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Hematology - Exam I Review

1. 2. 3. 4. Transport O2 to tissue, Transport CO2 to lungs, Neutralize acids: Erythrocytes Reference Range for Erythrocytes (RBCs): Men: 4.7-6.1 x millions/L Reference Range for Erythrocytes (RBCs): Women: 4.2-5.4 x millions/L The outer layer of the red cell membrane contains _____ & _____.: Glycolipid and glycoprotein 5. The central hydrophobic layer of the red cell membrane contains _____, _____, & _____?: protein, cholesterol, and phospholipid 6. The inner hydrophilic layer of the red cell membrane contains _____.: protein 7. What are the 6 stages in erythropoiesis? Name them in order.: 1. Pronormoblast (rubriblast), 2.Basophilic normoblast (prorubricyte), 3.Polychromatic normoblast (rubricyte), 4. Orthochromic normoblast (metarubricyte), 5.Reticulocyte, 6.Erythrocyte 8. Erythropoiesis (RBC production/synthesis) requires _____, _____, _____, & _____.: Erythropoietin, Iron, Folic Acid, & Vitamin B12 9. What is another term for Pronormoblast?: rubriblast 10. What is another term for Basophilic normoblast?: prorubricyte 11. What is another term for Polychromatic normoblast?: rubricyte 12. What is another term for Orthochromic normoblast?: metarubricyte 13. Hemoglobin synthesis requires _____ & _____.: Transferrin & Ferritin 14. Hemoglobin A1 = _____ chains: 2 2 (alpha & beta) 15. Hemoglobin A2 = _____ chains: 2 2 (alpha & delta) 16. Hemoglobin F = _____ chains: 2 2 (alpha & gamma) 17. hemoglobin that contains bound oxygen: Oxyhemoglobin 18. hemoglobin not combined with oxygen, formed when oxyhemoglobin releases its oxygen: Deoxyhemoglobin 19. an abnormal form of hemoglobin in which the iron component has become oxidized from the ferrous to the ferric state.: Methemoglobin 20. hemoglobin with a sulfur atom on one of its porphyrin rings, making it ineffective for transporting oxygen. Result from ingestion of sulfa-type antibiotics.: Sulfhemoglobin 21. a compound produced by the exposure of hemoglobin to carbon monoxide.: Carboxyhemoglobin 22. The reference method used to measure hemoglobin. The Hb iron is converted from the ferrous state to the ferric state to form methemoglobin. Methemoglobin combines with potassium cyanide to form the stable pigment is used to quantify Hb.: Cyanmethemoglobin 23. This metabolic pathway in RBCs generates ATP and NADH: Embden-Meyerhof glycolytic pathway 24. This metabolic pathway in RBCs produces NADPH: Phosphogluconate pathway 25. This metabolic pathway in RBCs prevents oxidation of Fe++: Methemoglobin Reductase pathway 26. This metabolic pathway in RBCs produces 2-3 DPG: Leubering-Rapaport shunt

