HEMATOLOGY

Questions/Keywords Response
ESR is increased. What is the cause of the increase LEUKEMIA
with WBC as the basis?
hyperfibrinogenemia ______ ESR: increases

Poiks decreases ESR

ESR is decreased. What is the cause of the LEUKOCYTOSIS
decrease with WBC as the basis?
Precursor of Kallikrein fletcher (prekallikrein)

Aplastic anemia antibiotic chloramphenicol

Normal newborn hemoglobin 16.5 g/dL

adults: 12-15 g/dl
A small hemorrhagic spot but larger than petechiae ecchymosis
characterized by a rounded or irregular blue or purplish
patch; also known as bruise and is found in skin and MM
Monocyte cytoplasm color with Wright’s stain: Bluish gray
lymphocytes-pale blue
rbcs-salmon pink
Acute leukemia type of anemia normo normo
>11x10 raised to the 9 th WBCs leukocytosis

Tertiary granules appear during what stages? metamyelocytes and bands

RBC with membrane folded over (folded cell) hgb C and hgb SC
It is referred to as a gamma heavy chain disease Franklin's disease:
Revisit mixing studies
Giant platelet syndrome Bernard Soulier Syndrome
Maximum number of minutes for tourniquet 1
Drabkin’s reagent wavelength 540nm
carboxyhemoglobin-576 nm-cherry red
sulfhemoglobin-618 nm-mauve lavender
methhemoglobin--630 nm--chocolate brown
Normal aptt boards: 25-35; 25-36
PT: 10-13
TT< or eq to 21
7 to 7.5 cm (70-75 mm) long, 1 mm bore (1.2 mm) Capillary tube
11.5 cm long, 3 mm bore
30 cm long,2.5 mm bore Wintrobe tube
Westergren tube

Codocyte other name target cell, bulls eye cell, leptocyte

The maintenance of a high intracellular potassium level na-k-pump
is governed by the _______.
Cyclooxygenase is inhibited by: aspirin
-Last stage in RBC series capable of mitosis POLYCHROMATOPHILIC NORMOBLAST -rubricyte
-In WBCs? myelocyte
-Last nucleated stage (rbcs) orthochromatophilic normoblast/metarubricyte
What is the solid tumor counterpart of stem cell lymphoma undifferentiated
leukemia?
Erythrocyte morphology abnomality: marked 4+
BD transfer needle gauge 18
used to transfer blood from synringe to tube
An RES component that removes RBC inclusions spleen
without lysing it.
M3 usually manifests this coag problem DIC
Pediatric needle gauge 23
Autosplenectomy is common in SCA (sickle cell anemia)

Computation: Corrected Reticulocyte Count; Corrected

WBC count

Function of eosinophil storage vesicles carry proteins from secondary granules to be released into
the extracellular medium

Clotting factor with “Fitzgerald factor” as another HMWK

name
Result of fibrinogen deficiency in clot PT Prolonged, APTT Prolonged, Thrombin Time Prolonged
test/coagulation studies
Fibrin clot electromechanical method: FIBROMETER

Carboxyhgb and Methgb are incapable of oxygen transport

helmet cells/with horn-like projections keratocytes

sometimes described as mexican hat by other references
Calculate the MCHC hct 47, rbc: 4.5; hgb-15
hgb/hct x 100
31.91%
Characteristic RBC in PM (Primary Myelofibrosis) Dacrocytic (Teardrops poiks)

What is the primary inhibitor of the fibrinolytic ALPHA-2-ANTIPLASMIN

system?
SCD anemia normocytic and normochromic

What is the major leukocyte in Aplastic anemia? lymph

Result of Factor X deficiency in clot test/coagulation PT Prolonged, APTT Prolonged, Thrombin Time Normal
studies
Embryonic hemoglobins gower 1 and 2, portland
Miller disk is utilized for _______. retics
nRBCs are counted in _____. WBC chamber
Smallest platelets seen in Aiskott Aldrich Syndrome

Blood cell disorder with a low platelet count and May-Hegglin anomaly
cytoplasmic inclusions with granules that look like Dohle
bodies.
CML negative for philadelphia chromosome poor prognosis
TRAP hallmark hairy cell leukemia
Not affected by a falsely elevated HCT? mch
A cell seen normally in the peripheral blood and is band
considered as the youngest type regularly seen in
smears.
Nucleated RBCs in smears is a sign of accelerated bone marrow erythropoiesis
 A black line is used for this Hgb S test: Dithionate solubility test
Cell counts 4200/uL
1:20 4,200,000/ml
4 wbcs 4,200,000,000/L
20,23,22,19
preferred anticoagulant for ESR 3.8% trisodium citrate or EDTA
Not stained by SBB lymphocytes
G6PD deficiecny is characterized by _______ bite cells

The only unmeasured hemoglobin in Cyanmeth. sulfhemoglobin

Primary or non-specific granules truly appear on this PROMYELOCYTE
stage:
Vasoconstriction is under: primary hemostasis
Length of the slide covered in PBS 2/3 to 3/4
Shift to the left includes band, metamyelocytes, myelocytes , promyelocytes
It shows a problem in platelet adhesion due to Mutations Bernard-Soulier syndrome
to platelet GP IB or GP IX.
PPE required in strict isolation gown, mask and gloves
Smudge cells, soccer-ball, clover leaf (reider cell) CLL
Rule of three normocytic normochromic
rbc x 3= hgb; hgb x 3= hct
WBC with bilobed nucleus and large granules that does pelger huet cells
not obstruct the nucleus.
Target INR/recommended INR range for treatment 2-3
of deep venous thrombosis
In normochromic and normocytic RBCs, Hct is ___x the 3
hgb
A cutaneous T cell lymphoma characterized by Sezary syndrome
peripheral lymphadenopathy, exfoliative erythroderma.

