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164 Cards in this Set
- Front
- Back
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MCV
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avg vol of RBCs
80-100 |
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MCV calc
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hct x 10/ RBC
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MCH
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avg weightof hgb in individ RBC
26-34 |
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MCH calc
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hgb x 10/ RBHC
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MCHC
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avg conc of total hgb
32-37 |
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MCHC calc
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Hgb/Hct x 100
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Incr MCV
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MA, HA with retics, liver disease, newborns
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decr MCV
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IDA, Thal. SA, leasd poison
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Incr MCH
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Maco Anemia
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Decr MCH
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microcytic, hypochromic anemia
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Incr MCHC
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spherocytes
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Decr MCHC
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IDA and Thal
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RDW
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RBC size, from histogram
11-15 |
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Hct
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percent of RBC in blood
M= 41-53 F= 36-46 |
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Hct calc
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MCV x RBC/ 10
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Hgb
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M= 13-18
F= 12-16 |
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Wright stain
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methylene blue and eosin
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Prussian blue stain
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for siderotic granules
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New methylene blue
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for RNA, in retics
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hematopoiesis in first 2 months in utero
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yolk sac
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hematopoiesis in utero, month 2-7
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liver and some spleen
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first cell to reach tissues and phago
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neuts
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> macros, phago in tissues. Arrive after neuts
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monos
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cellular immunity
prod cytokines, ILs |
T cells
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humoral imm
> plasma cells and prod abs |
B cells
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lymphs, destroy tumor cells and cells with viruses
aka LGL |
NK cells
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allergic response
parasitic infs |
eos
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immed hypersens rxns (anaphylactic)
expr IgE |
baso
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T cell marker
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CD4, helper
CD8, supressor CD2 and 3, early |
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B cell marker
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CD 19, 20
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large granules in neuts
abn look and fnx light sensitivity and hypopigment fatal early |
Chediak- Higashi
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hypersegmentation of neuts
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MA (B 12 def or Folate)
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nucleus peanut shaped, hyposegmentation
looks abn, normal fnx |
Pelger-Huet
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dohle like inclusions in neuts
looks abn, normal fnx giant plts, thrombocytopenia bleeding |
May Hegglin
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large granules in all cells or one cell line
looks abn, normal fnx must diff from tozic granulation |
Alder-Reily
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origiantes in bone marrow, systemic
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leukemia
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originates in lymph tissue, localized
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lymphoma
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Sudden onset
anemia, thrombocytopenia, neutropenia >30% blasts in bm |
Acute leukemia
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asymptomatic
mild anemia, slight incr plt, high WBC weight loss |
Chronic Leukemia
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stain for granular cells
diffs blasts of AML and ALL |
Myeolperoxidase
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stains phospholipids and proteins
granulocytes and auer rods stain pos diffs AML and and ALL |
Sudan black B
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primary granules of granulocytes stain positive
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Specific esterase
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monos stain postive
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nonspecific esterase stain
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stains imm lymphs, erythroblasts, megakaryocytes pos
for erythroleukemia (M6) and ALL |
PAS stain
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incr LAP
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Leukemoid rxn, pregnancy, PV
