UAMS HEMATOLOGY EXAM 3
QUESTIONS WITH COMPLETE
SOLUTIONS
Howell Jolly Body: - Correct Answers -DNA; seen in post-splenectomy, megaloblastic
anemias, anemias
Reticulocyte: - Correct Answers -RNA; associated with decreased RBC
survival/hemorrhage, hyperplastic marrow
Pappenheimer body: - Correct Answers -Iron; seen in sideroblastic anemia, thalassemia
• Heinz Body: - Correct Answers -Body: Precipitated Hemoglobin; seen in G6PD
deficiency Can only be seen with supravital stain
Ringed Sideroblast: - Correct Answers -Iron
Basophilic stippling: - Correct Answers -RNA aggregates; seen in thalassemia and lead
poisoning
NRBC: - Correct Answers -DNA
Agglutination will affect - Correct Answers -MCV
Increased WWBC will affect - Correct Answers -RBC count
Lipemia will affect Hemoglobin, NOT - Correct Answers -HCT
Megaloblastic Anemia - Correct Answers -Defective DNA synthesis from B12 or Folate
poor diet
Megaloblastic Anemia Bone marrow will show - Correct Answers -asynchrony,
karryohexis, giant metamyelocytes and bands Hypersegmented Neutrophils
Megaloblastic Anemia Lab results - Correct Answers -Pancytopenia Treat with
replacement vitamin therapy
,• Decrease Retic
• Increase Direct and indirect bilirubin and LD
Inherited defect in spectrin - Correct Answers -Hereditary Spherocytosis
Serum Iron (SI) - Correct Answers -directly measured • Measure of amount iron bound
to transferrin (in circulation) • 50-160 µg
Total Iron Binding Capacity (TIBC) - Correct Answers -· Amount of transferrin bound
with iron and unbound
• The amount of iron in plasma is limited by the amount of transferrin available to carry it
• Excess iron is added to sample to maximally saturate (bind to all iron binding sites).
Unbound iron is precipitated out, then ferrozine is used to release the iron from
transferrin.
• The amount of iron detected represents all binding sites available on transferrin · 250-
400 ug/dL
• % Transferrin Saturation - Correct Answers -Since the TIBC represents the total
number of sites for iron binding, and the SI represents the with iron, the degree to which
the available sites are occupied by iron is calculated
Hereditary Spherocytosis - Correct Answers -Decreased cell surface Peripheral smear:
Spherocytes (MCHC >36%) Polychromasia • 1 Osmotic fragility with hemolysis
beginning at a NaCl concentration
Auto Immune Hemolytic Anemia - Correct Answers -Spherocytes Polychromasia +DAT
Sex-linked, decrease in enzyme - Correct Answers -G-6-PD
G-6-PD Oxidant drugs cause - Correct Answers -hemoglobin to denature and
precipitate
G-6-PD Most often occurs - Correct Answers -hemoglobin in black males
• Heinz bodies seen with Methylene Blue - Correct Answers -G-6-PD
Pyruvate Kinase - Correct Answers -causing potassium loss as well as sodium Reduced
ATP production results in alterations of RBC membrane, failure of cation pumps loss,
which leads to cell dehydration
• Peripheral Smear: • Echinocytes
Beta Chain substitution (B6Glu->Val) - Correct Answers -Sickle Cell
Sickle Cell - Correct Answers -Sickle Solubility + • Confirm with Hb electrophoresis •
Sickle Cells Target Cells
, Beta Chain substitute - Correct Answers -Hgb C • Hgb E
• C crystals • Target cells - Correct Answers -Hgb C
Differentiate from C on cellulose and A on citrate - Correct Answers -• Hgb E
• Beta Chain substitute Mild Hemolytic Anemia - Correct Answers -• Hgb E
RETIC Increased - Correct Answers -after treatment for IDA, folate, B12
RETIC VALUES Increased in - Correct Answers -spherocytosis
RETIC VALUES aplastic anemia - Correct Answers -Normal or decreased
RETIC VALUES Increased after treatment - Correct Answers -for IDA, folate, B12
RETIC VALUES Decreased in - Correct Answers -untreated Iron, B12, Folate deficiency
Calculate the indices of a Hgb of 8.0 g/dL. - Correct Answers -Cannot determine.
