Term
when anticoagulant is added to fresh hole blood the straw-colored fluid that can be separated from cellular elements is a. serum b. plasma c. whole blood d platelets |
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Definition
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Term
what is of the following is false about EDTA a. removes ionized calcium from fresh hole blood b. used in most routine coagulation studies c. most common anticoagulant in hematology d. is in the lavender toped tube |
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Definition
b. used in most routine coagulation studies (this would be sodium citrate in blue toped tube) |
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Term
heparin keep blood from coagulating by neutralizing a. platelets b. ionized calcium c. fibrinogen d. thrombin |
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Definition
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Term
the anticoagulant EDTA is in what colored top tube |
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Definition
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Term
the anticoagulant heparin is in what colored top tube |
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Definition
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Term
the anticoagulant sodium citrate is in what colored top tube |
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Definition
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Term
the tube with no anticoagulant comes in what top colored tube |
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Definition
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Term
name the 5 significant steps in a vena puncture |
|
Definition
1.introduce you self and explain procedure 2. identify patient, check test requisition,assemble equipment, wash hands, put on PPE 3 select appropriate site 4 reapply tourniquet and preform puncture 5 remove tourniquet, then needle, apply pressure, label tubes |
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Term
appropriate vein for vena puncture are |
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Definition
cephalic, basilic, and median cubital |
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Term
a patient with IV in both arms needs a blood sample taken what is the proper procedure a. any vain is fine b obtain from above the IV site c. obtain from below the IV site d. do not draw blood |
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Definition
c. obtain from below the IV site |
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Term
the area to collect capillary blood from an infant is a. previous puncture site b. posterior curve of the heel c. the arch d. medial or lateral plantar surface |
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Definition
d. medial or lateral plantar surface |
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Term
a peripheral blood smear can be prepared from a. EDTA tube with in 1-hr of collection b. free-flowing capillary blood c citrated whole blood d. both a & b |
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Definition
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Term
the examination of bone marrow is useful in a. diagnosing bleeding disorders b. diagnosing disorders associated with erythrocytes & leukocytes c diagnosing acute leukemias d both a & b |
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Definition
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Term
the appropriate bone marrow aspiration sites are a anterior and posterior iliac crest b sternum and posterior iliac crest c tibia and sternum d both a&b |
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Definition
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Term
what color is an RBC when stained with basic stain |
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Definition
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Term
what color is an RBC when stained with acidic stain |
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Definition
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Term
what color is an RBC when stained with neutrophilic |
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Definition
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Term
which of the following is a non-romanowsky type stain a wright b may-grunwald c giemsa d methlene blue |
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Definition
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Term
posable cause of a wright stain being to red is a staining time to long b stain to basic c buffer was to acidic exposure was to short d buffer was to basic exposure was to long |
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Definition
c buffer was to acidic exposure was to short |
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Term
the centrioles appropriate function is a. protein production b. concentration of secretory granules c. lipid synthesis d. DNA synthesis e. points of attachment of the spindle fibers |
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Definition
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Term
the Rough ER appropriate function is a. protein production b. concentration of secretory granules c. lipid synthesis d. DNA synthesis e. points of attachment of the spindle fibers |
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Definition
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Term
