Term
| Which artery is most commonly used for an arterial blood sample? Which physical exam test is required prior to taking an arterial blood sample? Why? |
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Definition
| Radial, modified allen test is required to determine if collateral blood supply of the ulnar artery is enough to supply the hand if the radial artery collapses. |
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Term
| What tests need to be done after a patient is fasting? |
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Definition
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Term
| What tests are elevated due to strenuous exercise? |
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Definition
| Creatine Kinase (CK), Lactate Dehydrogenase (LD) and Aspartate Aminotransferase (AST). |
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Term
| How is 24 hour urine collected? What are the effects of improper storage of the container? |
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Definition
| Get rid of first sample, refrigerated in dark container. Crystallization, ketones can evaporate, bacteria can grow, glucose levels will go down because of bacteria utilizing it. (Look at slide for others). |
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Term
| What are the 3 main causes of anemia? |
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Definition
| increased RBC destruction, RBCs are not produced adequately or there is active bleeding. |
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Term
| What abnormalities are seen on CBC with anemia? |
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Definition
| Decreases hemoglobin, hematocrit and/or decreased RBC count. |
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Term
| What causes aplastic anemia? |
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Definition
| Anemia caused by destruction of bone marrow so it cannot produce RBCs. |
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Term
| What is hematopoiesis? Where does it occur? |
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Definition
| The process of blood cell production and development, it occurs in red bone marrow. |
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Term
| Which stain is used for peripheral blood smear? |
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Definition
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Term
| Explain how a WBC differential is conducted. |
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Definition
| 100 cells are counted on a peripheral smear and the percentages are noted. Done by a machine. |
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Term
| What causes increased destruction of RBCs? |
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Definition
| hemoglobinopathies, iron deficiency anemia, megaloblastic anemias and other rare congenital anemias |
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Term
| What does tissue hypoxia cause in the kidney? |
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Definition
| Increased EPO production by the kidneys. |
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Term
| What is the lifespan of an RBC? Where does RBC destruction occur? |
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Definition
| 120 days and the Reticuloendothelial system of the spleen, liver and red bone marrow is where RBC destruction occurs. |
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Term
| Describe the appearance of reticulocytes with Wright's stain. What is another name for reticulocytes? |
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Definition
| They have basophilic stippling (residual RNA) and are a little bit bigger. Another name for reticulocytes is polychromatic erythrocyte. |
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Term
| Which RBC indices indicates the size of the RBC? |
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Definition
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Term
| Which RBC indices indicates hemoglobin content in an RBC? |
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Definition
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Term
| What test indicates variability of RBC sizes? What is it called? |
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Definition
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Term
| What does the presence of spherocytes indicate? |
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Definition
| Usually hereditary spherocytosis. But also could be immune hemolytic anemia. |
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Term
| What do Burr cells indicate? |
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Definition
| Anemia of chronic disease |
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Term
| What do helmet (bite) cells indicate? |
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Definition
| G6PD deficiency and pulmonary emboli. |
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Term
| What do schistocytes indicate? |
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Definition
| DIC, sickle cell crisis and severe burns. |
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Term
| What do acanthocytes indicate? |
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Definition
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Term
| What do ovalocytes indicate? |
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Definition
| Thalassemias, myelodysplastic syndrome, megaloblastic anemia and iron deficiency anemia. |
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Term
| What do target cells indicate? |
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Definition
| Decreased intracellular hemoglobin, iron deficiency anemia, Thalassemias and liver disease. |
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Term
| What do stomatocytes indicate? |
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Definition
| Hereditary spherocytosis, Hereditary stomatocytosis or acute alcoholism. |
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Term
| What does Rouleaux indicate? |
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Definition
| Increased protein in the serum. Possibly Multiple myeloma. Stack of coins appearance, punched out lesions,. |
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Term
| What are some inclusions seen in WBCs? RBCs? |
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Definition
WBCs = Dohle bodies.
RBCs = Basophilic stippling, Howell-Jolly bodies, Pappenheimer Bodies, Heinz bodies, Reticulocytes. |
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Term
| Most common cause of megaloblastic anemia? |
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Definition
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Term
| What are the functions of WBCs? |
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Definition
| Immune function, phagocytosis and destruction of foreign bodies. |
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Term
| What do toxic granulation and vacuoles usually indicate? |
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Definition
| Often a bacterial infection. |
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Term
| What are megakaryocytes and what do they do? |
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Definition
| Platelet precursors that break off into platelets. |
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Term
| What is the normal CBC range for platelets? |
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Definition
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Term
| What can cause an increased reticulocyte count? |
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Definition
| Hemolytic/aplastic anemia, acute/chronic bleeding. |
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Term
| What is erythrocyte sedimentation rate? |
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Definition
| Indicates nonspecific inflammatory processes that measure how fast cells "fall", it is due to increased protein in the plasma. Indicates inflammation. |
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Term
| Why is G6PD deficiency significant? |
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Definition
| You should know before you give a patient certain medication. |
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Term
| Why is a bone marrow aspiration indicated? |
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Definition
| Lymphoma, aplastic anemia, leukemia. |
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Term
| What would you see on CBC if a patient had aplastic anemia? |
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Definition
| Everything would be decreased (RBCs, WBCs, platelets), the bone marrow is not functioning. |
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Term
| How does leukemia look on CBC? |
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Definition
| Increased WBC count, blasts. |
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Term
| How is anemia classified? |
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Definition
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Term
| What 3 things are needed for hemoglobin synthesis to occur? |
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Definition
| Iron, heme portion (polyporphyrin) and globin chains. |
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Term
| What is carboxyhemoglobin? |
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Definition
| Carbon monoxide hemoglobin complex. |
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Term
|
Definition
| Hemoglobin where Fe 2+ is oxidized to Fe3+, molecule can’t carry O2. |
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Term
| What is the pathophysiology of Hgb SS? |
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Definition
| Defective hemoglobin molecule forming polymers which damage the RBC membrane resulting in a sickle cell shape when RBC is deoxygenated; patient becomes hypoxic when the sickle cell get caught in the organs |
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Term
| What is the alpha thalassemia? Beta thalassemia? |
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Definition
Alpha = Lack of alpha chain production.
