Hematology Finals

• Bone marrow function

  Provide mature cells for peripheral circulation
• How do you calculate Hematocrit

  RBC count and MCV
• What does normal RBClook like

  • Biconcave with 6-8 um diameter
• What do retics look like with Wright stain

  Polychromatophilia
• How are the majority of dying red cells removed from the body?

  Extravascular Hemolysis
• What gives blue color to immature RBCs

  Remnant of RNA
• Function of erythropoietin

  Controls the rate of production by increasing mitosis and shortening maturation time, facilitates the release of iron from transferrin to the erythroid precursors, increase red cell precursors metabolic processes for increased energy
• Function of 2,3 DPG

  Enhances the release of oxygen from hemoglobin
• What is the normal adult hemoglobinmade up of?

  Alpha and beta chains
• Normal composition of adult hemoglobin


  • >95% HbA, <3.5% HbA2, <1-2% HbF
• Be able to define normal cells

  
  

  Biconcave disk with flat center like a doughnut with no hole
• Final maturation stage of B cell lymphocyte


  Plasma Cell
• Red cell lifespan

  120 days
• Marginating and circulating pools


  Located on the vessel walls and cells can move freely between them
• Left shift

  Immature granulocytes
• Causes left shifts

  Bacterial Infections
• Peripheral picture of patient with mono


  • Reactive lymphocytes
• Function of neutrophils

  Migration to the site of infection, phagocytosis of pathogenic material, and intracellular kill of phagocytized pathogens
• Inclusions WBCs can have

  • Toxic granules, vacuoles, dohle bodies (neutrophils)
• Normal maturation of granulocytes includes

  Condensation of nuclear chromatin, decreases cell size, loss of cytoplasmic basophilia, development of granules
• Function of Luebering-Rapaport pathway

  Synthesis of 2,3- DPG
• Function of Methemoglobin reductase pathway


  Maintains Fe+2 state of iron
• Function of hexose monophosphate shunt

  Protects RBC's from environmental oxidants
• What is the Hemoglobin defect in sickle cell anemia

  Substitution of valine for glutamic acid at the 6th position of the beta chain
• What hemoglobin S causes red cells to do


  Forms tactoids when deoxygenated
• Hemoglobin H and Bart's associated with

  Alpha thalassemia
• What is affected in Beta Thalassemia's


  Decreased rate of synthesis of beta-globin chains
• Peripheral picture of sickle cell patients

  • Target Cells
• Beta thalassemias Most closely resemble which anemia on the peripheral picture


  iron deficiency anemia
• How could you Confirm patient a patient is heterozygous or homozygous for hemoglobin S

  Hemoglobin electrophoresis
• Peripheral findings with aplastic anemia

  • Neutropenia, anemia and thrombocytopenia
• Sideroblast


  A nucleated RBC that contains excessive iron
• When to see Pappenheimer bodies

  Sideroblastic anemia
• Peripheral findings with aplastic anemia

  • Neutropenia, anemia and thrombocytopenia
• Sideroblast


  A nucleated RBC that contains excessive iron
• When you see pappenheimer bodies


  • Sideroblastic anemia
• If a patient has a WBC count 92,000

  Count a 200 cell differential for better statistical distribution
• If you see many target cells and hexagonal rod shaped crystals

  • Hemoglobin C diseases
• Microangiopathic hemolytic anemia


  RBC fragments because they were forced through fibrin clots
• Effect of lead poisoning on RBCs

  Basophilic Stippling