Hematology
_________________ is about the relationship of bone marrow to the systemic circulation, the realtionship of the plasma environment to the RBC life span, and relationship of the hemoglobin to RBCs
Hematology
A microscope has 4 main components, the ____________, ___________, ___________, and the _________ systems
framework, illumination, magnification, and the focusing
The microscopes ____________ includes the base, arm, stage, and rotating nosepiece
framework
The ___________ system includes the light source, Abbe condensor and iris diaphragm themselves and their adjusters
illumination
The _________ adjusters focus, centers, and directs the beam of light
condenser
The _______ _________ controls the amount of light
Field Diaphragm
____________ are the main magnifiers of the microscope
Objectives
The magnification system as a whole is called the ________ ______
Optical tube
The focusing system includes the ____________ and ______ focusing systems
coarse and fine
Total magnification = ocular magnification x __________ magnification
objective
___ (low power) is used for initial focusing and some cell counts
10x
___ (medium high-dry) is used for scanning and estimating counts
40x
___ (oil immersion) is used for identification and enumeration
100x
___________ reveals fine detail
Resolution
____________ distinguishes object from background
Contrast
The most utilized microscopic technique is ______________ ___________
Bright-field microscopy
Bright-field microscopy makes objects ______ against the bright background
dark
_____________ is the production, development, differentiation, and maturation of all blood cells
Hematopoiesis
The first 2 weeks to 2 months in fetal life is the ________ _______, where erythroblasts and embryonic hemoglobin is produced
mesoblastic period
2-7 months of the fetal life is the _______ _______, where WBCs and megakaryocytes start to appear
hepatic period
Megakaryocytes are the origin of ___________
platelets
The ______ ________ assumes the role of hematopoiesis 7 months post conception
bone marrow
The _______, _______, and _______ ______ can compensate in case of bone marrow damage and/or leukemia
spleen, thymus, and lymph nodes
____________ __________ can be caused by tumors or leukemic cells in the bone marrow
Extramedullary hematopoiesis
The spleen functions as _________, _________, __________ _______, and _________
storage, filtration, immunologic, and hematopoietic function
The spleen stores _____ of platelets and granulocytes
1/3
The spleen also inspects RBCs for damage, provides ________ _______, and produces blood cells
opsonizing antibodies
___________ _____ are capable of differentiation into Myeloid (Non-Lymphoid) or Lymphoid commited precursor cells
Multipotential cells
___________ and ___________ are responsible for controlling replication, maturation, and stem cell growth inhibition
Cytokines and interleukins
The normal Myeloid: Erythroid ratio is ___________ and reflects the production to lifespan ratioof various cell types
3:1 to 4:1
WBC life span is ______ hours
6-10
RBC life span is ______ days
120
______ are produced at a much higher rate than RBCs
WBCs
Bone marrow procedures are prefered to be done at the _______ ______
iliac crest
_________ are areas in a sample richest with cells
Spicules
Stains used for slide preparation are ________ ______ (for iron) and __________ (for everything else)
Prussian blue and Wrights
_______ is the most frequently ordered test in Hematology
CBC
CBC tests are preformed using ________
EDTA
CBC testing measures the amount of __________________________
RBCs, WBCs, PLTs, Hgb, Hct, MCV, MCH, MCHC, and RDW
WBC counts are normal at ___________ for both males and females
4.8-10.8
RBC counts are normal at ________ in males and _______ in females
4.7-6.1; 4.2-5.4
Hgb is normal at _______ in males and _______ in females
14-18; 12-16
MCHC is normal at ________%
32-36
MCV is normal at _________
80-100
PLTs are normal at _________
150-450
With WBCs, _ is considered critically low and __ is considered critically high
3; 25
With Hgb, _ is considered critically low and __ is considered critically high
7; 19
With PLTs, _ is considered critically low and __ is considered critically high
20; 1000
Corelation checks/Rule of threeformulas are _____________________________________
RBC x 3 = Hgb; Hgb x 3 = Hct ∓ 3
Correlation checks/rule of three only applies to ____________/____________ RBCs
