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Clinical Laboratory
Hematology
107
Health Care
Graduate
07/15/2007

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Term
Length of Time required to form Red Blood Cells
Definition
One Week
Term
What is the Outer Layer of the Red blood Cell composed of?
Definition
Hydrophilic, composed of proteins, glycolipids, glycoproteins
Term
What is the Central Layer of Red Blood Cells composed of?
Definition
Hydrophobic, contains cholesterol, phospholipids and proteins
Term
Cholesterol composes _________ of Red Blood Cell membrane Lipids.
Definition
25%
Term
What relationship does membrane cholesterol have with plasma Cholesterol?
Definition
It is continually exchanged, therefore if plasma cholesterol is high it can lead to problems with the Red Blood Cell membranes.
Term
______ Levels of membrane cholesterol are associated with decreased RBC survival and abnormal RBC morphologies.
Definition
Increased; abnormal morphologies include Target Cells and Acanthocytes
Term
What is the composition of the Inner layer of Red Blood Cells?
Definition
Hydrophilic; it is the cytoskeleton network of proteins
Term
What does Spectrin do in the Red Blood Cell?
Definition
Binds with other membrane proteins to form skeletal network of microfilaments; Controls the biconcave shape and pilability of the cell; and gives stability to the lipid bilayer
Term
How long does it take for a RBC to form?
Definition
One week
Term
What abnormalities are associated with decreased or abnormal Spectrin?
Definition
Decreased deformability, decreased life span of the RBC causing hemolytic anemia
Term
What are the 3 pathways present in the body to protect hemoglobin from oxidization?
Definition
Hexose Monophosphate Shunt; Methemoglobin Reductast and Leuberin-Rapaport Pathways
Term
What mechanisms exist in the Body to remove aging RBC's?
Definition
Removal by fixed macrophages in the body's reticuloendothelial system located primarily in the spleen.
Term
Normally ______ of Red Blood Cells are destroyed extravascularily. While only _______ are destroyed intravascularly.
Definition
Greater than 90%; only 5-10%
Term
What 9 tests is the CBC generally composed of?
Definition
RBC;WBC; Hgb; MCV; MCHC; PLT; Hct; MCH; RDW, Retic?
Term
How is the RBC Count Reported? and what is the reference range for males and females?
Definition
# of RBC/uL; Males 4.5-6.0 x 106 uL Females 4.0-5.5 x 106 uL
Term
What is the Function of the RBC Count?
Definition
Provides a count of the RBC's present
Term
What is the Function of the WBC Count? And how is it reported?
Definition
Provides a count of the number of White Blood Cells present. Reported as # WBC's/uL
Term
There will be a _________ WBC Count after a bacterial infection.
Definition
Decreased
Term
What is the Function of the Platelet count? And how is it reported?
Definition
Provides a count of the number of platelets present. Reported as #Plts/uL
Term
What is the Function of Hemogblobin?What factors does the Hemoglobin depend on?
Definition
Index of oxygen carrying capacity of the Blood. Total Blood hemoglobin depends on the # of RBC's as well as the amount of hemoglobin in each RBC.
Term
What is the Function of Hematocrit?
Definition
Serves as an indirect estimate of the number of RBC's and thus as an indirect estimate of the amount of hemoglobin
Term
How is Hemoglobin reported? And What are the reference Ranges for Males and Females?
Definition
Hgb/dL; Reference ranges Males 14-18 g/dL; Females 12-16 g/dL
Term
How is Hematocrit reported? And what are the Reference Ranges for Males and Females?
Definition
% of blood that is red cell mass; Males 40-54%, Females 37-47%
Term
What does MCV Stand for and what is the Function of the test?
Definition
MCV = Mean Corpuscular Volume; Represents average red cell volume
Term
What is MCV useful for?
Definition
Classifying anemias
Term
How is MCV Reported? and what is the normal range?
Definition
femtoliters/cell; Normal: 80-100 fL/cell
Term
What diseases are generally associated with Decreased (microcytic) MCV?
Definition
Sideoblastic anemias, iron deficiency anemias, Thalassemias
Term
What diseases are associated with increased (macrocytic) MCV?
Definition
B-12 and Folate deficiencies
Term
What does MCH stand for and what is its function?
Definition
Mean Corpuscular Hemoglobin; Estimates average weight of hemoglobin in each RBC.
Term
How is MCH reported? What is the reference range for MCH?
Definition
picograms Hgb/cell; Normal: 26-34 pg/cell
Term
What does MCHC Stand for? What is its function?
Definition
Mean Corpuscular Hemoglobin Concentration; Estimates the concentration of hemoglobin in each RBC. Provides a ratio of weight of hemoglobin to volume of the RBC
Term
How is MCHC Reported? What are the normal Values for MCHC?