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decr LAP
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CML
PNH |
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stains for Hairy cell leukemia only
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TRAP
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stains siderocytes
for iron precipitate, papenheimer bodies |
Prussian blue
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childhood leukemia
small homogenous lymphoblasts mostly T cells |
ALL L1
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mostly adults
large heterogenous lymphoblasts |
ALL L2
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adults and children
Burkitt lymphoma large uniform lymphoblasts |
ALL L3
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High grade non Hodgkin lymphoma
assoc with EBV |
Burkitt lymphoma
ALL L3 |
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in adults over 60, males
B cell mailg (CD19,20) hypercellular bm smudge cells |
CLL
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adults over 50, males
B cell malig (CD19,20) dry tap bm TRAP pos |
hairy cell leukemai
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monoclonal gammopathy
B cell prod of excess IgG adults over 60, males > skeletal tumors of plasma cells and bone lesions M spike for gamma glob incr blood viscosity prolonged bleeding Bence jones proteins, kidney damage |
Multiple Myeloma
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monoclonal gammopaty
B cell prod of excess IgM adults over 60 lymphadenopathy and hepatosplenomegaly incr blood viscosity |
Waldenstroms macroglobulinemia
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15-35 yo
assoc with EBV Reed-Sternberg cells (B cells) mild anemai, incr eos incr LAP and ESR |
Hodgkin lymphoma
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pts over 50
60% of lymphomas |
Non Hodgkin lymphoma
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neutropenia, anemia, decr plts
hypercellular marrow and > 30 bm blasts unreg prolif of myeloid stem cells |
AML
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mostly all blasts
stains neg for myelo and Sudan BB |
AML M0
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90% blasts
auer rods SBB, Myelop, Specific esterase pos |
AML M1
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<90 % blasts
may have auer rods SBB, Myelop, Specific esterase pos |
AML M2
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>30% promyelocytes
bundles of auer rods SBB, myelop, specific esterase pos |
APL M3
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>30% myeloblasts and >20% monos
may have auer rods SBB, Myelop, specific and nonspecific esterase pos |
AMML M4
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>30% monos
nonspecific esterase pos |
AMoL M5
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AMoL, children with >80% monos
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AMoL M5a
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AMoL, adults with <80% monos
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AMoL M5b
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>30% myeloblasts (SBB, Myelop pos) and >50% dysplastic normoblasts (PAS pos)
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AE: M6
Di Guglielmo syndrome |
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megakaryoblasts and atypical megakaryocytes
cytoplasmic blebs |
AMegL M7
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prolif of grans
adults >45 weight loss, splenomegaly, fever malaise incr M:E ratio ^^^ WBC mostly myelocytes decr LAP Philadelphi chrom t(9;22) |
CML
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prolif of megakaryocytes
adults >60 giant plts |
Essential thrombocytopenia
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malignant hyperplasia of all cell lines
mostly incr RBCs but decr EPO incr blood viscosity adults over 50 incr RBC indicies treat with theraputic phlebotomy |
Polycythemia Vera
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group of acquired clonal disorders
seen wiht blood cytopenias and bone marrow hyperplasia dyspoiesis |
Myelodysplastic Syndorme
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not responsive to therapy
<5% blasts |
Refractory Anemia
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ringed sideroblasts are >15% of bm cells
dimorphic RBCs |
RARS
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presents with leukocytosis
>5% bm blasts absolute monocytosis |
CMML
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same as CMML but with no absolute monocytosis
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RAEB
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20-30% blasts
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RAEB-t
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DNA fragments in RBCs
stain dark purple/black with Wrights stain |
Howell Jolly bodies
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multiple inclusions of RNA
throughout whole cell dark blue with Wright stain |
basophilic stippling
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dark staining iron granules clumped at outside of cell
with Prussian blue or Wrights stain |
pappenheimer bodies
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denatured hgb in RBC
seen in G6PD, Beta thal, Hgb H must use New methylene blue stain |
Heinz bodies
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seen with HJ bodies
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HA, MA, post splnectomy
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Seen with Basophilic stippling
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Thals, lead poisoning
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seen with Pappenheimer bodies
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SA, hemogloinopathies
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Seen with Cabot rings
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MA, MDS, lead poisoning
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hgb breaks down in the blood circ and free hgb is released
into plasma incr hgb, bilirubin, LD, urine urobil, hgb in urine, decr haptoglobin |
intravascular heme
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heme outside of cir blood