First rbc stage that becomes vividly pink (cytoplasm) polychromatophilic normoblasts
Active adult marrow sites verteb, pelvis, ribs, proximal ends of long bones, shoulder
blades (scapula)
____________ is characterized by macrophages with Burkitt’s lymphoma
starry sky pattern under low power and seen with
numerous apoptotic debris.
Condition with thin flattened and concave fingernails; koilonychia
seen in IDA
Factor deficiency in Ashkenazi jews factor XI deficiency---rosenthal
pattern in rosenthal: abn PTT and norma PT and TT---congenital single factor def
type of bleeding: mild intermittent bleeding
factor deficiencies that may show such pattern: VII and IX

hemoglobinopathy versus thalassemia Hemoglobinopathies: QUALITATIVE defect in hemoglobin

Thalassemia: QUANTITATIVE defect in hemoglobin
Platelet phospholipids are inhibited by: Lupus anticoagulant
Megaloblastic anemia description Macrocytic, normochromic:

CALLA marker CD 10: common all

tube for microhematocrit: 7cm long and 1mm bore diameter
Found in infections, poisoning, burns and chemotherapy and are described as dohle
RER with RNA with localized cytoplasmic maturation.

aka stress platelets reticulated platelet

What parameter can’t differentiate IDA from ACD? Transferrin sat

IDA-dec
 ACD-dec or normal
Provides a cytoskeleton to maintain platelet shape A.organelle zone
and a contractile system B.peripheral zone
C.sol-gel zone

Sol gel zone maintains platelet shape through __________: microtubules

Flow cytometry includes 1. electronics
2. fluidics
3. optics
4. Computer
1,2,3,4
Not a normal embryonic hemoglobin: portland 2
WBC correction is necessary because It causes a falsely elevated WBC count
A thin, flat red cell with hemoglobin at periphery and Leptocyte
increased central pallor showing a characteristic
hypochromic cell

patient’s battery of tests: blue-red-lavender

Lipid profile
Liver profile
CBC
PT and APTT
What is the correct order of draw?
Nodular lymphocyte-predominant hodgkin cell popcorn cell
adult population Neutrophil differential count range 50-70%
a second x chromosome seen in females Barr body/drumstick body
2-3% of neutro in fem
always 1 less number than the number of x chromosomes in
the body
Lab findings in Anemia of Chronic Disease -decreased or normal ferritin
-decreased TIBC
-decreased serum iron
If the RBCs are excessively lysed, a ___________ is Negative instrumental error:
possible.

Positive instrumental errors: BEA

Bubbles in the sample, extraneous electrical pulsesand
aperture plugs (most common)

Instrumental error that is either a positive or negative error: Improper

setting of aperture current or threshold
Needle length in routine phlebotomy Length of needle in routine phlebotomy: 1.0-1.5 inches
Coarse azurophilic MPS granules are seen in all alder reilly
leukocytes and more commonly in myelocytic series.
Vitamin K dependent factors 2, 7, 9, 10
A cell that is enucleated with 1/3 central pallor discocyte
This method is a key way of initial classification and a RPI
reliable assessment or measure of effective RBC production.
What is the usual marker for hematopoietic stem cells? CD 34

Normal variants of hemoglobin

A patient with PCV will have a ________ RP and APTT prolonged
Technical jargon for the variation in rbc volume seen in a anisocytosis--volume or diameter
blood smear? poik
shape? <6um <80fL
Microcytosis? >8um; >100fL
macrocytosis?
Macrohematocrit: Centrifuge at 2,000 to 2,300 g for ___ minutes 30
Microhematocrit: Centrifuge at 10,000 to 15,000 g for __ minutes 5
NK cell CD markers CD16 and CD56
MEMORIZE ALL PLATELET ESTIMATES
Sezary cells are present in _______. the skin, lymph nodes and peripheral blood

ALP is a part of the Neutrophil’s _______. tertiary granules--best is secretory

Next test for normocytic anemia A. Indices
B. Hemoglobin
C. Absolute reticulocyte count
60 percent leukocytes is normal in children 6 months to 2 years
A surgical connection between to structures, it usually means a connection ANASTOMOSIS
that is created between tubular structures, such as blood vessels or loops of
intestines