Beta = Reduced or absent beta chain production. |
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Term
| What is the best test to evaluate for hgb abnormalities? |
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Definition
| Hemoglobin electrophoresis |
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Term
|
Definition
| Deficiency of heme synthesis due to enzyme deficiency/dysfunction within the normal heme synthesis pathway. |
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Term
| What is the most common cause of secondary porphyria? |
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Definition
|
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Term
| Where is the majority of iron in the body? |
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Definition
|
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Term
| In what state is iron transported? |
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Definition
|
|
Term
| What are the storage forms of iron? |
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Definition
|
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Term
| Which test is best to evaluate iron body stores? |
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Definition
|
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Term
| What are the causes of iron def. anemia? |
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Definition
| Blood loss, diet, absorption issues, pregnancy |
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Term
| What is the pathophysiology of sideroblatic anemia? |
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Definition
| Defective heme synthesis due to increased iron, problem with the insertion into the porphyrin ring. |
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Term
|
Definition
| Increased iron absorbed in the gut |
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Term
| What are petechia, purpura and eccymosis? |
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Definition
| Pinpoint hemmorages, grouped together pinpoint hemmorages, intradermal hemorrhage |
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Term
| What is exposed during an injury to the blood stream to start the coagulation process? |
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Definition
| Collage, tissue factor/thromboplastin |
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Term
| What starts the intrinsic pathway? |
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Definition
|
|
Term
| What factor starts the extrinsic pathway? |
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Definition
|
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Term
| How doe aspirin affect platelets? |
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Definition
| reduces platelet aggregation |
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Term
| Which studies assess platelet function? |
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Definition
| Bleeding Time and platelet count |
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Term
| How do platelets and vonwillibrand factor interact? |
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Definition
| platlets need vWF to form adhesions. |
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Term
| Which factors are vitamin K dependent? |
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Definition
|
|
Term
| Which factor is the starting point of the common pathway? |
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Definition
|
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Term
| What does PT test assess? Normal range? |
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Definition
| Extrinsic pathway. Normal range is 11-15 seconds. |
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Term
| What is Coumadin indicated for? |
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Definition
| Medication given orally to patients with certain medical conditions to prevent development of very small “micro” blood clots. A fib, DVT and heart valve replacement. |
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Term
| What is the INR? What is the normal range? Normal for someone on coumadin? |
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Definition
| Standardized PT test results. Normal is 1. Normal for someone on coumadin is 2-3. |
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Term
|
Definition
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|
Term
| What is an activated clotting time used for? |
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Definition
| Used to check high dose heparin during coronary artery bypass, hemodialysis, angioplasty with stent. |
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Term
| How is fibrinolysis initiated? |
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Definition
| As soon as intrinsic starts it is initiated and it is initiated later with tpa |
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Term
|
Definition
| Enzyme that degrades fibrin |
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|
Term
| What results from plasmin interating with fibrin? |
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Definition
| Fibrinolysis with d dimer and fibrin degradatin products |
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Term
| What do elevated FDP and D- dimers indicate? |
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Definition
| Increased clotting and fibrinolysis. |
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Term
| What are protein S and protein C? |
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Definition
| coenzymes involed with regulating fibrinolysis, help break down clots |
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Term
|
Definition
| Autoimmune with IgG that attacks platelets |
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|
Term
| What is vonwillebrands disease? |
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Definition
| Deficiency of factor 8, not able to adhere to platelets, common congenital disease. |
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Term
|
Definition
|
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Term
|
Definition
| Factor 9 deficiency. (Christmas disease) |
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Term
|
Definition
| Coag and break down, bleed from everywhere, overstimulated pathways |
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|
Term
| Why do patient with severe liver disease have coagulophathies? |
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Definition
| Don’t produce coag factors very well, vit K deficiencies, decrease acids. |
|
|
Term
| what gauge of needle is appropriate for venipuncture? |
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Definition
|
|
Term
| what abnormalities are present when rbcs are hemolyzed in the sample? |
|
Definition
|
|
Term
| what is the difference between plasma and serum? |
|
Definition
| Serum does not have coagulation protein |
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Term
| Describe a plain red top. |
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Definition
| It contains no anticoagulant and is used for chemistry and serology testing. |
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Term
|
Definition
| It contains no anticoagulant and is used for tests requiring serum (most chemistry tests). |
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Term
| Describe a lavender/purple top. |
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Definition
| It contains EDTA and is used for hematology and blood bank testing. |
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Term
| Describe a light blue top. |
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Definition
| It contains and anticoagulant (sodium citrate) and is used for coagulation testing (plasma). |
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Term
|
Definition
| Contains an anticoagulant (Heparin) and is used for chemistry tests. |
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Term
|
Definition
| Contains an anticoagulant (Potassium Oxalate) and is used for glucose and blood alcohol testing. |
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|
Term
| Describe a Dark Blue top. |
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Definition
| It contains EDTA, Heparin or no anticoagulant and is used for specialty testing of toxicology or trace metals. |
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