Test your basic knowledge |

Hematology Clinical Medicine - I

Instructions:

Answer 50 questions in 15 minutes.
If you are not ready to take this test, you can study here.
Match each statement with the correct term.
Don't refresh. All questions and answers are randomly picked and ordered every time you load a test.

This is a study tool. The 3 wrong answers for each question are randomly chosen from answers to other questions. So, you might find at times the answers obvious, but you will see it re-enforces your understanding as you take the test each time.

1. What do growth factors do?
Vit B 12 and folic acid deficiency
Bind to receptors on cells and initiate carrying of signals that generate transcription factors and the cell proliferates
If platelets are below 40 -000 will spontaneously bleed and occurs where pressure it
volume % of RBC in blood - Female: 36-48 - Males: 42-52

2. Amount of Hb in Males and Females
Fetal Hg - 2 alpha and 2 gamma chains - 1%
Female: 12-16 gm/dl ***menopausal women have more Male: 14-17 gm/dl
HbA-2alpha and 2 beta chains
98% - alpha and beta

3. Decreased MCV
Usually 40-45% - fat cells make up 50-55Q% - Rest are RBC precursor
Adequate supply of iron - proper synthesis of heme - proper synthesis of globin chains
Tiredness - easily fatigued - DOE - palpitation - dizziness - bleeding - sores on mouth and tongue
FE deficiency - Hemoglobinopathies - sideroblastic anemia - lead poisoning

4. Pathology for Thallessemia
Deletion or point mutation of 1 or more globin genes - caused by reduced synthesis of 1 or more alpha globin chains or beta which leads to microcytic hypochromic anemia - means that the globin chain synthesis is defective from mutated or missing 1 or
Thrombocytopenia - Henoch- Scholein Purpura - Scurvy - ITP - TTP - DIC - Hemophilia A and B - Von Willebrands disease - Vit. K deficiency - Liver disease
RBC (erythrocytes) - WBC (leukocytes) - Platelet (thrombocytes) - blood cells are surrounded in Plasma
Hgb in the blood is too low to fulfill the O2 demands of the body - can be a specific disease of a sign of disease progress (GI CA)

5. Basophils are present in....
Process by which all blood cells form - develop - and are replaced in the body - blood production
55% of blood plasma - contains all the blood cells
Less than 1 persent
Parasite infections

6. WBC Count
Type of anemia characterized by smaller paler than usual RBC
1-2% - alpha and gamma
Acyclovir - Phenytoin - Quinin - Amphotericin B - Levamisole - Digoxin - Ibuprofin - Amiodarone - Rifampin - ASA
4.5-10

7. Erythropoietin
4 globin chaines: globin (each bines to 1 O2 molecule Heme: binds to iron
Less than 1 persent
GF produced by the kidney and is a glycoprotein - stimulates the production of RBC in response to tissue hypoxia - binds to specific receptors on the surface of RBC precursors
Abnormal size of cells and vary in abnormality

8. IL-2
T and B lymph
Usually 40-45% - fat cells make up 50-55Q% - Rest are RBC precursor
Humeral immunity: Ab production
Holds platelets together - factor VIII activated it and has to tighten - trapping more platelets

9. Leukapenia
Abnormal size of cells and vary in abnormality
Temporary infections - trauma/ tissue injury - Acute Infections: WBC count increases - Other causes:Leukemia - Malignant Neoplasms - Drugs -
XRT (radiation and Chemo - inherited immune disorders
Low WBC count - Bone marrow depression: drug related (H2 blockers) - primary bone marrow disorder - immune associated neutropenia (chemo) - fungal infection of bone marrow (HIV)

10. Bleeding D/O laboratory testing
Hereditary spherocytosis - G6PD deficiency - sickle cell syndrome
Alpha genes are on chromosome 16 - 2 genes on chromosome 16 for every alpha globin chain - total of 4 genes responsible for the 2 alpha globin chains
CBC with Diff - PT: prothrombin time ***important it analyzes clotting ability of 5 plasma coagulation factors - INR: internatoinal normalized ratio (1-2) - PTT: partial thromboplastin time (30-45sec): analyzes the first stage of clotting - bleeding
Acquired or inhereited

11. Thallassemia Syndormes
Hereditary disorder than can vary from mild to severe life threatening - common in areas with malaria and causes a problem with the function and structure of Hb - seen in populations from: SE asia - China - Mediterranean - lesser extent: Africa
Programmed cell death - eliminates old - unnecessary - or unhealthy/ abnormal cells - defects in the pathway are important in causing CA
Starts with vasoconstriction and this causes platelets to come to the site of damage and adhere to damaged collagen
Platelet problems - factor 10 and vwf deficiency - vitamin K deficiency - anti-thrombin III deficiency - protein C deficiency - acquired disorder or coagulation

