CBC & Diff Flashcards
If dyes are normal and the slide is bluer than normal. This could suggestion…
Patient may have increased blood protein
Patient’s blood smear have holes on the sides is a sign of…
Patient may have increased lipid levels (lipemia)
HCT Formula
(RBC X MCV) /10
Calculate MCH
(HGB / RBC) X 10
Calculate MCHC
(HGB / [RBC X MCV] ) X 1000
Calculate MCHC
What blood count indices are measured using electrical impedance?
WBC, RBC, and platelets
What blood count indices are found using the testing method beer’s law @ 525 nm?
Hgb
What blood count indices are derived from histogram?
MCV, and RDW
In optical light scatter forward angle light scatter (FALS) will give what kind of information about a cell?
cell size
In optical light scatter the side scatter (SS) will give what kind of cell information?
Granularity
Describe what happens in 5 part diffential
Cells sent through volume - conductivity - scatter (VCS) flow cell by hydrodynamic focusing. This method finds cell volume, physical and chemical components and determines [something]. It’s important in classifying mature cells and immature cells
What is platelet satellitosis?
In vitro phenomenon that occurs when blood is collected with EDTA. The specimen will have pseudothrombocytoopenia and high WBC count due to pseudoleukocytosis.
What are the possible solutions to platelet satellitosis?
Collect specimen in sodium citrate tube or
Perform WBC and platelet count on blue tube
Methylene blue dye stains what cell components?
Stains acidic cell components such as RNA or DNA.
Remember “Blue is basic”
Eosin Y dye stains…?
Stains basic cell components such as organelles (most proteins)
What is the purpose of absolute methanol in blood smear preparation?
Acts as a fixative to adhere cells to the glass slide
A smear is excessively blue or dark…. Potential causes could be?
Prolonged staining
Inadequate washing
Thick Blood smear
Too. Alkaline. Stain and/or buffer
A smear is excessively pink or light in stain…potential causes could be?
Insufficient staining
Prolonged washing
Too high an acidity of stain and/or buffer
A blood smear has precipitate in it… potential causes could be?
Unclean slides
Drying during staining process
inadequate filtration of stain
If a patient has an MCV below 80 fL, what would be observed in the blood smear and what is associated with these kinds of RBCs?
Microcyte would be observed. This is associated with
1. Iron Deficiency anemia
2. Sideroblastic anemia
3. Thalassemia minor
4. Chronic disease (occasionally)
5. Lead poisoning
6. Hemoglobinopathies (some)
A patient has an MCV over 100 fL. What kind of RBCs would be observed in a blood smear? What conditions are associated with these kinds of RBCs?
Macrocytes.
1. Liver disease
2. Vitamin B12 deficiency
3. Folate deficiency
4. Neonates
A patient’s CBC results shows an RDW greater than 14.5%. What does this suggest and what is associated with this kind of RBC?
Suggest a dimorphic population of RBCs.
Associated with transfusion, myelodysplastic syndrom, folate or iron deficiencies that is early in treatment process
A patient has an MCHC below 32 g/dL or 32%. This suggest what kind of RBC might appear? What is associated with this kind of RBC?
Hypochromic RBCs.
Iron deficiency anemia
Thalassemias
Sideroblastic anemia
Lead poisoning
Some cases of chronic inflammation
The presence of blue to salmon color RBCs are what? What conditions are associated with these RBCs?
Polychromatic RBCs or polychromasia.
Associated with acute and chronic hemorrhage.
Hemolysis
Effective treatment for anemia
Neonates
RBCs that have irregularly spaced projections that vary in length, and number. What are these cells called and what is associated with it?
Acanthocytes or spur cells
Associated with…
Abetalipoproteinemia
Severe liver disease
Splenectomy
Malabsorption
Hypothyroidism
Vitamin E deficiency
RBCs that have short and evenly spaced projections are called? What are these RBCs associated with?
Burr cells, echinocytes, or crenated cells
Associated with…
Uremia
Pyruvate kinase deficiency
Microangiopathic hemolytic anemia
Neonates (premature!!!)
Artifacts
RBCs that look spherical or round under the microscope with no central pallor. What are these RBCs? What is associated with them?
Spherocytes! Associated with…
Hereditary spherocytosis
Some hemolytic anemias
Transfused cells
Severe burns
RBCs, that look like targets. What are they and what is associated with them?
Target cells or codocytes
They are associated with…
Hemoglobinopathies
Thalassemia
Iron deficiency anemia
Splenectomy
Obstructive liver disease
RBCs that are elongate on each end sometimes forming a curve shape or S. They are composed of hemoglobin S. What RBCs is being described? What conditions are associated with it?
Sickle cell or drepanocyte
They are associated with homozygous hemoglobin S disease
An RBC that usually has 1 crystal per cell and composed of hemoglobin C. What RBCs are being described and what conditions are associated with them?
Hemoglobin C crystals! They are associated with homozygous hemoglobin C disease
RBCs with 1 - 2 fingerlike projections (that are crystals) is what kind of RBC? What disease is associated with these kind of RBCs?
