Hematology Final review

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moses1424
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Hematology Final review
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2011-03-16 14:37:22
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Hematology Final review
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Hematology Final review
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  1. EDTA
    • Use with Cell counts
    • Calcium Chelator
    • Can cause platelet Satellitism
  2. Sodium Citrate
    • Calcium Chelator
    • Use with Coag Studies
    • 9:1 blood to coag ratio
  3. Heparin
    • Antithrombin
    • Use: Special testing
    • Limited use in Hematology
  4. Hematopoiesis hormones
    Colony Stimulating Factors
  5. GM-CFS
    Granulocyte and macrophages colony stimulting factor.
  6. G-CSF
    Neutrophil colony stimulating factor
  7. RBC proliferation hormone
    erythropoietin
  8. Platelet production hormone
    Thrombopoietin
  9. WBC proliferation hormone/s
    • Leukopoietin
    • Interleukens
    • CSF
  10. Ontology blood cell formation
    • yolk sac: 2 weeks to 3 months
    • Liver & Spleen: 2-7 months
    • Bone marrow:7 months through rest of life
  11. RBC Cell line
    • Rubriblast
    • Prorubricyte
    • Rubricyte
    • Metarubricytes
    • Reticulocyte
    • Erythrocyte
  12. Hemoglobin Structure
    • 4 Hemes
    • 1 Globin
  13. Heme Structure
    Porphyron Rings + Iron
  14. Globin Structure
    • 2+2 Polypeptide Chains
    • Alpha
    • Beta
    • Gamma
    • Delta
    • Epsilon
    • Zeta
  15. HGB A1
    2 alpha & 2 beta
  16. % of normal HGB
    • A1: 96%
    • A2: 2-4%
    • F: 1-3%
  17. Hemoglobin Function
    • Gas transport
    • influenced by ph of blood and iron levels
  18. Oxyhemoglobin
    Fe+2 - O2
  19. Deoxyhemoglobin
    Fe+2
  20. Carboxyhemoglobin
    Fe+2 - CO
  21. Carbaminohemoglobin
    Fe+2 - CO2
  22. Methemoglobin
    Fe+3
  23. Sulfhemoglobin
    Sulfer
  24. RBC examination
    • Wright Stain
    • 6-8 microns
    • 1/3 central pallor
  25. PCV
    • Packed cell volume
    • 3 times HGB rule of thumb
  26. Reticulocyte Count
    • Stain with supervital Stain methylene blue or new methylene blue.
    • Count reticulocytes in 1000 RBCs
    • Automated stains with fluorescent
    • measured with flow cytometry
  27. Corrected reticulocyte count formula
    (uncorrected/hct) / normal HCT
  28. RPI
    • Reticulocyte production index
    • corrected retic. / maturation time
  29. MCV
    • Mean cell volume
    • (hct / rbc count) x 10 = __fl
  30. MCH
    • Mean cell hemoglobin
    • (HGB / RBC) x 10 =___pg
  31. MCHC
    • Mean Cell Hemoglobin Concentration
    • (Hgb / hct ) X 100
  32. Sed Rate Methods
    • Wintrobe
    • Westergren
    • Zeta
  33. Factors affecting Sed rate
    • Tube Size
    • Age & Gender of Patient
    • Protein Level
    • Anemia
  34. Anisocytosis
    Variation in size
  35. Poikilocytosis
    Variation of Shape
  36. Anisochromia
    Variation in color
  37. Acanthocyte
    Irregular Spines

    • Liver disorders
    • Abetalipoproteinemia
  38. Target cell
    Codocyte

    • Fe Deficiency
    • Liver Disorders
    • Hemoglobinopathy
  39. Teardrop cell
    Dacrocyte

    • Pernicious Anemia
    • Myeloproliferative Disorders
  40. Sickle Cell
    Drepanocyte

