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. Progenitor cells
55% of blood plasma - contains all the blood cells
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
Holds platelets together - factor VIII activated it and has to tighten - trapping more platelets
Excessive loss of RBC - inadequate production of RBC (problem with bone marrow) - increased destruction of RBC - secondary to chronic disease

2. INR
Parasite infections
Hereditary spherocytosis - G6PD deficiency - sickle cell syndrome
Standard for reporting the PT
M- 75-175 F- 65-165

3. ecchymosis
HbA2: 2 alpha and 2 delta globin chains - in 2% of the population
Skin - tend to bleed also into the muscles and joints
Confluent areas of bleeding right below the skin
Type of anemia characterized by smaller paler than usual RBC

4. Fibrin
Growth factor that causes neutraphils to grow
Cellular Immunity: helper - killer cells: affected with HIV
Holds platelets together - factor VIII activated it and has to tighten - trapping more platelets
Pathophysiologic basis: diminished product of increase destruction - Morphologic basis: measure of average RBC size

5. Abnormality in beta chain are present....
Plasma protein that binds to Fe and helps absorb it - 200-400
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
150 -000-450 -000
Asymptomatic until 4 months of life

6. HgB/ HCT is decreased with....
FE deficiency - Hemoglobinopathies - sideroblastic anemia - lead poisoning
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
Anemia - hemodilution (over hydration) - leukemia - hemolytic reactions - drugs
Increased retic with falling/ stable HgB - increase serum LDH - increase total bilirubin - transient hemoglobinuria

7. microcytic hypochromic anemia
Type of anemia characterized by smaller paler than usual RBC
Erythrocytes: 120 days - Platelets: 8-10 days - WBC: hours to few weeks - increase during infection
Immature red blood cells - normal: 0.5-1.5%: elevated in people with anemic anemia - low retic: anemia from decreased RBC production
GF produced by liver and stimulates production of megakariocytes

8. Composition of HgB
Have granules in the cytoplasm - neutrophil: 50-60%** most prominent - eosinophil: 1-4% - basophil: 0.5-1%
Standard for reporting the PT
Programmed cell death (cyto C. and caspases)
4 globin chaines: globin (each bines to 1 O2 molecule Heme: binds to iron

9. What is the life span of blood cells?
Erythrocytes: 120 days - Platelets: 8-10 days - WBC: hours to few weeks - increase during infection
Adequate supply of iron - proper synthesis of heme - proper synthesis of globin chains
Immature red blood cells - normal: 0.5-1.5%: elevated in people with anemic anemia - low retic: anemia from decreased RBC production
Detects presence of Ag-AB complex: direct or indirect - diagnostic for: hemolytic dz of a newborn - acquired hemolytic anemia - transfusion reaction - blood that sensitized patient. RBC

10. Decreased MCV
4 globin chaines: globin (each bines to 1 O2 molecule Heme: binds to iron
FE deficiency - Hemoglobinopathies - sideroblastic anemia - lead poisoning
N - M - Eo - Meg - B - RBC - stem
Lymphocytes: 20-40% - Monocytes: 2- 6% (circulate in the blood 1-3 days and mature in tissues)

11. Hypercoagulable states are...
Genetic and rare or acquired
Cause by increase destruction of RBC in the peripheral blood faster than the bone marrow can produce them - decstruction is intrinsic: defect in production - extrinsic: produced healthy
GF produced by liver and stimulates production of megakariocytes
Tetramer structure of proteins - proper arrangement of charged amino acids - interaction with low molecular weight substances

12. RBC
Erythrocytes - respond to tissue hypoxia and carry O2 to the body
Variation in size
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)
Skin - tend to bleed also into the muscles and joints

13. Patient with Anemia c/o
Protein encasement of heme: 2 chains per globin- 1 alpha and 1 non alpha - 4 globin chains per tetrameter - 2 alpha chains and a pair of non-alpha chains (beta or gamma)
In the bone marrow
Tiredness - easily fatigued - DOE - palpitation - dizziness - bleeding - sores on mouth and tongue
Low WBC count - Bone marrow depression: drug related (H2 blockers) - primary bone marrow disorder - immune associated neutropenia (chemo) - fungal infection of bone marrow (HIV)

14. Thrombopoietin
Polycythemia vera - CHF/COPD - Drugs - Living at high altitudes
GF produced by liver and stimulates production of megakariocytes
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
Programmed cell death - eliminates old - unnecessary - or unhealthy/ abnormal cells - defects in the pathway are important in causing CA

