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What is CFU-GEMM?
Colony forming units-Granulocytes, erythrocytes, monocytes, megakaryocytes.
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What percentage of bone marrow is compromised of red marrow? Yellow Marrow?
50:50
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Which areas are the best sites for bone marrow aspiration?
Iliac crest and sternum
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What is the normal M:E ratio?
4:1
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What is the ratio of stem cells to nucleated cells in the bone marrow?
1 in 1000
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What is the approximate blood volume in an adult?
6L
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How long does a red cell live?
120 days
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What is culling?
filtration -gets rid of older cells and recycles bilirubin, iron, and globin.
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What is pitting?
pulling inclusions off the cell membrane without destroying it; forms spherocytes.
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What is the composition of hemoglobin A?
2 alpha , 2 beta
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What is the composition of Hemglobin F?
2 alpha , 2 gamma
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What is the composition of hemoglobin A2?
2 alpha, 2 delta
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What is the composition of Gower 1?
2 zeta, 2 epsilon
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What is the composition of Gower 2 ?
2 alpha, 2 epsilon
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What is the composition of Portland?
2 zeta, 2 gamma
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What is methhemoglobin?
Hemoglobin with iron in ferric state (Fe 3+) and cannot combine with O2.
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What are howell jolly bodies?
Dna remnants seen in splenectomy patients.
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What are schistocytes?
- fragmented cells
- see heinz bodies
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Which red cell inclusion is associated with lead poisoning?
basophilic stippling
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What is rouleaux and what is it associated with?
Stacking of red cells and associated with mutiple myeloma.
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Acanthocytes
- abetalipoproteinemia
- severe liver disease
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Drepanocytes
- sickle cell
- crescent shape
- abnormal Hgb S
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Echinocytes
- "Burr cell" associated with uremia
- abnormal protein and spectrin on cell membrane
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Codocytes
- Bull's eye shape
- seen in thalassemia
- due to increase of plasma cholesterol
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Heinz bodies
- denatured hemoglobin
- G6pd deficiency
- stained with supravital stains
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Bite cells
On wright stain-heinz bodies appear as bite cells
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Pappenheimer bodies
small beaded inclusions associated with iron loading conditions
siderblastic anemia
stain with prussian
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Cabot's ring
- remnants of mitotic spindle
- megaloblastic anemia
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What causes the oxygen dissociation curve to shift to the right? To the left?
Decrease in O2 affinity is a shift to the right.
Increase in O2 affinity is a shift to the left
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Which inclusion is not stained with Wright's stain?
Heinz bodies
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What is the formula and normal values for MCV?
MCV=HCT/Rbc X 10
80-100 fl
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What is the formula and normal values for MCH?
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What is the formula and normal values for MCHC?
MCHC=HGB/HCT X 100
32-36 %
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What does NADH do?
reduce iron ferric state in methhemoglobin back to ferrous state.
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What is the normal size of an erythrocyte?
6- 8 um
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Which pathway provides ATP for red cell metabolism?
EM
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What is apoptisis?
Programmed cell death
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Which hemoglobin are not capable of transporting oxygen?
methemoglobin, sulf, carboxyhemoglobin
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What is the role of spectrin?
responsible for deformability of cell
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What is meant by shift to the left?
Increase O2 affinity.
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What is polychromasia?
- variation in color
- seen in reticulocytes
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What is anisocytosis?
variation in size
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What is poikilocytosis?
variation in shape
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Which inclusions would be associated with splenectomy?
Howell jolly bodies
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Name the maturation sequence of erythrocytes?
- Pronormoblast
- basophilic normoblast
- polychromatophilic normoblast
- orthochromic normoblast
- reticulocyte
- erythrocyte
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Last nucleated stage of RBC maturation?
Orthochromic normoblast
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What % of hemoglobin is sythesized in reticulocytes?
35%
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Pernicous anemia leads to what kind of anemia?
macrocytic anemia >100fl
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What type of anemia is present in hemolysis?
normocytic normochromic
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Bone marrow failure is present in?
aplasitic anemia
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Definite sign of intravascular hemolysis?
Hemoglobinuria
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How many genes are involved in production of alpha chains?
2 genes
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What would result in immediate increase in oxygen delivery to tissues?
Increase in 2,3 DGP
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What is the last stage of red cell which is capable of mitosis?
polychromatic normoblast (rubricyte)
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What state has a pyknotic nucleus which will eventually be extruded?
Orthochromatic normoblast (metarubricyte)
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What is the last stage of red cell capable of making hemoglobin?
reticulocyte
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Name two supravital stains?
- New methylene blue
- Brilliant cresyl blue
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What are the storage forms of iron?
Ferritin and hemosiderin
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What is the first breakdown product which is formed form hemoglobin?
globin into amino acids
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All blood cells are thought to be derived from what type of cell?
pluripotential stem cell
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Where does most of red cell production take place in the fetus during the earliest weeks of development?
Yolk sac (first 3 months)
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What does extramedullary hematopoiesis mean?
formation of cells that does not include the bone marrow
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What hemoglobin resists alkali and acid denaturation?
Hemoglobin F
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Macrocytes are associated with a deficiency of what?
Vitamin B12 and folic acid
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What is carboxyhemoglobin?
CO-carbon monoxide
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What are the 4 funcitons of spleen?
- storage
- filtration
- immunity
- hematopoiesis
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What would a deficiency fo spectrin or actin do to the red cell membrane?
cause cell rigidity, see spherocytes
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What causes relative erythrocytsis?
Increase in plasma volume
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Which metabolic pathway functions in facilitating the release of oxygen from hemoglobin to the tissues?
Rapoport-Leubering shunt (increase in 2,3 DPG)
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What causes a shift to the left in the oxygen dissociation curve?
- Decrease: 2,3 DPG, PCO2, temp
- Increase: Ph
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What pathway forms 2,3 DPG?
Rapoport-Leubering shunt
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What is the main function of the hexose monophosphate shunt in red cells?
- Produce ATP
- Protects cell against oxidation
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When do you see hypersegmentation?
In Vitamin B12 deficiency or folic acid
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What condition are there microcytes?
- Thalassemia
- Iron deficiency
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What factor is required to make basophils?
IL-3
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What factor is required to make Eosinophils?
GM-CSF
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When do you see an RPI of <2?
Hypoproliferative and maturation disorders
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What does an RPI >2 indicate?
Bone marrow response is adequate
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