Clinical Dx Exam 2

Front 1

Screening tests are

Back 1

highly sensitive
(might test other dx)

Front 2

Diagnostic tests are

Back 2

highly specific
ie troponin, blood cultures

Front 3

Instead of normal range, use

Back 3

reference range

Front 4

A value when you need to take action

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critical/panic value

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Sensitivity screening

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ability of test to identify positive results in patients WITH the disease

true positive rate

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the higher the sensitivity...

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the lower the chance of a false --

Front 7

specificity-confirmatory

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% of NEG results in people WITHOUT the disease

true negative rate

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the higher the specificity,

Back 8

the lower the chance of a false positive

Front 9

close to true value

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accuracy

Front 10

reproducability of a value

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precision

Front 11

blue top collection tube

Back 11

sodium citrate
used for most coagulation studies

Front 12

lavendar top collection tube

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EDTA
binds calcium
used for CBC, ESR, reticulocyte, HgA1

Front 13

Orange/Tiger Top collection tube

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serum separator tube
forms barrier between serum and cells during centrifugation

Front 14

Red top collection tube

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no anticoagulants!!
provides serum for testing

Front 15

gray top collection tube

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sodium flouride oxalate
prevents glycolysis
glucose tolerance testing

Front 16

yellow top collection tube

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blood culture

Front 17

green top collection tube

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heparin
inhibits action of thrombin

Front 18

2 tubes that contain antigoagulants to keep blood in liquid form

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lavendar (EDTA) and blue

Front 19

fibrinogen and clotting factors are found in

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plasma NOT serum

Front 20

blood consists of

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55% plasma
40-50% RBCs
1% WBCs

Front 21

where does hematopoeisis take place in
1) earliest stage
2) 2-7 months gestation
3) 7 months throughout life

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1) yolk sac, until 2-3 months gestation
2) liver and spleen EXTRAMEDULLARY
3) bone marrow (primary site) MEDULLARY

Front 22

lymphocytes and monocytes

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agranular leukocytes

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basophils, neutrophils, eosinophils

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granular leukocytes

Front 24

T cell, B cell, NK cell

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lymphocytes

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distribution of leukocytes

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neutrophils 60-70%
lymphocytes 20-25%
monocytes 3-8%
eosinophils 2-4%
basophils <1%

Front 26

phagocytic

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neutrophils and monocytes

Front 27

allergic/parasitive infextions

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eosinophils

Front 28

histamine/heparin

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basophils

Front 29

antibody production

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B lymphocyte

Front 30

targets viral/cancer cells

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T lymphocyte

Front 31

production of neutrophils, eosinophils, basophils, and monocytes

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myelopoeisis (7-10 days)
maturation pool-->functional pool

Front 32

blood smear contains what type of cells

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mature

Front 33

RBC production is controlled by

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erythropoietin

Front 34

120 day lifespan
recycled by spleen
biconcave disk-->central pallor
no nucleus
size of lymphocyte nucleus

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RBC characteristics

Front 35

form right before the mature RBC

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reticulocyte
stains bluish because it has more RNA

Front 36

WBC, RBC, Hg, Hct, RBC indices (MCV, MCH, MCHC, RDW), platelet, differential

Back 36

contained in CBC

Front 37

uses lasers to measure forward and side scatter

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flow cytometry
forward scatter=size
side scatter=granularity

Front 38

inadequate mixing of specimen

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interfering factor in specimen collection

Front 39

millions per 1 cubic mm

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how RBCs are measured measured

Front 40

4.7-6.1

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normal RBC range in MEN

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4.2-5.4

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normal RBC range in females

Front 42

distribution of RBC count

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infants>men>women

Front 43

adults contain 97% of this hemoglobin

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Hemo A

Front 44

Hemoglobin (RBC and Hct) panic values

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<8
>20 g/dl

Front 45

erythroctosis
hypoxia
polycythemia vera
dehydration

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increased hemoglobin

Front 46

anemia
hemoglobinopathy
diet deficiency
cirrhosis
pregnancy

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decreased hemoglobin

Front 47

hemoglobin x 3

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hematocrit %

Front 48

Hct/RBC

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MCV (mean cell volume)
average volume of red cells