12. Blood is produced....
large gylcoprotein - major adhesion molecule which allows platelets to stick - binding factor in factor VIII and prolongs its half life
Thalessemia - and sickle cell
In the bone marrow
Deletion or point mutation of 1 or more globin genes - caused by reduced synthesis of 1 or more alpha globin chains or beta which leads to microcytic hypochromic anemia - means that the globin chain synthesis is defective from mutated or missing 1 or

13. Poikilocytosis
Acyclovir - Phenytoin - Quinin - Amphotericin B - Levamisole - Digoxin - Ibuprofin - Amiodarone - Rifampin - ASA
Hereditary spherocytosis - G6PD deficiency - sickle cell syndrome
Abnormally shaped cells - schiztocyte - tear drop - oval
150 -000-450 -000

14. Alpha globin chain genetics
Alpha genes are on chromosome 16 - 2 genes on chromosome 16 for every alpha globin chain - total of 4 genes responsible for the 2 alpha globin chains
M- 75-175 F- 65-165
Encapsulated bacteria: Strep pneumonia and H. Influenza
Allergies - drug reactions (pCH) - parasitic diseases and tape worms

15. Hemoglobinopathies
Confluent areas of bleeding right below the skin
Bleeding usually begins in infancy or childhood - recurrent bleeding - bleeding from multiple sites
group of disorders affecting the structure - function - or production of Hgb - Hgb is important for normal O2 delivery to the tissues. If there is an abnormality then can cause hypoxia of the tissue.
Pathophysiologic basis: diminished product of increase destruction - Morphologic basis: measure of average RBC size

16. Reticulocyte count
4 globin chaines: globin (each bines to 1 O2 molecule Heme: binds to iron
Immature red blood cells - normal: 0.5-1.5%: elevated in people with anemic anemia - low retic: anemia from decreased RBC production
volume % of RBC in blood - Female: 36-48 - Males: 42-52
150 -000-450 -000

17. Platelet problem
GF produced by liver and stimulates production of megakariocytes
Male: 14-17 Female: 12-15
GF produced by the kidney and is a glycoprotein - stimulates the production of RBC in response to tissue hypoxia - binds to specific receptors on the surface of RBC precursors
low platelet count - skin bleeding - mucosa: especially bleeding of gums

18. Blood Facts
Bind to receptors on cells and initiate carrying of signals that generate transcription factors and the cell proliferates
8% of body weight- 5L in women and 5.5L in males
Parasite infections
lineage committed - create different blood cell lineages - can be very large - mostly all nucleaus. As they mature and differentiate - they become smaller in size and the nucleaus decreases in size - Ex: Lymphiod - meloid - and platelet lineage cells

19. Decreased Platelets
ITP/TTP: platelets destroyed - bone marrow suppression - drugs - prosthetic heart valve: chew up platelets
Production of RBC - stimulated by decrease in O2 -kidneys produce hormone erythropoietin
Autoimmnr hypersplensm
150 -000-450 -000

20. Heme- Heme interction
Autosomal co-dominant traits who inherit a different abnormal allele from each parent - Alpha chain is present in HbA - HbA2 - HbF: alpha chain mutations cause abnormalities in all three - beta chains are present in HbA and HbA2
GF produced by the kidney and is a glycoprotein - stimulates the production of RBC in response to tissue hypoxia - binds to specific receptors on the surface of RBC precursors
Usually 40-45% - fat cells make up 50-55Q% - Rest are RBC precursor
The property inherent in the arrangement of the heme and globin units that allows for oxygenation acquisition and delivery over a narrow range of tension

21. Proper O2 transport depends on...
High neutrophil count - due to acute - localized/ general bacterial infections - inflammation - myeloproliferative diseases
Have granules in the cytoplasm - neutrophil: 50-60%** most prominent - eosinophil: 1-4% - basophil: 0.5-1%
Tetramer structure of proteins - proper arrangement of charged amino acids - interaction with low molecular weight substances
Female: 12-16 gm/dl ***menopausal women have more Male: 14-17 gm/dl

22. Hemoglobin
Autosomal co-dominant traits who inherit a different abnormal allele from each parent - Alpha chain is present in HbA - HbA2 - HbF: alpha chain mutations cause abnormalities in all three - beta chains are present in HbA and HbA2
Abnormal size of cells and vary in abnormality
O2 bearing molecule and carries 02 throughout the body
Confluent areas of bleeding right below the skin

23. Major Adult Hgb
Low neutrophil count - seen in bone marrow/ blood diseases - drugs - chemicals (benzene) - radiation (affects bone marrow)
Acquired or inhereited
HbA-2alpha and 2 beta chains
Hb analysis and electrophoresis with functional assays for sickling - solubility - and O2 affinity are used for routine clinical evaluations