When is basophilic stippling observed? - Correct Answers -Thalassemia, lead
poisoning, megaloblastic anemia, sickle cell
What is the M:E ratio in anemia? - Correct Answers -• 1:1
• In a normal bone marrow, what percentage of white blood cells are the mature cells? -
Correct Answers -• 50% of neutrophils are myelocytes, metamyleocytes, bands and
segs
• What is an advantage of using automated instruments? - Correct Answers -Increased
precision
What is myeloid: erythroid ratio for erythroid hyperplasia? - Correct Answers -• 1:1
the normal M:E ratio? - Correct Answers -• 3:1
• In aplastic anemia, what is the bone marrow fat to cell ratio? - Correct Answers -90:10
If the wrong type of blood is transfused, what type of hemolysis is found? - Correct
Answers -Intravascular
Which chemistry tests are elevated in hemolytic anemia? - Correct Answers -Bilirubin
and LD
Which group of anemias has the most polychromasia? - Correct Answers -Hemolytic
Anemias
QUESTIONS WITH COMPLETE
SOLUTIONS
Howell Jolly Body: - Correct Answers -DNA; seen in post-splenectomy, megaloblastic
anemias, anemias
Reticulocyte: - Correct Answers -RNA; associated with decreased RBC
survival/hemorrhage, hyperplastic marrow
Pappenheimer body: - Correct Answers -Iron; seen in sideroblastic anemia, thalassemia
• Heinz Body: - Correct Answers -Body: Precipitated Hemoglobin; seen in G6PD
deficiency Can only be seen with supravital stain
Ringed Sideroblast: - Correct Answers -Iron
Basophilic stippling: - Correct Answers -RNA aggregates; seen in thalassemia and lead
poisoning
NRBC: - Correct Answers -DNA
Agglutination will affect - Correct Answers -MCV
Increased WWBC will affect - Correct Answers -RBC count
Lipemia will affect Hemoglobin, NOT - Correct Answers -HCT
Megaloblastic Anemia - Correct Answers -Defective DNA synthesis from B12 or Folate
poor diet
Megaloblastic Anemia Bone marrow will show - Correct Answers -asynchrony,
karryohexis, giant metamyelocytes and bands Hypersegmented Neutrophils
Megaloblastic Anemia Lab results - Correct Answers -Pancytopenia Treat with
replacement vitamin therapy
,• Decrease Retic
• Increase Direct and indirect bilirubin and LD
Inherited defect in spectrin - Correct Answers -Hereditary Spherocytosis
Serum Iron (SI) - Correct Answers -directly measured • Measure of amount iron bound
to transferrin (in circulation) • 50-160 µg
Total Iron Binding Capacity (TIBC) - Correct Answers -· Amount of transferrin bound
with iron and unbound
• The amount of iron in plasma is limited by the amount of transferrin available to carry it
• Excess iron is added to sample to maximally saturate (bind to all iron binding sites).
Unbound iron is precipitated out, then ferrozine is used to release the iron from
transferrin.
• The amount of iron detected represents all binding sites available on transferrin · 250-
400 ug/dL
• % Transferrin Saturation - Correct Answers -Since the TIBC represents the total
number of sites for iron binding, and the SI represents the with iron, the degree to which
the available sites are occupied by iron is calculated
Hereditary Spherocytosis - Correct Answers -Decreased cell surface Peripheral smear:
Spherocytes (MCHC >36%) Polychromasia • 1 Osmotic fragility with hemolysis
beginning at a NaCl concentration
Auto Immune Hemolytic Anemia - Correct Answers -Spherocytes Polychromasia +DAT
Sex-linked, decrease in enzyme - Correct Answers -G-6-PD
G-6-PD Oxidant drugs cause - Correct Answers -hemoglobin to denature and
precipitate
G-6-PD Most often occurs - Correct Answers -hemoglobin in black males
• Heinz bodies seen with Methylene Blue - Correct Answers -G-6-PD
Pyruvate Kinase - Correct Answers -causing potassium loss as well as sodium Reduced
ATP production results in alterations of RBC membrane, failure of cation pumps loss,
which leads to cell dehydration
• Peripheral Smear: • Echinocytes
Beta Chain substitution (B6Glu->Val) - Correct Answers -Sickle Cell
Sickle Cell - Correct Answers -Sickle Solubility + • Confirm with Hb electrophoresis •
Sickle Cells Target Cells
, Beta Chain substitute - Correct Answers -Hgb C • Hgb E
• C crystals • Target cells - Correct Answers -Hgb C
Differentiate from C on cellulose and A on citrate - Correct Answers -• Hgb E
• Beta Chain substitute Mild Hemolytic Anemia - Correct Answers -• Hgb E
RETIC Increased - Correct Answers -after treatment for IDA, folate, B12
RETIC VALUES Increased in - Correct Answers -spherocytosis
RETIC VALUES aplastic anemia - Correct Answers -Normal or decreased
RETIC VALUES Increased after treatment - Correct Answers -for IDA, folate, B12
RETIC VALUES Decreased in - Correct Answers -untreated Iron, B12, Folate deficiency
Calculate the indices of a Hgb of 8.0 g/dL. - Correct Answers -Cannot determine.
When is basophilic stippling observed? - Correct Answers -Thalassemia, lead
poisoning, megaloblastic anemia, sickle cell
What is the M:E ratio in anemia? - Correct Answers -• 1:1
• In a normal bone marrow, what percentage of white blood cells are the mature cells? -
Correct Answers -• 50% of neutrophils are myelocytes, metamyleocytes, bands and
segs
• What is an advantage of using automated instruments? - Correct Answers -Increased
precision
What is myeloid: erythroid ratio for erythroid hyperplasia? - Correct Answers -• 1:1
the normal M:E ratio? - Correct Answers -• 3:1
• In aplastic anemia, what is the bone marrow fat to cell ratio? - Correct Answers -90:10
If the wrong type of blood is transfused, what type of hemolysis is found? - Correct
Answers -Intravascular
Which chemistry tests are elevated in hemolytic anemia? - Correct Answers -Bilirubin
and LD
Which group of anemias has the most polychromasia? - Correct Answers -Hemolytic
Anemias