Definition
g Hgb/dL; Normal 31-37 g/dL
Term
What does RDA stand for? What is its function?
Definition
Red Cell Distribution Width; Measure of Anisocytosis (variation in RBC Size) and represents the coefficient of variation (CV) of red cell size.
Term
How is RDA reported and what are the normal ranges?
Definition
Reported as %; Normal: 11-15%
Term
What is the Function of the Retic Count?
Definition
Serves as an index of RBC production by the bone marrow, Normal: 0.5-2.0%
Term
The Retic count can be diagnostic of ________.
Definition
Kidney disorders, not making or releasing enough erythopoietin.
Term
What is the appearance of Polychomatophilic RBC's (Reticulocytes)?
Definition
Cells slightly larger than normal RBC's and appear blue or blue-gray
Term
What is the colour of Reticulocytes due to?
Definition
Residual RNA present in the cell
Term
What is the appearance of Hypochromic cells, and in what conditions are they generally seen?
Definition
Cells with increased area of central palor; Seen in conditions causing impaired hemoglobin synthesis.
Term
What are examples of conditions causing impaired hemoglobin synthesis?
Definition
Iron deficiency anemia; Thalassemias; sideoblastic anemia; Lead poisoning
Term
What is the appearance of microcytic cells, and in what conditions are they generally seen?
Definition
Cells which are smaller than normal with an average diameter of less than 7 um. Seen in conditions causing impaired hemoglobin synthesis.
Term
What is the appearance of macrocytic cells, and in what conditions are they generally seen?
Definition
Cells which are predominantely larger than normal size with an average diameter greater than 9 um. (MCV greater than 100 fL/cell) Conditions causing impaired DNA synthesis, accelerated erythropoiesis, and conditions where membrane cholesterol levels are increased
Term
What condition causes accelerated erythropoiesis?
Definition
Hemolytic anemias
Term
What condition can cause increased membrane cholesterol levels?
Definition
Liver Disease
Term
What conditions can cause impaired DNA synthesis?
Definition
Folate or B-12 deficiencies
Term
What is Anisocytosis?
Definition
Cells having a variety of sizes. Normally less than 5% of cells vary from normal shape
Term
What is Poikilocytosis?
Definition
Cells having a variety of shapes. Normally less than 5% of cells vary from normal shape
Term
What is the appearance of Spherocytes? What is the problem associated with spherocytes?
Definition
Sperical cells with decreased central palor making them appear microcytic and hypochromic; they have decreased surface membrane area.
Term
The spherocytic shape change is _________.
Definition
Irreversible
Term
What does the CBC tell?
Definition
WBC: Infection, inflammation, leukemias, myelodysplastic syndromes
RBC/Hgb?Hct: Anemias
MCV: Classification of Anemias (microcytic, normocytic, macrocytic)
MCH/MCHC: Confirm anemia
Plt: Bleeding disorders
Retic: RBC Production
Term
What parameters define a Red Blood Cell as Normocytic?
Definition
Cells possesssing cell diameter 6-8 um and a MCV of 80-100 fL/cell
Term
What parameters define a Red Blood Cell as Normochromic?
Definition
Cells with central pale area approx 1/3 of cells diameter, RBC's with a normal concentration of hemoglobin.
Term
What is the appearance of Ovalocytes or Elliptocytes? What is the size of the cells?
Definition
Oval egg-shaped or elongated cells, when seen on end may appear like short rods. They can be normocytic or macrocytic. Normochromic or Hypochromic
Term
Macrocytic Ovalocytes are associated with ______________.
Definition
Megaloblastic Anemias
Term
Oval or egg-shaped RBC's are associated with which disorders?
Definition
Thalassemias and Myelodysplastic Syndromes,
Term
Elliptical or Pencil-Shaped RBC's are characteristic of which disorders?
Definition
Hereditary elliptocytosis, Iron deficiency Anemia
Term
What are the characteristics of Target Cells?
Definition
Cells with a large portion of hemoglobin displayed at the rim of the cell and a portion of hemoglobin either central, eccentric or banded
Term
What Disorders Typically display target Cells?
Definition
Hemoglobin C disease or Trait, Iron deficiency anemia and Thalassemias; Cells are always hypochromic
Term
What is the appearance of Teardrop Cells?
Definition
Look as if one end has been pulled out to a tail while the other side is still rounded.
Term
In what disorders are Teardrop Cells Seen?
Definition
Idiopathic myelofibrosis, Thalassemias, Iron deficiency anemias
Term
What is the appearance of Stomatocytes? In which disorders can Stomatocytes be seen?
