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256 Cards in this Set
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Increased number of red cells with variations of size |
Anisocytosis |
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Size of normocyte |
7-8 um |
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Normal MCV value |
80-100 fl |
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Larger than normal RBCs |
Macrocytes |
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What do you call rbcs that has a MCV of more than 100 FL |
Macrocytes |
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Macrocytes are generally associated with |
Impaired DNA Synthesis |
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Usually seen when MCV is <80fL |
Microcytes |
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Smaller than normal RBCs (<7.0um) |
Microcytes |
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Microcytes are generally associated with |
Defective Hemoglobin Formation |
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4 Ways to detect Anisocytosis |
-Nucleus of Small Lymphocytes -Using MCV Volume -Using the RDW Value - Using RBC Histogram |
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What is the formula of mcv |
(HCT/RBC ct) (10) |
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A calculated index from the RBC histogram given by the hematology analyzers to helpidentify anisocytosis and provide information about its degree. |
Red Cell Distribution width |
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True or false: the wider the RBC Histogram the more normal the RDW |
False The wider the RBC Histogram the more abnormal is the RDW |
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It is based on the width of the RBC distribution curve and the mean RBC size |
RDW-CV |
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The RDW CV is based on both the??? |
-Red Cell Distribution Curve -Mean RBC Size |
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Based on the actual measurement of the width of the RBC distribution curve in fl |
RDW SD |
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RDW SD is based on the actual measurement of what factor in fL |
Red Cell Distribution curve |
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In the reference range of RDW CV what is the time frame expected in newborns to matture in adult reference range levels? |
6 months |
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Reference range of adults in RDW CV |
11.5-14.5% |
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Reference range of newborns in RDW CV |
14.2%-19.9% |
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RDW SD reference range level |
36-46 fL |
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Earliest method provided by the hematology analyzers to measure red cell variation |
RDW CV |
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The RDW CV is dependent on what factors? |
-MCV -Width of the Red Cell Distribution Curve |
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width of the curve is measured at the point that is 20% above the baseline |
RDW SD |
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RDW SD's width of the curve is measured at the point that is how much above the baseline? |
20% |
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True or false the RDW CV is influenced by MCV |
True |
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True or false the RDW SD is not influenced by MCV |
True |
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Which is a more reliable measure of RBC variability specifically in highly abnormal conditions |
RDW SD |
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Normal RDW and Increased MCV (Macrocytic) |
Liver disease |
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Normal RDW and Normal MCV (Normocytic) |
G6PD deficiency |
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Normal RDW and decreased MCV (Microcytic) |
Anemia of Chronic Disease |
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Increased RDW and Increased MCV (Macrocytic) |
Megaloblastic anemia |
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Increased RDW and decreased MCV (Microcytic) |
Iron deficiency anemia |
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Increased RDW and normal MCV (Normocytic) |
Sickle Cell Anemia |
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visual display of cell size (x-axis) and cell frequency / number of cells (y-axis) |
RBC histogram |
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RBC Histogram x axis |
Cell size |
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RBC Histogram Y axis |
Cell frequencies or number of cells |
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Provided by many high-volume instruments to provide size distribution of the different cell populations |
RBC Histogram |
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Rbc histograms are made by automated analyzer to analyze what cells |
-RBC -Platelets -WBC |
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What are the 2 parameters calculated from RBC Histogram |
-MCV -RDW |
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Volume sizes that the RBC Histogram counts as rbc |
36-360 fL |
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What is the least amount of FL that a RBC Histogram can count |
24 fl |
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When the object being counted by the RBC Histogram falls in the 24-36flL range will it be included in the RBC Ct |
