglobin be high or low?

very very high!

Is less O2 delivered a shift to the right or left?

left

is more O2 delivered a shift to the right or left?

right

Chains of Hb A

A2B2

chains of Hb F

A2 gamma2

chains of Hb A2

A2 Delta2

what percentage of rbcs are removed from circulation daily?

1%

how many rbcs are produced in 1 hours in a healthy adult?

100 billion

during erythropoiesis, the cells go from ___ dependence to ___ dependence

EPO to Iron

Reticulocytes are (increased/decreased) in sickle cell anemia

increased

Reticulocytes are (increased/decreased) in aplastic anemia

decreased

what is inside a mature RBC?

microtubles, intermediate filament, cytoplasm, plasma membrane

where do mature erythrocytes derive their energy from?

anaerobic breakdown of glucose

what is the most abundant peripheral protein in the rbc?

spectrin

what part of the rbc strengthens the membrane, protects it from breaking, and supports biconcave shape and deformability?

microfilaments

what is the principle RBC glycoprotein?

Glycophorin

What does glycophorin carry?

RBC ags

What symptoms does a person with hereditary elliptocytosis show?

person doesnt really get sick and the cells function okay

What protein allows calcium out of the rbc?

calmodulin

another name for a bite cell

degmacyte

what is a common cause for bite cells?

G6PD deficiency

chains for hb H

B4

chains for Hb Barts

Gamma 4

what chromosome codes for beta globulin hb chain?

11

what chromosome codes for alpha globulin Hgb chain?

16

what type of thalassemia carriers are resistant to malaria and coronary heart disease (bc of lower BP)?

B-thalassemia

what is methemaglobin?

iron of the hb molecule is ionized to the ferric state (Fe3+)

how much iron do we absorb a day?

1-2 mg/day

where do we absorb iron?

duodenum

What are howell jolly bodies made of?

dna

what are heinz bodies made of?

denatured hb

what are pappenheimer bodies made from?

iron deposits

What are hb H inclusions made of?

hb

what is basophillic stippling made of?

RNA

what stain can you see heinz bodies with?

supravital

a process responsible for generation, differentiation, and maturation of functional blood cells

hematopoiesis

complex of sequence of events in which pluripotential stem cells first commit to either a lymphoid or myeloid lineage and then develop into terminally mature cells

hematopoiesis

does hematopoiesis occur in red marrow or yellow marrow?

red marrow

Highly vascular modified connective tissue that occupies the cavities of flat bones, sternum, vertebrae, pelvis, ribs, skull, and proximal portion of long bone in adults

red marrow

normal myeloid maturation

myeloblast, promyelocyte, myelocyte, metamyelocyte, band/stab, segmented

normal erythroid maturation (dumb names)

pronormoblasts

normoblasts basophilic

normoplasts polychromatophilic

normoblasts orthochromatic

mature rbc

stage 1 of rbc maturation (dumb names)

pronormoblasts

stage 2 of rbc maturation (dumb names)

normoblastic basophilic

stage 3 of rbc maturation (dumb names)

normoblastic polychromatophilic