Hematology Final review

• Use with Cell counts
• Calcium Chelator
• Can cause platelet Satellitism

• Calcium Chelator
• Use with Coag Studies
• 9:1 blood to coag ratio

• Antithrombin
• Use: Special testing
• Limited use in Hematology

Colony Stimulating Factors

Granulocyte and macrophages colony stimulting factor.

Neutrophil colony stimulating factor

erythropoietin

Thrombopoietin

• Leukopoietin
• Interleukens
• CSF

• yolk sac: 2 weeks to 3 months
• Liver & Spleen: 2-7 months
• Bone marrow:7 months through rest of life

• Rubriblast
• Prorubricyte
• Rubricyte
• Metarubricytes
• Reticulocyte
• Erythrocyte

• 4 Hemes
• 1 Globin

Porphyron Rings + Iron

• 2+2 Polypeptide Chains
• Alpha
• Beta
• Gamma
• Delta
• Epsilon
• Zeta

2 alpha & 2 beta

• A1: 96%
• A2: 2-4%
• F: 1-3%

• Gas transport
• influenced by ph of blood and iron levels

Fe+2 - O₂

Fe+2

Fe+2 - CO

Fe+2 - CO₂

Fe+3

Sulfer

• Wright Stain
• 6-8 microns
• 1/3 central pallor

• Packed cell volume
• 3 times HGB rule of thumb

• Stain with supervital Stain methylene blue or new methylene blue.
• Count reticulocytes in 1000 RBCs
• Automated stains with fluorescent
• measured with flow cytometry

(uncorrected/hct) / normal HCT

• Reticulocyte production index
• corrected retic. / maturation time

• Mean cell volume
• (hct / rbc count) x 10 = __fl

• Mean cell hemoglobin
• (HGB / RBC) x 10 =___pg

• Mean Cell Hemoglobin Concentration
• (Hgb / hct ) X 100

• Wintrobe
• Westergren
• Zeta

• Tube Size
• Age & Gender of Patient
• Protein Level
• Anemia

Variation in size

Variation of Shape

Variation in color

Irregular Spines

• Liver disorders
• Abetalipoproteinemia

Codocyte

• Fe Deficiency
• Liver Disorders
• Hemoglobinopathy

Dacrocyte

• Pernicious Anemia
• Myeloproliferative Disorders

Drepanocyte

• Sickle Cell Anemia
• HGB S,C, Harlem

• Hereditary elliptocytosis
• Thalassemia
• Sickle Cell

DIC

• Helmet Cells
• DIC

• Larger than 100fl
• Vit B12 or folate deficiency
• Alcoholism
• Chemotherapy
• Reticulocytosis

• Smaller than 80fl
• Iron Deficiency
• Thalassemia
• Chronic Anemia
• Sideroblastic Anemia

• RBC is round with no central pallor
• Hereditary Spherocytosis
• Immune Hemolytic Anemia

• Could be artifact
• Alcoholism
• Hereditary Stomatocitosis

• RNA Aggregates
• Course Granulation throughout cell

• Anemias
• Lead poisoning

• Thread like loops
• Residual Nuclear membrane

• Pernicious Anemia
• Lead Poisoning

• Precipitated Denatured Hgb
• Seen only with supravital Stains

G-6-PD Deficiency

• Small round Dark purple Masses of DNA
• Nuclear remnant

• Hemolytic Anemia
• Post Splenectomy

• Siderotic granules in non-nucleated red
• confirm with prussian blue
• Called Pappenheimer Bodies with Wright Stain

• Post Splenectomy
• Sideroblastic Anemia
• Sickle Cell Anemia

Central Pallor >1/3 of cell

• Fe Deficiency
• Chronic Anemia
• Thalassemias

Cytoplasm Stains Blue-grey due to presence of RNA

Reticulocytosis

Stacking off RBCs due to increased serum protin

• Multiple Myeloma
• Waldenstrom's Macroglobulinemia

• Ussually Metarubricyte
• Associated with increased bone marrow activity.

• Anemias
• Bleeding

• Iron Deficiency, hypochromic anemias
• Megeloblastic Anemias
• Aplastic Anemias
• Hemolytic Anemias
• Anemia Assoc with nonhematological disorders

• Bleeding
• Diet
• malabsorbtion
• parasites
• hemmorrhoids

• absorbs up to 4g of iron a day
• danger of iron deposits in joints and organs

• Sex linked
• Pappenheimer Bodies on wright stain
• too much iron

• Interferes with iron storage in the mitochondria
• Damages Heme synthesizing
• leads to microcytic hypochromic anemia
• neurological dysfunction and skin lesions
• abdominal cramping

• MCV 100-160fl
• Hgb Normal to low
• RBC usually low
• Hyper segmented neutrophils
• Platelets low to normal

• Charactarized by cellular depletion & fatty replacement of bone marrow.
• Decrease in RBCs and WBCs and platelets (pancytopenia)

• Drugs
• Chemical Irradiation
• Immune dysfunction

• Normal No lysis at .85% or .45%
• Spherocytosis none at .85% lysis occurs at .45%

• Sever Hemoglobinopathy
• Affects 1:375
• Valine for Glutamic acid @ 6th position of beta chains

• Amino acid lysine for glutamic acid at sixth position of beta chains.
• mild chronic hemolytic anemia
• Hgb C crystals
• Hgb C 97%
• Hgb F <7%
• Hgb A none

Continued production of Hgb F into adulthood.Homozygous 100% Hgb FHeterozygous 30% Hgb F

Due to deletion of 1 gene with 3 functioning genes.Production of Alpha Chains is affected only slightly.Hematologically normal appearance.

• Silent Carrier
• Alpha Thalassemia Minor (Heterozygous)
• Hgb H disease.
• Alpha Thalassemia Major (Hydrops Fetalis)