Not Included |
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When the RBC Histogram is narrow is it positive or negative for anisocytosis |
Negative |
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When the RBC Histogram is wider or flattened curve is it positive or negative for anisocytosis |
Positive |
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Shift to the left: Narrow or Widened rbc histogram |
Narrow |
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Shift to the right: Narrow or Widened rbc histogram |
Widdened |
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Has greater affinity for oxygen: Shift to the right or Shift to the lefy |
Shift to the left |
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Has lesser affinity for oxygen: Shift to the right or Shift to the lefy |
Shift to the Right |
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Term used to refer for a Histogram with 2 rbc population |
Bimodal |
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Cite 3 examples that causes bimodal rbc histogram |
-Blood Transfusion -Cold Agglutinin Disease -Hemolytic anemia with Schistocytes |
ABC |
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General term for a variation in the normal coloration |
Anisochromia |
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It occupies 1/3 of the RBC |
Central Pallor |
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occurrence of hypochromic cells and normochromic cells in the same blood smear. |
Anisochromia |
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This may be found in: o Sideroblastic anemias o Hypochromic anemia after transfusion with normal cells o Some weeks after Iron Therapy for Iron Deficiency Anemia |
Anisochromia |
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Central Pallor = >1/3 of diameter of rbc |
Hypochromic Cells |
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Central Pallor = <1/3 of diameter |
Hyperchromic |
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Hypochromic cells are usually associated with? Microcytes or Macrocytes |
Microcytes |
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Grading of hypochromia: Thin Rim of hemoglobin |
4+ |
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Grading of hypochromia: 3/4 of diameter |
3+ |
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Grading of hypochromia: 2/3 of diameter |
2+ |
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Grading of hypochromia: 1/2 of diameter |
1+ |
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Annulocytes are also called aa |
-Pessary Cells -Ghost Cells |
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RBC w/ a thin rim of Hgb and a large central pallor |
Anulocytes |
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RBCs that lack central pallor even tho they lie in a desirable area of evaluation |
Hyperchromic Cells |
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True or false: Anulocyte maybe observed in Iron Deficiency anemia |
True |
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Are spheroctes Hyperchromic or Hypochromic? |
Hyperchromic |
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What causes the RBC to be hyperchromatic |
Shape change |
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MCHC is low: True Hyperchromia Is the statement above correct or incorrect |
Incorrect True Hyperchromia=HighMCHC |
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What is the only hematological disease related to erythrocytes that has an increased value of MCHC |
Hereditary Spherocytosis |
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Value of the MCHC of the hereditary spherocytosis |
35-38 g/dl |
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3 major symptoms of hereditary spherocytosis |
-Jaundice -Anemia -Splenomegaly |
JAS |
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The result of Hereditary spherocytosis in DAT |
Negative |
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-MCV: NORMAL TO LOW - MCH: NORMAL - MCHC (31 – 37g/dL): SLIGHTLY INCREASED |
Hereditary Spherocytosis |
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greatly increased in Hereditary Spherocytosis (but can be corrected with either glucose or ATP) |
Autohemolysis Test |
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What corrects the Autohemolysis Test of Hereditary Spherocytosis |
-ATP -Glucose |
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increased but not diagnostic to hereditary spherocytosis |
Osmotic Fragility Test |
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What is the normal value of MCHC |
31-37 g/dL |
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EMA stands for |
Eosin-5'-Maleimide |
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Confirmatory test for hereditary spherocytosis |
EMA Binding Test |
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Larger that normal red cells with bluish tinge stain |
-Polychromatophilic Erythrocytes -Diffusely Basophilic Erythrocytes |
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The bluish tinge exhibited in Diffusely Basophilic erythrocytes with the use of Wright stain is caused by |
Residual RNA |
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Increase in Polychromatophilic Erythrocytes / Diffusely Basophilic Erythrocytes is associated with |
-Decrease RBC Survival -Hemorrhage -Erythroid Hyperplastic Bone Marrow |
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Grading of polychromasia:3% |
3+ |
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Grading of polychromasia: 5% |