27. Name the 3 cells that have alterations in their RBC membrane: spherocytes, target cells, acanthoytes 28. an abnormal degree of variation in the shape of erythrocytes in the blood: poikilocytosis 29. a poorly hemoglobinized erythrocyte seen in hemoglobinopathies and thalassemia. In Wright stain, there is a concentration of hemoglobin in the center and periphery.: target cell (codocyte) 30. also called a target cell: codocyte 31. an erythrocyte with a single pointed extension, resembling a teardrop.: teardrop cell (dacryocyte) 32. an abnormal erythrocyte that has a higher than normal concentration of hemoglobin by virtue of a spherocytic shape.: spherocyte 33. an erythrocyte with spiny blunt projections of varying lengths distributed irregularly over its surface. Associated with abetalipoproteinemia or abnormalities of lipid metabolism, such as that occuring in liver disease.: acanthocyte 34. also called a spur cell: acanthocyte 35. a mature red blood cell that is characterized by having short, equally spaced projections; formed during dehydration of the cell and reversible up to a point. May be an artifact, bu they also are seen in association with uremia, pyruvate kinase deficiency, and in some long-distance runners because of an unknown mechanism.: echinocyte 36. a fragmented erythrocyte characteristic of micoangiopathic hemolytic anemia, severe burns, disseminated intravascular coagulation, and prosthetic mechanical trauma.: schistocyte 37. a severe, chronic, incurable hemoglinopathy that occurs in people who are homozygous for hemoglobin S. The abnormal hemoglobin results in distoration of erythroctes and is characterized by crises of joint pain, anemai, thrombosis, fever, and splenomegaly.: sickle cell 38. also called a sickle cell: drepanocyte 39. the presence of small, dark-blue to purple granules, evenly distributed, within an erythrocyte stain with Wright stain. These inclusions are composed of precipitated ribosomal protein (RNA).: basophilic stippling 40. red blood cell inclusion bodies composed of ferric iron. With iron stain, they appear as dark-blue granules often seen at the periphery of the cell. With Wright stain they appear as pale blue clusters.: pappenheimer bodies 41. they are also called pappenheimer bodies: siderotic granules 42. threadlike structures, often appearing as purple blue loops or rings in erythrocytes by Wright's stain. These inclusions are thought to be composed of remnants of mitotic spindle.: cabot rings 43. on Wright staind blood films, these appear as round, blue to purple erythrocyte inclusions composed of DNA. Usually one per affected erythrocyte.: howell-jolly bodies

44. small, round, blue to purple inclusions present in erythrocytes stained with a vital stain. They may be found single or in multiples within the erythrocyte and are composed of precipitated hemoglobin.: heinz bodies 45. What is the reference range for MCV?: 80-100 fL 46. Equation for MCV: Hct (%) x 10 / RBC count 47. What is the reference range for MCH?: 27-31 pg 48. measures hemoglobin content in red cells based on number: Mean corpuscular hemoglobin (MCH) 49. measures average size of red cells: Mean corpuscular volume (MCV) 50. Equation for MCH: Hgb x 10 / RBC count 51. Increased MCH is caused by: macrocytes, lab error 52. Decreased MCH is caused by: hypochromic, iron deficiency anemia 53. measures hemoglobin conetent in red cells based on size and number: Mean corpuscular hemoglobin concentration (MCHC) 54. Equation for MCHC: Hgb x 100 / Hct 55. What is the reference range for MCHC?: 32-36% 56. increased MCHC is caused by: spherocytes, lab error 57. measures anisocytosis: Red cell distribution width (RDW) 58. CV of red cell histogram: RDW 59. Equation for RDW: SD of RBC histogram/MCV x 100 60. What is the reference range for RDW?: 11.5 - 13.5 % 61. increased RDW is caused by: iron deficiency 62. normal RDW with low MCV could indicate this disease: thalessemia minor 63. Why is bone marrow aspirate used? (5 answers): cytochemical studies, cytology studies, cell culture, chromosome analysis, DNA analysis 64. Why is bone marrow biospy used? (3 answers): iron stains, solid tumors (lymphoma, metastatic carcinoma), structure of bone marrow 65. What sites are used in an adult for a bone marrow collection? (4 answers): posterior iliac creast, sternum, anterior iliac crest, vertebrae 66. A condition in which there is reduced oxygen delivery to the tissues. It may result from increased destruction of red cells, excessive blood loss, or decreased production of red cells.: Anemia 67. What are common symptoms of anemia? (9 possible answers): fatigue, weakness, dyspnea, dizziness, headache, rapid pulse, pallor, jaundice, fever 68. This disease is associated with a decreased serum iron, decreased TIBC, and increased ferritin: Anemia of chronic inflammation 69. anemia caused by increased absorption and storage of iron in tissues: sideroblastic anemia 70. immature red cells which contain excess iron: sideroblast 71. treatment for sideroblastic anemia: deforoxamine 72. anemia caused by increased serum ferritin, serum iron, increased RDW, stainable iron in bone marrow: sideroblastic anemia 73. ____________ is a classic finding associated with lead toxicity.: basophilic stippling

