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Hematology > Automation > Flashcards

Automation Flashcards

1
Q

What are the four (4) principles of automation in hematology?

A
  1. Electrical impedance principle
  2. Radiofrequency conductivity
  3. Flow cytometry
  4. Analysis of instrumental data output
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2
Q

What is the electrical impedance principle also called?

A

Coulter principle

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3
Q

State the principle behind electrical impedance.

A

It is the changes in electrical impedance (resistance)
produced by a particle as it passes through a
small aperture.

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4
Q

What is electrical impedance is also referred to as?

A

resistance

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5
Q

Increases or Decreases?

As a diluted suspension of cells is drawn through
the aperture, the passage of each individual cell
momentarily \_\_\_\_\_\_\_ the impedance (resistance) of the electrical path between two submerged electrodes that are located on each side of the aperture

A

increases

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6
Q

what is the relationship between the # of pulses generated during a specific period to the # of particles?

A

proportional

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7
Q

True or False

1 resistance = 1 pulse

A

True

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8
Q

True or False

1 resistance = 1 pulse = 1 cell

A

True

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9
Q

In electrical impedance, what indicates the cell’s volume?

a. resistance
b. interruption of current
c. amplitude or magnitude of electrical pulse
d. angle

A

c. amplitude or magnitude of electrical pulse

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10
Q

What device displays the pulses that are generated by the cells as they interrupt the current?

A

Oscilloscope

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11
Q

True or False

When using an oscilloscope, the height of each pulse corresponds the volume of the cell.

A

True

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12
Q

It depicts the volume distribution of the cellscounted.

A

Volume Distribution Histogram

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13
Q

True or False

In a histogram, the size of the voltage pulse is equal to the size/volume of the cells.

A

True

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14
Q

What is the range of the volume threshold for RBC?

A

24-36 fL

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15
Q

What is the range of the volume threshold for WBC?

A

30-35 fL

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16
Q

What is the range of the volume threshold for platelets

A

2-20 fL

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17
Q

Factors that affect volume measurement

A
  1. Aperture diameter
  2. Protein buildup
  3. Coincident passage loss
  4. Orientation of the cell in the center of their aperture
  5. Deformability of the RBC
  6. Recirculation of cells back into the sensing zone
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18
Q

Mechanism of hydrodynamic focusing

A

The sample stream is surrounded by a sheath fluid
as it passes through the central axis of the aperture

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19
Q

In hydrodynamic focusing, what is the purpose of the sheath fluid?

A

It ensures that the cells flow in a single line

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20
Q

In hydrodynamic focusing, explain the purpose of laminar flow to the central sample stream.

A

It allows the central sample stream to narrow sufficiently to separate and align the cells into a single file for it to pass through the sensing zone

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21
Q

Formula for hematocrit determination

A

HCT = (RBC x MCV) / 10

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22
Q

Principle of hematocrit determination

A

Cumulative RBC pulse height detection

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23
Q

Identify if the interference/s causes spurious increase or decrease

unlysed red cells and platelet clumping

WBC

A

spurious increase

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24
Q

Identify if the interference/s causes spurious increase or decrease

monoclonal proteins

WBC

A

spurious increase

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25
Q

Identify if the interference/s causes spurious increase or decrease

cryoglobulin, cryofibrinogen, and heparin

WBC

A

spurious increase

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26
Q

Identify if the interference/s causes spurious increase or decrease

Nucleated red cells

WBC

A

spurious increase

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27
Q

Identify if the interference/s causes spurious increase or decrease

clotting

WBC

A

spurious decrease

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28
Q

Identify if the interference/s causes spurious increase or decrease

smudge cells

WBC

A

spurious decrease

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29
Q

Identify if the interference/s causes spurious increase or decrease

uremia plus immunosuppressants

WBC

A

spurious decrease

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30
Q

Causes of spurious increase in RBC count

Interference / potential causes of erroneous results in with ACC

ACC= automated cell counters

A
  1. cryoglobulin
  2. cryofibrinogen
  3. giant platelets
  4. High WBC (>50 000/mL)
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31
Q

Causes of spurious decrease in RBC count

Interference / potential causes of erroneous results in with ACC

ACC= automated cell counters

A
  1. autoagglutination
  2. clotting
  3. hemolysis (in vitro)
  4. microcytic red cells
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32
Q

Causes of spurious increase in platelet count

Interference / potential causes of erroneous results in with ACC

ACC= automated cell counters

A
  1. cryoglobulin
  2. cryofibrinogen
  3. hemolysis (in vitro and in vivo)
  4. microcytic red cells
  5. red cell inclusions
  6. white cell fragments
33
Q

Causes of spurious decrease in platelet count

Interference / potential causes of erroneous results in with ACC

ACC= automated cell counters

A
  1. clotting
  2. giant platelets
  3. heparin
  4. platelet clumping
  5. platelet satellitosis
34
Q

This principle of automation is determined using a high-frequency electromagnetic probe that provides information on the cells’ internal constituents.

A

Radiofrequency conductivity

35
Q

It is the resistance to a high voltage electromagnetic current flowing between both electrodes simultaneously

A

Radiofrequency (RF) resistance

36
Q

True or False

In radiofrequency conductivity, the total volume of the cell is proportional to the change in direct current (DC), the cell interior density is proportional to pulse height or change in the RF signal.

