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Hematology Exam 3
Hematology Exam 3
65
Health Care
Professional
04/12/2013

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Term
What two "pools" make up the peripheral blood granulocyte pools?
Definition
Circulating Pool and Marginating pool
Term
True or False:

Circulating and marginating pooled blood remains within the vessels for 2-5 days.
Definition
False

6-10 hours
Term
How many cell divisions occur within the mitotic pool? How long does this "mitotic stage" generally occur for?
Definition
4-5 cell divisions

3-6 days
Term
The mitotic pool "cells which can divide/replicate" consists of which WBC precursors?
Definition
Myeloblasts, promyelocytes, myelocytes
Term
The maturation and storage pool is also known as... This phase occurs for how many days?
Definition
Post-mitotic pool

5-7 days
Term
True or False:

The storage pool contains 15-20 times more cells than circulating blood.
Definition
True
Term
Which WBC precursors/cells are contained within the post-mitotic pool? (i.e. which WBC precursours/cells do NOT divide)
Definition
Metamyelocytes, bands, PMNs
Term
What are the three factors which affect the quantity of peripheral neutrophils?
Definition
Bone marrow production and release

Rate of egress to tissue/survival time in the blood

Rate of marginating to circulating neutrophils
Term
Benign neutrophilia is also known as? What is this type of neutrophilia a result of?
Definition
Reactive neutrophilia

Extrinsic physiologic or pathologic process (cold, virus, etc.)
Term
True or False:

Pseudoneutrophilia is also referred to as Acute Neutrophilia
Definition
False

Psuedoneutrophilia is immediate neutrophilia, not acute
Term
Immediate neutrophilia occurs because ...
Definition
there is a redistribution of marginating and circulating cells
Term
How long after a stimulation does it take for acute neutrophilia to occur?
Definition
4-5 hours
Term
What cell is likely to show an increase during acute neutrophilia?
Definition
Bands
Term
An extreme reaction to infection or necrotizing tissue is referred to as?
Definition
Leukemoid reaction
Term
A leukemoid reaction is known as how many WBC's per microliter?
Definition
greater than 30,000
Term
A leukemoid reaction resembles what form of leukemia?
Definition
CML
Term
What is a normal value range for a leukocyte alkaline phosphate (LAP) test?
Definition
20-100
Term
An increased Leukocyte alkaline phosphate test indicates what type of disease process is occurring?
Definition
Leukemoid reaction or polycythemia vera
Term
A decreased leukocyte alkaline phosphate test indicated what type of disease process is occurring?
Definition
CML
Term
Acute leukemia is dominated by what type of cells?
Definition
Blasts
Term
What 3 clinical features are present with AML?
Definition
Anemia, bleeding/bruising, infections
Term
What type of anemia is present during AML?
Definition
Normocytic/normochromic
Term
True or False:

Auer Rods are present with AML?
Definition
True
Term
A bone marrow differentiation which has greater than 20% blasts is considered to be which form of leukemia?
Definition
AML
Term
True or False:

Increased levels in uric acid and LDH are consistent with AML
Definition
True
Term
The most common malignancy of childhood is?
Definition
ALL
Term
True or False:

Pathophysiologically, AML occurs via increased proliferation of stem cells and a mutation.
Definition
True
Term
What type of anemia is present with ALL?
Definition
Normocytic/normochromic
Term
What is the predominant cell present with ALL?
Definition
Blasts
Term
Extramedullary hematopoesis occurs during which form of leukemia?
Definition
CML
Term
True or False:

With CML the mutant stem cells can still mature
Definition
True
Term
True or False:

CLL has the ability to transform into an acute phase which leaves a person with 1 month to live.
Definition
False

CML instead of CLL

6 month survival instead of 1 month
Term
Abdominal fullness, fever, and vague malaise is associated with which form of leukemia?
Definition
CML
Term
True or False:

With CML, platelets have the ability to be increased or decreased, but they are rarely normal.
Definition
True
Term
Eosinophils and/or basophils are likely to be increased as a result of which form of leukemia?
Definition
CML
Term
True or False:

With CML, there is a narrow range of granulocyte precursors, mainly blasts, within the bone marrow
Definition
False

There is a wide range of granulocyte precursors
Term
Extreme hypercellularity in the bone marrow is associated with which form of leukemia?
Definition
CML
Term
Which form of leukemia uses the Philadelphia Chromosome as a definitive diagnostic measure?
Definition
CML
Term
The philadelphia chromosome occurs because of a translocation between which two chromosome?
Definition
Chromosomes 9 and 22
Term
Which enzyme is increased as a results of the philadelphia chromosome? Why is this advantageous (treatment-wise)?
Definition
Tyrosine kinase

It's advantageous because tyrosine kinase responds well to targeted cell therapy
Term
What is the average age for someone who is suffering from CLL?
Definition
mid 60's
Term
Which form of leukemia resembles lymphoma but is found in the bone marrow?
Definition
CLL
Term
Other than being symptom free, what is the clinical presentation of CLL?
Definition
Lymphoadenopathy
Term
An increased level in smudge cells occurs with which form of leukemia?
Definition
CLL
Term
What is the predominant cell with CLL?
Definition
mature-appearing lymphocyte
Term
What are the relative platelet levels with CLL? (not a number)
Definition
slightly decreased
Term
If anemia is present with CLL, which type of anemia is it most likely to be?
Definition
hemolytic anemia
Term
True or False:

When collecting a bone marrow sample, it is okay to just collect an aspiration sample.
Definition
False

You typically do an aspiration and biopsy
Term
If just looking at a slide MACROSCOPICALLY, how can you differentiate between a bone marrow slide and a peripheral blood slide?
Definition
By the presence of spicules on the bone marrow slide
Term
A normal adult has what percentage of cellularity within their bone marrow?
Definition
50%
Term
True or False:

A plasma cell is a T-lymphocyte that has reached it's final stage in preparation for immunoglobulin production
Definition
False

Everything is true except plasma cells are B-lymphocytes, not T-lymphocytes
Term
What is endomytosis and which cells experience this?
Definition
Doubling of DNA content w/o cell division

Seen in megakaryocytes
Term
What causes the blueness to appear in the cytoplasm of RBC precursor cells?
Definition
RNA
Term
What is the last RBC precursor which can divide?
Definition
polychromatic normoblast
Term
The first RBC precursor which you can tell is making hemoglobin is...
Definition
polychromatic normoblast

because in previous cells, rna is dominant over the hemoglobin
Term
True or False:

Primary granules are non-specific
Definition
True
Term
True or False:

A metamyelocyte is a mitotic cell
Definition
False
Term
Empiripolesis
Definition
Other cells can pass through a cells cytoplasm, seen in megakaryocytes
Term
The rate of egress refers to...
Definition
How quickly a cell can move into the tissue
Term
Which objective would you estimate the number of megakaryocytes present?
Definition
Low Power
Term
Which objective would you observe megakaryocyte morphology?
Definition
High power
Term
Which objective would you estimate the myeloid to erytheroid ratio?
Definition
High power
Term
Which objective would you obtain the actual myeloid to erytheroid ratio?
Definition
Oil
Term
Which objective would you estimate cellularity under?
Definition
Low power
Term
Lymphocytes are observed under which objective?
Definition
High power
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