old RBCs are phago by macros and liver/spleen "normal" |
extravascular heme
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measures amount or iron bound to transerrin
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Serum iron
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measures total amoutn of iron that transferrin could bind
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TIBC
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an indirect storage of iron
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serum ferritin
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decr O2 affinity, more O2 released from tissues, decr pH
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right shift in O2 dissociation curve
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increases O2 affinity, less O2 released from tissues, incr pH
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left shift in O2 dissociaton curve
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mc anemia
microcytic/hypochromic Serum Iron, Ferritin, hgb, hct, and retics decr RDW and TIBC incr |
IDA
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inability to use available iron microcytic/hypochromic
normal to incr ferritin decr serum iron and TIBC |
Anemia of CD
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caused by blocks in heme pathway> defective heme synthesis and iron overload
ringed sideroblasts pappenheimer bodies microcytic/hypochromic incr serum iron, decr TIBC |
SA
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causes MA (macrocytic)
caused by intrinsic factor def sore tongue, CNS probs decr retics, pancytopenia, ovalocytes, HJ bodies B12 defSchillings test |
PA
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causes MA (macrocytic)
no CNS involvement decr retics, ovalocytes |
folate def
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bm failure> pancytopenai
normo/normo anemai bleeding, infs, iron oveloadd can be acquired, genetic, or idiopathic |
Aplastic anemia
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genetic aplastci anemia
seen with dwrfism, enal disease, mental retardation |
fanconi anemia
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true red cell aplasia
leukocytes and plts normal genetic |
Diamond-Blackfan anemia
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gradual long term blood loss
often caused by GI bleed |
Chronic lood loss anemai
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most common RBC memb defect
incr MCHC incr bilirubin incr osmotic fragility |
hereditary spherocytosis
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sex linked enzymedefect
mc def in H-M shunt pathway forms heinz bodies and results in methemoglobin |
G6PD def
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mc enzyme def in EM pathway
reduces RBC lifespan |
PK def
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acquired memb defect
RBC memb has incr affinity for binding complement incr hgb in urine at an acid pH at night ham's and Sugar water test |
PNH
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due to IgG biphasic Donah Landsteiner ab to P ag
fixes complement to RBC in cold and lyses when warmed |
PCH
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DIC
HUS TTP |
MAHAs
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systemic clotting
dur to toxins that trigger release of TF fibrin is deposited > RBc frags |
DIC
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in children with GI infs with E. coli
clots with renal damage |
HUS
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mc in adults
clots form causing RBC frags and CNS inpairment |
TTP
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when valine replace glutamic acid at position 6 of both beta chains
nop hgb A prod 20% hgbFseen with tissue necrosis due to decr O2 and kidney failurepos hgn solubility test imune to P. falciparum |
HgbSS
sick cell disease |
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when valine replaces glutamic acid at position 6 of one beta chain
inherited form 1 parent 60% hgbA no clinical sympts pos hgb solubility test immune to P. falciparum |
Hgb AS
sickle cell trait |
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when lysine replaces gultamic acid at pos 6 on both beta chains
no hgbA intracellular rodlike crystals |
HgbCC disease
HgbC |
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double heterozygous condition where an abn sickle gene is inherited from one parent and an abnormal C gene from other
no hgb A crystals, target cells pos hgb solubility test |
HgbSC disease
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inherited disordes causing decr synth pf normal globin chains
microcytic/hypochomic anemia with target cells |
Thalassemias
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decr or absent both beta chains > excess alpha chains
no hgbA prod, 90% hgbF excess alpha chain precip> Heinz bodies hepatosplenomegaly, stunted growth, prominant facial bones target and tear drop cells |
Beta thal Major- Cooley anemia
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decr rate of synth of one beta chain
mild anemai with target cells and baso stippling hgbA2 is slightly incr to compensate |
beta thal Minor
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all four alpha gene deleted
no normal hgb prod 80% barts( gamma hgb) cant carry O2 |
Alpha thal Major
Hydrop fetalis |
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threee alpha gene deleted
excess beta chains heinz bodies 30% Beta4 hgb = unstable |
Hgb H
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two alpha gene deleted
6% hgb barts in newborns target cells |
Alpha thal minor, trait
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one alpha gene deleted
asympt |
Alpha thal Silent carrier
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automated cell count errors:
incr MCV and HCT, decr MCHC |
hyperosmolarity, glc >600
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automated cell counter errors;
incr MCV, MCH, MCHC decr RBC and HCT |
cold agglu
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automated cell count errors:
incr HGB, MCH, MCHC |
lipemia
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rule of three
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RBC x 3 = HGB
Hgb x 3 = HCT |
