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What is CFU-GEMM?
Colony forming units-Granulocytes, erythrocytes, monocytes, megakaryocytes.
What percentage of bone marrow is compromised of red marrow? Yellow Marrow?
Which areas are the best sites for bone marrow aspiration?
Iliac crest and sternum
What is the normal M:E ratio?
What is the ratio of stem cells to nucleated cells in the bone marrow?
1 in 1000
What is the approximate blood volume in an adult?
How long does a red cell live?
What is culling?
filtration -gets rid of older cells and recycles bilirubin, iron, and globin.
What is pitting?
pulling inclusions off the cell membrane without destroying it; forms spherocytes.
What is the composition of hemoglobin A?
2 alpha , 2 beta
What is the composition of Hemglobin F?
2 alpha , 2 gamma
What is the composition of hemoglobin A2?
2 alpha, 2 delta
What is the composition of Gower 1?
2 zeta, 2 epsilon
What is the composition of Gower 2 ?
2 alpha, 2 epsilon
What is the composition of Portland?
2 zeta, 2 gamma
What is methhemoglobin?
Hemoglobin with iron in ferric state (Fe 3+) and cannot combine with O2.
What are howell jolly bodies?
Dna remnants seen in splenectomy patients.
What are schistocytes?
- fragmented cells
- see heinz bodies
Which red cell inclusion is associated with lead poisoning?
What is rouleaux and what is it associated with?
Stacking of red cells and associated with mutiple myeloma.
- severe liver disease
- sickle cell
- crescent shape
- abnormal Hgb S
- "Burr cell" associated with uremia
- abnormal protein and spectrin on cell membrane
- Bull's eye shape
- seen in thalassemia
- due to increase of plasma cholesterol
- denatured hemoglobin
- G6pd deficiency
- stained with supravital stains
On wright stain-heinz bodies appear as bite cells
small beaded inclusions associated with iron loading conditions
stain with prussian
- remnants of mitotic spindle
- megaloblastic anemia
What causes the oxygen dissociation curve to shift to the right? To the left?
Decrease in O2 affinity is a shift to the right.
Increase in O2 affinity is a shift to the left
Which inclusion is not stained with Wright's stain?
What is the formula and normal values for MCV?
MCV=HCT/Rbc X 10
What is the formula and normal values for MCH?
What is the formula and normal values for MCHC?
MCHC=HGB/HCT X 100
What does NADH do?
reduce iron ferric state in methhemoglobin back to ferrous state.
What is the normal size of an erythrocyte?
6- 8 um
Which pathway provides ATP for red cell metabolism?
What is apoptisis?
Programmed cell death
Which hemoglobin are not capable of transporting oxygen?
methemoglobin, sulf, carboxyhemoglobin
What is the role of spectrin?
responsible for deformability of cell
What is meant by shift to the left?
Increase O2 affinity.
What is polychromasia?
- variation in color
- seen in reticulocytes
What is anisocytosis?
variation in size
What is poikilocytosis?
variation in shape
Which inclusions would be associated with splenectomy?
Howell jolly bodies
Name the maturation sequence of erythrocytes?
- basophilic normoblast
- polychromatophilic normoblast
- orthochromic normoblast
Last nucleated stage of RBC maturation?
What % of hemoglobin is sythesized in reticulocytes?
Pernicous anemia leads to what kind of anemia?
macrocytic anemia >100fl
What type of anemia is present in hemolysis?
Bone marrow failure is present in?
Definite sign of intravascular hemolysis?
How many genes are involved in production of alpha chains?
What would result in immediate increase in oxygen delivery to tissues?
Increase in 2,3 DGP
What is the last stage of red cell which is capable of mitosis?
polychromatic normoblast (rubricyte)
What state has a pyknotic nucleus which will eventually be extruded?
Orthochromatic normoblast (metarubricyte)
What is the last stage of red cell capable of making hemoglobin?
Name two supravital stains?
- New methylene blue
- Brilliant cresyl blue
What are the storage forms of iron?
Ferritin and hemosiderin
What is the first breakdown product which is formed form hemoglobin?
globin into amino acids
All blood cells are thought to be derived from what type of cell?
pluripotential stem cell
Where does most of red cell production take place in the fetus during the earliest weeks of development?
Yolk sac (first 3 months)
What does extramedullary hematopoiesis mean?
formation of cells that does not include the bone marrow
What hemoglobin resists alkali and acid denaturation?
Macrocytes are associated with a deficiency of what?
Vitamin B12 and folic acid
What is carboxyhemoglobin?
What are the 4 funcitons of spleen?
What would a deficiency fo spectrin or actin do to the red cell membrane?
cause cell rigidity, see spherocytes
What causes relative erythrocytsis?
Increase in plasma volume
Which metabolic pathway functions in facilitating the release of oxygen from hemoglobin to the tissues?
Rapoport-Leubering shunt (increase in 2,3 DPG)
What causes a shift to the left in the oxygen dissociation curve?
- Decrease: 2,3 DPG, PCO2, temp
- Increase: Ph
What pathway forms 2,3 DPG?
What is the main function of the hexose monophosphate shunt in red cells?
- Produce ATP
- Protects cell against oxidation
When do you see hypersegmentation?
In Vitamin B12 deficiency or folic acid
What condition are there microcytes?
- Iron deficiency
What factor is required to make basophils?
What factor is required to make Eosinophils?
When do you see an RPI of <2?
Hypoproliferative and maturation disorders
What does an RPI >2 indicate?
Bone marrow response is adequate
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