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Heme II Test II

Terms in this set (51)

A typical blood picture in infectious mono shows an absolute...
Lymphocytosis without anemia and with many reactive lymphocytes
Define opsonization.
Preparing neutrophils to be ingested
Morulae may be seen in this disease..
Human Ehrlichiosis and Anaplasmosis
Neutropenia occurs as a result of ...
Cancer Chemotherapy
Define lipid storage disease
Lipid Storage diseases are a group of inherited disorders in which key metabolic enzyme is missing or inactive
Autosomal disorder that manifest recurring infections and albinism
Chediak-Higashi
Enzyme deficiency of Gauchers disease
Β-Glucocerebrosidase
Enzyme deficiency of Niemann-Pick disease
Sphingomyelinase
Enzyme deficiency of Tay-Sachs disease
Hexosaminidase A
Infectious mono may cause this complication in less than 1% of patients.
Hemolytic Anemia
What's the corrective action for platelet satellitism?
Recollect in Sodium Citrate, blood reacts with EDTA causing platelets to form around neutrophils (false low platelet count)
Where does toxic granulation occur?
Clusters of toxic granulation usually appear in Neutrophils sometimes the granulation is so heavy as to resemble basophilic granules
What causes toxic granulation ?
Enhanced lysosome enzyme production (infection or inflammation)
What type of cell is indicative of Pelger-Huet?
Hyposegmentation disorder in which lobes of the segmented neutrophils are peanut-shaped or bilobed
Define Dohle bodies.
Cytoplasmic inclusions that consist of ribosomal RNA. Rod-Shaped near cytoplasmic membrane
Which disorder has granules in every cell line?
Alder's Anomaly
What can be seen in a peripheral smear for a patient with May-Hegglin Anamoly?
Thrombocytopenia giant platelets, Dohle bodies in neutrophils, abnormal bleeding
List the lipid storage diseases
Gaucher's disease, Tay-sachs and Niemann Pick (not Chediak-Higashi syndrome)
List the hereditary WBC disorders
May-Hegglin Anomaly, Alder's Anomaly (Alder-Reilly Anomaly), Pelger-Huet Anomaly, and Chediak-Higashi Syndrome
Viral disorders usually have an increase in this cell type.
Lymphocytes
Bacteria disorders usually have an increase in this cell type.
Segmented Neutrophils
In which age group would you see an increase in lymphocyte concentration?
Children 1 to 4 years
Calculate absolute count.
Absolute= WBC count x % cell
WBC= 2.5 x (10)3/mcl
Lymphs 30%
2.5x (10)3 x .30 = 750 lymphs
Calculate relative count.
% of a particular cell counted from the 100 WBC differential
What does CD mean in reference to cell identification?
Represent surface antigen markers on the surface of circulating cells
Specific granulation is predominantly seen in which cell?
Myelocyte
Define delta check
Comparison to previous value
Which cell when seen in a peripheral smear is reported as critical?
Bacteria
Autosplenectomy is characteristic of
Sickle Cell Anemia
Define aplastic crisis
"Marrow Failure" decrease of reticulocytes in the body"
What distinguishes Sickle cell trait from sickle cell disease?
Trait-inherit one gene for normal Hgb A and one gene Hgb S

Disease- inherit two genes for Hgb S
A patient with sickle cell disease has an increase in which Hgb?
Hgb S
Explain how Hgb S can be separated from Hgb D.
Hemoglobin Electrophoresis (citrate Agar at pH 6.0)
What's significant about Hgb E, Hgb C and Hgb A2 in alkaline electrophoresis?
They have the same migration point
What is the dithionite solubility test used for?
First level screening purpose is to detect the presence of Hgb S in the sample

The end point is easy to read as a turbid solution in the presence of Hgb S
In sickle cell anemia, _____is substituted for glutamine.
Valine
In Hgb C, ____ is substituted for glutamine.
Lysine
What's the normal hgb for a sickle cell anemia patient?
Decreased Hgb (6-8 g/dl)
Which Hgb is the second most common variant in the world?
HgB E
Individuals with Fanconi's anemia will have which Hgb?
Increased Hgb F
Explain significance of osmotic fragility test.
Test choice for confirming a diagnosis of Hereditary Spherocytosis (HS)

(elevated curve-HS, autoimmune hemolytic anemia, decreased curve-Thalassemia, IDA)
What is the most common enzyme deficiency in the world?
G6PD
What is glutathione?
The chief red blood cell antioxidant and serves to protect the red blood cell from oxidant stress caused by peroxide buildup and other compounds or drugs
What is significant of the RBCs in PNH?
Increased susceptibly of the RBCs to complement lysis directly related to a clonal membrane defect, classically in this disorder RBCs are destroyed while patients sleep
List procedures to screen and/or diagnose PNH?
Sugar Water Test, Ham's Test, Flow Cytometry
What causes PCH (Paroxysmal Cold Hemoglobinuria)? What is the screening procedure?
A rare hemolytic anemia caused by the anti-P, which attaches to the RBCs at a lower temperature and then activates complement at warmer temperatures, lysis occurs at body temperature
This enzyme is required to generate ATP from ADP.
Pyruvate kinase
What is CAS (Cold Agglutinin Syndrome)? What population is affected?
Causes hemolysis by an IgM autoantibody of wide thermal range (complement is fixed on RBCs during cold temps 0-5 degrees Celsius and then red blood cells agglutinate and hemolyze as body temps increase 25-30 degrees Celsius.)

The population that is affected is primarily individuals older that 50 years
What happens to a RBC with Heinz bodies as it squeezes through the spleen's membrane?
They become pitted from the RBCs by the spleen, forming bite cells
What is significant about oat-shaped cells?
The are reversible sickle cells
What is the causative agent in infectious mononucleosis?
EBV
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