24. Hemobglobin A
Sickle cell - G6PD - thalessemia
N - M - Eo - Meg - B - RBC - stem
98% - alpha and beta
Confluent areas of bleeding right below the skin

25. Variations with HbA
Erythrocytes: 120 days - Platelets: 8-10 days - WBC: hours to few weeks - increase during infection
8% of body weight- 5L in women and 5.5L in males
HbA2: 2 alpha and 2 delta globin chains - in 2% of the population
Plasma protein that binds to Fe and helps absorb it - 200-400

26. Platelets
large gylcoprotein - major adhesion molecule which allows platelets to stick - binding factor in factor VIII and prolongs its half life
Megakaryocytes (growth stimulated by thrombopoieten) - help prevent hemorrhages
Hgb in the blood is too low to fulfill the O2 demands of the body - can be a specific disease of a sign of disease progress (GI CA)
Less than 80 MCV - iron deficiency - thalessemia - siderblastic

27. T cell
Cellular Immunity: helper - killer cells: affected with HIV
Acquired or inhereited
Variation in size
In the bone marrow

28. Transferrin
If platelets are below 40 -000 will spontaneously bleed and occurs where pressure it
Plasma protein that binds to Fe and helps absorb it - 200-400
N - M - Meg - RBC
Thalessemia - and sickle cell

29. Serum Ferritin
Lymphoid Leukemia - Mono - acute infections a/w viral diseases
What is stored in body M: 18-270 W: 18-160
If platelets are below 40 -000 will spontaneously bleed and occurs where pressure it
N - M - Meg - RBC

30. Eosinophilia Causes
Asymptomatic until 4 months of life
Allergies - drug reactions (pCH) - parasitic diseases and tape worms
Palpable - slightly raised areas of bleeding
90-91% water - 6-7% are proteins like Albumin - Remaining 2-3%: electrolytes - carbohydrates and fats - chemical messengers (growth factors) and gases like O2 and CO2

31. B Cell
O2 bearing molecule and carries 02 throughout the body
55% of blood plasma - contains all the blood cells
Autosomal co-dominant traits who inherit a different abnormal allele from each parent - Alpha chain is present in HbA - HbA2 - HbF: alpha chain mutations cause abnormalities in all three - beta chains are present in HbA and HbA2
Humeral immunity: Ab production

32. Detection of hemoglobinopathy
Platelet problems - factor 10 and vwf deficiency - vitamin K deficiency - anti-thrombin III deficiency - protein C deficiency - acquired disorder or coagulation
Bind to receptors on cells and initiate carrying of signals that generate transcription factors and the cell proliferates
55% of blood plasma - contains all the blood cells
Hb analysis and electrophoresis with functional assays for sickling - solubility - and O2 affinity are used for routine clinical evaluations

33. Abnormality in beta chain are present....
Baseline test - wellness screening - diagnosing certain condition - response to treatment and recovery - monitor certain health conditions
Asymptomatic until 4 months of life
Lymphoid Leukemia - Mono - acute infections a/w viral diseases
Encapsulated bacteria: Strep pneumonia and H. Influenza

34. Hemoglobin A2
Male: 14-17 Female: 12-15
HbF: 2 alpha and 2 gamma
1-2% - alpha and gamma
Platelets - In BM: very large - In blood: small irregular shaped cell fragments - involved in hemostasis

35. beta globin chain genetic
Lymphoid Leukemia - Mono - acute infections a/w viral diseases
7th month
90-91% water - 6-7% are proteins like Albumin - Remaining 2-3%: electrolytes - carbohydrates and fats - chemical messengers (growth factors) and gases like O2 and CO2
Beta genes are on chromosome 11 - 1 gene on chromosome 11 for each globin chain - totatl 2 genes responsible for the 2 beta globin chains

36. Hemolytic Anemia
Hemoglobulinopathy - inherited or acquired - Problem: RBC membrane defects so will get episodic or continuous RBC destruction - varies from mild to severe
8% of body weight- 5L in women and 5.5L in males
Low neutrophil count - seen in bone marrow/ blood diseases - drugs - chemicals (benzene) - radiation (affects bone marrow)
M- 75-175 F- 65-165

37. microcytic hypochromic anemia
Autoimmnr hypersplensm
Low neutrophil count - seen in bone marrow/ blood diseases - drugs - chemicals (benzene) - radiation (affects bone marrow)
Type of anemia characterized by smaller paler than usual RBC
Holds platelets together - factor VIII activated it and has to tighten - trapping more platelets

38. CBC with differential
Immature red blood cells - normal: 0.5-1.5%: elevated in people with anemic anemia - low retic: anemia from decreased RBC production
Bleeding usually begins in infancy or childhood - recurrent bleeding - bleeding from multiple sites
Complete blood count with differential: tells what percentage of cells make up the blood
lineage committed - create different blood cell lineages - can be very large - mostly all nucleaus. As they mature and differentiate - they become smaller in size and the nucleaus decreases in size - Ex: Lymphiod - meloid - and platelet lineage cells