2+ |
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Grading of polychromasia: 10% |
3+ |
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Grading of polychromasia: >11% |
4+ |
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Grading of polychromasia:1% |
Slight |
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Increased number of red cells with variation in SHAPE |
Poikilocytosis |
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Almost spherical in shape and it Lacks the central pallor |
Spherocytes |
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Inherited condition wherein there are RBC proteins absent in the membrane causing change in shape |
Hereditary Spherocytosis |
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Conditions associated with Spherocytes |
-Hwreditary Spherocytosis -Burns -AIHA -ABO HDN -Following transfusion of stored blood |
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What area of the blood smear contains red blood cells with no central pallor |
Feathered Edge |
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Stomatocytes are also known as |
Mouth cell |
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Elongated RBCs with a slit-like central pallor (may be considered as an artifact) |
Stomatocytes |
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Associated conditions with Mouth Cells |
-Rh deficiency syndrome -Alchoholism -Electrolyte Imbalance -Severe Liver Disorder -Overhydrated Hereditary Stomatocytosis |
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Hereditary Xerocytosis is also known as |
Dehydrated Hereditary Stomatocytosis |
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Most common form of stomatocytosis |
Dehydrated Hereditary Stomatocytosis |
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Dehydrated Hereditary Stomatocytosis is characterized by the presence of |
Xerocytes |
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dehydrated form of stomatocytes Appear to have puddled at one end |
Xerocytes |
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caused by the puddling of the Hemoglobin at one end of the cytoplasm of RBC |
Xerocytes |
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Other term for Acanthocytes |
-Spur Cells -Thorn Cells |
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RBCs with irregularly spiculated surface it also has uneven projections arising from the cytoplasm |
Acabthocytes |
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Abetalipoproteinemia is also known as |
-Bazzen Kornzweig Syndrome -Hereditary Acanthacytosis |
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Characterized by defective apo B synthesis (VLDL, LDL, Chylomicron) |
Abetalipoproteinemia |
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Is abetalipoproteinemia found in the plasma |
No it is not found in the plasma |
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Associated conditions with acanthocytes |
-Abetalipoproteinemia -McLeod Syndrome -PK Deficiency -Hepatic Hemangioma -Neonatal Hepatitis -Postsplenectomy -Post Heparin admission -Liver Cirrhosis assoc with Hemolytic Anemia |
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Burr Cells is also known as |
Echinocytes |
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RBCs with regularly spiculated surface |
Echinocytes |
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Echinocytes are asocciated with what diseasea |
-Uremia -PK deficiency |
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PK Deficiency has what possible PBS findings |
-Acanthocytes -Burr Cells |
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Marked increase in plasma urea and other nitrogenous waste products |
Uremia |
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What type of anemia is uremia |
Normocytic, Normochromic Anemia |
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What electrolyte imbalance is found in uremia |
K+ |
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True or false: Uremia promoted acidemia |
True |
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-Uremic frost (dirty skin)- Generalized edema- Foul breath Urine like sweat |
Uremia |
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Oval shaped RBCs |
Ovalocytes |
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Hereditary Ovlocytosis is also known as |
Southeast Asian Ovalocytosis |
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Cigar Shaped RBC |
Elliptocytes |
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Thalassemia is also known as |
-Hereditary Leptocytosis -Mediterranean Anemia |
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Disease associated with elliptocytes |
-Hereditary Elliptocytes -Thalassemia |
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Pear-shaped or teardrop-shaped RBCs |
Dacrocytes |
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Also called as teardrop cells |
Dacrocytes |
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Disease associated with dacrocyte |
-Primary Myelofibrosis -Medaloblastic Anemia -Myelophthisic Anemia -After Heinz body formation induced by drug ingestion -Tuberculosis -Tumor metastasized to bone marrow -Thalassemia -Some Hemolytic Anemias |
8 |
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Primary Myelofibrosis exhibits what in the BM |
-Hypercellularity -Increased Megakaryocytes -Fibrosis |
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What cells are seen in the PBS of Primary Myelofibrosis |
-Immature Granulocytes -Normoblast -Dacrocytes |
