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2010-07-11 02:55:09
Heme Hemo

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  1. name in order the blood cell maturation sequence order of RBC colony forming unit
    • Rubriblast
    • Prorubricyte
    • Rubricyte
    • Metarubricyte
    • Reticulocyte
    • Erythrocyte
  2. what is the iron transport protein
  3. what is the major iron storage form
  4. what is the water insoluable iron storage form(long term)
  5. when do excessive formation of porphyrins occur
    if any enzymatic step in heme sythesis is blocked
  6. What are the heme precursors
    • delta-aminolevulinic
    • porphobilinogen
    • uropophyrinogen
    • coprophyrinogen
    • protoporphyrin
    • hemeglobin
  7. when there is a shift to left what happens with the oxygen
    it not released to tissue adequately
  8. when there is a shift to the right what happens with oxygen
    Oxygen is released to tissue more easily
  9. why is EDTA unavailable to participate in the coagulation cascade
    it chelates calcuim
  10. what anticoagulant is the anti-thrombin agent
  11. what are the sources of error in hemoglobin
    • lipemia
    • high white count
    • extremely icteric sample
  12. what is the reference range for hemoglobin
    • male-16 + or - 2g/dl
    • female-14 + or - 2g/dl
  13. what measures packed cell volume in percent
  14. what are the sources of error in hematocrit
    • failure to seal tube adequately with clay
    • incorrect reading due to uneven clay plug
    • inappropriate centrifuge time
  15. what are the reference ranges of hematocrit
    • male=45 + or - 5%
    • female=42 + or - 5%
  16. what is the depth of the chamber in the hemacytometer
  17. what is the formula for manual cell counts using the hemacytometer
    • # of cells counted x 1 x dilution factor
    • total vol.

    • (vol. of 1 square=lengthxwidthxdepth )
    • total vol=vol. x # of squares counted
  18. explain how to do the WBC count in hemacytometer
    • count all 9 sqaures
    • total vol counted=1mm x 1mm x 0.1mm x 9=0.9mm
  19. what is the reference range of the wbc count using the hemacytometer
  20. solve formula when the wbc count=60 in hemacytometer
    • 60 x 1 x 100=6.667mm or 60 x 10%=60 + 6=66 66 x 100=6600mm
    • .9
  21. solve formula of platelet counted=150
    • 150 x 1 x 100=150,000/mm
    • .1
    • (mutiply # of plts. counted by 1000)
  22. what is the formula, ref. range, indication of the indice of MCV
    • Hct x 10
    • Rbc
    • 80-100fl
    • <80 microcytic anemia
    • >100 macrocytic anemia
  23. what is the formula, ref. range, and indication of the MCH indices
    • HgB x 10
    • Rbc
    • 28-32
    • varies withhemoglobin content and cell size
  24. what is the formula, ref. range, and indication of MCHC indices
    • HB x 100
    • HCT
    • 32-36%
    • <32 hypochromic >36 hyperchromic(sperocytes), lipemia, HB SS, CC
  25. what is the formula, ref. range, and indication of RDW indices
    • SD of MCV x 100
    • mean MCV
    • 11.5-14.5%
    • >14.5 anisocytosis
  26. what is the function of rbc
    oxygen transport to tissue and carbon dioxide removal from tissue; cell nutrition
  27. what are the ref ranges for rbc
    • female=3.8-5.2
    • male=4.5-6.1
  28. what is the function of neutrophil
    phagocytic response to bacteria
  29. what is the ref range for neutrophil
    • relative=50-70%
    • absolute=2500-7000 ul
  30. what is the function of lymphocyte
    humoral and cell mediated immunity
  31. what is the ref range of lymphocytes
    • relative=20-40%
    • absolute=1000-4000UL
  32. What is the funciton of monocyte
    phagocytic response to bacteria
  33. what is the ref range of monocytes
    • relative 3-10
    • absolute 150-1000
  34. what is the function of basophil
    inflammatory response mediator
  35. what is the ref range of basophils
    • relative 0-2
    • absolute 0-200
  36. what is the function of eosinophil
    allergic responsed regulator
  37. what is the ref ranges for eosinophil
    • relative 0-3%
    • absolute 0-300
  38. what is the function of platelets
  39. what is the ref range for platelets
    absolute 150,000-400,000
  40. what are neutrophils increased in 50-70%
    bacterial infections