39. Lymphocytosis Causes
4.5-10
volume % of RBC in blood - Female: 36-48 - Males: 42-52
Lymphoid Leukemia - Mono - acute infections a/w viral diseases
150 -000-450 -000

40. Elevated MCV
Vit B 12 and folic acid deficiency
150 -000-450 -000
Tiredness - easily fatigued - DOE - palpitation - dizziness - bleeding - sores on mouth and tongue
Arrest of bleeding - depends on vessel wall - platelets - and coagulation factors (fibrolytic factors)

41. Iron Serum test
Programmed cell death (cyto C. and caspases)
Platelets - In BM: very large - In blood: small irregular shaped cell fragments - involved in hemostasis
M- 75-175 F- 65-165
98% - alpha and beta

42. Megakariocytes/ Thrombocytes
Programmed cell death - eliminates old - unnecessary - or unhealthy/ abnormal cells - defects in the pathway are important in causing CA
Sickle cell - G6PD - thalessemia
Platelets - In BM: very large - In blood: small irregular shaped cell fragments - involved in hemostasis
RBC (erythrocytes) - WBC (leukocytes) - Platelet (thrombocytes) - blood cells are surrounded in Plasma

43. Mild forms of thalessemia need to be differentiated from...
Acyclovir - Phenytoin - Quinin - Amphotericin B - Levamisole - Digoxin - Ibuprofin - Amiodarone - Rifampin - ASA
Increased retic with falling/ stable HgB - increase serum LDH - increase total bilirubin - transient hemoglobinuria
FE deficiency - have normal FE iron studies because cannot attach to Hb molecule
Complete blood count with differential: tells what percentage of cells make up the blood

44. Hematopoiesis
Programmed cell death - eliminates old - unnecessary - or unhealthy/ abnormal cells - defects in the pathway are important in causing CA
Process by which all blood cells form - develop - and are replaced in the body - blood production
Most abundant protein in the plasma and helps establish the osmotic gradient
Low WBC count - Bone marrow depression: drug related (H2 blockers) - primary bone marrow disorder - immune associated neutropenia (chemo) - fungal infection of bone marrow (HIV)

45. By what month in the fetus does the development of the RBC move to the bone marrow?
Asymptomatic until 4 months of life
7th month
Erythrocytes - respond to tissue hypoxia and carry O2 to the body
Thrombocytopenia - Henoch- Scholein Purpura - Scurvy - ITP - TTP - DIC - Hemophilia A and B - Von Willebrands disease - Vit. K deficiency - Liver disease

46. Agranulocytes
Have granules in the cytoplasm - neutrophil: 50-60%** most prominent - eosinophil: 1-4% - basophil: 0.5-1%
Lymphocytes: 20-40% - Monocytes: 2- 6% (circulate in the blood 1-3 days and mature in tissues)
Holds platelets together - factor VIII activated it and has to tighten - trapping more platelets
Low WBC count - Bone marrow depression: drug related (H2 blockers) - primary bone marrow disorder - immune associated neutropenia (chemo) - fungal infection of bone marrow (HIV)

47. Inherited Hemoglobinopathy
Hb analysis and electrophoresis with functional assays for sickling - solubility - and O2 affinity are used for routine clinical evaluations
Begins later in life - may be a medication related - may be related to underlying medical condition - may be idiopathic - may involve more than 1 system
Palpable - slightly raised areas of bleeding
Autosomal co-dominant traits who inherit a different abnormal allele from each parent - Alpha chain is present in HbA - HbA2 - HbF: alpha chain mutations cause abnormalities in all three - beta chains are present in HbA and HbA2

48. G-CSF
Most abundant protein in the plasma and helps establish the osmotic gradient
Tetramer structure of proteins - proper arrangement of charged amino acids - interaction with low molecular weight substances
It is bound to intrinsic factor: protein produced and secreted by gastric parietal cells - B12 is absorbed in the terminal ilium and stored in the liver
Growth factor that causes neutraphils to grow

49. Patient with Anemia c/o
Variation in shape
Increased retic with falling/ stable HgB - increase serum LDH - increase total bilirubin - transient hemoglobinuria
Complete blood count with differential: tells what percentage of cells make up the blood
Tiredness - easily fatigued - DOE - palpitation - dizziness - bleeding - sores on mouth and tongue

50. Erythropoiesis
Skin - tend to bleed also into the muscles and joints
Excessive loss of RBC - inadequate production of RBC (problem with bone marrow) - increased destruction of RBC - secondary to chronic disease
Production of RBC - stimulated by decrease in O2 -kidneys produce hormone erythropoietin
HbA2: 2 alpha and 2 delta globin chains - in 2% of the population