CBC & Diff Flashcards by Joshua Nguyen

If dyes are normal and the slide is bluer than normal. This could suggestion…

Patient may have increased blood protein

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Patient’s blood smear have holes on the sides is a sign of…

Patient may have increased lipid levels (lipemia)

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HCT Formula

(RBC X MCV) /10

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Calculate MCH

(HGB / RBC) X 10

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Calculate MCHC

(HGB / [RBC X MCV] ) X 1000

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Calculate MCHC

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What blood count indices are measured using electrical impedance?

WBC, RBC, and platelets

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What blood count indices are found using the testing method beer’s law @ 525 nm?

Hgb

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What blood count indices are derived from histogram?

MCV, and RDW

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In optical light scatter forward angle light scatter (FALS) will give what kind of information about a cell?

cell size

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In optical light scatter the side scatter (SS) will give what kind of cell information?

Granularity

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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

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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.

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What are the possible solutions to platelet satellitosis?

Collect specimen in sodium citrate tube or
Perform WBC and platelet count on blue tube

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Methylene blue dye stains what cell components?

Stains acidic cell components such as RNA or DNA.

Remember “Blue is basic”

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Eosin Y dye stains…?

Stains basic cell components such as organelles (most proteins)

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What is the purpose of absolute methanol in blood smear preparation?

Acts as a fixative to adhere cells to the glass slide

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A smear is excessively blue or dark…. Potential causes could be?

Prolonged staining
Inadequate washing
Thick Blood smear
Too. Alkaline. Stain and/or buffer

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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

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A blood smear has precipitate in it… potential causes could be?

Unclean slides
Drying during staining process
inadequate filtration of stain

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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)

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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

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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

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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

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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