the smooth ER appropriate function is a. protein production b. concentration of secretory granules c. lipid synthesis d. DNA synthesis e. points of attachment of the spindle fibers |
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Definition
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Term
the golgi apparatus appropriate function is a. protein production b. concentration of secretory granules c. lipid synthesis d. DNA synthesis e. points of attachment of the spindle fibers |
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Definition
b. concentration of secretory granules |
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Term
glycogen is a a protein b lipid c carbohydrate d hormone |
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Definition
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Term
the nucleus of the cell contains a chromatin, nucleoli, and nucleoplasm b chromatin, nucleoli, and ribosomes c DNA, RNA, and ribosomes d DNA, RNA, and mitochondria |
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Definition
a chromatin, nucleoli, and nucleoplasm |
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Term
heterochromatin is a genetically inactive b found in patches or clumps c genetically inactive and pale staining d both a and b |
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Definition
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Term
the maturational sequence of the thrombocyte is a megakaryoblast-promegakaryocyte-megakaryocyte-metamegakaryocyte-thrombocyte b promegakaryocyte-megakaryocyte-metamegakyryocyte-thrombocyte c megakaryoblast-promegakaryocyte-megakaryocyte-thrombocyte d megakyryoblast-promegakaryocyte-metamegakaryocyte-thrombocyte |
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Definition
c megakaryoblast-promegakaryocyte-megakaryocyte-thrombocyte |
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Term
the chromatin pattern, in most cells, as the cell matures a becomes more clumped b becomes less clumped c remains the same |
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Definition
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Term
the presence of nucleoli is associated with a immature cells b all young cells except myeloblasts c one erythroblasts d disintegrated cells |
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Definition
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Term
in the blast stage of development of leukocytes the cytoplasm of the cell is a dark blue and lacks vacuoles b light blue and lacks granules c light blue and has specific granules d gray with many dark blue granules |
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Definition
b light blue and lacks granules |
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Term
the appropriate mature leukocyte for segmented neutrophil is a large orange granules b an elongated and curved nucleus c light sky blue cytoplasm d kidney bean shaped nucleus e averages approximately 56% of normal adult leukocytes in the peripheral blood |
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Definition
e averages approximately 56% of normal adult leukocytes in the peripheral blood |
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Term
the appropriate mature leukocyte for monocyte is a large orange granules b an elongated and curved nucleus c light sky blue cytoplasm d kidney bean shaped nucleus e averages approximately 56% of normal adult leukocytes in the peripheral blood |
|
Definition
d kidney bean shaped nucleus |
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Term
the appropriate mature leukocyte for lymphocyte is a large orange granules b an elongated and curved nucleus c light sky blue cytoplasm d kidney bean shaped nucleus e averages approximately 56% of normal adult leukocytes in the peripheral blood |
|
Definition
c light sky blue cytoplasm |
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Term
the appropriate mature leukocyte for band form neutrophil is a large orange granules b an elongated and curved nucleus c light sky blue cytoplasm d kidney bean shaped nucleus e averages approximately 56% of normal adult leukocytes in the peripheral blood |
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Definition
b an elongated and curved nucleus |
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Term
the appropriate mature leukocyte for eosinophil is a large orange granules b an elongated and curved nucleus c light sky blue cytoplasm d kidney bean shaped nucleus e averages approximately 56% of normal adult leukocytes in the peripheral blood |
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Definition
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Term
which of the following are the characteristics of erythropoietin a glycoprotein b secreted by the liver c secreted by the kidneys d all of the above |
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Definition
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Term
which of the following is the characteristics of erythropoietin a produced primarily in the liver of the unborn b gene for erythropoietin is found on chromosome 11 c most erythropoietin is secreted by the liver in adults d cannot cross the placental barrier |
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Definition
d cannot cross the placental barrier |
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Term
