hematology final

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hematology final
2011-10-17 15:24:37
final hematology review

review for final
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  1. Acanthocyte
    Cell with irregular, long, asymmetrical projections; s
  2. Anisocytosis
    Variation in size of RBC's
  3. Basophilic stippling
    Small aggregates of RNA are seen as small blue dots in the RBC
  4. Elliptocyte
    Elongated, elliptical cell; non-specific when occasionally seen; rare disorder of hereditary elliptocytosis
  5. Heinz body
    Precipitated Hgb seen as a perimembranous blue dot only after supravital staining
  6. Howell-Jolly body
    Small, round deeply basophilic nuclear remnant; seen when spleen is absent
  7. Pappenheimer body
    Multiple, tiny iron containing granular blue dots; seen when spleen is absent and with iron overload
  8. Poikilocytosis
    Variation in shape of RBC's
  9. Spherocyte
    Small, round dense cell without central pallor; suggests extravascular (splenic) hemolysis in previously normal persons; with hereditary spherocytosis there is increased osmotic fragility
  10. Schistocyte
    Fragmented, irregularly shaped seen with intravascular hemolysis such as microangiopathic hemolytic anemias (DIC, TTP). A variant called a "helmet cell" appears cut in half
  11. Sickle cell
    Curved, banana-shaped cell with pointed ends found in sickle cell disease from aggregation of Hgb S
  12. Target cell codocyte
    Cell with central and peripheral staining with intervening pallor due to increased redundancy of RBC membrane; seen with liver disease, in some thalassemias, and with Hgb C
  13. Tear drop cell dacryocyte
    Cell pinched at one end, prominent in myelofibrosis and myelophthisic conditions
  14. Neutrophils
    in response to bacterial infection or inflammatory disease
  15. Eosinophils
    in response to allergic disorders, inflammation of the skin, and parasitic infections
  16. Basophils
    increase in cases of leukemia, chronic inflammation, the presence of a hypersensitivity
  17. Lymphocytes
    increase in cases of viral infection, leukemia, cancer of the bone marrow,
  18. Monocyte
    in response to infection of all kinds
  19. Neutrophils
    (10-12 um diameter)
  20. Eosinophils
    larger than PMNs 12-17 um diameter
  21. Basophils
    0.5% of the WBCs are difficult to find. They are 10-12 um diameter
  22. Monocytes
    the largest WBC 14-20 um diameter
  23. Platelets
    small (2-5 um) fragments of cytoplasm detached from Megakaryocytes in the bone marrow.
  24. Lymphocytes
    both small (slightly larger than an Rbc 7-8 um) and medium to large (up to 12 um
  25. Hematopoiesis
    The process responsible for the replacement of circulating cells, governed by multiple cytokines
  26. Commitment
    When two cells derived from the same precursor take a separate route of development
  27. Circulating cells are
    Mature ,Incapable of mitosis
  28. CFU-GEMM
    Granulocytes, erythroid cells, monocytes, megakaryocytes
  29. CFU-GM
    Granulocytes, monocytes
  30. CFU-Mk
  31. Pluripotential hematopoietic stem cell
    self renewal
  32. Earliest differentiation daughter cells give rise to
    Common lymphoid progenitor cell (CLP), Common myeloid progenitor cell (CMP)
  33. CLP gives rise to
    T and B cells, natural killer cells, lymphoid dendritic cells
  34. CMP gives rise to
    Neutrophils, monocytes, eosinophils, basophils, erythrocytes, megakaryocytes
  35. Growth factor cytokines
    Most are produced by stromal cells in the hematopoietic microenvironment
  36. Later acting growth factors to maturation
    • Granulocyte stimulating factor (G-CSF)
    • Monocyte stimulating factor (M-CSF)
    • Erythropoietin (EPO) – erythrocytes
  37. Erythropoiesis –Progenitor cells give rise to
    BFU-E, Regulated by IL-3, GM-CSF
  38. Erythropoiesis –Progenitor cells give rise to
    CFU-E- Depends primarily on EPO
  39. CFU-E
  40. Gives rise to the first recognizable erythrocyte precursor-Pronomoblast
  41. Extracellular Matrix (ECM)
    Composed of-Collagen,Glycoproteins,Glycosaminoglycans
  42. hematopoietic microenvironment
    PCs can interact with only some types of ECM components
  43. Leukocytes diapedese
    pass through the vessel walls.
