3.18 STROM STRUCTURE OR BLOOD CELLS

Question 1

EDTA

Answer 1

• Added to blood samples to prevent clotting
• “takes out Ca”
• kelating agent

Question 2

STAIN USE TO LOOK AT BLOOD CELLS UNDER MICROSCOPE

Answer 2

WRIGHT-GIEMSA STAIN

• CONTAINS: EOSIN (AROMATIC/ACIDIC) AND METHYLENE BLUE (AROMATIC/BASIC)
• DRY CELLS TO INCREASE ENTRANCE INTO CELLS

Question 3

EOSIN

Answer 3

• AROMATIC/ACIDIC (neg. charge)
• SOLUBLE IN ETHANOL/NOT WATER
• STAINS HYDROPHOBIC BASIC MACROMOLECULES (Hgb)
• binds best to eosinophils

Question 4

METHYLENE BLUE

Answer 4

• AROMATIC/BASIC (Pos. Charge)
• SOLUBLE IN WATER AND METHANOL
• STAINS HYDROPHOBIC ACIDIC MACROMOLECULES (nucleic acids** and others)
• STAINS BASOPHILS THE BEST

Question 5

RBC DESIGN REQUIREMENTS

Answer 5

• FLEXIBLE SHAPE (BIOCONCAVE DISC)
• DURABLE MEMBRANE (CABLE: SPECTRIN BOUND TO ANKYRIN BOUND TO BAND 3)
• MAX Hgb/O2 CARRYING CAPACITY (ELIM SOME ORGANELLES)
• OFFSET OSMOTIC PRESSURE (NA/K ATPase- 3 NA OUT AND 2 K IN)
• ANTI-OXIDANT SYSTEM (GSH, NADPH, G6PD)
• ENERGY SUPPLY (ANAEROBIC)
• ABILITY TO TUNE DOWN COMPLEMENT FIXATION (DAF, CD55)

Question 6

ANTI-OXIDANT SYSTEM

Answer 6

• GLUTATHIONE IS USED TO REDUCE REACTIVE OXYGEN SPECIES WITH FREE SH
• GSH IS THEN REDUCED WITH NADPH (PENTOSE PHOSPHATE SHUNT)
• DEFECTS CAN LEAD TO Fe+++ that can not carry O2 (methemoglobin)

Question 7

NORMOCHROMIC

Answer 7

ANEMIA WITH NORMAL [Hgb] IN RBC BUT INSUFFICIENT # OF RBC

Question 8

HYPOCHROMIA

Answer 8

LACK OF COLOR IN RBC B/C OF LACK OF Hgb AND LACK OF BINDING BY EOSIN
-NORMALLY ABOUT 1/3 OF CENTER IS PALE BUT CELL HAS A LARGER CENTRAL PALE AREAN THAN USUAL

Question 9

ANISOCYTOSIS

Answer 9

ABNORMAL DISTRIBUTION OF RBC SIZE USUALLY Fe deficiency related

Question 10

POIKILOCYTOSIS

Answer 10

ABNORMAL RBC SHAPE USUALLY Fe deficiency related

Question 11

POLYCHROMASIA

Answer 11

RBC W/ EXCESS RESIDUAL RNA SHOW BLUISH TINGE

• USAUALLY MEAN PT IS MAKING A LOT OF RBC (GOOD) B/C THEY ARE SOMEHOW RAPIDLY LOSING THEM (BAD)
• NEWLY FORMED RBC HAVE MORE RNA THAN OLDER ONES (TAKE UP METH BLUE/BASIC STAIN)

Question 12

BITE CELLS

Answer 12

CAUSED BY DEFECT IN ANTI-OX, CHUNK OF RBC WITH OX Hgb IS REMOVED BUT THE RBC RETAINS OVERALL SHAPE WITH BITE TAKEN OUT
-G6PD: MOST COMMON DEF YOU WILL SEE WITH THIS

Question 13

SCHISTOCYTES

Answer 13

RESULTS FROM RBC THAT HAS BEEN SLICED IN HALF (HIT CAN CAUSE)

• LOOK LIKE ARMY HELMET
• IMPORTANT TO DIFF FROM BITE CELLS

Question 14

HEMATOCRIT

Answer 14

A/B
A: ERYTHROCYTES
B: BLOOD VOLUME
% OF BLOOD VOLUME OCCUPIED BY RBC EASY WAY TO TELL IF ANEMIC SAME INFO AS Hgb # (newer)

Question 15

COULTER CHAMBER WITH A/C CURRENT

Answer 15

• RBC COUNT AND VOLUME
• PEAK # = COUNT
• PEAK HEIGHT = VOLUME
• INCLUDES LEUKOCYTES BUT MINIMAL AND DO NOT WORRY ABOUT

Question 16

COULTER CHAMBER WITH D/C CURRENT

Answer 16

COUNT VS COMPLEXITY (WHATS INSIDE)

• CAN LYSE RBC AND GET LEUKOCYTE COUNT: NEUTROPHILS, MONOCYTES, EOSINOPHILS AND LYMPHOCYTES
• SAME RESULTS WITH LYSIS OF RBC AND PUTTING THROUGH FLOW CYTOMETER

Question 17

WHAT ANALYZER DOES NOT COUNT

KNOW!!!!!!!!!!!!

Answer 17

• BANDS: IMMATURE NEUTROPHILS
• BLASTS: MAY BE COUNTED AS LYMPHOCYTES (COULD BE LEUKEMIA)
• RBC FRAGMENTS: MAY NO BE DETECTED OR COUNTED AS PLATELETS
• PLATELET CLUMPS: CAN RESULT IN ARTIFACTUAL THROMBOCYTOPENIA
• GET A PERIPHERAL BLOOD SMEAR AND MANUAL ANALYSIS IF SUSPECT SOMETHING ELSE GOING ON

Question 18

THINGS ANALYZER WILL COUNT

Answer 18

Hgb, RBC #/VOLUME, RDW, PLATELET #/VOLUME