W1-9 Principles of hematology
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Questions and Answers

What is the primary purpose of a bone marrow aspirate and biopsy?

  • To diagnose and stage various blood and bone marrow disorders (correct)
  • To assess the response to chemotherapy in solid organ tumors
  • To treat acute megakaryoblastic leukemia
  • To monitor the progression of lung diseases
  • What is the typical procedure for obtaining a bone marrow aspirate and biopsy?

  • Collection of blood samples for laboratory analysis
  • Use of imaging techniques to visualize the bone marrow
  • Surgical removal of bone tissue from the hip bone
  • Insertion of a needle into the sternum to extract bone marrow samples (correct)
  • What can a hypercellular bone marrow indicate?

  • Chronic lymphocytic leukemia
  • Multiple myeloma
  • Acute Megakaryoblastic Leukemia (correct)
  • Hodgkin's lymphoma
  • What do the results of a bone marrow aspirate and biopsy help determine?

    <p>The treatment plan for blood and bone marrow disorders</p> Signup and view all the answers

    Which laboratory test is most appropriate to order for a patient with a suspected hematologic disorder to identify blood cell characteristics?

    <p>Peripheral blood smear (PBS)</p> Signup and view all the answers

    What is the primary purpose of ordering a complete blood count (CBC) for a patient with a suspected hematologic disorder?

    <p>To identify the components of a CBC</p> Signup and view all the answers

    In a patient suspected of having a hematologic disorder, which laboratory test would help in identifying anemia morphology and underlying mechanisms?

    <p>Peripheral blood smear (PBS)</p> Signup and view all the answers

    What would be the most appropriate test to order to determine if a patient with suspected hematologic disorder has intravascular or extravascular hemolysis?

    <p>Hemoglobin electrophoresis</p> Signup and view all the answers

    If indicated, which test would be essential to explain the indications for bone marrow aspirate and biopsy?

    <p>Bone marrow examination</p> Signup and view all the answers

    Which lab test would be most useful in identifying the cause for each type of given anemia in a patient with suspected hematologic disorder?

    <p>Iron panel</p> Signup and view all the answers

    Which laboratory test is the best indicator of oxygen-carrying capacity of blood?

    <p>Hemoglobin, Hb (g/dL)</p> Signup and view all the answers

    What is the average volume of red blood cells (RBCs) known as?

    <p>Mean cell volume (MCV)</p> Signup and view all the answers

    Which condition is indicated by MCV < 80 µm³?

    <p>Microcytic anemia</p> Signup and view all the answers

    What does the term 'hyperchromic' refer to in relation to red blood cells?

    <p>Increased MCH concentration</p> Signup and view all the answers

    In which condition is the red cell distribution width (RDW) normal?

    <p>Thalassemias</p> Signup and view all the answers

    What does an increase in segmented neutrophils (%) indicate?

    <p>(Acute) inflammatory response</p> Signup and view all the answers

    Which condition is associated with increased eosinophils (%)?

    <p>(Acute) allergic reactions</p> Signup and view all the answers

    What does a decrease in platelet count indicate?

    <p>(Acute) inflammatory response</p> Signup and view all the answers

    'Immature cells' such as erythroblasts and myeloblasts can be observed in which type of PBS evaluation?

    <p>Differential count of WBCs</p> Signup and view all the answers

    'Megathrombocytes', which are very large platelets, can be observed in which type of PBS evaluation?

    <p>Assessment of presence/absence of platelets</p> Signup and view all the answers

    What can be assessed by evaluating RBCs in a peripheral blood smear (PBS)?

    <p>Shape and hemoglobin concentration of RBCs</p> Signup and view all the answers

    What is the relevance of assessing WBCs in a peripheral blood smear (PBS)?

    <p>Analyzing abnormal cell morphology in WBCs</p> Signup and view all the answers

    Which condition is characterized by normocytic and normochromic RBCs?

    <p>Sickle-cell anemia</p> Signup and view all the answers

    What condition is associated with microcytic and hypochromic RBCs?

    <p>Iron-deficiency anemia</p> Signup and view all the answers

    Which disease can result in the presence of spherocytes in the blood smear?

    <p>Hereditary spherocytosis</p> Signup and view all the answers

    What is the characteristic RBC size in megaloblastic (B12- and folate-deficiency) anemia?