  44. The greatest difference between reference intervals occur between
    Newborns and adults
  45. clinical pathways refer to plans
    developed by physicians
  46. critical pathways refer to care and service
    provided by interdisciplinary health care team
  47. follow-up testing based on screening test is
    reflex testing
  48. Plasma makes of __ blood volume
  49. Erythrocytes __ blood volume
  50. fee for service
    chose there own health care
  51. capitated payment plans
    for defined population per member fee
  52. Prospective payement system
    fixed amount for services
  53. HSC->
  54. MPP gives rise to
    CLP and CMP
  55. CMP
    CFU- GM, GEMM, EMk
  56. CFU-EMk gives rise to
    BFU-E and BFU-Mk
  57. BFU give rise to
    CFU E and Mk
  58. Neutrophils and monocytes derived from the common committed bipotential progenitor cell
  59. the growth of hematopoietic precursor cells requires the continous presence of
    growth factors
  60. the first effects of GF is to promote
    cell survival
  61. BFU form large colonies after
    14 days
  62. CFU grow to maximum size in
    7 to 8 days and depends on EPO
  63. all hematopoietic cells are derived from the CFU-GEMM except
  64. the following cell is most sensitive to EPO
  65. Pleiotrophy refers to
    act on one or more cell type
  66. a true hormone
  67. Erython
    delivery of O2 from lungs to the tissues and transfer of CO2 from tissues to lungs
  68. RBC is a
    7-8 µm,80-100 fl
  69. Average adult RBC
    2.2 L of rbcs 100-120 days
  70. BFU-E
    1st progenitor committed to RBC line
  71. CFU-E
    high concentration of EPO receptors
  72. Normoblasts
    5-7 days maturing in BM
  73. Reticulocyte
    Matures in 2-3 days, first 1-2 days spent in BM, remainder in circulation
  74. Pronormoblast also known as
  75. Pronormoblast
    20-25 µm, fine chromatin (“lacy” appearance, 1-3 faint nucleoli
  76. Pronormoblast produces
    8-32 mature RBCs
  77. Pronormoblast cytoplasm stains
    deeply blue (basophilic)
