BCC_Hemetology_ Old Final WIMBA Review – Flashcards
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A 65-year-old man with recently diagnosed colon cancer complains of fatigue and shortness of breath. WBC 8.3 RBC 3.20 Hgb 7.0 Hct 23.1 MCV 72.2 MCH 21.8 MCHC 30.3 RDW 16.9 PLT 560.9 Serum iron: decreased TIBC: increased Ferritin: decreased Fecal occult blood: +
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Iron deficency anemia
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A 78-year-old pale, thin widow is brought to the hospital when her children notice increasing pallor and shortness of breath. WBC 3.2 RBC 1.20 Hgb 5.1 Hct 14.0 MCV 116.6 MCH 42.5 MCHC 36.4 RDW 18.9 PLT 85.8 Vitamin B12: WNL Folic acid: decreased Liver enzymes: WNL LDH: increased Reticulocytes: 1.0%
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Megaloblastic anemia
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A 45-year-old woman with rheumatoid arthritis complains of malaise and headaches. WBC 5.3 RBC 4.60 Hgb 11.3 Hct 36.1 MCV 78.5 MCH 24.6 MCHC 31.3 RDW 14.9 PLT 160.0 Serum iron: low TIBC: low Ferritin: increased Fecal occult blood: Negative Reticulocytes: 1.2%
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Anemia of Chronic inflammation
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A 52-year-old farmer complains of fatigue and ease of bruising. WBC 2.1 RBC 2.61 Hgb 7.9 Hct 24.1 MCV 92.3 MCH 30.3 MCHC 32.7 RDW 12.9 PLT 54.3 Reticulocyte count = 0.3%
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Aplastic anemia
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A 60-year-old woman complains of fatigue, back pain, and passing red urine in the morning but not at other times of the day. WBC 4.3 RBC 2.02 Hgb 6.2 Hct 17.9 MCV 88.6 MCH 30.7 MCHC 34.6 RDW 16.9 PLT 109.6 Relative reticulocyte count = 9.8%. Serum indirect bilirubin and LDH activity both elevated. Haptoglobin level abnormally low. Flow cytometric testing = patient RBCs and granulocytes lacked GPI-anchored proteins (CD55 and CD59), while all control materials provided appropriate results. Hemosiderin detected in urine sediment with Prussian blue staining. What other testing will aid in determination of the diagnosis?
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Serum lysis
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A 4-year-old girl is admitted to the hospital for abdominal pain, vomiting, motor disturbances, and a darkening of her gums. WBC 6.1 RBC 4.44 Hgb 11.3 Hct 34.0 MCV 76.5 MCH 25.4 MCHC 33.2 RDW 22.9 PLT 189.4 Serum iron: WNL TIBC: WNL Ferritin: WNL Which characteristic may be seen with this disease?
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Basophilic Stippling
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What poikilocyte/inclusion is commonly associated with G6PD deficiency?
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Heinz bodies
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Name 3 changes within a neutrophil that could occur with a severe bacterial infection.
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vacuoles, dohle bodies, toxic granulation
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A 43-year-old man presents with bone pain, fatigue, and ease of bruising. WBC 78.3 Band neutrophils RBC 3.20 Seg neutrophils 1 Hgb 9.9 Lymphs 9 Hct 30.1 Monos MCV 94.1 Eos MCH 30.9 Basos MCHC 32.8 Metamyelocytes RDW 12.9 Myelocytes PLT 14.7 Promyelocytes Large unclassified cells 90 (blasts) Myeloperoxidase + Sudan Black + NBE - PAS -
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AML M1
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A 30-year-old woman complains of fatigue, weakness, bone pain, and bruising. Manual differential: WBC 68.3 Band neutrophils RBC 2.60 Seg neutrophils Hgb 7.0 Lymphs 3 Hct 21.6 Monos MCV 83.1 Eos MCH 26.9 Basos MCHC 32.4 Metamyelocytes RDW 15.9 Myelocytes 2 PLT 8.3 Promyelocytes 75 Blasts 20 Myeloperoxidase + Sudan Black + NBE- PAS - Cytogenetics: t(15;17) PT: high APTT: high FBG: low D-dimer: +
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AML M3
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A 5-year-old boy is taken by his mother to a physician for listlessness, pallor, and bruising. Manual differential: WBC 2.3 Band neutrophils RBC 2.50 Seg neutrophils 11 Hgb 7.0 Lymphs 9 Hct 21.1 Monos MCV 84.4 Eos MCH 28.0 Basos MCHC 33.2 Metamyelocytes RDW 16.9 Myelocytes PLT 10.0 Promyelocytes Blasts 80 Myeloperoxidase - Sudan Black - NBE - Periodic acid +Positive for TdT, CD10, CD19, and CD20 Negative for surface immunoglobulins (sIg): -
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B cell ALL
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A 65-year-old man is admitted to the hospital for a knee replacement. On physical examination, cervical lymphadenopathy was noted. The following are presurgical CBC values: Manual differential: WBC 48.3 Band neutrophils 3 RBC 4.50 Seg neutrophils 15 Hgb 13.9 Lymphs 75 Hct 42.1 Monos 5 MCV 93.5 Eos 2 MCH 30.8 Basos MCHC 33.0 Metamyelocytes RDW 13.9 Myelocytes PLT 160.9 Promyelocytes Many smudge cells
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CLL
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Name the disease: Fibrinogen: 256 mg/dL D-dimer: 0.3 g/mL Factor VIII assay: 40% activity Bleeding time: 28 min Platelet aggregation: Absence of aggregation in response to ristocetin VWF antigen: 35% VWF activity: 30%
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VWD
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Which of the following is associated with Chediak-Higashi syndrome?