74. mild microcytic, hypochromic anemia with basophilic stippling could indicate _________: lead poisoning 75. lead poisoning affects _____, _____, and _____: brain, kidneys, bone marrow 76. lead blood levels > ________ g/mL indicates lead poisoning: 10 g/mL 77. What are treatments for lead poisoning?: gastric lavage, chelation therapy with EDTA 78. What would you suspect if you saw in the bone marrow a low M:E ratio, megaloblasts, and hypercellularity?: megaloblastic anemia 79. What would you suspect if you saw in the peripheral blood pancytopenia, macrocytes, and hypersegmented neutrophiles?: megaloblastic anemia 80. What would you suspect with biochemical changes such as elevated LD, elevated unconjugated bilirubin, decreased folic acid, and decreased vitamin B12?: megaloblastic anemia 81. a progressive autoimmune disorder that results in megaloblastic macrocytic anemia due to a lack of, or antibodies to, parietal cells or intrinsic factor essential for the absorption of vitamin B12.: pernicious anemia 82. a substance that is secreted by the gastric mucosa and is essential for the intestinal absorption of vitamin B12.: intrinsic factor 83. A deficiency of, or antibody to, intrisic factor causes ______________.: pernicous anemia 84. a treatment for pernicious anemia: vitamin B12 injection 85. macrocytosis and pancytopenia could indicate this anemia: pernicous anemia 86. this test is used to identify pernicous anemia: schilling test 87. this condition can be caused even if you have a normal schilling test and normal B12: folic acid deficiency 88. the following conditions indicates what kind of anemia: chronic liver disease, alcoholism, immunosuppressive drugs, poisoning with arsenic and chlordane, hemolytic anemia (reticulocytosis): macrocytic nonmegaloblastic anemia 89. an abnormally large, nucleated, immature precursor in the erythrocytic series; an abnormal counterpart to the normoblast. in addition to size, the nucleus appears more immature than the cytoplasm. they give rise to macrocytic red blood cells.: megaloblast 90. an autosomal recessive disorder of lipoprotein metabolism in which lipoproteins containing apolipoprotein B are not synthesized. It is characterizd by the presence of acanthocytes in blood and low levels of cholesterol in the plasma.: abetalipoproteinemia 91. presence in the blood of erythrocytes with excessive variation in volume: anisocytosis 92. a deficiency of all the formed elements of blood, representing a failure of the cellgenerating capacity of bone marrow.: aplastic anemia 93. the protein component of the ferritin molecule: apoferritin 94. the second identifiable stage in erythrocyte maturation; it is derived from the pronormoblast.: basophilic normoblast 95. _________________, have come to be recognized as the hallmark of the diseases affecting DNA metabolism: megaloblastic anemia 96. The root cause of megaloblastic anemia is impaired ___________.: DNA synthesis

97. __________ deficiency during pregnancy can result in impaired formation of the fetal nervous system, resulting in neural tube defects such as spina bifida.: folate 98. _____________ is bound by intrinisic factor produced by the gastric parietal cells.: vitamin B12 99. ____________ binding to intrinsic factor is required for absorption by the enterocytes.: vitamin B12 100. The absorption of vitamin B12 can be impaired by the lack of _____________.: Intrinsic factor 101. Lack of intrinsic factor constitues a significant cause of impaired ______________ absorption.: vitamin B12 102. A condition resulting from the autoimmune lumphocyte-mediated destruction of parietal cells also can cause a loss of intrinsic factor. This condition is called ____________________.: pernicious anemia 103. The loss of intrinsic factor can be detected using the ___________.: Schilling test 104. Four tests used to screen for megaloblastic anemia.: CBC, neutrophil lobe count, bilirubin, and lactate dehydrogenase 105. What disease is associated with the following conditions: pancytopenia, decreased hemoglobin, decreased hematocrit, MCV from 100 - 150fL, RDW elevated.: megaloblastic anemia 106. what disease is associated with hypersegmented neutrophils with 6 or more lobes: megaloblastic anemia 107. ______________ is used to distinguish malabsorption of vitamin B12 resulting from pernicious anemia.: schilling test 108. Schilling test: oral dose of radioactive vitamin B12 given. if the radioactive vitamin B12 does not appear in the urine, it means that there is a _____________________problem. The test is repeated but intrinsic factor is given orally along with the radioactive vitamin B12. If the radioactive vitamin now appears in the urine, it means that intrinsic factor corrected the problem, and the patient is diagnosed as having _______________-.: malabsorption, pernicious anemia

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