Definition
Cells that have a rectangular or slit-like central pale area; Thought to be a step in progression from normal shape to that of a sphereocyte. Hereditary spherocytosis, Hereditary Stomatocytosis or Acute Alcoholism
Term
What is the appearance and mechanism of action associated with Rouleaux?
Definition
Cells partially adhering to each other, microscopically have appearance of a stack of coins. Abnormal protein levels causes the RBC's to lose their tendency repel each other, causing them to adhere to each other
Term
What disease State can be associated with Rouleaux?
Definition
Multiple Myeloma (abnormal protein levels primarily fibrinogen or globulins)
Term
What is the appearance of Burr Cells? With which disease states are Burr cells associated?
Definition
Cells with 10-30 rounded spicules evenly spaced over the surface of the cell. Renal Disease, Liver disease or burns. (Can also be due to artifact or due to specimen contamination or improper slide preparation)
Term
What is the appearance of Helmet (Bite-Blister) Cells? What is generally the causal factor for their formation?
Definition
Cells with distinctive projections, usually 2, surrounding an empty area of Red Cell membrane, Looks as if a "bite" was taken out of it. Results due to splenic removal of inclusion bodies (ex. heinz bodies)
Term
In what disorders and Ethnic descent are Helmet cells usually seen?
Definition
Seen in G6PD deficiencies or pulmonary emboli; People of Mediterranean Descent
Term
What are Schistocytes? What causes Schistocytes?
Definition
Small bizarre shaped cell fragments; Seen during periods of intravascular hemolysis or mechanical trauma (Disseminated Intravascular coagulation or Severe Burns)
Term
What is the appearance of Acanthocytes? What causes Acanthocytes and with which disease are they associated?
Definition
Cell with normal or slightly reduced size possesing 3-8 finger-like projections distributed in an irregular manner along the cell membrane. The Cell membrane has increased levels of cholesterol. Abetalipoproteinemia or Severe Liver Diseases
Term
Reticulocytes are ___________.
Definition
a stage in RBC maturation just before the mature cell (just before the remnants of the nucleus is ejected)
Term
The material seen in Reticulocytes is __________.
Definition
Residual RNA, which appears as Dark blue dots or thin irregular linear structures arranged in loose aggregates
Term
What is the appearance of Basophilic Stippling?
Definition
Small dark blue dotlike structures scattered fairly uniformly through the RBC.
Term
What is the cause of Basophilic Stipling? With which Disease states is it associated?
Definition
Derived from RNA and mitochondrial remnants. Conditions with defective or accelerated HEME synthesis ex. Lead Poisoning or Thalassemias.
Term
What is the appearance of Howell-Jolly Bodies? From what are they derived?
Definition
Small round blue-black inclusions that occur singly or doubly in an eccentric position; derived from nuclear remnants
Term
When/Why do Howell-Jolly Bodies form? What diseases typically display Howell-Jolly Bodies?
Definition
Develop in periods of accelerated or abnormal erythropoiesis (red cells not being made properly/discharged too quickly) Seen in Thalassemias, Hemolytic Anemias, Megaloblastic Anemias. (Generally these are removed by the spleen and commonly seen in splenectomy)
Term
What is the appearance of Pappenheimer Bodies? From what are Pappenheimer Bodies formed?
Definition
Small irregular magenta-coloured granuels that Usually occur in small groups; Derived from Hemosiderin granules (Non-HEME iron deposits)
Term
In what disease States are Pappenheimer Bodies seen?
Definition
Sideroblastic Anemias, Hemochromatosis, Disorders causing iron overload: hemoglobinopathies and following splenectomy.
Term
What is the appearance of Heinz Bodies? From what are they derived?
Definition
Small scattered blue dotlike structures of varying size in the RBC; Derived from denatured or precipitated hemoglobin
Term
In what diseases can Heinz Bodies be Seen?
Definition
Seen in increased numbers in G6PD Deficiencies, Alpha-thallassemias and Drug-induced hemolytic anemias.
Term
What is the progression of formation of Granulocytic WBC's and Their appearance?
Definition
CFU-GM --> Myeloblast -->Promyelocyte -->Myelocyte--> Metamyelocyte-->Banded Granulocyte--> Segmented Granulocyte; Conspicuous secondary granules present in cytoplasm;
Term
Where does growth and development of granulocytic and monocytic cells occur? How long does it take?
Definition
In the bone marrow; accomplished in 7-11 days
Term
What is the progression of development of Monocytes?
Definition
CFU-GM -->Monoblast-->Promonocyte--> Monocyte
Term
What is Lymphopoiesis?
Definition
The growth or development of lymphocytes
Term
What is the function of White Blood Cells?
