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Hematology Internship Section 2
Part C: Bone Marrows
39
Biology
Undergraduate 4
10/05/2015

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Term
Calculate the M:E Ratio from the following BM differential count of 500 cells:
Myeloblasts - 10
Promyelocytes - 20
Myelocytes - 105
Metamyelocytes - 180
Segs - 80
Rubriblasts - 0
Prorubricytes - 10
Rubricytes - 25
Metarubricytes - 25
Plasma Cells - 5
Lymphocytes - 35
Monocytes - 5
Definition
6.6:1
Term
Is the below M:E Ratio Normal?
BM differential count of 500 cells:
Myeloblasts - 10
Promyelocytes - 20
Myelocytes - 105
Metamyelocytes - 180
Segs - 80
Rubriblasts - 0
Prorubricytes - 10
Rubricytes - 25
Metarubricytes - 25
Plasma Cells - 5
Lymphocytes - 35
Monocytes - 5
Definition
This is NOT Normal
Term
What is a normal M:E Ratio?
Definition
3:1
Term
When a M:E Ratio is NOT Normal, what is the term that is used to describe this marrow?
Definition
Myeloid Hyperplasia or Erythroid Hypoplasia
Term
On a BM tap that yields a dry specimen, Wright stain smears could be prepared from:
Definition
Touch prep slide from trephine biopsy
Term
When examining the BM smear on Low magnification 10X objective (initial scan), the tech is examining for ALL of the following EXCEPT:
A. BM Cellularity
B. # & Distribution of Megakaryocytes
C. Nonyhematopoietic tumor cells infiltrating BM
D. Details of nuclear & cytoplasmic maturation process
Definition
D. Details of nuclear & cytoplasmic maturation process
Term
In the estimation of BM Cellularity, the cellularity is reflected in the ratio of Nucleated hematopoietic cells to:
Definition
Fat Cells
Term
The cells found in LARGEST Concentration in a Normal adult BM are:
Definition
Granulopoietic and Erythropoietic Precursors
Term
The name of the LARGEST Cell in the normal marrow that Produces Platelets is:
Definition
Megakaryocytes
Term
When observing a BM Smear, the technologist observes that only fat and connective tissue are formed. This is found in individuals with:
Definition
Aplastic anemia or chemotherapy
Term
The major iron storage compound is:
Definition
Ferritin
Term
Match the BM findings with the listed anemias:
Aplastic Anemia
Definition
Fat to cell ration of 90:10
Term
Match the BM findings with the listed anemias:
Hemolytic Anemia
Definition
RBC Hyperplasia
Term
Match the BM findings with the listed anemias:
Megaloblastic Anemia
Definition
Large, basophilic RBC precursors with asynchrony, karyorrhexis and "moth eaten" nuclei
Term
Match the BM findings with the listed anemias:
Sideroblastic Anemia
Definition
Increased ringed sideroblasts
Term
Match the BM findings with the listed anemias:
Iron Deficiency Anemia
Definition
Small, pale RBC precursors with jagged cytoplasm, absent Iron
Term
Match the following disorders with their descriptions:
CLL
Definition
90% Small Mature Lymphs
Term
Match the following disorders with their descriptions:
Multiple Myeloma
Definition
80% Immature and multi-nucleated plasma cells
Term
Match the following disorders with their descriptions:
CML
Definition
M:E ratio of 20:1
Immature granulocytes
Increased Eos & Basos
Term
Match the following disorders with their descriptions:
ALL
Definition
>30 blasts
+PAS
Other Stains Negative
Term
Match the following disorders with their descriptions:
M1 AML
Definition
>30 blasts with Auer Rods
Term
Match the following disorders with their descriptions:
M4 AML
Definition
>30 blasts
+ Specific esterase
+ Non-specific esterase
Term
Match the following disorders with their descriptions:
Metastatic tumor
Definition
Large cells in tight clumps with INCREASED NC ratio and Giant Nucleoli
Term
Match the following disorders with their descriptions:
Lipid storage disorders (Niemann-Pick or Gaucher's)
Definition
Increased histiocytes with ingested fat
Term
Match the hematology stains with their use:
Demonstrate ringed sideroblasts
Definition
Prussian Blue
Term
Match the hematology stains with their use:
Stain for trephine biopsy or clot section
Definition
H&E or other histologic stain
Term
Match the hematology stains with their use:
Positive (+) in Sezary Cells
Definition
PAS
Term
Match the hematology stains with their use:
Routine BM Aspirate Smears
Definition
Wright Stain
Prussian Blue
Term
Match the hematology stains with their use:
Used to diagnose Myelofibrosis
Definition
Reticulin or silver stain
Term
Match the hematology stains with their use:
Positive in M6 & M7 Leukemia
Definition
PAS
Term
Match the hematology stains with their use:
Positive in Hairy Cell Leukemia
Definition
TRAP
Term
Match the hematology stains with their use:
Stains Iron Blue
Definition
Prussian Blue
Term
Which bones in an adult contain active bone marrow tissue?
Definition
Flat Bones
Term
What are examples of Flat bones where active bone marrow tissue can be found?
Definition
Skull, Ribs, Vertebrae, & Hip
Term
The TdT stain is POSITIVE in:
Definition
ALL
Term
Why do patients with Polycythemia vera and other myeloproliferative disorders have reduced marrow iron stores?
Definition
They have HIGH Cell Turnover including RBCs. INCREASED production of RBCs INCREASES the need for Iron & Iron Stores are REDUCED.
Term
Why do patients with thalassemia have INCREASED Iron Stores?
Definition
Thalassemia patients require continual blood transfusions. The body holds on to this extra iron and stores it. Also, ferritin is an acute phase reactant & when increased from inflammation, interferes with Iron metabolism thus allowing for Increased Iron stores but inadequate Iron available for normal RBC production.
Term
If an immature lymphoid cell has a surface immunoglobulin, it is a ______.
Definition
B Cell
Term
Why do patients with chronic disease have INCREASED Iron Stores?
Definition
Activated macrophages in chronic disease hold on to iron, preventing the stored iron from getting to the bone marrow for RBC production. Also, ferritin is an acute phase reactant & when increased from inflammation, interferes with Iron metabolism thus allowing for Increased Iron stores but inadequate Iron available for normal RBC production.
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