15. Decreased Platelets
ITP/TTP: platelets destroyed - bone marrow suppression - drugs - prosthetic heart valve: chew up platelets
Thrombocytopenia - Henoch- Scholein Purpura - Scurvy - ITP - TTP - DIC - Hemophilia A and B - Von Willebrands disease - Vit. K deficiency - Liver disease
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
FE deficiency - have normal FE iron studies because cannot attach to Hb molecule

16. WBC Count
Bind to receptors on cells and initiate carrying of signals that generate transcription factors and the cell proliferates
FE deficiency - Hemoglobinopathies - sideroblastic anemia - lead poisoning
Have granules in the cytoplasm - neutrophil: 50-60%** most prominent - eosinophil: 1-4% - basophil: 0.5-1%
4.5-10

17. Hgb anatomy
Bleeding usually begins in infancy or childhood - recurrent bleeding - bleeding from multiple sites
Protein encasement of heme: 2 chains per globin- 1 alpha and 1 non alpha - 4 globin chains per tetrameter - 2 alpha chains and a pair of non-alpha chains (beta or gamma)
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
Hemoglobulinopathy - inherited or acquired - Problem: RBC membrane defects so will get episodic or continuous RBC destruction - varies from mild to severe

18. Macrocytic cells
T lymph - stem cell
O2 bearing molecule and carries 02 throughout the body
Have granules in the cytoplasm - neutrophil: 50-60%** most prominent - eosinophil: 1-4% - basophil: 0.5-1%
Greater than 100 MCV - B12 deficiency - folic acid deficiency - pernicious anemia (form of B12)

19. Lymphopenia Causes
O2 bearing molecule and carries 02 throughout the body
XRT (radiation and Chemo - inherited immune disorders
Arrest of bleeding - depends on vessel wall - platelets - and coagulation factors (fibrolytic factors)
Immature red blood cells - normal: 0.5-1.5%: elevated in people with anemic anemia - low retic: anemia from decreased RBC production

20. WBC
Leukocytes - neutraphils - monocytes - basophils - lymphocytes - eosinophils--> 5 different cells divided into 3 classes - immune system and fights viral - bacterial - fungal - parasites - and allergens - classified by presence or absence of granules
Programmed cell death - eliminates old - unnecessary - or unhealthy/ abnormal cells - defects in the pathway are important in causing CA
RBC (erythrocytes) - WBC (leukocytes) - Platelet (thrombocytes) - blood cells are surrounded in Plasma
Humeral immunity: Ab production

21. B Cell
N - M - Eo - Meg - B - RBC - stem
Humeral immunity: Ab production
Thalessemia - and sickle cell
Adequate supply of iron - proper synthesis of heme - proper synthesis of globin chains

22. Anisocytosis
Abnormal size of cells and vary in abnormality
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
Allergies - drug reactions (pCH) - parasitic diseases and tape worms
RBC (erythrocytes) - WBC (leukocytes) - Platelet (thrombocytes) - blood cells are surrounded in Plasma

23. Neutropenia
Hb analysis and electrophoresis with functional assays for sickling - solubility - and O2 affinity are used for routine clinical evaluations
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)
Encapsulated bacteria: Strep pneumonia and H. Influenza

24. Bacteria that patients with sickle cell anemia are at risk for
Plasma protein that binds to Fe and helps absorb it - 200-400
Encapsulated bacteria: Strep pneumonia and H. Influenza
FE deficiency - have normal FE iron studies because cannot attach to Hb molecule
Programmed cell death (cyto C. and caspases)

25. When is a CBC with difference ordered?
Baseline test - wellness screening - diagnosing certain condition - response to treatment and recovery - monitor certain health conditions
Platelets - In BM: very large - In blood: small irregular shaped cell fragments - involved in hemostasis
Increased retic with falling/ stable HgB - increase serum LDH - increase total bilirubin - transient hemoglobinuria
Female: 12-16 gm/dl ***menopausal women have more Male: 14-17 gm/dl

26. Intrinsic Hemolytic anemia
Hereditary spherocytosis - G6PD deficiency - sickle cell syndrome
Lymphocytes: 20-40% - Monocytes: 2- 6% (circulate in the blood 1-3 days and mature in tissues)
MCV - index for classifying anemia - Norma: 80-100
Variation in size