the nucleated erythrocyte with a reddish pink cytoplasm and condensed chromatin pattern is a a arubricyte b basophilic normoblast c metarubricyte d either b or c |
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Definition
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Term
with a normal diet an erythrocyte remains in the reticulocyte stage in the circulating blood for a 1 day b 2.5 days c 3 days d 120 days |
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Definition
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|
Term
after the molecule of hemoglobin gains the first two oxygen molecules the molecule a expels 2,3 DPG b has decreased oxygen affinity c becomes saturated with oxygen d adds a molecule of oxygen to an alpha chain |
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Definition
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|
Term
if normal adult A1 and fetal hemoglobin F are compared fetal hemoglobin has______ affinity for oxygen a less b the same c greater |
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Definition
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|
Term
oxyhemoglobin is a ____ than deoxyhemoglobin a weaker acid b stronger acid |
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Definition
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|
Term
the initial condensation reaction in the synthesis of porphyrin preceding heme formation takes place in the a liver b spleen c red bone marrow d mitochondria |
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Definition
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|
Term
the initial condensation reaction in the synthesis of porphyrin preceding heme formation takes place in the and requires a iron b vitamin b6 c vitamin b12 d vitamin d |
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Definition
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|
Term
the final steps in heme synthesis including the formation of protoporphyrin take place in a cells nucleus b cells cytoplasm c the spleen d the mitochondria |
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Definition
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|
Term
if globin synthesis is insufficient in a person iron accumulates in the cells_____ a nucleus b cytoplasm c golgi apparatus d mitochodria |
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Definition
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|
Term
if globin synthesis is insufficient in a person iron accumulates in the cells cytoplasm as _____ aggregates a transferrin b ferritin c albumin d iron |
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Definition
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|
Term
relative polycythemia exists when a increased erythropoietin is produced b the total blood volume is expanded c the plasma volume is increased d the plasma volume is decreased |
|
Definition
d the plasma volume is decreased |
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|
Term
when porphyrin synthesis is impaired the ___ becomes encrusted a lysosomes b nucleoli c mitochondria d vacuoles |
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Definition
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|
Term
when porphyrin synthesis is impaired the mitochondria becomes encrusted with a protoporphyrin b hemoglobin c iron d delta aminolevulinic acid |
|
Definition
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|
Term
the function of the methemoglobin reductase pathway is to a prevent oxidation of heme iron b produce methemoglobinemia c provide cellular energy d control the rate of glycolysis |
|
Definition
a prevent oxidation of heme iron |
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|
Term
what is the normal value of MCV |
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Definition
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|
Term
what is the normal value of MCH |
|
Definition
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|
Term
what is the normal value of MCHC |
|
Definition
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|
Term
Name and describe the variations in size of a mature erythrocyte |
|
Definition
Normocytic-about 7um, Microcytic <7um, Macrocytic >7um, Anisocytic- mixed sizes(not normal) |
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|
Term
Correlate at least 1 clinical condition with each of the size variations: anisocytosis, macrocytosis, microcytosis |
|
Definition
anisocytosis-anemias, macrocytosis-liver disease, vit b12 deficiency/folate deficiency, microcytosis- iron deficiency anemia |
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|
Term
explain the terms used when a mature erythrocyte assumes an irregular shape: |
|
Definition
polikilocytosis- general term for abnormally shaped rbc's acantocyte- irreg. shaped projections schistocyte-fragmented erythrocyte, often display pointed extremities echinocyte- short, evenly spaced projections usu. with central pallor (burr cell) spherocyte- round, no central pallor zone target cell- bull's eye sickle cell- elongated cell with point on each end, may be curved or S shaped Hemoglobin C crystal- hexagonal Hemoglobin SC crystal- 1-2 fingerlike projections, cell may appear folded Elliptocyte- cigar shaped Ovalocyte- egg shaped tear drop cell- shaped like tear drop/pear, may have 1 blunt projection Stomatocyte- slitlike area of central pallor |
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|
Term
