Note: Study this love, I know naka read naka ani, this is your review.

I love you so much,

Goodluck for MTLE 2021!!! –Kiara 
Check-up Test: Dec 20, 2020 (32 days to go til’ RMT)

Hematology
Blood collection, anticoagulants and others (including Safety) – (5%)

 Size of blood for smear – 2-3mm

 Distance of blood drop from the edge of the label – 0.25in/1cm
 Longitudinal – Most ideal method for reading smear
 Length of needle – 1-1.5in
 Gauge in tuberculin syringe – 25
 Gauge of needle in bleeding of donors – 16
 Ocular – Interpupillar distance

Hematology tests and procedures – (30%)

Routine – (15%)
 Degree of hypochromia measured as 1/3 – Normal
 Macrocyte in ESR – False increase
 Effect of increased Hgb in ESR – Increased
 ESR in wintrobe tube is read using – Left side
 Disposable ESR tubes – Dispettes
 Hematocrit method in wintrobe – Macrohematocrit
 Size of the unfilled portion of the capillary tube in microhematocrit –
10-15mm
 Length of capillary tube – 75mm
 Length of plug in capillary tube – 4-6mm
 Centrifugation for microhematocrit – 10,000-15,000g for 5mins
 1st layer in spun hematocrit – Fat
 4th layer in spun hematocrit - RBC
 MCV – Computed from hematocrit and RBC count
 1 RBC not counted – Decrease count by 10,000
 Measures erythropoiesis – Reticulocyte count
  3-5% rouleaux – Slight high

Automation – (10%)
 Relation of voltage pulse to cell size – Directly proportional
 Blood clots will have what effect on RBC count using automated
counters – Decreased
 Positive error – Bubbles, electric impulse, aperture plugs
 Negative error – Hemolysis
 Platelet satellitism – Decreased platelet count

Special – (5%)
 Screening test for HbS – Dithionite solubility
 Requires fresh sample – MPO, LAP
 Differentiate Leukemoid Reaction from CML – LAP

Hematopoiesis, Diseases/Disorders and Reference Values – (40%)

Hematopoiesis (in general) – (6%)
 Pluripotential stem cell – 2 possible cell lines
 Differentiate pure anemia from bone marrow malfunction – WBC count
 Bone marrow – Sternum, tibia, POSIC
      Not true regarding yellow marrow – Hematopoietic
 CD 34 – Stem Cell
Erythropoiesis and RBCs – (12%)
 Generates ATP – Embden-Meyerhof
 Generates 2,3-DPG – Luebering-Rapoport
 Decreased affinity to O2 is associated with – Increased Temperatire,
2,3-DPG, CO, decreased blood pH
 Acanthocyte – McLeod phenotype, abetalipoproteinemia
 Bronze cells – Spherocytes
 Codocyte – Mexican hat cell
 Dacryocyte – Myelofibrosis
 Echinocyte – Burr cell
 Horn-like cell – Keratocyte
 Stomatocyte – Rh null
 Hemoglobin synthesis – Polychromatophilic normoblast to reticulocyte
  Thalassemia – Quantitative defect
 Hemoglobinopathy – Qualitative defect
 Alpha Thalassemia – Decreased HbA, HbA2, HbF
 Beta Thalassmia – Decreased HbA, increased HbA2, HbF
 Microcytic - <6µm
 Chronic blood loss – Microcytic, hypochromic
 Acute blood loss – Normocytic, normochromic
 Aplastic anemia – Normocytic, normochromic
 Major cause of death in sickle cell anemia – Infectious crises
 Not used for evaluation of anemia – MCH
 Not used in actual RBC description – Hyperchromia
 Haptoglobin – To verify in vivo hemolysis
 Rouleaux formation is seen in – Conditions that increase plasma
proteins

Leukopoiesis and WBCs – (12%)

 Stem cell to blast 5 days. Lifespan in tissue phase 9-10 days –
Granulocytes
 Nucleoli 3+, Dark blue to blue cytoplasm, Lacy chromatin pattern –
Myeloblast
 Primary granules – Promyelocyte
 Stage which you can identify specific WBC – Myelocyte
 Kidney shaped nucleus - Metamyelocyte
 Sausage shaped nucleus – Band
 Not an end stage cell – Monocyte
 Not capable of phagocytosis – Lymphocyte
 Pince-nez – Pelger Huet
 Sezary cell – Mycosis fungoides, T-cell, Sezary syndrome
 Seen in 2nd trimester of pregnancy – Neutrophilia
 Diurnal variation is observed in – Neutrophil (decreased in AM,
increased in PM)
 Leukemia without maturation – M1
 M2 – Most common AML
 M3 – DIC
 M5 – Schilling’s Leukemia
 Granulocyte – Specific esterase positive
 Differentiate Acute Monocytic Leukemia from ALL – Myeloperoxidase
 Differentiate Acute Myelomonocytic Leukemia from ALL - SBB
  Absence of Philadelphia chromosome – Poor prognosis of disease
 Philadelphia chromosome (+) – Chronic Myelogenous Leukemia
Thrombopoiesis and Platelets – (10%)
 Stem cell to blast 5 days. Lifespan 8-11 days – Platelets
 Nuclei with demarcating membrane – Promegakaryocyte
 Platelet – 8-20/field
 Clot retraction – Function of platelets
 Outer surface – Glycocalyx
 Platelet adhesion – vWF, gpIb
 Platelet aggregation – Fibrinogen, gpIIb-IIIa
 Aspirin – inhibit cyclooxygenase
 ADAMTS13 – cleaves vWF
 Platelet alpha and dense granules, mitochondria – Organelle zone
 Platelet Factor 3 – Phospholipid
 Alpha granule disorder – Gray platelets
 Dense granule disorder – Storage pool
 Platelet retention in multiple myeloma - Reduced

Coagulation (Principles, Procedures, Diseases/Disorders and Reference

Values) – (20%)
Hemostasis – Theories/Concepts, Mechanisms – (2%)
 NV of template bleeding time – 2-8mins
 Screening test for secondary hemostasis – Clotting time
 Principal enzyme involved in fibrinolysis - Plasmin

Coagulation procedures/tests – (8%)

 Stypven time – Common pathway
 Duckert’s Test – Factor 13
 Unaffected by heparin therapy – Reptilase time
 Prekallikrein is detected through – APTT
 Effect of Kaolin to APTT – Decreased/Shortened APTT
 D-dimer test positive after – 4hrs
 Euglobulin clot lysis time – Screening test for fibrinolysis
 Electromechanical – Fibrometer
Coagulation factors, diseases/disorders & reference values – (10%)
 Required in all pathways – Factor 4
 Factor 3 – Tissue thromboplastin
 Activates extrinsic pathway – Tissue thromboplastin
 Prothrombin group – Vitamin K dependent
 Factor consumed during coagulation – Thrombin group
 Factors that deteriorate at room temperature – 5,8
 Factors that are activated at cold temperature – 7,11
 Barium Sulfate – absorbs prothrombin group
 Coumarin – prolong prothrombin time
 Protamine sulfate – reverses heparin overdose
 Ecchymosis – Deficiency in platelets
 Asymptomatic patient suspected having coagulation disorder – test
APTT
 DIC – Fibrinogen decrease 4-24hrs, platelet decrease 48hrs

Quality assurance – (5%)