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Schistocyte is also known as |
Schizocyte |
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Fragmented RBC |
Schisticyte |
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Disease associated with Schistocyte |
-MAHA -TTP -HUS -DIC -HELLP |
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Group of disorders characterized by RBC fragmentation and thrombocytopenia |
MAHA |
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MAHA is a group of disorders characterized by? |
-RBC Fragmentation -Thrombocytopenia |
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Major MAHAs |
-TTP -HELLP -HUS -DIC |
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What do you call the type of schistocyte that may appear in MAHA |
Helmet Cell |
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Characterized by narrowing or obstruction of small blood vessels by fibrin or platelet aggregates resulting in the fragmentation of RBCs |
MAHAs |
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Hemolytic Uremic syndrome is associated with |
Escherichia coli serotype O157:H7 infection |
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Characterized by renal failure, thrombocytopenia, schistocytes (PBS), and severe mucocutaneous hemorrhage |
HUS |
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DIC is also known as |
-Defibrination Syndrome -Consumption Coagulopathy |
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Generalized over-activation of the coagulation and fibrinolytic systems |
DIC |
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Tests for DIC |
-D-Dimer Test -Prothrombin Fragment |
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Related Conditions of DIC |
-Tissue Trauma -Obstetric Complication -Mucous Secreting Tumors -Acute Infections -Snake Bites -Acute Promyelocytic Leukemia |
TOMASA |
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Drepanocyte is also called us |
-Sickle Cell -Meniscocyte |
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Crescent shaped cell |
Drepanocyte |
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Associated diseases with drepanocytes |
-Sickle Cell Anemia -Hemoglobin SC |
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Two forms of drepanocytes |
-Irreversible Sickle Cell -Oat-Shaped Sickle Cell |
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Crescent-shaped with long projections and When reoxygenated, they may undergo fragmentation |
Irreversible Sickle Cell |
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When reoxygenated, they return to the original biconcave disk shape |
Oat-Shaped Sickle Cell |
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When reoxygenated, what happens to Irreversible Sickle Cell
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Fragmentation Does not go back to its original shape |
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When reoxygenated, what happens to Oak Shape Sickle Cell |
Reverts to its original Biconcave Disk Shape |
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Leptocyte is also known as |
-Codocyte -Platycyte -Mexican Hat Cell -Greek Helmet Cell -Target Cell -Bulls Eye Cell |
6 |
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RBCs which show a centrally stained area with a thin outer rim of hemoglobin |
Target Cells |
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Associated Diseases with codocytes |
-Liver Disease -Certain Hemoglobinopathies -Thalassemia -LCAT Deficiency |
LCTL |
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Other term for bite cells |
Degmacytes |
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Demonstrate a semicircular defect in their edge |
Degmacytes |
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Disease associated with degmacytes |
G6PD |
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Description: Folded RBCs |
Biscuit Cells |
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Examples of Associated Conditions of biscuit cells |
Hemoglobin SC Disease |
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Bipolar or central distribution of hemoglobin |
Bronze Elliptocyte |
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Examples of Associated Conditions of bronze ellliptocyte |
Sickle Cell anemia |
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Pale-pink staining ghost of the red cell (the membrane remaining after the contents been released) |
Semilunar Bodies |
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Semilunar Bodies are the same size with |
Leukocytes |
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Semilunar Bodies are seen in |
-Malaria -Conditions Causing Overt Hemolysis |
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Described as irregular, dark blue to purple granules evenly distributed within an RBC |
Basophilic Stippling |
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Basophilic Stippling is also known as |
Punctuate Basophilia |
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Content of Basophilic Stippling |
Aggregated RNA |
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Stains used to visualize punctuate basophilia |
-Wright stain -Supravital stain |
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Color of Basophilic Stippling in Wright stain |
Dark Blue to Purple |
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Forms of Basophilic stippling |
-Fine Stippling -Coarse Stippling |
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Kind of Stippling in which it is usually observed when there is increased polychromatophilia |