normocytic/normochromic
Pluripotent stem cells mature into ____________________
Pronormoblasts
Pronormoblasts are stimulated by EPO and matures into ___ RBCs
16
RBCs have ___ stages of maturation, where the cell decreases in size and decreases in N:C ratio
6
As RBCs age, the color changes from blue to _______
salmon
__________ RBCs are large, blue and has a nucleus
Immature
__________ RBCs are small, salmon, and have no nucleus
Mature
Pronormoblasts (1) has a N:C ratio of _____
6:1
Pronormoblasts (1) have a nucleus with __________ packed chromagin
densely
Basophilic Normoblasts (2) have a N:C ratio of _____
6:1
Basophilic Normoblasts have a round nucleus with _______ ______ appearance
Crystalline Chromatin
Polychromatophilic Normoblasts (3) have a N:C ratio of ______
4:1
Polychromatophilic Normoblasts (3) have a condensed, moderately compacted nucleus with no _______
Nucleoli
____________________________ ____________________ is where hemoglobin is first appears
Polychromatophilic Normoblasts
3
Orthochronic Normoblasts (4) have a N:C ratio of _____
1:1
Orthochronic Normoblasts (4) has a ________, velvet nucleus
Dense
_________________ has no nucleus or N:C ratio, also has remnants of RNA in the cytoplasm
Reticulocytes
________ _____ are disc shaped and have no nucleus
Mature RBCs
Matuer RBCs are found in ____________ __________
peripheral blood
Polychromasia and nucleated RBCs are observed with ___________ ____________
Effective Erythropoiesis
Precursor cells hemolyzing before their maturation is complete is seen with ____________ ___________
Ineffective erythropoiesis
__________ ____ are RBCs in stages 1-4 of the maturation cycle
Precursor cells
The outer layer of the RBC membrane contains _____________ and ____________
glycoprotein and glycolipids
The central layer of the RBC membrane contains ______________ and ______________
cholesterol and phospholipids
The inner layer of the RBC membrane is the ______________
cytoskeleton
RBC membranes protein matrix is supported by ___________ and ___________ proteins
Integral and peripheral
The cytoskeletons gives the RBCs there elasticity and is made up of the proteins ___________ and ___________
Spectrin and Ankyrin
RBC metabolism has 3 pathways, the ______________________________________________________
Embden-Meyerhof, pentose phosphogluconate, and methemoglobin reductase pathway
The embden meyerhof pathway provides _____ of ATP required to run the Na/k pumpand generates NADH
90%
The pentose phosphogluconate pathway generates ___________ and 5-10% of ATP
NADPH
The methemoglobin reductase pathway keeps hemoglobin in the ____________ state
ferrous
_______ is the average volume of one RBC
MCV
______ is the average weight per RBC
MCH
MCH = (_________) x 10
Hgb/Htc
_______ is hemoglobin concentration
MCHC
MCHC = (Hgb/Htc) x ____
100
MCV has a valuable role in monitoring _______________ and _____________ properties
preanalytical and analytical
______________ is variation in the size of RBCs
Anisocytosis
_____________ are <6 microns in diameter and <80 MCV
microcytes
_____________ are >8 microns in diameter and >100 MCV
Macrocytes
______________ is the absence or reduced production of globin chains
Thalassemia
____________________ is the high presence of abnormal RBCs
Poikilocytosis
__________________ lack biconcave shape and have an increased hemoglobin content
Spherocytes
Spherocytes are associated with diseases such as ___________________________
Hereditary spherocytosis, Hemolytic anemia, and post transfusion
Ovalo/elliptocytes are associated with diseases such as ________________________________________
Thalassemia and Megaloblastic anemia/ Hereditary elliptocytosis and Iron deficiency anemia
Echinocytes (Burr) are associated with diseases such as ___________________________-
hypernatreamia, Renal disease, and Severe burns
Acanthocytes are associated with _______________________________________
liver disease, alcoholism, post-splenectomy, and Vit E deficiency
Schistocytes (fragments) are associated with __________________________________________
disseminated Intravascular coagulation, hemolytic anemia, and Artificial heart valves
Drepanocytes are associated with ______________________
Sickle cell anemia
Codocytes (Target) are hallmark indicators of _________ _________, also indicates Hgb C disease, post splenectomy, and iron deficiency anemia
liver disease