27. IL-1
T lymph - stem cell
Skin: hematomas - petechiae - nose and mouth/ throat bleeding - LN: usually not involved - HLA: look for enlarged spleen - liver - MSS: hemathrosis (bleeding into the joints - swollen - tender)
Excessive loss of RBC - inadequate production of RBC (problem with bone marrow) - increased destruction of RBC - secondary to chronic disease
Temporary infections - trauma/ tissue injury - Acute Infections: WBC count increases - Other causes:Leukemia - Malignant Neoplasms - Drugs -

28. Blood cells transport mechanism
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
Baseline test - wellness screening - diagnosing certain condition - response to treatment and recovery - monitor certain health conditions
Excessive loss of RBC - inadequate production of RBC (problem with bone marrow) - increased destruction of RBC - secondary to chronic disease
HbA-2alpha and 2 beta chains

29. Hemostasis
Arrest of bleeding - depends on vessel wall - platelets - and coagulation factors (fibrolytic factors)
Low WBC count - Bone marrow depression: drug related (H2 blockers) - primary bone marrow disorder - immune associated neutropenia (chemo) - fungal infection of bone marrow (HIV)
Cellular Immunity: helper - killer cells: affected with HIV
RBC (erythrocytes) - WBC (leukocytes) - Platelet (thrombocytes) - blood cells are surrounded in Plasma

30. What do growth factors do?
Genetic and rare or acquired
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
Detects presence of Ag-AB complex: direct or indirect - diagnostic for: hemolytic dz of a newborn - acquired hemolytic anemia - transfusion reaction - blood that sensitized patient. RBC
Bind to receptors on cells and initiate carrying of signals that generate transcription factors and the cell proliferates

31. Heme- Heme interction
Anti-thrombin III deficiency - Lupus anticoagulant - other conditions for hyper-coagulation
Most abundant protein in the plasma and helps establish the osmotic gradient
7th month
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

32. Megakariocytes/ Thrombocytes
Platelets - In BM: very large - In blood: small irregular shaped cell fragments - involved in hemostasis
Most abundant protein in the plasma and helps establish the osmotic gradient
Thalessemia - and sickle cell
Excessive loss of RBC - inadequate production of RBC (problem with bone marrow) - increased destruction of RBC - secondary to chronic disease

33. Granulocytes
Primary function is to support O2 transport - hard to bind the first O2 to Hgb but once it does it becomes easier to bind - It must bind at the partial pressure of O2 of alveolus and then it releases it to the tissue at the partial pressure of O2 at
Baseline test - wellness screening - diagnosing certain condition - response to treatment and recovery - monitor certain health conditions
Male: 14-17 Female: 12-15
Have granules in the cytoplasm - neutrophil: 50-60%** most prominent - eosinophil: 1-4% - basophil: 0.5-1%

34. Gestation HgB
HbF: 2 alpha and 2 gamma
Skin - tend to bleed also into the muscles and joints
150 -000-450 -000
Hb analysis and electrophoresis with functional assays for sickling - solubility - and O2 affinity are used for routine clinical evaluations

35. HgB/ HCT is increased with....
Polycythemia vera - CHF/COPD - Drugs - Living at high altitudes
Normal adult Hg - 2 alpha and 2 beta globin chains - attached to each chain is heme - 95-98%
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
Megakaryocytes (growth stimulated by thrombopoieten) - help prevent hemorrhages

36. Reticulocyte
Immature RBC right before it fully matures - Mature (spend 3 days in) red bone marrow and then circulate in the peripheral blood for 1 day and fully mature (extrusion of nucleaus) - 1% of RBC in the body
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
Platelets - In BM: very large - In blood: small irregular shaped cell fragments - involved in hemostasis

37. Bleeding/ Hypercoagulation disorders
Platelet problems - factor 10 and vwf deficiency - vitamin K deficiency - anti-thrombin III deficiency - protein C deficiency - acquired disorder or coagulation
Process by which all blood cells form - develop - and are replaced in the body - blood production
High neutrophil count - due to acute - localized/ general bacterial infections - inflammation - myeloproliferative diseases
Breaking open of the RBC's and release of HgB (spleen)

38. purpura
Asymptomatic until 4 months of life
Temporary infections - trauma/ tissue injury - Acute Infections: WBC count increases - Other causes:Leukemia - Malignant Neoplasms - Drugs -
Palpable - slightly raised areas of bleeding
Anti-thrombin III deficiency - Lupus anticoagulant - other conditions for hyper-coagulation

