Ch 3 QBC Star Flashcards
QBC Star Complete Blood Count Results
Hematocrit
Hemoglobin
Mean Corpuscular Hemoglobin Concentration
WBCs
Granulocytes
% of Granulocytes
Lymph/Monocytes
% of Lymph/Monocytes
Platelets
Most frequently ordered lab
CBC
CBC
RBC indices:
Mean corpuscular volume (MCV)
Mean corpuscular Hgb (MCH)
Mean corpuscular Hgb Concentration (MCHC)
RBC distribution width (RDW)
What is analyzed when a CBC with differential is ordered?
Various types of WBCs
Normal adult male RBC range
4.5-5.9 (x106 cells/uL)
Normal adult female RBC Range
4.5-5.1 (x106 cells/uL)
Anemia causes a disproportionate decrease in:
Hct & Hgb
Hgb ranges in adult males
14-17.5 g/dL
Hgb ranges in adult females
12.3-15.3 g/dL
Hgb critical value (low)
<8 g/dL
Provides a direct indicated of the oxygen-transport capacity of the blood
Hgb concentration
Hct in males
42-52%
Hct in females
37-47%
Ratio of the volume of erythrocytes to that of the whole blood
Hematocrit (Hct)
Hct is usually __ times the Hgb.
3
Red blood cell chracteristics
RBC indices
RBC indices assess
Size and Hgb content of the RBC
MCV normal range
76-96 fL/cell
Estimate of the average size (VOLUME) of RBCs and is the most clinically useful of the RBC indices
MCV
Calculated from the Hct and red cell count
MCV
An increase in the MCV is normally associated with:
Vitamin B12 or folate deficiency
A decrease in MCV is normally associated with:
Abnormality in Hgb synthesis, most likely caused by iron deficiency
Normal range of Mean Corpuscular Hemoglobin (MCH)
27-32 pg/cell
Amount of hemoglobin per RBC
MCH
Increase MCH is seen in:
Vitamin B12 and folate deficiency
Decrease in MCH is seen in:
Iron deficiency
Normal range of Mean Corpuscular Hemoglobin Concentration (MCHC)
30-35 g/dL
Hemoglobin divided by the hematocrit
MCHC
Normal range of platelets
150k-400k/uL
Critical value (low) platelets, risk of hemorrhage
<20,000
Critical value (high) platelets, risk of thrombosis
1,000,000
Thrombocytosis can be caused by stress and infection but may also be caused by:
Splenectomy
Trauma
Iron-deficiency anemia
Cirrhosis
Thrombocytopenia can be caused by:
Thrombotic thrombocytopenic purpura (TTP)
DIC
Leukemia
Metastatic cancers
Normal WBC Range
4.5-11.0 (x103 cells/mm3)
Critical (low) value of WBCs
<2,000
Critical (high) value of WBCs
30,000
Tally of the total number of WBCs in a given volume of blood plus the relative percentages of the WBC by type
Differential
Leukopenia may be caused by:
Bone marrow deficiency or failure
Collagen-vascular diseases (Lupus)
Disease of the liver or spleen
Radiation therapy or exposure
Leukocytosis can be caused by:
Anemia
Bone marrow tumors
Infectious Diseases
Inflammatory diseases (RH or Allergy)
Leukemia
Severe emotional or physical stress
Tissue damage (burns)
Differential normal range for:
Neutrophil
50-70%
Differential normal range for:
Bands
0-5%
Differential normal range for:
Eosinophils
1-5%
Differential normal range for:
Basophils
0-1%
Differential normal range for:
Monocytes
1-6%
Differential normal range for:
Lymphocytes
20-40%
Less mature neutrophils known as bands due to the:
Cresent shaped nucleus
Neutrophilia would be caused by
An acute infection
The appearance of band cells in an infection is termed:
Left shift
When neutrophils and or bands are elevated, what decreases?