Fine Stippling |
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Fine Stippling is usually observed when there is? |
Increased Polychromatophilia |
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This kind of Stippling may be observed in plumbism or other disorders with impaired Hb synthesis, in megaloblastic anemia, and in other forms of severe anemia |
Coarse Stippling |
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Coarse Basophilic Stippling is observe in |
-Plumbism -Megaloblastic Anemia -Impaired Hb synthesis -Severe Anemias |
PIMS |
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Associated conditions in Basophilic Stippling |
-Lead Poisoning -Arsenic Poisoning -Pyrimidine 5' Nucleotidase Poisoning -Anemias with impaired Hb synthesis -Refractory Anemia -Alchoholism -Megaloblastic Anemia |
LAPARAM |
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Other term for Sideroblastic Granules |
Pappenheimer Bodies |
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Described as multiple Dark blue irregular granules (in Prussian Blue iron staining) |
Sideroblastic Granules |
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Described as Pale blue clusters (in Wright staining) |
Sideroblastic granules |
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Pappenheimer bodies are dark blue in what stain |
Prussian Blue |
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Pappenheimer bodies are pale blue in what stain |
Wright stain |
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Contents of Sideroblastic granules |
Intra-erythrocytic collections of iron |
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Stain used in Sideroblastic granules |
Iron stains |
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Stains used in pappenheimer bodies |
-New Methylene Blue -Wright Stain |
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Siderotic granules are associated with what diseases |
-Sideroblastic anemia -Thalassemia -hemochromatosis or hemosiderosis |
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Characterized by a dimorphic peripheral blood picture (presence of BOTH normochromic and hypochromic RBCs in the same blood smear) |
Sideroblastic Anemia |
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Types of RBC seen in Sideroblastic anemia |
-Normochromic -Hypochromic |
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Frequently appears singly in a cell (only one per cell), usually round, and <1um in diameter, blue to purple in color) |
Howell jolly bodies |
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Contents of Howell jolly bodies |
Round remnants of nucleus chromatin |
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Visualizations used in Howell jolly bodies |
-Wright stain -New Methylene Blue -Fuelgen Reaction Positive |
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Histo chemical stain for DNA |
Fuelgen Reaction |
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Associated conditions of HJB |
-Megaloblastic Anemia -Post Splenectomy -Thalassemia |
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Threadlike structures that appear as purple-blue loops or ring |
Cabot rings |
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Conditions associated with Spherocytes |
-Hwreditary Spherocytosis -Burns -AIHA -ABO HDN -Following transfusion of stored blood |
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What is the content if Cabot rings |
Mitotic spindle fiber |
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What can be use to visualize Cabot rings |
Wright stain |
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Associated conditions with Cabot rings |
-Megaloblastic anemia -Refractory Anemia -Lead poisoning |
MRL |
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Heinz bodies most of the time appear |
Eccentrically |
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along the inner RBC membrane, large, round, blue to purple materials |
Heinz Bodies |
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Content associated with heinz bodies |
Denatured and precipitated Hemoglobin |
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True or false: Heinz bodies can be demonstrated using Wright stain |
False |
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Used for visualization of Heinz Bodies |
Supravital stains -NMB -BCB -Methyl Violet -Crystal Violet |
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Associated Conditions with Heinz bodies |
-G6PD -Drug Induced Hemolytic Anemia -Unstable Hemoglobin Disease (Congenital Heinz Body Hemolytic Anemia) |
DUG |
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An inherited condition resulting from sensitivity to the fava beans; |
Favism |
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Favism is associated with what enzyme deficiency |
G6PD |
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Favism usually occurs on what region and race |
-Mediterranean -Chinese |
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Unstable Hemoglobin disease |
-Hb Koln -Hb Casper/ Southhampton -Hb Genova -Hb Gunhill -Hb M-Saskatoon -Hb Bristol -Hb Torino -Hb Seattle |
8 |
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Description: Small, multiple, evenly distributed throughout the red cell, granular, greenish-blue bodies |
Hb H inclusion Bodies |
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Content if Hb H |
Precipitated Hb H |
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Abnormal Hb composed of 4 β (beta) globin chains |
Hb 4 |
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Hb H is composed of |
