ASCP Exam Simulator - Hematology 2023 with 100% correct answers

Paroxysmal Cold Hemoglobinuria (PCH) Stem cell mutation in the PIGA gene that causes abnormal differentiated hematopoietic cells to be cloned. These cells bind large amounts of complement, causing hemolysis. Spurr Cell Anemia Acquired hemolytic anemia due to liver disease in which serum lipoproteins increase. Hereditary Acanthocytosis (abetalipoproteinemia) Autosomal recessive disorder distinguished by an absence of B-lipoprotein and low levels of cholesterol, triglyceride, and phospholipid. Hereditary Pyropoikilocytosis inherited disorder related to deficiency in a-spectrin and the presence of modified spectrin. Megaloblastic anemia Caused by folic acid or vitamin B12 deficiency. Thrombopoiesis, erythropoiesis, and granulopoiesisis is ineffective. The bone marrow will contain normal, or even increased megakaryocytes, but the number of platelets entering the peripheral circulation is decreased. Intravascular hemolysis increased levels of serum LDH and bilirubin - high levels of LDH are normally found within RBCs. increased number of reticulocytes - release of an increased number of immature RBCs from the marrow to account for the RBCs that are lost through hemolysis; failure to show reticulocytosis with hemolytic episodes would indicate an ineffective erythropoiesis (possible BM function problem) decreased haptoglobin - alpha 2 globulin that binds to free hemoglobin intravascularly. The large hemoglobin-haptoglobin complex cannot be filtered by the kidneys, so it travels to the liver where hepatocytes will process the hemoglobin in a mechanism similar to that of extravascular hemolysis. Alpha thalassemias Silent carrier form - there is no anemia manifested, although a slight decrease in the MCV and MCHC may be seen. Alpha thalassemia minor - patients typically have mild anemia with a decrease in MCV and MCHC. Alpha thalassemia intermedia - hemoglobin H disease (4 beta globin chains) is the second most severe expression; patients exhibit a variable degree of microcytic, hypochromic anemia. Alpha thalassemia major - hydrops fetalis due to Bart's hemoglobin (4 gamma chains) is a lethal disease where infants die in utero or soon after birth. Iron-depletion phase of treatment for hereditary hemochromatosis (HH) The serum ferritin decreases to between 20 and 50 ng/ml. Ferritin levels will decrease rapidly as storage iron is depleted. Transferrin saturation and serum iron will eventually decrease after iron stores have been depleted, however, they will not be the first indicators of successful treatment. The clot-based assay that is most specific for measuring fibrinogen function is: Thrombin time (TT) Thrombin reagent is added directly to the patient's platelet poor plasma. This initiates the coagulation pathway at the last step of the common pathway (fibrinogen to fibrin). Although PT and aPTT are affected by fibrinogen levels, many other factors influence these tests, so they're not very specific for fibrinogen.