    <p>Macrocytic</p> Signup and view all the answers

    What is the color of immature RBCs identified as polychromatophilic or orthochromic macrocytes on a Wright-Giemsa stained blood smear?

    <p>Gray</p> Signup and view all the answers

    What is the marker of erythropoietic activity that is a result of early release of immature RBCs from the bone marrow?

    <p>Reticulocyte count (RC)</p> Signup and view all the answers

    Which mechanism involves the phagocytosis of RBCs by macrophages in the spleen, liver, and lymph nodes?

    <p>Extravascular hemolysis</p> Signup and view all the answers

    What is the end product of bilirubin metabolism that gives stool its characteristic dark brown color?

    <p>Urobilin</p> Signup and view all the answers

    'Hyperchromic' and 'microcytic' spherocytes seen in a PBS would be counted as which type of cells by a CBC analyzer?

    <p>'Normochromic' and 'normocytic'</p> Signup and view all the answers

    'Polychromasia' on a blood smear indicates what about the cells?

    <p>They have increased RNA in the cytoplasm.</p> Signup and view all the answers

    Which site is NOT involved in metabolic transformation during extravascular hemolysis?

    <p>Kidneys</p> Signup and view all the answers

    In intravascular hemolysis, which of the following is a clinical feature?

    <p>Blood vessel lumen</p> Signup and view all the answers

    What is the main site of hemolysis in extravascular hemolysis?

    <p>Spleen, liver, and lymph node macrophages</p> Signup and view all the answers

    Which laboratory finding is characteristic of intravascular hemolysis?

    <p>No free hemoglobin</p> Signup and view all the answers

    What is the mechanism of metabolic transformation in intravascular hemolysis?

    <p>Immune destruction by C5b-9</p> Signup and view all the answers

    Which enzyme is typically elevated in extravascular hemolysis?

    <p>Lactate dehydrogenase (LDH)</p> Signup and view all the answers

    Which condition is associated with increased urobilinogen in urinary samples?

    <p>Extravascular hemolysis</p> Signup and view all the answers

    Study Notes

    • The text is from an educational resource titled "Principles of Hematology" by Michael M. Yakubovskyy.
    • The text covers various topics related to hematology, including laboratory tests for suspected hematological disorders, components of a complete blood count (CBC), peripheral blood smear analysis, and anemia classification.
    • Laboratory tests for suspected hematological disorders include a complete blood count (CBC), peripheral blood smear (PBS), differential white blood cell (WBC Diff) count, corrected reticulocyte count (CRC), hemoglobin electrophoresis, iron panel, serum B12 and folate levels, and bone marrow examination.
    • CBC includes RBC indices (red cell count, hemoglobin, hematocrit, mean cell volume, mean cell hemoglobin, mean corpuscular hemoglobin concentration, and red cell distribution width), WBC count and differential count, and platelet count.
    • The components of a CBC and their relevance to blood cell characteristics are important for diagnosing and understanding various blood disorders. For instance, microcytic anemia is characterized by an MCV below 80 fL, while normocytic anemia has an MCV between 80 and 100 fL.
    • Peripheral blood smear (PBS) analysis is essential for recognizing and interpreting various abnormalities, such as immature cells, atypical lymphocytes, megathrombocytes, parasites, and other abnormal cells or structures.
    • Normal adult PBS typically includes RBCs, WBCs, and platelets, with variations in size, shape, hemoglobin concentration, and inclusion bodies.
    • Anemia classification can be based on RBC size (normocytic, microcytic, and macrocytic) and color intensity (normochromic, hypochromic, and hyperchromic). For example, iron-deficiency anemia is hypochromic and microcytic, while sickle-cell anemia is normochromic and normocytic.
    • Spherocytes, which are sphere-shaped RBCs with normal MCV, MCH, and MCHC, are seen in hereditary spherocytosis and immune hemolytic anemia.
    • Nucleated RBCs are produced during erythropoiesis and can be seen in a peripheral blood smear.

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    Description

    Test your knowledge in recognizing and interpreting the characteristics evaluated in a peripheral blood smear (PBS), including variation in RBC size (Anisocytosis, related to MCV), normocytic and normochromic RBCs, microcytic and hypochromic RBCs, and macrocytic RBCs.

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