They are called hemoglobin SC crystals. They are associated with hemoglobin SC disease.
RBCs with slit like openings at the area of central pallor are called? What is associated with them?
Stomatocytes associated with…
Hereditary stomatocytosis
Alcoholism
Liver disease
Rh null phenotype
Artifact
RBCs that are cigar shaped are…?
RBCs that are egg-shaped are…?
Both are associated with what kind of condition?
Cigar shaped - Elliptocyte
Egg shaped - Ovalocyte
Both are associated with….
Hereditary elliptocytosis or ovalocytosis
Thalassemia major
Iron deficiency anemia
Megaloblastic anemia - oval macrocytes
Myelopthisic anemias
RBCs that are tear drop shapes are called? They are associated with…?
Dacryocytes or teardrop cells are associated with…
Myelofibrosis w/ myeloid metaplasia
Thalassemias
Myelophthisic anemias
other causes of extramedullary hematopoiesis
Fragmented RBCs are called…? What is associated with these kind of RBCs?
Schistocyte or schizocyte are associated with….
Microangiopathic hemolytic anemias (DIC)
Severe burns
Hemolytic uremic syndrome
Thrombotic thrombocytopenic purpura
Renal graft rejection
Stacked RBCs are called? What is associated with this?
Rouleaux is associated with increased concentrations of globulins and/or paraproteins
Clumping of erythrocytes with no outlines of individual cells is a sign of what on a blood smear?
Autoagglutination. Shows antigen/antibody reaction occurred.
Hyposegmented neutrophils are associated with…?
Pelger-Huet anomaly
Myeloproliferative or
Myelodysplastic disorders
Hypersegmented neutrophils are associated with…?
6 or or lobed…
Megaloblastic anemias
Chronic infection
Hereditary - rare
Presence of vacuoles in WBCs is associated with…
Bacterial or fungal infection
Poisoning
Burns
Chemotherapy
Artifact
Dohle bodies are associated with?
Bacterial infection
Poisoning
Burns
Chemotherapy
May-Hegglins anomaly
Pregnancy
Toxic granulation in WBCs are associated with…?
Bacterial infection
Poisoning
Burns
Chemotherapy
Pregnancy
G-CSF therapy
Decrease number or absence of specific granules is a sign of…? What conditions are associated with this event?
Degranulation or agradnulation
Associated with infection or Myelodysplastic syndrome
Fused primary granules; that can be red in color is…?
Auer rods. They are associated with acute leukemia in leukemic myeloblasts and promyelocytes - FAB M1 to M6
MCV under 80 fL suggests the presence of
Microcytic RBCs aka Microcytes
What is associated with microcytic RBCs
Iron deficiency anemia
Sideroblastic anemia
Thalassemia minor
Chronic disease disease (occasionally)
Lead poisoning
Hemoglobinopathies (some)
MCV over 100 fL suggests the presence of …
Macrocytic RBCs aka Macrocytes
What is associated with macrocytic RBCs?
Liver disease
Vitamin B12 deficiency
Folate deficiency
Neonates
RDW % over 14.5 percent suggests
Anisocytosis and possibly dimorphic population of RBCs.
What diseases / conditions are associated with an RDW over 14.5%
Transfusion
Myelodysplastic syndromes
Folate or iron deficiencies; early in treatment process
MCHC under 32 g/dL or 32% suggests what kind of RBC will be present?
Hypochromia
What conditions are associated with hypochromia?
Iron deficiency anemia
Thalassemias
Sideroblastic anemia
Lead poisoning
Some cases of chronic inflammation
What cell is blue to salmon color reflecting residual RNA?
Polychromasia
What conditions or diseases would have polychromasia?
Acute and chronic hemorrhage
hemolysis
Effective treatment for anemia
Neonates
What cells have irregularly spaced projections that vary in width, length, and number; usually dense?
Acanthocytes or spur cells
What conditions/diseases are associated with acanthocyte / spur cells?
Abetalipoproteinemia
Severe Liver disease
Splenectomy
Malabsorption
Hypothyroidism
Vitamin E deficiency
What kind of cells have burr-like erythrocyte with short, evenly spaced projections?
Burr cells, echinocyte, or crenated cell
What is associated with burr cell, echinocyte, or crenated cell?
Uremia
Pyruvate kinase deficiency
Microangiopathic hemolytic anemia
Neonates (especially premature)
artifact
What kind of cells are round with no central pallor zone?
Spherocytes
What conditions / diseases are associated with spherocytes?
Hereditary spherocytosis
Some hemolytic anemias
Transfused cells
Severe burns
What is t he name of cells that look like targets?
Target cells
What is associated with target cells?
Hemoglobinopathies
Thalassemia
Iron deficiency anemia
Splenectomy
Obstructive liver disease
What is the name of the cells that are elongated with points on each end. They may be curved or s-shaped and composed of hemoglobin S?
Sickle cells or drepanocytes
What is associated with drepanocytes?
Homozygous hemoglobin S disease