    • Sickle Cell Anemia
    • HGB S,C, Harlem
  41. Elliptocytes or Ovalocytes
    • Hereditary elliptocytosis
    • Thalassemia
    • Sickle Cell
  42. Burr Cell
    DIC
  43. Blister Cells
    • Helmet Cells
    • DIC
  44. Macrocyte
    • Larger than 100fl
    • Vit B12 or folate deficiency
    • Alcoholism
    • Chemotherapy
    • Reticulocytosis
  45. Microcyte
    • Smaller than 80fl
    • Iron Deficiency
    • Thalassemia
    • Chronic Anemia
    • Sideroblastic Anemia
  46. Spherocyte
    • RBC is round with no central pallor
    • Hereditary Spherocytosis
    • Immune Hemolytic Anemia
  47. Stomatocytes
    • Could be artifact
    • Alcoholism
    • Hereditary Stomatocitosis
  48. Basophilic Stippling
    • RNA Aggregates
    • Course Granulation throughout cell

    • Anemias
    • Lead poisoning
  49. Cabot rings
    • Thread like loops
    • Residual Nuclear membrane

    • Pernicious Anemia
    • Lead Poisoning
  50. Heinze Bodies
    • Precipitated Denatured Hgb
    • Seen only with supravital Stains

    G-6-PD Deficiency
  51. Howell-Jolly Bodies
    • Small round Dark purple Masses of DNA
    • Nuclear remnant

    • Hemolytic Anemia
    • Post Splenectomy
  52. Siderocyte
    • Siderotic granules in non-nucleated red
    • confirm with prussian blue
    • Called Pappenheimer Bodies with Wright Stain

    • Post Splenectomy
    • Sideroblastic Anemia
    • Sickle Cell Anemia
  53. Hypochromia
    Central Pallor >1/3 of cell

    • Fe Deficiency
    • Chronic Anemia
    • Thalassemias
  54. Polychromasia
    Cytoplasm Stains Blue-grey due to presence of RNA

    Reticulocytosis
  55. Rouleaux
    Stacking off RBCs due to increased serum protin

    • Multiple Myeloma
    • Waldenstrom's Macroglobulinemia
  56. Nucleated Reds
    • Ussually Metarubricyte
    • Associated with increased bone marrow activity.

    • Anemias
    • Bleeding
  57. Types of Anemias
    • Iron Deficiency, hypochromic anemias
    • Megeloblastic Anemias
    • Aplastic Anemias
    • Hemolytic Anemias
    • Anemia Assoc with nonhematological disorders
  58. Causes of iron deficiency
    • Bleeding
    • Diet
    • malabsorbtion
    • parasites
    • hemmorrhoids
  59. Hemochromatosis
    • absorbs up to 4g of iron a day
    • danger of iron deposits in joints and organs
  60. Sideroblastic anemia
    • Sex linked
    • Pappenheimer Bodies on wright stain
    • too much iron
  61. Lead poisoning
    • Interferes with iron storage in the mitochondria
    • Damages Heme synthesizing
    • leads to microcytic hypochromic anemia
    • neurological dysfunction and skin lesions
    • abdominal cramping
  62. Macrocytic Normochromic Anemias
    • MCV 100-160fl
    • Hgb Normal to low
    • RBC usually low
    • Hyper segmented neutrophils
    • Platelets low to normal
  63. Aplastic Anemia
    • Charactarized by cellular depletion & fatty replacement of bone marrow.
    • Decrease in RBCs and WBCs and platelets (pancytopenia)

    • Drugs
    • Chemical Irradiation
    • Immune dysfunction
  64. Osmotic fragility lysis %s
    • Normal No lysis at .85% or .45%
    • Spherocytosis none at .85% lysis occurs at .45%
  65. Sickle Cell Anemias
    • Sever Hemoglobinopathy
    • Affects 1:375
    • Valine for Glutamic acid @ 6th position of beta chains
  66. Hgb C disease
    • Amino acid lysine for glutamic acid at sixth position of beta chains.
    • mild chronic hemolytic anemia
    • Hgb C crystals
    • Hgb C 97%
    • Hgb F <7%
    • Hgb A none
  67. Hereditary Persistance of fetal Hgb (HPFH)
    Continued production of Hgb F into adulthood.Homozygous 100% Hgb FHeterozygous 30% Hgb F
  68. Silent Alpha Carrier
    Due to deletion of 1 gene with 3 functioning genes.Production of Alpha Chains is affected only slightly.Hematologically normal appearance.
  69. 4 Inheritance of Alpha Thalassemia.
    • Silent Carrier
    • Alpha Thalassemia Minor (Heterozygous)
    • Hgb H disease.
    • Alpha Thalassemia Major (Hydrops Fetalis)
  70. Electrophoresis Citrate Agar Order

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