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Membrane defect of lysosomes
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Which of the following is most closely associated with erythroleukemia?
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ringed sideroblasts
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In which malaria species do you see a characteristic band in the trophozoite stage?
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Plasmodium malariae
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Which of the following is true of 2,3-BPG?
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It enhances the release of oxygen from hemoglobin
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The principle energy source for mature red blood cells is
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adenosine triphosphate (ATP) generated from anaerobic glycolysis
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What is the last stage of cell capable of undergoing mitosis?
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Polychromatic Normoblast
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Which of the following is the measure of the size of red blood cells?
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MCV
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What types of globin chains does Hemoglobin F consist of?
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2 alpha and 2 gamma
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If 2,3-BPG is increased, which direction does the oxygen dissociation curve shift?
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Right
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All of the following are found in heme except:
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Ferric iron
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Specific (secondary) granules of the neutrophilic granulocyte:
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Appear first at the myelocyte stage
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What is the last granulocyte in the maturation sequence able to undergo mitosis?
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myelocyte
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The light colored zone adjacent to the nucleus in a myelocyte is the
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Golgi
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Which of the following molecules is stored in platelet ___-granules (dense bodies)?
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serotonin
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Hemolysis in paroxysmal nocturnal hemoglobinuria (PNH) is
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caused by RBC membrane defect
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Lab findings in hereditary spherocytosis do NOT include:
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decreased osmotic fragility
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The characteristic erythrocyte found in pernicious anemia is:
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macrocyte
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A bone marrow failure syndrome that results from damaged or defective stem cells is:
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Aplastic anemia
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Which of the following tests is a good indicator of accelerated erythropoiesis
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Reticulocyte count
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What characteristic red cell shape is associated ith extravascular hemolysis
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sphereocyte
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Which of the following is detectable only by examining a peripheral blood smear
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poikilocytosis
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What does forward scatter measure
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size
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What type of leukemia is CALLa associated with?
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ALL
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The platelet count in Polycythemia Vera is
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Increased
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What type of leukemia is M4?
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Acute Myelomonocytic Leukemia
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What is the characteristic cell found in Hodgkin's lymphoma?
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Reed-Sternberg
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Which of the following would not be found in CML?
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20% blasts
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List the four myeloproliferative disorders (something is being overproduced)
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CML, ET, PV, MMM (CIMF)
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What MDS has <1% blasts in bone marrow and blood and <15% ringed sideroblasts?
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RA
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What is the key characteristic of MDS
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Dyspoiesis
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Which of the following is least likely to contribute to death for patients with MDS?
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Neuropathy
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A patient had the following results: WBC 8.3 RBC 2.5 Platelet 75 Left shift Philadelphia chromosome - negative LAP 136 Differential showed nRBCs, schistocytes, teardrops, giant platelets
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Leukoerythroblastosis in myelofibrosis
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What markers would be found on an immature B cell ALL?
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CD10 and TdT
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How long do platelets live?
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10 days
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Bleeding time assesses
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platelets
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Bleeding time is affected by
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Aspirin
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Thrombin time is affected by
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Heparin
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Lab results on a patient with a severe bleeding problem are as follows: Platelet count 125 x 109/L MPV 16.0 fL (ref. range = 8-10 fL) Bleeding time >15 min (ref. range = 2-10 min) PT 12 sec APTT 32 sec Platelet Aggregation Normal response to ADP, collagen, epinephrine; no response with ristocetin
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Bernard Soulier Syndrome
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Which of the following is a characteristic of acute idiopathic thrombocytopenic purpura?
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Spontaneous remission within a few weeks
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A 4-year-old child is seen in the ER with petechiae and a platelet count of 15 x 109/L. She has no previous history of bleeding problems. 3 weeks earlier she had chicken pox. The physician advises the parents to keep the child off the playground to avoid injury and the child will recover within several weeks to a month with no further treatment. What condition does this child most likely have?
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ITP
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The following results are obtained on a patient with a severe bleeding problem: Platelet count 256 x 109/L Bleeding time >15 min Clot retraction Deficient Platelet Normal response to ristocetin; weak Aggregation response to ADP, collagen, epinephrine
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Glanzmann thrombasthenia
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If a patient were deficient in Von Willebrand Factor, which test result would be abnormal?
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BT
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Determine the factor deficiency: PT Prolonged PTT Normal
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VII
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Determine the factor deficiency: PT prolonged, APTT prolonged Mixing studies: serum- no correction Aged- no correction Adsorbed- corrects
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V
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List the prothrombin group
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2,7,9,10 (vitamin k dependent)
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PT Normal PTT prolonged Mixing studies no correctionn
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inhibitor
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Determine the disease PT normal PTT prolonged TT normal BT prolonged D-dimer negative
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VWD
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Determine the disease: PT Prolonged PTT Prolonged TT Prolonged BT Prolonged D-Dimer Positive
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DIC
