Hematology Final Exam

1.    Discuss the predictive value of the CBC results and how they form the expectations of what you might see on the peripheral smear. (Page 5 - 26 pdf)

The results show the negative predictive values of the hemoglobin about 79% and the leukocyte count indicated 86% the white blood cells distribution provide a diagnostic clue of the patient suffering from acute malaria.

2.    Compare the course of the disease and list all differences between PNH and MAHA (MicroAngiopathic Hemolytic Anemia) and how they get diagnosed in the clinical laboratory. (Page 120 - 156 pdf)

The Micro-Angiopathic Hemolytic Anemia is nonimmune hemolytic anemia. The causes of the disorder are as a result of external factors.

The difference between the PNH and the MAHA is that PNH is an acquired defect of intrinsic in nature ( page 125 - 136 pdf).

List four microcytic anemias, and tell how they get differentiated from each other (page 142 – 156 pdf)

a.    Iron deficiency refers to Less Fe available or abnormal deposition condition called anemia of inflammation

b.    Thalassemia refers to the Decreased Globin production

c.    Suimderoblastic anemia

d.    Lead toxicity

3.    Discuss the similarities between macrocytic and microcytic anemia, the various causes, and how they are distinguished from each other in the clinical lab (page 430 – 478 pdf)

Similarities

Their hemolytic occur as either intravascularly or extravascularly. They mostly destroy the Reticulo-endothelial systems.

Causes of macrocytic anemia include

a.    The Hemolysis

b.    The alcohol

c.    The hypothyroidism

d.    The liver disease

e.    The pregnancy

f.    The myelodysplastic syndromes

Causes of microcytic anemia include

e.    The Decreased Iron incorporation meaning Less Fe avaialble or abnormal deposition condition called anemia of inflammation

f.    The Decreased Globin production leading to condition called Thalassemia

Differences

a.       Macrocytic anemia has MCV < 100

b.      Microcytic anemia has MCV < 80

c.       Microcytic causes the Small RBCs get produced due to decreased Hgb production

d.      Macrocytic causes Defective DNA synthesis leading to abnormally large erythroblasts

e.       Caused by B12 folic acid deficiency

4.    List the WHO classification scheme for AML and discuss the advantages of the WHO classification over the FAB (page 321 – 369 pdf

1.    AML evolving from MDS or has features similar to those in MDS

2.    AML arising from de novo

Advantages

a.    Provision of morphologic and cytochemical framework identification

b.    The classification provides easy prediction of genetic abnormalities

5.    Discuss the classification of lymphomas (page 612 – 689 pdf)

a. B-lymphoblastic Leukemia caused by the basic molecular and pathophysiologic mechanism

b.    Lymphoplasmacytic lymphoma as widely also known as the waldenstroms macroglobulinemia.

c.    Chronic lymphocytic leukemia best known as the small lymphocytic lymphoma

6.    List the special stains (New Methylene Blue, Iron stain, KliehourBetke, Myeloperoxidase, Leukocyte alkaline phosphatase, Non-specific esterase, Specific esterase, TRAP) used in the hematologic exam and tell what they are used to differentiate (page 580 – 678 pdf).

Types of stains for testing argentaffin include

a.    The Diazo (diazonium salts)

b.    The Fontana-Masson

c.    The Schmorl's

d.    The Autofluorescence

Types of stains for testing chromaffin include:

e.    The Modified Giemsa

f.    The Schmorl's

g.    The Wiesel's

Types of stains for testing argyrophil include:

h.    The Grimelius also called Bouin's fixative preferred)

i.    The Pascual's

7.    How is ALL diagnosed?  Please discuss all criteria (page 884 – 909 pdf).

a.    The argentafin testing gets conducted to determine the condition of the patient tissues. Then the Chromaffin level gets tested to remove some impurities. Then finally the test for the argyrophil get conducted

8.    List the WHO classification for Myelodysplastic syndromes, ALL & AML (page 1130 – 1178 pdf).

WHO classification for Myelodysplastic

a.    Viewing a patient as either proliferative for the MDS

b.    Viewing a patient as dysplastic manifestation for the MPD

WHO classification for ALL

a.    L1

b.    L2

c.    L3

WHO Classification of Myelodysplastic syndromes, ALL & AML

c.    AML with a translocation between chromosomes 8 and 21

d.    AML with a translocation or inversion in chromosome 16

e.    AML with a translocation between chromosomes 9 and 11

f.    APL (M3) with a translocation between chromosomes 15 and 17

g.    AML with a translocation between chromosomes 6 and 9

h.    AML with a translocation or inversion in chromosome 3

i.    AML (megakaryoblastic) with a translocation between chromosomes 1 and 22

9.    How do you differentiate between T cell ALL and M3?

The surface markers for the T cell is 15 % to 20 %

The surface markers for the ALL is 50 % to 60 %

The surface markers for the M3 is 10 % to 20 %

10.    What are the differences between Hb S disease and Thalassemia (page 1230 – 1234 pdf)?

Thalassemania the condtion characteristics by decreased Globin production

Hgb S the condition characterized by the production of decresed RBCs

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