A

True

37
Q

What principle of automation?

simultaneous measurement of multiple physical characteristics of a single cell as the cell flows in a suspension through a measuring device.

A

Flow cytometry

38
Q

True or false

In flow cytometry, as the cells pass through the sensing zone and interrupt the beam, light is scattered in all directions.

A

True

39
Q

Describe the relationship

In flow cytometry, the # of pulses generated is ________ to the # of cells passing through the sensing zone in a specific period.

A

directly proportional

40
Q

what medium makes the results obtained from flow cytometry superior to impedance because it is more accurate and specific?

A

Immunoflourescence dye

41
Q

What is the corresponding mechanism of ‘threshold’ (impedance) in flow cytometry?

A

Gating

42
Q

what is being identified with the given angles of light scatter

0° forward angle

A

cell size

43
Q

what is being identified with the given angles of light scatter

10° light scatter

A

Cell structure & complexity

44
Q

what is being identified with the given angles of light scatter

90° light scatter

A

Lobularity (granulocyte)

45
Q

what is being identified with the given angles of light scatter

Depolarized 90°

A

Resolves Eosinophils
because of their crystalline
granularity

46
Q

It is a numerical or graphical boundary that
can be used to define the characteristics of
particles to include for further analysis

A

Gate

47
Q

Explain the gating process

A

It is the process of selecting an area in a scattergram during the flow experiment to be able to decide what will you analyze.

48
Q

In quadrants, we can separate your cells unto four principal populations (Q1, Q2, Q3, Q4), describe the expression of the cells in each quadrant.

A

Q1- cells that are strongly expressing positive color (single positive; either red or blue)
Q2 - double positive; it has blue & red
Q3- double negative (neither blue & neither red)
Q4- single positive same as Q1

49
Q

What does VCS stand for?

A

Volume, conductivity, and scatter

50
Q

Identify which factor in VCS technology is described

using direct current impedance, the
volume of each cell is measured

A

volume

51
Q

Identify which factor in VCS technology is described

radiofrequency penetrates the cell which generates the data points of cell size and cell internal structure.

A

Conductivity

52
Q

Identify which factor in VCS technology is described

mid-angle scatter detected by a beam of laser light which generates data about cellular granularity and cell surface structure.

A

scatter

53
Q

It is a single channel that analyzes approximately 8,000 cells in a near-native condition.

A

VCS technology

54
Q

In VCS technology, approximately how many cells are analyzed in a near-native condition

A

approximately 8,000 cells

55
Q

In flow cytometry, what is used to interpret results instead of a histogram?

A

A scattergram

56
Q

what is the shape and distribution of a histogram

A

Symmetrical bell-shaped or Gaussian
distribution

57
Q

In a histogram, how would you interpret a flattened curve?

A

Increase in standard deviation

58
Q

In an erythrocyte histogram, what is the interpretation if there is another population in the right bottom threshold?

A

The presence of macrocytic RBCs

59
Q

In an erythrocyte histogram, what is the interpretation if there is another population in the left bottom threshold?

A

The presence of microcytic RBCs

60
Q

What does MPV stand for?

A

Mean platelet volume

61
Q

An incease in MPV can denote the presence of __________

A

giant platelets

62
Q

Disorders associated with a decreased MPV

A
  1. Aplastic anemia
  2. Megaloblastic anemia
  3. Wiskott-Aldrich sydrome
63
Q

Decreased or increased MPV

After chemotherapy

A

decreased mpv

64
Q

Disorders associated with an increased MPV

A
  1. Idiopathic thrombocytopenic purpura
  2. sickle cell anemia
65
Q

Decreased or increased MPV

After splenectomy

A

increased mpv

66
Q

Abnormal Curve in front of lower discriminator

a. AG Flag
b. WU Flag
c. UD Flag

A

a. AG Flag

67
Q

Deviation on upper discriminator curve

a. AG Flag
b. WU Flag
c. PU Flag

A

b. WU Flag

68
Q

This refers to the level at which the machine can
measure the particular analyte

A

Linearity

69
Q

This flag appears when UD exceeds the preset height by > 40%

a. AG Flag
b. WU Flag
c. UD Flag

A

UD Flag (PU Flag)

70
Q

What causes platelet clumps (2)

A
  1. Clotted sample
  2. EDTA-incompatibility
71
Q

What are the possible causes of an abnormal height at the upper discriminator (UD/PU Flag) in a platelet histogram? (3)

A
  1. Platelet clumps
  2. Giant platelets
  3. Micro RBCs
72
Q

What are included in an electrical impedance report? (4)

A
  1. CBC results
  2. Scattergram
  3. Histogram
  4. Flagging
73
Q

Intrumental error (negative or positive)

excessive lysing of RBC

A

negative

74
Q

Intrumental error (negative or positive)

bubbles

A

positive

75
Q

Intrumental error (negative or positive)

extraneous electrical pulses

A

positive

76
Q

Intrumental error (negative or positive)

aperture plugs

A

positive

77
Q

what is the most common intrumental error that causes positive results

a.excessive lysing of RBC
b. bubbles
c. aperture plugs
d. extraneous electrical pulses

A

c. aperture plugs

78
Q

what casues aperture plugs

A

sucking of clotted samples

79
Q

what causes extraneous electrical pulses?

A

improper grounding

Hematology (1 decks)

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