Correlate at least one clinical condition with each of these erythrocytic shape variations: acanthocytes, crenated rbc's, elliptocytes, polkilocytosis, sickle cells, spherocytes, stomatocytes, tear drops |
|
Definition
acanthocytes- vit e deficiency, severe liver disease, splenectomy crenated rbc's- microangiopathic hemolytic anemia elliptocytes- iron deficiency anemia polkilocytosis- hemolytic anemia sickle cells- homozygous hemoglobin disease spherocytes- hereditary spherocytosis stomatocytes- alcoholism tear drops- primary myelofibrosis |
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|
Term
describe the alterations in color that can be seen in an erythrocyte: |
|
Definition
normochromic- normal color hypochromic- less color than normal (central pallor bigger than normal) hyperchromic- typically no color (no central pallor) polychromic- refers to blue color |
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|
Term
Correlate at lease 1 clinical condition with the conditions of: hypochromia and polychromatophilia |
|
Definition
hypochromia- iron deficiency anemias polychromatophilia- acute and chronic hemorrhage |
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|
Term
Name and describe the appearance of inclusions that may be seen in a variety of abnormal conditions |
|
Definition
Howell-jolly bodies- dark blue to purple, round to oval, 0.5-1um, usu. 1, composition-DNA Basophilic stippling- dark blue to purple, fine/coarse punctate granules, numerous, comp. RNA Pappenheimer bodies- light blue, fine irregular granules in clusters, usu. 1 cluster, comp. iron Cabot rings- dark blue to purple, loop, ring, or fig. 8, may look like beads on a string, 1-2/cell, comp. remnants of mitotic spindle Heinz bodies- dark blue to purple, single/multiple generally membrane bound, comp. precipitated hemoglobin (supravital stain) |
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Term
Correlate at least 1 clinical condition with the following erythrocyte inclusions: basophilic stippling, cabot rings, Heinz bodies, hemoglobin C crystals, howell-jolly bodies, papenheimer bodies, siderotic granules |
|
Definition
basophilic stippling- lead intoxication cabot rings- myelodysplastic syndrome Heinz bodies0 unstable hemoglobin hemoglobin C crystals- homozygous hemoglobin C disease howell-jolly bodies- splenectomy pappenheimer bodies- splenectomy siderotic granules- ? |
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|
Term
Name the clinical condition associated with alteration in erythrocyte distribution on a blood smear |
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Definition
Rouleaux- chains/rows, disperse with saline, acute/chronic inflammatory disorders Autoagglutination- clusters, will not dispense with saline, antigen-antibody reactions |
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|
Term
Identify the structure of hemoglobin |
|
Definition
consist of: -4 heme groups/hgb molecule; Fe +2 at center of each heme, -4 globulin chains/hgb mol.; globin chain has hydrophobic pocket -each polypeptide chain has attached heme group and divides into 2 alpha and 2 beta chains -each chain int he molecule coils into 8 helices, forming egg shaped molecule with a central cavitiy |
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|
Term
Describe the biosynthesis of heme and globin: |
|
Definition
Heme- mitochondria and cytoplasm -glycine + succinyl CoA -Transferrin (protein that transports iron) Globin-polypeptide chains - produced on ribosomes - globin chains (formed when amino acids put into sequence) |
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Term
Name and describe the importance of four metabolic pathways of erythrocytes: |
|
Definition
1.Embden-Meyerhof pathways- generates ATP 2.Hexose Monophosphate Shunt- prevents denaturation of globin 3.Methemoglobin Reductase- prevents oxidation of heme iron 4.Luebering-Rapaport- regulates oxygen affinity |
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|
Term
Identify three types of normal hemoglobin in adults and their normal values: |
|
Definition
1. Carboxyhemoglobin- hgb + Co, 1-3% 2. Sulfhemoglobin- hgb + sulfur, norm <1% 3. Methemoglobin- hgb with iron in the Fe +3 state, <2% formed each day |
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|
Term
Discuss the various mechanisms by which erythropoietin effects erythropoiesis: |
|
Definition
erythropoietin binds to erythroid precursors & stimulates & controls production: -regulates stages of production -control rate of production -early release of reticulocytes -increase hemoglobin production |
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|
Term
List the erythroid precursors in order of maturity, including the morphologic characteristics, cellular activity, and functional capabilities of each: |
|
Definition
pronormoblast--> basophilic normoblast-->polychromatic normoblast-->orthochromic normoblast
As age: -cell diameter decreases and cytoplasm becomes less basophilic -nuclear diameter decreases (N/C ration decreases); color changes from dark purplish red to dark blue -nuclear chromatin becomes coarser, clumped, and condensed--> nucleoli disappear |
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|
Term
Pronormoblast (Rubriblast): |
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Definition
size-12-20um, n/c ratio-8:1, nucleus- large round to oval with 1-2 nucleoli and dark, fine chromatin, cytoplasm- dark blue and may have prominent Golgi -distinctive blue color reflects RNA activity needed to produce the protein required for hemoglobin synthesis |