Lymphocytes
Lymphocytosis is typically an indication of:
Viral infection
Eosinophilia is an indicated of:
Parasitic infection
Allergic disorders
The ratio of the volume of erythrocytes to that of the whole blood
Hematocrit
Hct can be measured directly by:
Centrifugation with macro-methods or micro-methods
Hct can be measured indirectly as the product of:
MCV times RBC count in automated instruments
Hct value below the reference interval of age and sex
Anemia
Hct value above the reference interval of age and sex
Polycythemia
The main function of hemoglobin
Transport oxygen from the lungs where tension is high to tissues where tension is low
The average concentration of hemoglobin in a given volume of packed red cells
Mean Corpuscular Hemoglobin Concentration (MCHC)
Hgb/Hct x 100
Mean Corpuscular Hemoglobin Concentration
CBC test, used to determine if patients have bleeding disorders or bone marrow diseases, such as leukemia
Platelet Count
WBCs
Bacterial infections, inflammations, leukemia, trauma, intense exercise, or stress
Leukocytosis
WBCs
Chemotherapy, radiation therapy, diseases of the immune system
Leukopenia
Test used to determine infection or leukemia
Helps monitor the body’s response to treatments and bone marrow function
WBC
WBCs with granules in their cytoplasm
Granulocytes
Granulocytes are also called
Polymorphonuclear leukocytes (PMN or PML)
Three granulocytes, distinguished by their appearance under Wright Stain:
Neutrophil
Eosinophil
Basophil
Most abundant type of phagocyte
Important against infectious disease
50-70% if WBCs
Neutrophils
Act as phagocytes and modulate inflammatory response
Inflammatory conditions, allergic reactions, asthma, myocardial diseases
0-5%
Eosinophils
Eosinophils are increased with the presence of:
Helminths
One of the least abundant cells in the body, 0-1%
Granules are numerous enough to partially conceal the nucleus
Abundant with histamine, heparin, chondroitin sulfate, peroxidase, platelet activating factor, and other substances
Basophil
Second most WBC in the body, 20-40%
Causes of reactive: -Viral -Bacterial -Drug Reaction -Misc (autoimmune disease, allergic reaction, malnutrition, hyperthyroidism)
Lymphocyte
Lymphocytosis is present when there is an excess of lymphocytes in:
Peripheral blood
Absolute lymphocyte count decreases with:
Age
Definition of lymphocytosis
4.0 x 10(9)/L
Multiplying the percentage of lymphocytes by the total leukocyte count
Absolute lymphocytosis count
Used to describe malignant appearing cells
Atypical lymphocytes
Used to describe formed or benign lymphocytes
Reactive Lymphocytes
Reactive lymphocytes usually account for less than __% of the total lymphocyte present
10%
Other terms used to describe reactive lymphocytes
Immunocytes
Transformed lymphocytes
Immunoblasts
Plasmacytoid lymphocytes
Turk cells
Downy Cells
Viral causes of reactive lymphocytes:
Adenovirus, Chicken Pox, Cytomegalovirus, EBV (mono), Hepatitis, Herpes Simplex, Herpes Zoster, HIV, Influenza, Paramyxovirus (mumps), Rubella (measles)
Bacterial causes of reactive lymphocytes:
Brucellosis
Parathyroid fever
Pertussis
TB
Typhoid fever
Drug reaction causes of reactive lymphocytes
During recovery from acute infections (children)
Miscellaneous causes of reactive lymphocytes:
Acute infectious lymphocytosis
Allergic reactions
Autoimmune diseases
Hyperthyroidism
Malnutrition
Rickets
Syphilis
Toxoplasmosis
Nuclear convolutions
Lacy, delicate chromatin
Dull gray-blue cytoplasm
Blunt pseudopodia
Monocyte
The monocyte is formed in the marrow, transported by blood and migrates to tissues where it transforms into:
Histiocyte or macrophage
Makes up the mononuclear phagocyte system (reticuloendothelial system)
Blood monocytes and tissue macrophages
The mononuclear phagocyte system has an important role in defense against:
Microorganisms: mycobacteria, fungi, bacteria, protozoa, and viruses
Two routine user controls for the QBC Star
“STAR” button
Door Release Latch
Power switch location
Rear panel on the left side
“STAR” Button location
Top of the QBC Star toward the right side
Teal colored button and has several functions
“STAR” Button
“STAR” button
When an untested tube is in the analyzer
Start Testing
“STAR” button
When the instrument is in the process of testing
Abort Testing
“STAR” button
After automatic test results printout, before opening the door
Reprint Test Results
You can only reprint test results before:
Opening the door
Door Release Latch location
Front panel, just below the door
The door will only be opened when the system:
Determines that it is safe to do so
Door Release Latch pops open the door located:
On the top
All system prompts are presented on:
Liquid Crystal Display (LCD)
Printer location:
Top panel of the instrument
Test results print automatically at:
End of testing cycle
Paper release level is located on the:
Right side of printer
Pulled the lever _____ to enable loading paper
Forward
Manual Advance Wheel for paper is located on the _____ side of the printer
Right
Rotated the manual advance wheel toward the ____ to advance paper when loading
Rear
Rotated the wheel _____ to retract paper (unjam a paperjam)
Forward
Floppy disk drive is located:
Front panel and bottom right
The floppy disk drive is used primarily for:
Software updates
To access the floppy disk drive, flip the top of the access door _______
Downward
Floppy disks should be inserted:
Shutter first and the label upward
Setup Keyboard is located:
Front of the printer beneath the printer access panel
Used to enter setup information into the computer, such as the date and time, LCD contrast, etc.