4 abnormal beta globin chain |
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It is denatured beta globin chain |
Hb H |
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What is the appearance of RBC with Hb H inclusion bodies |
Pitted Golf Ball |
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True or false: Wright stain is used to visualize Hb H |
False |
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What are used to visualize Hb H |
Supravital Stains -NMB -BCB |
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What are the contents of Parasite? |
Protozoans |
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Pink dots scattered in the RBC cytoplasm that is associated with parasites |
Schuffner' dots |
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Schuffner's dots are also called as |
Eosinophil Stippling |
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Also known as maltese cross |
Babesia spp |
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Content: Aggregated RNA |
Basophilic Stippling |
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Content: Intra-erythrocytic collections of iron |
Siderotic Granules |
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Content: Round remnants of nuclear chromatin (DNA) |
Howell Jolly Bodies |
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Content: Mitotic spindle remnant |
Cabot Rings |
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Content: Denatured and precipitated hemoglobin |
Heinz Bodies |
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Content: Precipitated Hb H |
Hemoglobin Inclusion Bodies |
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Content: Protozoa/Protozoans |
Parasites |
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Term used to describe the aggregation of RBCs |
Rouleux Formation |
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Rouleux Formation is also known as |
Pseudoagglutination |
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Rouleux Formation is caused by increased |
-Fibrinogen -Globulins |
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Hemoglobin ref range in conventional units for children and adult female |
12-15 g/dl |
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Hemoglobin ref range for adult male |
14-18 g/dl |
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Hemoglobin SI unit ref range for children and adult female |
120-150 g/L |
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Hemoglobin SI unit ref range for adult male |
140-180 g/L |
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Main component of the red blood cell |
Hemoglobin |
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What percentage does the red cell is composed of hemoglobin? |
95% |
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Reddish color of blood is caused by the presence of |
Hemoglobin |
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Also known as the respiratory pigment |
Hemoglobin |
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Concentration of Hb within RBCs: |
Approx 34 g/dL |
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MW of hemoglobin |
Approx 64000 Daltons |
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Caused of the difference in the Hb levels of male and females |
Hormones |
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Who Concentration of Hb within RBCs? |
Felix Seyler |
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When did Felix Seyler identified hemoglobin? |
1892 |
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About 65% of cytoplasmic hemoglobin is produced before the |
Nucleus is extruded |
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35% of the Hemoglobin are synthesize on what stage |
Early Reticulocyte |
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Single most common complex organic molecule in vertebrates |
Hemiglobin |
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1 gm or Hb can carry how many Oxygen |
1.34ml |
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1 gram of Hemoglobin can carry a constant |
3.47 mg of iron |
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Components of Hb |
-Globin -Protoporphyrin Iz -Ferrous (Fe2+) -2-3 BPG |
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Fe2+ combined with Protoporphyrin IX |
Heme |
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Other term for heme |
Ferroprotopoorphyrin IX |
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Transient resident of hemoglobin to help release Oxygen in the peripheral tissues |
2-3 BPG |
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Number of AA of alpha hemiglobin |
141 |
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Number of AA of beta hemiglobin |
146 |
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Number of AA of delta hemiglobin |
146 |
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Number of AA of gamma hemiglobin |
146 |
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Composed of 146 amino acids in which alanine is present on the 136th AA |
Gamma A |
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Composed of 146 amino acids in which glycine is present on the 136th AA |
Gamma G |
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Number of AA of epsilon hemiglobin |
146 |
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Number of AA of zeta hemiglobin |
141 |
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Number of AA of theta1 hemiglobin |
Unknown |
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