HEMATOLOGY: Question 6

A patient has been diagnosed with anemia and the physician wants to assess how well the bone marrow is producing RBC's. The physician requests which of the following test to be drawn and tested?

 

a.  Haptoglobin

b.  Reticulocyte

c.  Myoglobin

d.  Iron Panel

 

ANSWER:  b. RETICULOCYTE

SOURCE:  keywordhungry.com

HEMATOLOGY: Question 5

What RBC inclusion can be seen on blood smear of a child who accidentally ingested moth balls?

ANSWER:  HOWELL JOLLY BODIES

SOURCE: www.medical-labs.net

HEMATOLOGY: Question 4

What is the condition commonly associated with STOMATOCYTES?

ANS:  LIVER DISEASE

NOTES:

Stomatocytes are red cells with a slit-like or “fish-mouth” central pallor. Stomatocytes may be seen in patients with alcoholic liver disease, hereditary stomatocytosis, or Rh null disease.  They may form in vitro in the presence of certain cationic medications or low pH.

SOURCE: hematology.org

HEMATOLOGY: Question 3

What is the condition commonly associated with the cell pointed?

ANS:  UREMIA

NOTES:

Burr cells - aka echinocytes/crenated cells

                   - associated diseases: uremia or pyruvate kinase deficiency

                   - frequent artifacts:  excess EDTA (underfilled collection tube), slow drying, drying in a
                      humid environment, or an alkaline pH from glass slides

True burr cells are less numerous vs artifact burr cells.

SOURCE: www.labce.com/spg28876_burr_cells_echinocytes.aspx

HEMATOLOGY: Question 2

What is the condition commonly associated with TEARDROP RBCs?

ANS:  MYELOFIBROSIS

NOTES:

Teardrop cells are also known as Dacrocytes.   Squeezing through the tight fibrosis in the marrow, and in navigating through a markedly enlarged and cellular spleen, the red cells take on an unusual, “teardrop” shape.

SOURCE: pathologystudent.com/teardrop-red-cells

HEMATOLOGY: Question 1

What is the screening test for sickle cell disease?

ANS:  SOLUBILITY TEST

PRINCIPLE: 

Hemoglobin S is less soluble in a reducing agent than other forms of hemoglobin.

NOTES:

The solubility test is the most common screening test for sickle cell or presence of HbS. It is based on the relative insolubility of HbS when combined with a reducing agent such as sodium dithionite. When anticoagulated blood is mixed the reducing agent, the red cells will lyse due to the presence of saponin and the hemoglobin in the red cells will be released. 

The solubility test cannot be used to differentiate sickle cell disease (homozygous for HbS) from sickle cell trait (heterozygous for HbS). 

Hemoglobin electrophoresis is considered the diagnostic procedure and is especially important considering that there are other hemoglobin variants that will also cause a positive solubility test, such as HbC Harlem. 

 If HbS is present, it will form liquid crystals and give a cloudy or turbid appearance to the solution. If HbS is not present, the solution will appear transparent. 

SOURCES OF ERROR: 

1. A patient with an exceptionally high hematocrit may give a false positive result, while an individual with a very low hemoglobin may give a falsely negative result.
2. Unstable hemoglobins may give a false positive result. 
3. False positives can occur with elevated plasma proteins and lipids.

source: shp.utmb.edu