Setup Keyboard
QBC star makes it possible to quantify:
Buffy coat cells
The grayish-white layer (Buffy coat) contains packed:
Leukocytes and thrombocytes
QBC Star tube is spun at a high rate of speed that separates blood into layers or bands from:
Heaviest to lightest
QBC Star tubes are designed to enhance:
natural separation
QBC Star:
Granulocytes appear:
Orange-yellow
QBC Star:
Lymphocytes/monocytes appear:
Green
QBC Star:
Platelets appear:
Yellow-orange
QBC Star tube, mechanically expands the buffy coat layer
Precision plastic float
QBC Star
Directly measured from the cell layers
Hematocrit
WBCs
Platelet count
The float, whose density approximates the buffy coat cells, will also penetrate the:
Red blood cell layer
Directly related to the density of the red blood cells, and is based on the depth of penetration of the float into the RBC layer
Hemoglobin
Electronically calculated using the standard formula (Hgb/Hct) x 100
Mean corpuscular hemoglobin concentration (MCHC)
QBC star is internally coated with anticoagulants that allow for collection of:
Capillary blood
The QBC Star system is intended for in vitro:
Diagnostic use
QBC Star
Materials and equipment required for testing
Whole blood (venipuncture in purple top)
QBC Star Blood collection tubes
QBC Star Instrument
Printer Paper
What is displayed after you turn on the QBC Star
“System Check in Progress Please Wait”
When self-test is complete, and the system is ready the following message will display:
“Ready Insert sample Close Door Press Star”
QBC Star blood source can either be:
Capillary stick drop of blood
Venous blood (Purple Top)
Purple top
It is important to gently invert the blood tube ____ times
12-15
The QBC Star tube fills itself by:
Capillary action
Fill the QBC Star tube to the:
Second black line
QBC Star tube must always be filled to at least the:
First black line
QBC Star tube
Blood volume is between ___ and ___ microliters
65-75
Place the QBC Star Tube into the instrument within ___ minutes of filling
15 minutes
Rock the QBC Star tube back and forth at least _____ times to mix the blood with the orange coating
Four
QBC Star Tube
Do not allow the blood to touch the:
White plug at the end of the tube
One rock of the QBC Star Tube
Blood to flow from collection end toward the plug end AND back
Push the ____ to start the test cycle
“Star”
If the system detects the cap is not seated properly, what message will show?
“Sample cap Not Seated”
The instrument mixes the tube contents for:
30 seconds
What descends from the top of the tube toward the closure end, ultimately mixes the blood and reagents in the tube?
The float
The centrifuge accelerates to high speed to separate and pack the cell populations into distinct:
Cell bands
Series of readings taken that are displayed while test is being performed
“Reading Cycle in Progress”
“Scanning QBC Sample”
“Analyzing QBC Scan Data”
You must manually keep track of the link between the test results and the:
Patient
Electronic QC values are only printed every:
8 hours
Startup
Any results out of reporting range are shown on the display as:
Dashes instead of actually numerical values
Out of range readings are indicated for:
Greater than or less than the maximum or minimum level
Calculated values based on out-of-range readings print as
“No Report”
Dispose the use QBC Star tube in:
Biohazard Sharps container
Clean the interior and exterior surfaces of the QBC Star with a damp cloth and use ______ to remove stains
Mild detergent
If blood or glass should escape the plastic protective tube, clean and disinfect the QBC Star instrument as follows:
Put on puncture resistant gloves
Use hemostats to pick up glass/plastic fragments
Dispose of fragments in sharps container
Clean surfaces with 10% bleach
Let stand for 10 minutes
Rinse thoroughly with water and dry