  78. Basophilic normoblast is also known as
  79. Basophilic normoblast
    16-18 µm
  80. Basophilic normoblast
    chromatin is coarser than the Pronormoblast
  81. Prorubricyte/basophilic normoblast are nucleoli apparent?
  82. nucleoli are usually not apparent
  83. Basophilic normoblast nucleus is
    wheel-spoke appearance
  84. Polychromatophillic normoblast is also known as
  85. Polychromatophillic normoblast size is
    12-15 µm
  86. Polychromatophillic normoblast/rubricyte cytoplasm is
    gray-blue cytoplasm
  87. Rubricyte chromatin is
    chromatin irregular and coarsely clumped, shrinking nucleus
  88. What stage does hemoglobin start to synthesize?
  89. Orthrochromic normoblast is also know as
  90. Orthrochromic normoblast/metarubricyte size is
    10-15 µm
  91. Orthrochromic normoblast nucleus occupies
    1/4 of the cell, chromatin heavily condensed
  92. Orthrochromic normoblast/metarubricyte cytoplasm is
    pink or salmon color with hint of blue
  93. Reticulocytes size is
    7-10 µm
  94. remaining 20% of hemoglobin,
    –2-3 days (in marrow and circulation)
  95. Responsible for net negative charge of rbc
    Zeta potential
  96. hemoglobin concentration Female =
    12.0 – 16.0 g/dL
  97. normal hemoglobin concentration male =
    14.0 – 17.4 g/dL
  98. normal hemoglobin concentration newborn
    13.5 – 20.0 g/dL
  99. Each heme contains___ ferrous (Fe++) iron in its center
  100. one Fe++ iron molecule binds to____ molecule of O2
  101. 1 Hb molecule can carry __ O2 molecules
  102. Embryonic hemoglobin types
    • Gower I (ζ2ε2), Gower II (α2ε2),
    • Portland (ζ2y2)
  103. Hg type 1 year- adulthood
    HbA (α2β2) 97%, HbA2 (α2δ2) 2.5%
  104. oxygen transport–Curve shifts to right
    p50 increased O2 affinity has decreased
  105. oxygen transport–Curve shifts to left
    p50 is decreased, O2 affinity has increased
  106. Methemoglobin
    Hb has the ferric Fe3+
  107. Conditions that stimulate erythropoiesis
    anemia, cardiac or pulmonary disorders, abnormal hemoglobins,high altitude
  108. Destruction of senescent rbcs
    90% extravascularly 10% intravascularly
  109. extravascular destruction
    Occurs in the macrophages of *spleen, liver, BM
  110. Innate immune response
    nonspecific defense mechanism, neutrophil, monocyte, macrophage
  111. Acquired (adaptive) immune response
    antigen-specific response initiated in lymphoid tissue à contact with lymphocytes
  112. EPO is a thermostable ______ hormone
    renal glycoprotein
  113. higher altitudes affect what is the range
  114. Ribosomes
    Assemble amino acids into protein Free and Fixed
  115. Golgi apparatus
    Packages proteins, forms lysosomes
  116. Euchromatin
    unwound and loosely twsisted Transcriptionally active
  117. Heterochromatin
    Transcriptionally inactive
  118. The chromatin structure of a cell's nucleus is light staining, loosely coiled in appearance is
    An immature cell transcriptionally active
  119. Nuclear condensation and blebbing occurs during necrosis or apoptosis
  120. Do necrotic cells initiate the inflammatory response?
  121. Is necrosis energy dependent
  122. Programmed cell death (suicide) is
  123. Removal of excess neutrophils and b lymphocytes after an event is regulated by
  124. Rough ER important in
    synthezing and assembly of proteins.
  125. Assemble amino acids into proteins
  126. Lipids are synthesized by
    smooth ER
  127. More test are ordered based on screening test is
    reflex testing
  128. Caused by external injurious agent, passive event, effects large number of cells
  129. energy dependent, Caused by the cell itself, single cell
  130. Microscope condenser directs
    light beam on to sample
  131. Hemoglobin curve on spectrophotometer is a
  132. R represents the restriction point in cell cycle that
    after which the cell no longer depends on extracellular signals
  133. Period of nuclear division
  134. DNA synthesis (duplicated) is what phase
  135. Period of quiescence
  136. Period after DNA is duplicated
    time between the completion of S and the onset of mitosis G2
  137. Period of cell growth before DNA is duplicated
    The time between the end of mitosis and the next round of DNA replication G1
  138. Factor I
  139. Factor II
  140. Factor III
    Tissue factor
  141. Factor IV
  142. Factor V
    ProACCELERIN labile
  143. Factor VII
    proconvertin stable factor
  144. Factor VIII
    Antihemolytic factor
  145. Factor IX
    Plasma thromboplastin component, christmas factor
  146. Factor X
    Stuart factor
  147. Factor Xi
    Plasma thromboplastin antecedent
  148. Factor XII
    Hageman factor
  149. XIII
    Fibrin stabilizing factor
  150. Which factors have not activated form
    TF (III) and Calcium
  151. Intrinsic pathway factors?
  152. Extrinsic pathway
    TF (III) not normally found in blood, VII
  153. Common pathway factors
    X, V, II, I
  154. Prothrombin group
    Vitamin K dependent
    Prothrombin, Proconvertin, plasma thromboplastin (christmas), Stuart
  155. Prothrombin group
    proteins C, S and Z
  156. Prothrombin group
    All synthesized by liver, all factors but prothrombin found in serum.