  41. what are lymphocytes increased in 20-40%
    viral infections
  42. what are monocytes increased in 3-10%
    TB syphillis malignancies
  43. what are eosinophils increased in 0-3%
    allergies parasites CML
  44. what are basophils increased in 0-2%
    immediate hypersensivity CML
  45. Name what is associated with this cell morphology:
    hypersegmented neutrophil
    hyposegmented neutrophil
    toxic granulation/vacuoles
    dohle bodies
    atypical lymphs(increased size and basaphilla)
    • pernicious anemia
    • pelger huet anomaly pseudo-Pelger huet(AML AIDS)
    • bacterial infections burns may-hegglin
    • infections mono ( epstein-barr virus) other viral infections
  46. what is the ref range for platelets
    8-20 per oil immersion field
  47. what is the formula for corrected wbc count
    • wbc count x 100
    • 100 + #nrbcs
  48. what does anisocytosis mean
    variation in size
  49. what does polychromasia mean
    blue color in rbc ( if stained with reticuloctyes stain it would be reticulocytes)
  50. define poikilocytosis
    variation in shape
  51. what inclusion is indicative of thalassemia and lead poisoning
    basophillic stippling
  52. what is the indication of heniz body inclusion
    • G6PD Deficiency
    • Thalassemia
  53. what inclusion is megaloblastic anemia indicated of
    cabot ring
  54. if rule of three the correlation of Hb, Hct, and rbc what should you consider
    • clotted specimen
    • cold agglutinin(warm sample and rerun)
    • lipemic or icteric sample
  55. what is associated with cold agglutinin disease;warm sample & rerun
    increase in MCV and MCHC and decrease in red cell count
  56. what is the priniciple of erythrocyte sedimentation rate (westergren-ESR)
    measures rate of fall of red cells through plasma
  57. what is the reference ranges of ESR
    • female=0-20mm/hr
    • male=0-15mm/hr
  58. what is the clinical correleation of ESR
    increase seen in presence of abnormal plasma proteins(inflammatory conditions)
  59. what are the sources of error in ESR
    • increase-tilting tube standing too long increase temp. excess EDTA
    • decrease-QNS specimen decrease temp
  60. what stains are used in reticulocyte stain
    • a supra vital stain which stains red cells in living state
    • a. new methylene blue
    • b. brilliant cresyl blue
  61. what do reticulocyte monitor
  62. formula for reticuloctyes
    • #retics in 1000 RBCs
    • 10
  63. formula for absolute retics
    # RBCs x % retics
  64. formula for corrected retic count
    • % retics x pt. hct
    • 45
  65. what is the ref. ranges for retics
  66. what is the reticulocyte production index formula
    • corrected retic count
    • maturation time usually use 2
  67. what position is hemoglobin S on the beta chain
    6th position of valine for glutamic acid
  68. what position is hemoglobin C on the beta chain
    6th posiition of lysine for glutamic acid
  69. the perpherial blood is composed of
    rbc, wbc, platelets,plasma(water, electrolytes, and protein)
  70. what is hematopoeisis
    the production and maturartion of peripheral blood cells
  71. where do cellular elements of the perpheral blood arise from
    precursor cells in the bone marrow
  72. why it is good for rbc to deform in shape
    it aids to the passage through very small capaillaries
  73. what happens to rbc as they mature
    increase in hemoglobin and content and decreasre in size
  74. what happens to rbc nucleus during maturation
    decreases in size until it is extruded
  75. what happens to rbc cytoplasm during maturation
    increases in amount relative to the nucleus
  76. name the six stages of rbc maturation for morphologic identification
    pronormoblast basophillic normoblast polychromatophilic normoblast orthochromic normoblast polychromatophilic red cell erythrocyte
  77. define normochromic rbcs
    rbc with central pallor no more than one third the diameter of the cell
  78. define hypochromic
    rbc with central pallor greater than 1/3 the diameter of the cell
  79. when do you see hypochromic rbcs
    in iron deficiency anemia
  80. define anisocytosis
    variation in reb blood cell size
  81. when do you see anisocytosis
    in iron deficiency megaloblastic anemia and burn pts.