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|
Term
Basophilic normoblast (Prorubricyte): |
|
Definition
size-10-15 um, n/c ration-6:1, nucleus- round to slightly oval with 0-1 nucleoli and slightly condensed chromatin, cytoplasm-dark blue, cell contains no evidence of the pink color that indicates hemoglobin development |
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|
Term
Polychromatic Normoblast (Rubricyte): |
|
Definition
size-10-12 um, n/c ratio 4:1, nucleus-round with no nucleoli and quite condensed chromatin, cytoplasm-gray-blue as result of hemoglobininztion |
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|
Term
Orthochromic Normoblast (Metarubricyte): |
|
Definition
size- 8-10 um, n/c ratio 0.5-1, nucleus- round with no nucleoli and fully condensed chromatin, cytoplasm-more pink to salmon than blue (in later stage nucleus will be extruded from cell and after this stage cell is no longer able to undergo mitosis) |
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|
Term
Explain the events that occur during reticulocyte maturation: |
|
Definition
RNA is catabolized, and the ribosomes disintegrate, the loss of ribosomes and mitochondria, along with full hemoglobinization of the cell makes the transition from reticulocyte to full maturation of the erythrocyte |
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|
Term
Describe the normal distribution and replacement pattern of reticulocytes in the circulation: |
|
Definition
-normal circumstances: # of reticulocytes in bone marrow = # in circulating blood -to maintain a stable pool in circulation, the bone marrow replaces the # of erythrocytes that have reached their full life span |
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|
Term
Compare the morphological appearances of reticulocytes stained with Wright stain and a supravital stain: |
|
Definition
Wright stain- sometimes appear more lumpy/slight grey-blue color persists
Supravital (new methylene blue) stain- polychromatic erythrocytes appear as reticulocytes b/c contain precipitated ribosomal material= dark blue spots |
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|
Term
Give the normal value of the uncorrected reticulocyte count: |
|
Definition
# retics counted/# rbc's counted (typ. 1000) x 100
-0.5-2% |
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|
Term
Calculate the corrected reticulocyte count and the reticulocyte production index |
|
Definition
Corrected Retic count= retic count(in %) x hematocrit/average normal hct (=45%)
RPI= corrected retic count(%)/ maturation time in days (pg. 97 table 5.2) |
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|
Term
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Definition
-process of blood cell production, differentiation, and development |
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|
Term
discuss the formation of blood cells in each phase: embryonic, fetal, and adult |
|
Definition
1.mesoblastic phase (embryonic): mesoblastic mesoderm makes 1st cell, 2-8 wks., primitive erythroblasts (yolk sac) 2. Hepatic phase (fetal): liver-hematopoietic organ, definitive erythropoiesis (liver makes blood including wbc's), 2-5 months 3. Medullary Phase (adult): bone marrow-hematopoiesis, decrease liver hematopoiesis, major site at 6 months (as an adult just the flat bones) |
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|
Term
describe the role of each of the following in development of blood cells: bone marrow, liver, spleen, lymph nodes, and thymus |
|
Definition
1.bone marrow- functions to provide constant mature red blood cells for circulation 2.liver- in adult synthesizing proteins, storing minerals & vitamins, conjugating bilirubin, and transporting bilirubin(to get rid of) 3.spleen- in adults function as RBC filtration, cell restructuring reservoir for platelets, and immunity 4.lymph nodes- in adults functions to make new lymphocytes, immunoglobulins, and filtration 5.thymus- in adults function to produce T lymphocytes (where T Cells go to mature) |
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|
Term
Identify growth factors that stimulate red blood cell production: |
|
Definition
1.Erythropoein- a glycoprotein hormone that stimulates erythropoiesis and produced mainly by kidneys in response to tissue hypoxia 2.thrombopoietin- a hormone believed to be of renal origin that is secreted in response to the need for platelets (stimulating clotting) 3.interleukins- soluble protein molecules that work with hematopoietic growth factors to stimulate proliferation and differentiation of specific blood cell lines. |
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|
Term
list the preferred sites for bone marrow aspiration in an adult |
|
Definition
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|
Term
name for indications for a bone marrow examination |
|
Definition
-cellular type/proportion -diagnose -abnormal/immature cells |
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|
Term
describe overall features that are important in the identification of a cell |
|
Definition
-overall cell size -nuclear-cytoplasmic ration |
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|
Term
compare nuclear and cytoplasmic characteristics to cell maturity: |
|
Definition
1.Nuclear characteristics: -chromatin pattern(clumped=young/loose=old), -shape (young round/oval), -nucleoli: not visible as cell matures.