Fibrinolysis screening test Euglobulin clot lysis time

Duration of myelocyte to metamyelocyte 4.3 days

Disease of connective tissue and coagulation vWD- von willebrand’s disease
factor deficiency
Source of energy for platelets A. Phospholipids B. Glucose
This reagent converts methemoglobin to potassium cyanide
cyanmethemoglobin.
Normal template bleeding time range 6-10 min
Expected ESR in Poikilocytosis decreased
Most common complication of venipuncture; leakage of bruising (ecchymosis)
small amount of blood.
Histologic presence is definitive of Hodgkins Reed Sternberg
Hemtocrit layers
First: -First layer of spun hematocrit: FATTY LAYER
Second: -Second layer of spun hematocrit: PLASMA
Third: -Third layer of spun hematocrit: BUFFY COAT
Bottom: -Bottom layer of spun hematocrit: PACKED CELLS
Nucleated RBCs and schistocytes are seen in MAHA

Parameters for MCV computation. HCT and RBCcount

What factor is transglutaminase Factor XIII

MCV, RDW are from: -is derived from RBC Histogram
MPV, PDW? -is derived from Platelet Histogram
Increased EDTA will lead to _____ESR and _____ HCT: Decreased hematocrit, decreased ESR

Fibrinogen level in Hemophilia A, B, and C All may be normal

Why use only 1 inch needle? less intimidating to the patient, better control and less
frightening
A patient with BJ proteins and multiple myeloma show rouleaux
this characteristic in a peripheral smear:

Specific or secondary granules appear on this stage: MYELOCYTE

Erythropoietin actions: -stops apoptosis

-allows early reticolocyte release from Bone marrow
-reduces maturation time of cells in Bone marrow
COAG-A-MATE, Electra and Ortho-Koagulab are _________. Photo-optical methods of clot detection.

The Platelet Glycocalyx is known as _____. Outer surface of platelet: Glycocalyx

FACTOR XI DEFICIENCY rosenthal

False elevation in ESR -high temp

 -ref specimen is not allowed to reach room temp before
processing
In Sulfhemoglobinemia, blood is colored ______. Mauve lavender

The very first cell produced bt the developing embryo rbc-14th day

Correction for WBCs adults-5

neonates-10
What is extramedullay hematopoiesis? Blood production outside the bone marrow:

These are needle-shaped or round inclusions in the Auer

cytoplasm of myoblasts and promyelocytes; described to
be composed of condensed primary granules
5th month gestation major hematopoietic site Liver

This is a neutrophilic protein seen in secondary granules Lactoferrin

with a function of binding iron.
Also known as the labile factor: proaccelerin/ accelerator globulin
Recommendation for counting band cells count with segmenters
Factors VII and XI are activated by _____ cold temp
Labile factors: Factors V and VIII
Flower cells are seen in adult t-cell leukemia-htlv 1
In smear preparation, a drop of blood must be __cm 1
from the edge of the slide.
IDA anemia micro, hypo

Microcytic, hypochromic:
Anemia of chronic disease, thalassemia, IDA and sideroblastic

Clot retraction is possible due to: _________ THROMBOSTHENIN

What age group has the predominance of red bone marrow in the early childhood or infancy
bones?

5-7-adipose replaces red bone marrow from long shafts of the bones.
This is characterized by mutations to platelet GP IIb or Glanzmann's thrombasthenia
Illa resulting into a defect of fibrinogen-dependent
platelet aggregation

RPI formula: % retics x pt hct/45 over maturation time

Maturation time:
pt’s hematocrit
40-45 1
35-39 1.5
25-34 2
15-24 2.5
<15 3
<2-3 is inadequate marrow response
in adults, these 2 sites are the best sites for bone sternum and posterior iliac crest
marrow collection.
Initial sickle cell hemolysis in OFT begins at ____ NaCl 0.35% also in thalassemia
concentration normal- 0.45%
HS-0.65%
Factor for platelet estimate in patients with 20,000
normal RBC count
When blood escapes on small skin and MM areas, it is referred to as Purpura
______.
hemolytic anemia, Acute blood loss, aplastic anemia Normocytic, normochromic:
 MEMORIZE ALL COAGULATION FACTOR NAMES/ SUB-NAMES AND FUNCTIONS
What is the screening test for PNH? Sugar water screening test

Preferred adult site for BM collection iliac crest

Flame cells IgA myeloma
Foam-Niemann
the mechanism about oxygenation status that kidneys
communicates or relays information to erythropoietin
producing sites is found in the ______
Grease or dirt in the slide may lead to _____ in smears. holes
Complete hemolysis in SCA is seen in ___% Nacl: 0.20% also in thalassemia

Normal 0.3%
HS: 0.45%
Cause of menorrhagia factor V
Factor IX
Factor VII
vWF

Menorrhagia--primary hemostasis-petechiae, purpura,

ecchymosis, epistaxis, gum bleeding and hematemesis
secondary: hemarthroses, ICH, hematomas, post-
surgical bleed
It is due to a deficiency of glucocerebrosidase Gaucher’s
manifesting a rare disorder of fat metabolism.

Side light scatter: CELL GRANULARITY

Forward light scatter: CELL SIZE
In calculating for the RPI, the retic count is divided by: 2 (in general, if no mention of pt hct, a correction of 2 is assumed.