  82. what cell are normal rbc the same size of
    the nucleus of small lymphocytes
  83. what are microcytic cells smaller than
    the nucleus of small lymphocytes
  84. when are microcytes seen
    in thalasssemia and iron deficiency anemia
  85. describe macrocytes
    rbc that are larger than the nucleus of small lymphocytes
  86. when are macrocytes seen
    in anemia due to folate and vitamin B12 deficiency
  87. define poikiolocytosis
    variation in rbc shape
  88. when are poikilocytosis seen
    sickle cell anemia severe iron anemia burn pts
  89. when are spherocytes seen
    in hereditary spherocytosis and immune hemolytic anemia
  90. when are teardrops seen(dacrocytes)
    result from marrow replacement by fibrosis or malignancy
  91. when are stomocytes seen
    in acute alcoholism and liver disease
  92. when may you schisotocytes(keratocytes)
    in disseminated intravascular coagulation or thrombotic thromobocytopenic purpura
  93. when are target cells seen(codacytes)
    in liver disease and thalassemia
  94. list all the inclusions
    • basophillic stippling
    • heniz body
    • howell jolly body
    • pappenheimer body
  95. when are basophillic stippling seen
    lead poisioning thalasemia and sideroblastic anemia
  96. describe howell jolly bodies
    are nuclear fragments often seen in rbc seen from pts who have their spleen removed
  97. what is heniz bodies associated with
    G6PD deficiency and composed o denatured hemoglobin
  98. give the sequence for the granulocytic maturation
    • myeloblast
    • promyelocyte
    • myelocyte
    • metamyelocyte
    • band
    • neutrophil
  99. what can bacterial infections cause to neutrophils
    toxic changes
  100. when are hyposegmented neutrophils
    in pts with Pelger-Huet anomaly or myelodysplastic syndrome
  101. describe hypersegmented neutrophils
    neurtrophil with six or more nucleur segments
  102. what are hypesegmented neutrophils associated wih
    pts with anemia due to vit. b12 and folate deficiency
  103. when are toxic granules seen
    in pts with bacterial infection
  104. where do lymphocyte maturation primarily occur
    in thymus and bone marrow
  105. where the majority of lymphocyhtes reside
    in lymph nodes spleen and other extravacular sites
  106. reactive lymphocytes(atypical) may be associated with
    viral infections
  107. what are lymphcytes with a cleaved(cut in half) nucleus associated with
    whooping cough(pertussis) in children
  108. where the majority of monocytes reside
    in tissues and called macrophages
  109. another name for platelets
  110. primary site of platelet production
    Bone marrow
  111. where do platelets arise from
    large precursor cell called megakarocyte
  112. when are smudge cells seen
    in chronic lymphocytic leukemia
  113. what is infectious mononucleosis
    viral disease caused by by the Epstein-Barr virus
  114. what is May-Hegglin anomaly
    rare dominant trait
  115. what is Cheediak-Higashi syndrome
    rare autosomal recessive trait resulting in abnormal neutrophil function and frequent bacterial infection
  116. how is chronic myelogenous leukemia chacterized
    large increase in granulocyte production and the presence of the Philadelphia chromosome,t(9,22)
  117. What do acute leukemias result from
    clonal proliferation in the bone marrow of immature cells having little or no maturation(blasts)
  118. what is the criteria for diagnosis of acute leukemia
    presence of 30% of blasts in perpherial blood and/or bone marrow
  119. describe acute lymphoblastic leukemia
    proliferation of blasts having lymphoid characteristics and is more common in children
  120. describe chronic lymphocytic leukemia
    increased small lymphocytes with coarsely clumped chromatin, smudge(basket) cells, most common form, seen in prevalent in adults
  121. what is mutiple myeloma
    clonal proliferation of plasma cells usually in the bone marrow
  122. what is rouleaux formation
    four or more rbcs lined up resembling a stack of coins
  123. what is lymphoma
    a clonal proliferation of lymphocytes occurring in tissue
  124. what is the presence of poikilocytosis and red cell fragments (shistocytes) a characteristic of
    mechanical trauma(artificial heart valve)
  125. what condition is seen if numerous reactive atypical lymphocytes seen
    infectious mononucleosis