Hemoglobinopathies
This occurs when valine replaces glutamic acid on position 6 on only one beta chain
Sickle cell trait
** SS disease is when it occurs on both beta chains
Thalassemias are the result of a __________ (structural or quantitative) defect in the ________ portion of hemoglobin
Quantitative / globin-chain
A patient has an extremely high WBC and a shift to the left is seen in the peripheral blood smear. The patient has an LAP score of 300. What is the most likely reason for these findings?
Leukemoid reaction
** LAP ( Leukocyte Alkaline Phosphatase Stain) important because patient labs can present very similar to CML but CML will have decreased LAP score as will AML
This cell is suggestive of Hodgkin disease
Pic #6
Reed-Sternberg Cell
___________ is a malignancy of the lymphoplasmacytoid cells, which manufacture IgM
Waldenström’s macroglobulinemia
What hemoglobinopathy has the following Hemoglobin % :
3% A2
5% F
92% C
Hgb C disease
This is a Homozygous disorder caused by point mutation of the HBB gene on chromosome 11 and can result in the following Hgb pattern:
Hgb A = 15-35%
Hgb F = 60-90%
Hgb A2= 2-5%
Beta Thalassemia Major ( Cooley's anemia )
Naphthol AS-D chloroacetate esterase ( specific ) is usually positive in what cell line?
Alpha-naphthyl acetate esterase ( non-specific) is positive in what cell line?
Granulocytes / monocytes
the WHO classification requires what percentage for the blast count in the blood or bone marrow for the diagnosis of AML
=/> 20%
**FAB is 30%
A 19-year-old man came to the emergency department with severe joint pain, fatigue, cough, and fever. Review the following laboratory results:
WBCs 21.0 × 109/L RBCs 3.23 × 1012/L Hgb 9.6 g/dL PLT 252 × 109/L Differential: 17 band neutrophils; 75 segmented neutrophils; 5 lymphocytes; 2 monocytes; 1 eosinophil; 26 NRBCs What is the corrected WBC cout?
16.7 x 10 ( 9th) / L
Total WBC × 100 or (21.0 × 100) ÷ 126 =
Patients with the sickle cell trait have a resistance to Malaria caused by what protozoa
Plasmodium falciparum
This type of Thalassemia results in a mild anemia and the typical Hgb pattern seen here:
Hgb A = 90%
Hgb F= 2-5%
Hgb A2 = 2-7%
This cytochemical stain is used to help differentiate Blasts of AML vs ALL .. it specifically stains positive blasts of AML and negative for ALL by staining lipids present
Sudan Black B
In myelofibrosis, the characteristic abnormal red blood cell morphology is that of
Which antibody is associated with paroxysmal cold hemoglobinuria (PCH)
Anit-P
A cellulose acetate electrophoresis revealed a large band of hemoglobin in the hemoglobin S portion. This band quantified at 95%. The peripheral smear revealed 70% target cells and the solubility test was negative. Based on this information what is the hemoglobin?
Hemoglobin D
Hemoglobin composed of 4 beta chains
Hgb H
Cells that exhibit a positive stain with acid phosphatase and are not inhibited with tartaric acid are characteristically seen in
Hairy Cell Leukemia
myeloproliferative disorder characterized by uncontrolled proliferation of erythroid precursors. However, production of all cell lines is usually increased
Polycythemia vera
Osmotic fragility of Red cells is increased in situations where there is increase spherocytes like that seen in hemolytic anemia associated with hereditary spherocytosis .. however osmotic fragility test will be decreased in what disease state ?
Sickle cell anemia
In this hemoglobinopathy the patient Inherited Both Beta Chains with Substitution glutamic acid replaced by lysine at position 6
Alpha2 Beta26glu to lys
Hemoglobin C disease
Alpha thalassemia Major results in what 100% of what type of Hgb being formed ?
Hgb Bart's - babies do not survive
* Hgb Barts = 4 gamma chains all 4 alpha chains deleted
Periodic acid schiff (PAS) stain performed on a bone marrow aspirate smear showed abnormal (chunky globular) pattern of staining in the erythroblasts. This is suggestive of
erythroleukemia
What cell besides lymphocytes do we typically seen increased in CML?
Basophil
If a patient has a reticulocyte count of 7% and an
Hct of 20%, what is the corrected reticulocyte
count?
3.1%
Corrected reticulocyte count = reticulocytes (%) × Hct ÷ 45