  157. Fibrinogen group
    • Thrombin sensitive clotting factors(activated by thrombin)
    • I, V, VIII, XIII
    • Not found in serum consumed during clotting
  158. Contact group
    XII, PK, HK
  159. Contact group is activated by
    negatively charged surfaces, found in serum, also involved in fibrinolysis
  160. Cofactors
    TF, V, VIII, HK, protein S
  161. Enzymes
    • serine XIIa, XIa, Xa, IXa, VIIa, IIa
    • transgluta.. XIIIa
  162. Substrate
  163. Deficiency of VIII
    Hemophilia A, gene on X chromosome
  164. VIII circulates in plasma in a complex with___ in secondary hemostasis
  165. VWF is synthesizd by
    endothelial cells and megakaryocytes
  166. VWF role in primary hemostasis
    mediates adhesion of platelets to vessel wall
  167. Fibrinogen is synthesized by
  168. 3 stages of coverting fibrinogen to fibrin
    thrombin cleavage of fibrinogen into a fibrin monomer, polymeraization of monors to polymers, stabilization of fibrin polymers XIIIa
  169. stem cells have 3 possible fates
    Self renewal, commitment CLP,CMP, apoptosis
  170. Cell membrane has bilayer of phopholipid
    hydrophobic tails, hydrophilic heads
  171. Blood coagulation is the
    • formation of hemostatic plug
    • convert fibrinogen to insoluble fibrin
  172. Hemostasis is a complex between
    Blood vessels, platelets, soluble plasma proteins
  173. Fibrin forming
  174. Fibrin lysing
  175. Primary hemostasis
    formation of platelet plug
  176. Secondary hemostasis
    Reinforcement of platelet plug
  177. hemostasis occurs in
    Venules and arterioles
  178. Injured endothelial lining
    promotes platelet adhesion, activatges coagulation factors initiatng both intrinsic and extrinsic pathways, inhibits fibrinolysis
  179. Megakaryocytes 4 stages
    Megakaryoblast, promegakaryocyte, granular megakaryocyte, mature magakaryocyte
  180. Endomitosis is
    Double DNA content without division nuclear division or cell division
  181. Platelets are released in ___ and 1 megakaryocyte can produce
    BM and 1000-3000 platelets
  182. Regulation of platelet production
    Thrombopoietin, cytokines
  183. Platelet life span
    9-12 days, removed by spleen and liver
  184. Platelets released in BM 2/3 circulate or stay in spleen
    Circulate, 1/3 stays in spleen.
  185. Platelets not activated are in the ____ state and shaped
    resting, discoid
  186. Upon activation platelets shape changes to
    Round and sticky.
  187. Upon activation platelets requires _____to adhere to the collagen in the subendothelial vessel wall.
  188. Agonist are
    the granules to activate platelets from resting state
  189. Myeloblast cytoplasm is
  190. promyelocyte nucleoli
    still visible and primary granules in cytoplasm
  191. Myelocyte nucleoli are ___ present and cytoplasm contains
    not visible and secondary granules dawn of neutrophilia, last stage of mitosis
  192. metamyelocyte nucleus is
    kidneyben shaped,
  193. In the neutrophil is an X chromatin body
    Barr body
  194. Total leukocyte count for adult
    4.5-11.0 x 109/L
  195. Monocyte maturation
    Monoblast, promonocyte, monocyte, macrophage
  196. differentiatng myelocytes from promyelocytes is
    secondary granules
  197. primary granules appear in
  198. The first heavy Ig chain produced in b lymphocyte
  199. Neutrophils regulated by 3 cytokines
    Interleukin-3 (IL-3), GM-CSF and G-CSF
  200. Neutrophils
    • Mitotic pool – 3-6 days, 4-5 cell division
    • Myeloblasts, promyelocytes, myelocytes
  201. Neutrophils in the post mitotic pool life span
    5-7 days, Metamyelocytes, bands, segs, 3 times the size of mitotic pool
  202. Neutrophils spend how many hours before moving into tissues
  203. Neutrophil normal range
    1.8 - 7 x 10(9)/L
  204. Life span of eosinophil PB and then tissues
    18 hours, several weeks
  205. Eosinophils function
    allergic disease, parasitic infection or chronic inflammation
  206. Charcot-Leyden cyrstals are the breakdown of
  207. basophils are associated with _____ and spend only ____ in PB
    Asthma and only hours
  208. monocytes lifespan
    54 hours in BM, 8 hours in PB
  209. 80% of lymphs are
    long lived
  210. relative counts equal
  211. absolute counts
    whole WBC + diff % would be 0.54