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average volume of red cells

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Mean cell volume

Front 50

Hgb/RBC

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MCH (mean cell hemoglobin)
weight of hemoglobin per RBC

Front 51

Hgb/Hct

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MCHC (Mean cell hemoglobin concentration)

Front 52

weight of hemoglobin of average RBC

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Mean cell hemoglobin

Front 53

measure of degree of anisocytosis (variation in RBC size)

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RDW (red cell distribution width)

Front 54

low MCV

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thalassemia and Fe def anemia

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low MCV/normal RDW

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thalassemia

Front 56

low MCV, high RDW

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iron deficiency anemia

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segmented or polysegmented
45-73%

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mature neutrophil (PMNs)

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bands or stabs
3-5%

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young neutrophil

Front 59

increase in neutrophil number in response to invading organisml higher in children

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neutrophilia

Front 60

decrease production of neutrophils, excess stored in BVs

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neutropenia

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hypersegmented neutrophils can be seen in megaloblastic anemia and liver disease

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right shift of neutrophils
(more mature)

Front 62

marrow release of less mature neutrophils
more than 10-12% bands

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left shift of neutrophils

Front 63

more lymphocutes than neutrophils

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inverted/reverse diff

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atypical lymphocytes seen in

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mono, viral hep, CMV, toxoplasmosis

Front 65

become macrophages in tissue

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monocytes (horseshoe shape and often contain vaculoles)

Front 66

Neoplasm
Allergy
Addisons
Collagen vasc disease
Parasites
(NAACP)
PIE (pulm infiltrate eosin)

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eosionophilia

Front 67

phagocytic, are called mast cells when found in tissue

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basophil

Front 68

infective/inflammatory states
burns, chemo, pregnancy, TB

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Dohle bodies
(light blue line)

Front 69

variation in RBC size

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anisocytosis

Front 70

variation in RBC shape

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poikilocytosis

Front 71

MCV <80 with ansicocytosis

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Iron def anemia

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MCV>101 with anisocytosis

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B12/folate deficiency

Front 73

may be due to mechanical trauma of RBCs (aortic stenosis)

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schistocytes

Front 74

spikes on perimeter of cell (not uniform)

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acanthocytes

Front 75

regularly spaced spikes on RBC
seen in uremia

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Burr cell (echinocytes)

Front 76

teardrop RBCs
may be liver/bone marrow problem

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dacrocytes

Front 77

RNA granules in RBC seen with lead or heavy metal poisoning
may also have blue/black gums (Burton's lines)

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basiphilic stippling

Front 78

denatured or precipitated protein seen in G6PD def

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Heinz bodies (blue dot on RBC)

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drug-induced hemolytic anemia with Heinz bodies

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G6PD def

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purple dot near RBC periphery that resembles DNA (chromatin remnant) seen after splenectomy

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Howell-Jolly bodies

Front 81

iron particles seen in

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Prussian blue reaction

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pappenheimer bodies (blue, purple granules) characteristic of

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Siderocytes

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stack of coins formation seen in multiple myeloma

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rouleaux formation

Front 84

use methylene blue (supravital stain) for

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reticulocyte count

Front 85

inflammation will have what effect on ESR

Back 85

increase

Front 86

microcytic, polycythemia vera, spherocytosis, sickle cell will have what effect on ESR

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decrease

Front 87

inflammation, multiple myeloma, macrocytic disorders, pregnancy, polymyalgia rheumatica and temporal arteritis will cause what to ESR

Back 87

increased rate

Front 88

produced by liver and increased with inflammation
disappears with salicylated or steroids

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C-reactive protein