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1 98 年 不 療 理 98 年 類 臨 1 不 不 1 RBC cytoskeleton 異 spherocytosis or ovalocytosis acanthocyte 2 pyruvate kinase target cell burr cell 3 Heme porphobilinogen, PBG -ALA heme globin 2&1 1&2 4&2 2&4 5 列 Sulfhemoglobin 不 見 硫 療 6 列 狀 EPO 1% 狀 不 狀 7 數 MCV Serum iron 8 列 Transferrin Bone marrow sideroblast Hb 見 9 RBC Hb Hct 降 MCV MCH>27 pg reticulocytes 2% >0.6 mg/dl 罹 不 良 10 列 transcobalamin TC, transcobalamin TC Vit.B 12 TC 量 <50 ng/ml TC megaloblastic anemia Vit.B 12 TC 11 FAB 類 ringed sideroblasts sideroblasts % 5% 10% 15% 20% 12 見 Protoporphyrin synthase ALA dehydrase 13 列 HbF -ALA synthase Coproporphyrinogen oxidase 2 2 力 利 HbF<2% ph 3.3

2 列 不 Hb Gower 1 Hb Portland Hb Gower 2 HbF 15 列 不 -thalassemia trait HbA 2 HbF Hb Bart s HbA 16 列 HbH disease RBC anisocytosis poikilocytosis Hb Bart s HbH MCV Heinz 17 列 不 易 2,3-DPG H + 度 HbS HbF 18 率 95% 85% 75% 26.6% 19 RBC acanthocyte membrane 異 Annexin Glycophorin A Triglyceride Cholesterol 20 臨 年 10 g/dl 11.5 g/dl 13.5 g/dl 15 g/dl 21 列 ph 2,3-DPG K + Na + 22 行 xb x-bar-b control A B 列 Item HCT UL Target LL /03/15 14:20 MCV MCH MCHC Hb channel 異 列 不 data variation A B RBC/Platelet channel 異 了 數 異 mean range variance standard deviation 24 列 50% blasts 列 non-erythroid cells 20% WHO World Health Organization 類 類 列 AML without maturation Acute myelomonocytic leukemia Acute erythroid leukemia Acute basophilic leukemia

3 列 率 不 acute lymphoblastic leukemia acute myeloid leukemia 率 論 年 B cell acute lymphoblastic leukemia T cell acute lymphoblastic leukemia 率 年 老 年 年 M7 率 26 列 Mycosis fungoides B cell lymphoma T cell lymphoma HTLV-I EBV 27 列 S zary syndrome T-lineage 惡 S zary cell 裂 IgG paraprotein M-protein 28 列 hyperviscosity syndrome polycythemia -thalassemia -thalassemia multiple myeloma 29 Myelofibrosis 10~20% 列 Acute myeloid leukemia Acute lymphoblastic leukemia Hairy cell leukemia Chronic lymphocytic leukemia 30 Myelofibrosis 異 Rouleaux formation Spherocyte Target cell Tear drop RBC and erythroblast 31 淋 chronic lymphocytic leukemia 淋 T cell B cell NK cell Large granular lymphocyte 易 不 易 狀 數 9.8 g/dl /L /L 粒 Pelger-Huët 列 淋 Acute lymphocytic leukemia Hairy cell leukemia Chronic myeloid leukemia 異 Myelodysplastic syndrome 33 列 Glycophorin AML-M4 AML-M5 AML-M6 AML-M7 34 secondary polycythemia 塞 力 降 異 不 異 塞 35 不 良 myelodysplastic syndrome 類 WHO FAB 不 列 myelodysplastic syndrome FAB WHO Refractory anemia RA Refractory anemia with ringed sideroblasts RARS Refractory cytopenia with multilineage dysplasia RCMD Refractory anemia with excess blasts in transformation RAEB-T