39. Hematopoiesis
In the bone marrow
Pathophysiologic basis: diminished product of increase destruction - Morphologic basis: measure of average RBC size
Process by which all blood cells form - develop - and are replaced in the body - blood production
The flat bones: sternum - pelvis - proximal ends of the long bones

40. By what month in the fetus does the development of the RBC move to the bone marrow?
7th month
Pathophysiologic basis: diminished product of increase destruction - Morphologic basis: measure of average RBC size
Encapsulated bacteria: Strep pneumonia and H. Influenza
Abnormal size of cells and vary in abnormality

41. Variations with HbA
Erythrocytes - respond to tissue hypoxia and carry O2 to the body
HbA2: 2 alpha and 2 delta globin chains - in 2% of the population
Have granules in the cytoplasm - neutrophil: 50-60%** most prominent - eosinophil: 1-4% - basophil: 0.5-1%
Female: 12-16 gm/dl ***menopausal women have more Male: 14-17 gm/dl

42. IL- 3
N - M - Eo - Meg - B - RBC - stem
Breaking open of the RBC's and release of HgB (spleen)
Type of anemia characterized by smaller paler than usual RBC
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

43. Leukapenia
HbF: 2 alpha and 2 gamma
M- 75-175 F- 65-165
Low WBC count - Bone marrow depression: drug related (H2 blockers) - primary bone marrow disorder - immune associated neutropenia (chemo) - fungal infection of bone marrow (HIV)
Humeral immunity: Ab production

44. Platelets
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
Temporary infections - trauma/ tissue injury - Acute Infections: WBC count increases - Other causes:Leukemia - Malignant Neoplasms - Drugs -
Adequate supply of iron - proper synthesis of heme - proper synthesis of globin chains
Megakaryocytes (growth stimulated by thrombopoieten) - help prevent hemorrhages

45. Leukocytosis
Arrest of bleeding - depends on vessel wall - platelets - and coagulation factors (fibrolytic factors)
8% of body weight- 5L in women and 5.5L in males
Asymptomatic until 4 months of life
Temporary infections - trauma/ tissue injury - Acute Infections: WBC count increases - Other causes:Leukemia - Malignant Neoplasms - Drugs -

46. Coombs Antiglobulin Test
Hemoglobulinopathy - inherited or acquired - Problem: RBC membrane defects so will get episodic or continuous RBC destruction - varies from mild to severe
Lymphocytes: 20-40% - Monocytes: 2- 6% (circulate in the blood 1-3 days and mature in tissues)
Increased retic with falling/ stable HgB - increase serum LDH - increase total bilirubin - transient hemoglobinuria
Detects presence of Ag-AB complex: direct or indirect - diagnostic for: hemolytic dz of a newborn - acquired hemolytic anemia - transfusion reaction - blood that sensitized patient. RBC

47. Eosinophilia Causes
HbA2: 2 alpha and 2 delta globin chains - in 2% of the population
Variation in size
Allergies - drug reactions (pCH) - parasitic diseases and tape worms
MCV - index for classifying anemia - Norma: 80-100

48. Acquired Disorders
Leukocytes - neutraphils - monocytes - basophils - lymphocytes - eosinophils--> 5 different cells divided into 3 classes - immune system and fights viral - bacterial - fungal - parasites - and allergens - classified by presence or absence of granules
Production of RBC - stimulated by decrease in O2 -kidneys produce hormone erythropoietin
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

49. Amount of Hb in Males and Females
T and B lymph
Female: 12-16 gm/dl ***menopausal women have more Male: 14-17 gm/dl
Detects presence of Ag-AB complex: direct or indirect - diagnostic for: hemolytic dz of a newborn - acquired hemolytic anemia - transfusion reaction - blood that sensitized patient. RBC
Platelet problems - factor 10 and vwf deficiency - vitamin K deficiency - anti-thrombin III deficiency - protein C deficiency - acquired disorder or coagulation

50. PE for anemia
8% of body weight- 5L in women and 5.5L in males
ITP/TTP: platelets destroyed - bone marrow suppression - drugs - prosthetic heart valve: chew up platelets
Mild: tired - pale - often assymptomatic - pallor - jaudnice - tachycardia - palpitation - spleen enlargement - glossitis - cheilosis (sore in the mouth) - neurologic sxs
Variation in shape