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incr in chronic inflamm )RA and pregnancy) bact inf, malignancy, tissue damage, MM, WM, sever anemia
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ESR
normal is 0-20 mm/ hr |
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reticuloendothelial system
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where RBCs are prod, mature, and die
bm, spleen, liver, thymus, ln |
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sites involved in extramedullary hematopoiesis
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outside the bm
liver spleen seen with hepato and splenomegaly when bm cant compensate enough |
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hormone that stims RBC prod in bm by acting on progenitor cells
kidneys sense tissue O2 levels, if level not high enough, it is prod |
EPO
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earliest known erythroid precursor cells that eventually differentiate into erythrocytes
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BFU-E
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very early erythroid precursor cells that eventually differentiate into erythrocytes
expressing the highest amounts of receptors for Epo and their growth is absolutely dependent on the presence of Epo |
CFU-E
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bone marrow biopsy
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to aid in diagnosis
use posterior illiac crest shoudl be 50% hematopoietic tissue and 50% adipose 30-70% cellularity is normal |
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M:E ratio
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3:1-4:1
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erythrocyte maturation
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rubriblast
prorubricyte rubricyte metarubricyte retic mature RBC |
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last imm RBC capable of cell division and last stage to synthesize hgb
youngest cell to enter circulation |
retic
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how is a plt prod
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myeloid progen cell responds to thrombopoietin
produces daughter cell by endomitosis, nuclear division w.o cytoplasmic divsion |
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occurs in mitochondria of normoblasts
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heme synth
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occurs in ribosomes
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globin synth
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heme synthesis
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delta ANA
porphobil uroporphyrin copropophro protoporph heme + globin |
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2 alpha
2 gamma |
HgbF
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2 alpha
2 beta |
HgbA
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2 alpha
2 delta |
Hgb A2
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thr relationship btwn O2 tension and hgb sat with O2
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O2 diss curve
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decr is O2 affinity
more O2 to tissues decr body pH incr 2,3 DPG |
right shift,
O2 curve |
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incr O2 affinity, decr O2 to tissues
incr in body pH decr 2,3-DPG |
left shift O2 curve
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hgb with Fe3+
cant transp O2 incr cyanosis and anemia |
Methemoglobin
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see in MA and normal for newborns
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macrocytes
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seen in IDA, thals, SA and ACD
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microcytes
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in liver disease (alcohol), hgbopathies, thals, IDA
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target cells
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seen in HS, G6PD def, and hemolytic anemias
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spherocytes
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seen in MA, thals, extramed. hemato
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teardrops
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seen in MAHA
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helmet cells
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evenly spaced projections with central pallor
in liver disease, uremia, hepairn, PK def |
echinocyte
burr cell |
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unevenly spaced projections with no central pallor
seen in alcoholic liver disease, post splenectomy, abetalipoproteinemia caused by excess chol on memb |
acanthacyte
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primary lymph tissue
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bm
thymus |
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secondary lymph tissue
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where ag contact occurs
ln, spleen, peyers patches |
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hypercell marrow, overprod of all cells
myeloid stem cell defect |
chronic myeloprolif disorders
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prolif of megakaryocytes
in adults >60 giant plts |
ET
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malig hyperplasia of multipotent stem cell
incr in all cells, mostly RBCs but decr EPO incr blood viscosity adults >50 treat with theraputic phleb |
PV
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myeloid stem cell disorder
prolif of all cells with marrow dyspoiesis progressive marrow fibrosis adults >50 bleeding due to abn plt fnx extramed hemato |
Chronic idiopathic myelofibrosis
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corrected WBC count (for NRBCs)
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WCB x 100 /100 + NRBC
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corrected retic count
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retics x HCT/ 45
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leukocytosis
shift to left dohle bodies toxic grans |
leukemoid rxn
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