4 列 Reed-Sternberg cell Hodgkin s disease non-hodgkin s disease mast cell eosinophil 37 列 M-protein paraprotein Multiple myeloma Chronic lymphocytic leukemia Refractory anemia Polycythemia vera Waldenström s macroglobulinemia 38 t(2;5) (p23;q35) 兩 NPM ALK 見 列 Anaplastic large cell lymphoma Small lymphocytic lymphoma Mantle cell lymphoma Follicular lymphoma 39 Acromere Centromere Telomere Microsatellite 女 暈 狀 Hb=18 g/dl total red cell volume 45 ml/kg JAK2 mutation (+) Adult T cell lymphoma/leukemia Aplastic anemia -Thalassemia Polycythemia vera 41 列 WHO 類 Myelodysplastic/Myeloproliferative disease Chronic myeloid leukemia Chronic myelomonocytic leukemia 5q- syndrome Idiopathic myelofibrosis 42 列 不 disseminated intravascular coagulation 理 度 塞 43 FAB French-American-British 類 療 列 AML-M0 AML-M2 AML-M3 AML-M7 44 類 globin thrombin time reptilase time Afibrinogenemia Primary fibrinolysis Heparin therapy Antithrombin deficiency 46 列 Vit.K deficiency PT APTT TT Clotting time 47 Warfarin fibrin polymer prothrombin group fibrinolysis thrombin 48 列 Vit.K dependent Gla domain 量 20 kda BaSO 4 Ca ~4 5~8 9~12 13~14 50 列 不 High molecular weight kininogen Prekallikrein Factor XIIa Kallikrein Factor XI XIIa XIa 不 PTT Prekallikrein Factor XI

5 Giant platelet Voltage-pulse 數 來 列 數 數 數 52 列 度 Factor I Factor V Factor Factor 53 列 Weibel-Palade body Tissue factor von Willebrand factor Fibrinogen Factor V 54 列 protein C Vitamin K dependent Factor Va a Plasmin 易 55 Factor V Leiden 異 列 protein C 易 APTT 56 Protein Z Factor I, a Factor Va, a Factor a, a Factor Xa, 57 Clauss fibrinogen 度 不 度 不 58 異 dysfibrinogen 列 fibrinogen Clauss Clauss 59 microangiopathic hemolytic anemia 不 列 disseminated intravascular coagulation thrombotic thrombocytopenic purpura 尿 hemolytic uremic syndrome immune hemolytic anemia 60 disseminated intravascular coagulation 列 Haptoglobin 狀 數 Schistocytosis 61 列 不 disseminated intravascular coagulation Prothrombin fragment Urea solubility test D-dimer Ethanol gelation test 62 列 D-dimer polyclonal 度 塞 D-dimer 裂 late fibrin degradation product 63 度 A hemophilia 0.01 IU/mL IU/mL 0.05 IU/mL 0.06 IU/mL 64 APTT 參 若 thrombin time APTT 70 行 APTT 立 列 狀 狼 lupus anticoagulant heparin

6 O AB AB 列 H hh H hh ABO cis-ab ABO cis-ab 66 列 antiserum titer reagent RBCs 度 離 67 Coombs control cells O(+) anti-d sensitized AB(+) anti-d sensitized O(+) anti-h sensitized AB(+) anti-a anti-b sensitized 68 不 anti-d anti-e anti-k anti-mi a anti-c 69 行 量 不 70 若 autoantibodies 行 crossmatching 行 Elution Absorption Washing Heating 71 列 Forward Grouping Reverse Grouping Anti-A Anti-B Anti-A,B A 1 Cells B Cells acquired B A 2 A 1 A 2 B 72 若 A, Le(a-b+) A Le a H Le b 73 B(+) Donor O(+) 列 compatible compatible incompatible incompatible kg 125/75 mmhg 14 g/dl 不 不 不 250 ml 75 APTT kaolin 易 讀 76 4 尿 列 Rh Kell Duffy Kidd 77 列 不 量 降 platelet concentration single donor platelets 不 易 若 12 數 corrected count increment 不 5000/ L 不 78 列 Polyagglutination T Tk Tn Acquired B 79 列 labile factor Factor I Factor Factor V Factor 80 列 Thromboxane A 2 5