Medialab Hematology

Bone marrow beggings producing cells in the ________ month of fetal life

Fourth to fifth (4-5m)

Liver: 1 month

Spleen: 2 month

Which of the following cellular components not develop solely in Bone Marrow

Lymphocytes

Is a myeloid, erythroid and megakaryocyte stages

This abnormalities are associated with

Increased red blood cells production

We see: spherocytes and basophilic stippling

All following are granulocytes EXCEPT

Mott cell

Mast cell

Neutrophilic band

Basophil

Almost appear granulated but are containing Russell’s bodies (accumulation of immunoglobulins in the cytoplasm)

Potent platelet inhibitors of platelet aggregation is produced by endothelial cells

Prostacyclin

Prevents formation of platelet plug in primary hemostasis

Platelet function

Clotting

Plug formation

Release serotonin

Repair of injured tissues

Thrombopoiesis, from least mature to most mature

Stem cell

Magakaryoblast

Promegakaryocyte

Megakaryocyte

Thrombocyte

Important proteins regulators of iron metabolism EXCEPT

Hemosiderin

Is an iron-rinch brown pigment NOT protein

Hepcidin, Transferrin receptor, Ferroportin are important proteins

Negative regulator of intestinal iron absorption

Hepcidin

Is the “master iron regulating protein”

In which developmental stage do red blood cells begin forming hemoglobin in amounts large enough to be visualized on a Wright-stained bone marrow aspirate smear?

Polychromatic normoblast

Hemoglobin synthesis is detectable in the basophilic normoblast, but the formation of large amounts of hemoglobin begins in the polychromatic (polychromatophilic) normoblast.

The following polypeptide chains are found in normal adult hemoglobin A:

Alpha y beta

Which of the following statements is correct regarding the bone marrow compartments?

The two main compartments of the bone marrow are the vascular sinuses and hematopoietic cords

Bone marrow biopsy in adults

Iliac crest (posterior)

Bone marrow celullarity formula

100 - age = cellularity of BM

El range es ± 10 de la edad

Effusion fluids are classified as transudates or exudates. According to Light's criteria, all of the following applies to an exudate EXCEPT?

Pleural fluid lactate dehydrogenase (LDH) <2/3 the normal upper limit for serum

To be classified as an exudate, the pleural effusion must meet one of the following criteria:

Pleural fluid/serum LDH > 2/3 the upper limit for serum

Pleural fluid/serum protein ratio >0.5

Pleural fluid/serum LDH ratio >0.6

Serum-ascites albumin gradient (SAGG) <1.1 g/dL

In adults hematopoiesis occurs:

Proximal end of long bones

Most common nucleated cell in Bone Marrow

Metamyelocyte 6-17%

Alder Reilly anomaly

Large, darkly staining cytoplasmic granules composed of partially digested mucopolysaccharides

Phenotypes indicatives of a natural killer (NK)

CD2+, CD3-, CD11b+, CD16+

CD20

B cell marker

CD41, CD42

Megakaryocytic cell markers

The tibia not have active hematopieitic in the bone marrow in ADULTS

Only on children

Mature B cell expression marker

CD19

Life spam of red blood cell

120 days

3-4 months

Blood composed of

45% formed elements

55% plasma

A patient has the following hematology test results. Classify the anemia present by choosing one of the options below.

Hgb = 8.1 g/dL

Hct = 31%

RBC = 4.0 x 1012/L

Microcytic, hypochromic

MCV= 31/ 4.0 × 10=77.5 (microcytic 80-100 normal)

MCH = 8.1/4.0 × 10= 20.25pg (decreased)

The bone marrow in alpha thalassemia usually demostrates

Hyperplasia

Which MCV confirm this image

110 fL

For which of these conditions or procedures there may be an increased number of megakaryocytes in the bone marrow, but a decreased number of circulating platelets?

Folic acid deficiency

Beta thalassemia minor

Which of the following combination of globin chains comprise Hemoglobin H?

Four beta chains

Beta thalassemia chromosome

11

Alpha thalassemia chromosome

16

Which group of conditions increases the risk of HbS polymerization?

Acid pH

Dehydration

2-3 DPG increased

Which of the following laboratory test results indicates that a sickle cell patient may be in aplastic crisis?

Decreased retic count

A patient is admitted to the emergency room with lethargy and pallor.

The CBC results are as follows:

RBC = 4.1 x 1012/L

Hemoglobin = 7.9 g/dL

Hematocrit = 29%

How would classify this anemia?

Microcytic hypochromic

Calculating MCV, MCH, MCHC

Causes of hemolytic anemia

Plasmodium infection

Thermal injury

Brown recluse spider bite

An alpha thalassemia patient is diagnosed as having three of their four genes deleted which code for alpha hemoglobin chains. Which one of the following types of hemoglobin is abnormal and would be found in such a patient?

HbH

What is a correct characteristic of Alpha Thalassemia?

Decreased or absent alpha chain production results in excess gamma chain production during and shortly after birth, followed by excess beta chains later.

Which hemoglobin increase in delta-beta thalassemia major

HbF 100%

A patient is admitted to the emergency room with severe lethargy, glossitis, and muscle dysfunction. After the physician orders a complete blood count with differential, the hematology technologist observes cells matching the image to the right.

Which condition is most consistent with the clinical and laboratory findings?

Iron deficiency anemia

Anemia of chronic inflammation, also known as anemia of chronic disease, can be caused by all of the following mechanisms EXCEPT:

Decreased ferritin

(Are normal or increased)

A peripheral smear with red blood cells photographed in a typical field was submitted for review. All of the following conditions are most likely associated with the red blood cell population found here, EXCEPT:

Hereditary Hematomachrosis (HH)

Associated with: Srvere liver disease,Hemoglobinopathy, Beta thalassemia

Which of the following hemoglobins is replaced by hemoglobin H (HbH) after birth in individuals with HbH disease?

Bart’s