2.cytoplasmic characteristics: -staining: in wright stain darker blue-young to light blue/pink-mature -granulation: progress from no granules->nonspecific granules->specific -shape: develops more irreg. outline as cell matures -quantity of cytoplasm: in some cells-increase, ex. megakaryocyte; others abnormal to increase, ex. lymphocytes -vacuolization: often seen in older cells and abnormalities, ex. bacterial/viral infections -inclusion bodies: aid in identification of cell types |
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|
Term
describe the general function and chemical composition of cellular membranes |
|
Definition
Function: -interchange of substances -detects hormonal signals -cellular identity -structure
Chemical composition: consist of proteins, phospholipids, cholesterol, and traces of polysaccharide |
|
|
Term
describe the feature of the cytoplasm: |
|
Definition
maintains cellular integrity of the interior of the cell by controlling and influencing the passage of materials in and out of the cell |
|
|
Term
name the cytoplasmic organelles found in the cell: |
|
Definition
1.endoplasmic reticulum: rough er=production of proteins; smooth er= synthesis of lipids and breakdown of fat/lipid to energy 2.golgi apparatus: direct traffic 3.mitochondria: permeable barrier 4.ribosomes: site of protein synthesis (contain RNA) |
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|
Term
describe the features of the nucleus: |
|
Definition
functions as the control center for cells and is essential for long term survival |
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|
Term
correlate the nuclear structure to the activities of the cell: |
|
Definition
1.nucleoli: -site of synthesis and processing of various species of ribosomal RNA -changes as cell grows-->related to rate of synthesis of ribosomal RNA 2.chromatin: genetic material composed of nucleic acids and proteins Functions: 1.dictate the nature of proteins that can be synthesized, thereby controlling the function of the cell; 2. to transmit information for cellular control from one generation to the next |
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|
Term
correlate the cytoplasmic structures to the activities of the cell: |
|
Definition
1.lysosomes->digestive juices 2.microbodies->function in phagocytosis 3.microfilaments->helps with cytoskeletal support and motility 4.microtubules->supports structure |
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|
Term
name at least 3 hematological abnormalities that can be detected by molecular methods |
|
Definition
-sickle cell anemia -Niemann-Pick disease -Gaucher's disease -hereditary spherocytosis & hereditary elliptocytosis |
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|
Term
follow standard precautions when collecting a blood specimen: |
|
Definition
-handwashing, gloves, lab coat, sharps precautions, etc. |
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|
Term
list collection equipment used for venipuncture and skin puncture |
|
Definition
1.venipuncture: needle, adapter, tourniquet., collection tubes, gauze, alcohol/cleaner 2.skin puncture: lancet(needle), collection tube, gauze, alcohol/cleaner |
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|
Term
correlate tube stopper color and additive, if any, and explain their modes of action: |
|
Definition
1.light blue-sodium citrate, binds calcium 2.red- no anticoagulant, serum 3.green- heparin, inhibits thrombin formation(antithrombin) 4.lavender/purple-EDTA, binds calcium 5.grey- sodium fluoride, glucoses 6.yellow/gray-thrombin, quickly clots |
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|
Term
discuss the selection of a vein for venipuncture: |
|
Definition
1.medan cubital- bind of arm where cephalic and basilica meet, 1st choice 2. cephalic- 2nd choice, outer side 3. basilica- 3rd choice, closest to artery, inside arm |
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|
Term
describes the steps recommended by the NCCLS for venipuncture in adults: |
|
Definition
1.identify patient, 2. assemble supplies, 3. position patient, 4. select site, 5. cleanse site, 6. apply tourniquet, 7. perform venipuncture, 8. mix tubes with additives, 9. release tourniquet, 10. cover site and remove needle, 11. bandage patients arm, 12. dispose of needle, 13. properly label specimen with full name, dob, date, time (military), and initial |
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|
Term
list the order of draw as recommended by NCCLA for an evacuated tube system |
|
Definition
1. blood cultures 2. light blue 3. red/ serum tubes 4. green 5. lavender 6.grey |
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|
Term
discuss complications encountered in blood collection and proper response of phlebotomist |
|
Definition
1.bevel on lower wall of vein does not allow blood to flow, pull back slightly to allow flow 2.bevel on upper wall of vein does not allow blood to flow, pull back slightly to allow flow 3.needle partially inserted into vein causes blood leakage into tissue, remove needle and d/c procedure 4.needle inserted through both walls, pull back till inside vein and blood flows? |
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|
Term
explain appropriate use of skin puncture equipment and procedure to be followed |
|
Definition
1.needle: bevel length 1 1/2 in, gauge= increased #, decreased size 2.adapter: used to secure needle and tube, disposable 3.tourniquet: helps locate a vein, applied 3-4inches above site, left on no longer than 2 min. |
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|
Term
list four reasons for specimen rejection: |
|
Definition
1.tube unlabeled 2.id on tube and requisition don't match 3.specimen hemolyzed 4.specimen collected in wrong tube 5. specimen collected at wrong time |
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