Definition
Functions in Host defence by phagocytosis (granulocytes or monocytes) or immune response (lymphocytes); Leave bloodstream to site of invasion or inflammation; ACtive in phagocytosis; Ingest bacteria and dispose of dead matter; Attracted by certain chemicals released by microbes & inflamed tissue (Chemotaxis)
Term
What is the appearance of Neutrophils? What is the function of Neutrophils?
Definition
Granular, fine Neutral granules which stain pale violet-pink; Phagocytize and destroy microbes (use lysozyme, defensins & Strong oxidants)
Term
What is the appearance of Band Neutrophils? What is a band Neutrophil?
Definition
The nucleus is band or rod shaped Nuclear chromatin is coarse clumped and darkly stained; a immature form of Neutrophil
Term
What is the appearance of Segmented Neutrophils?
Definition
Nucleus has 2-5 lobes, Nuclear Chromatin coarse clumped and darkly stained
Term
What is the life Span of Neutrophils?
Definition
7 Hours in blood; 2-5 days in tissues
Term
What does "Left Shift" refer to?
Definition
An Increase in the immature forms of Neutrophils in the Peripheral Blood (mostly segmented forms)
Term
What is the appearance of Eosinophils?
Definition
Granular cells; with granules which stain red or orange; Nucleus generally has 2 Distinct Lobes; Nuclear chromatin coarse clumped and darkly stained
Term
What is the function of Eosinophils?
Definition
Combat the effects of histamine in allergic reactions; Phagocytize antigen-antibody complexes; Destroy certain parasitic worms (Helminths)
Term
What is the Life Span of Eosinophils?
Definition
8 Hours in Blood; Approx 12 Days in Tissues
Term
What is the appearance of Basophils?
Definition
Granular, Coarse granules stain blue-purple to black; Nucleus generally have 2 distinct lobes; Nuclear chromatin coarse, clumped and darkly stained.
Term
What is the Life Span and Function of Basophils?
Definition
Develop into mast cells which liberate heparin, histamine and Serotonin which act to intensify inflammatory response in allergic reactions; Life Span Several hours in Both Blood and Tissue
Term
Lymphocytes are _________. What is the function of Lymphocytes?
Definition
Agranular; Essential component of immune defence system, interact with antigens and mount an immune response
Term
What is the appearance of Lymphocytes?
Definition
Agranular, Nucleus stains sky blue with occasional azurophilic granules (2nd most predominant to neutrophils)
Term
What is the appearance of Plasma Cells?
Definition
Cytoplasm Dark blue, agranular, pale area next to nucleus; Nucleus small, ova or round, nuclear chromatin clumped and lumpy.
Term
What is the Life span of Plasma Cells?
Definition
Weeks, months or Years
Term
What is the appearance of Monocytes?
Definition
Agranular, Nucleus usually kidney-shaped or lobulated (folded), Nuclear chromatin is fine and arranged in lacy strands, Numerous fine, pale, red, dust-like particles throughout the cytoplasm (Very big, lightly staining cell); Cytoplasm is pale blue-grey, has abundant pseudopodia and ground-glass appearance, vaculoes may be present.
Term
What is the Function of Monocytes?
Definition
Differentiate into macrophages and phagocytize debris and microbes
Term
What is the appearance of Hypersegmented Neutrophils? What are they associated with?
Definition
Neutrophils with nuclei that have 6 or more lobes; Generally seen in Megaloblastic Anemias
Term
Hyposegmented Neutrophils (Pleger-Huet Anomaly) appear as ________ and are present in which disorders?
Definition
Bilobed Neutrophils (dumbell shaped); also more band forms seen, Neutrophil cytoplasmic inclusion; commonly seen in Acute infections (particularily bacterial infections)
Term
What is the appearance of cells possessing Toxic Granulation?
Definition
Accentuation of normal cytoplasmic granules, granules become more numerous, larger and deeper staining (dark blue-black)
Term
Vacuoles appear as ______ in the cytoplasm.
Definition
Holes.
Term
What is the Appearance of Dohle Bodies? Where are they generally located in the cell? What are they formed by?
Definition
Large, gray-blue structures in cytoplasm, often located next to cytoplasmic border. Structures are aggregates of rough endoplasmic Reticulum.
Term
Bacterial Infection can cause _______, _______, _________.
Definition
Toxic granulation, Dohle bodies, Vacuoles.
Term
What is the appearance, occurance and size of Reactive Lymphocytes?
Definition
Nucleus may be round, elongated, or lobulated, chromatin is coarse and prominently clumped cytoplasm abundant, pale blue often staining unevenly appears "soft" and is easily indented by surorunding RBC's; Normally will be less than 10% of all lymphocytes; Size 9-30 um
Term
What abnormalities are associated with increased numbers of reactve Lymphocytes?
Definition
Viral infections, Pertussis and Toxoplasmosis
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