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Hematology 1 Discussion > CHAPTER 3.5 - DIFFERENTIAL COUNT > Flashcards

CHAPTER 3.5 - DIFFERENTIAL COUNT Flashcards

1
Q

Quantitative and qualitative study of the types of leukocytes

A

DIFFERENTIAL COUNT

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2
Q

Represents the percentage distribution of the different WBCs

A

DIFFERENTIAL COUNT

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3
Q

DIFFERENTIAL COUNT Includes:

A

o Quantitative & qualitative study of thrombocytes
oAge and morphologic abnormalities or RBCs

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4
Q

DIFFERENTIAL COUNT

4 General steps:

A
  1. Preparation of blood smear
  2. Staining of the smear
  3. Counting of the cells
  4. Reporting
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5
Q

Blood smears must be made within

A

2-3 hours

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6
Q

Advantages of EDTA blood smear
1. Can create
2. May be prepared at
3. Avoids

A

multiple slides

later time

platelet clumping

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7
Q

SOURCES OF SPECIMEN:

A

EDTA BLOOD

ANTICOAGULANT FREE BLOOD (CAPILLARY BLOOD)

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8
Q

Best for evaluating blood morphology

A

ANTICOAGULANT FREE BLOOD (CAPILLARY BLOOD)

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9
Q

ANTICOAGULANT FREE BLOOD (CAPILLARY BLOOD)

Advantages:

A

• Made at the patient’s side
• Artifacts are minimized

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10
Q

ANTICOAGULANT FREE BLOOD (CAPILLARY BLOOD)

• Disadvantages:

A

• Platelet clumping
• Few films can be made

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11
Q

METHODS OF BLOOD SMEAR PREPARATION

A
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12
Q

BM preparations; NOT for routine

A

Coverslip Method

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13
Q

PBS

A

Coverslip Method

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14
Q

ADV: superior leukocyte distribution

A

Coverslip Method

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15
Q

Coverslip - rotated 45° (16sided)

A

Coverslip Method

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16
Q

Never touch the coverslips with fingers

A

Coverslip Method

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17
Q

Erlich’s

A

Coverslip Method

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18
Q

Beacom’s

A

Glass Slide-Coverslip Method

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19
Q

Wedge Slide/Push Smear

A

Two-Glass Slide Method

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20
Q

Uses 2 slides

A

Two-Glass Slide Method

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21
Q

Film slide

A

Two-Glass Slide Method

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22
Q

Two-Glass Slide Method Pusher Spreader slide

A

30-45 degree

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23
Q

Two-Glass Slide Method Considerations:
1. Drop of blood (?) in diameter
2. (?) of spreader (smooth & swift)
3. (?) of patient

A

2-3mm

Speed

Gct

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24
Q

Two-Glass Slide Method SPREADER SLIDE:
 Must be (?) than the stationary slide
 Spreading edge:
 With

A

narrower

clean, smooth, polished & thin

beveled edge

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25
Q

Two-Glass Slide Method DISADVANTAGES:
 Tendency of (?) at the slide edges & feathered ends (ADV: easier to find abnormal cells)
 (?) of nucleated cells
 Greater (?) to cells

A

larger cells to settle

Poor distribution

trauma

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26
Q

prepares dual smears simultaneously ata constant angle and speed.

A

Miniprep/Hemaprep

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27
Q

 glass slides are placed on a platform inside the instrument (0.2 ml WB)

A

Hemaspinner

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28
Q

 Instrument spins causing the slide to be covered with a monolayer of cells

A

Hemaspinner

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29
Q

 Uses beam of sensor light

A

Hemaspinner

30
Q

Advantages of Hemaspinner

A

o Even distribution
o Consistency of preparation
o Large examination area
o Fewer broken cells

31
Q

Disadvantages of Hemaspinner

A

o Longer preparation
o Smears can not be done outside the lab
o No specific location for abnormal cells
o Centrifugal force may cause distortions

32
Q

 finding reactive immature or abnormal cells that are present in small numbers

A

Buffy Coat Smear

33
Q

 Megaloblastic nucleated RBC or hypersegmented neutrophils

A

Buffy Coat Smear

34
Q

 WhenWBCcountis<1× 109/L

A

Buffy Coat Smear

35
Q

 Finding abnormal plasma cells

A

Buffy Coat Smear

36
Q

 Easier to locate bacteria & parasites

A

Buffy Coat Smear

37
Q

 For blood parasites

A

Thick Blood Smear

38
Q

blood parasites

A

o Malaria
o Filaria
o Trypanosomes
o Spirochetes

39
Q

CHARACTERISTICS OF A PROPERLY PREPARED WEDGE SMEAR

  1. Length: must occupy at least (?) of the slide
  2. Should be free of (?)
  3. Should have (?) appearance
  4. Should be (?) than the stationary slide
  5. Must have (?) from thick to thin
  6. (?) to allow proper fixation
  7. Should terminate in a (?)
  8. Should contain at least (?) in which 50% of the RBCs do no overlap each other; the remainder ma overlap in doublets or triplets and the central pallor should be clear
A

1/2 to 2/3

waves, holes, and ridges

smooth and even

narrower

gradual transition

Thin enough

feathery tail

10 LPF

40
Q

EFFECTS OF THICK SMEAR:

A

o Excess plasma causes nucleated cells to shrink
o RBCs form rouleaux

41
Q

EFFECTS OF THIN SMEAR:

A

Effects:
o Increased number of smudge el
o RBCs become artificially spheroid w/ distorted shape
o More nucleated cell on the edges

42
Q

ARTIFACTS OF SMEAR PREPARATION
(Common in EDTA)

A
  1. Monocyte vacuolation
  2. Reactive lymphocytes
  3. RBC spiculation
  4. Dole bodies may disappear on standing
  5. Basophilic granules
  6. Drying artifacts
43
Q

– vacuolated cytoplasm with convoluted nuclei & “swiss cheese” cvtoplasm

A

Reactive lymphocytes

44
Q

Causes of Drying artifacts

A

 Humid environment
 Severe anemia
 Water contamination of fixative

45
Q

Types of Drying artifacts

A
  1. Red cell artifacts
  2. Hairy appearance of lymphocytes
  3. Shrinkage of normal leukocytes
46
Q

METHODS OF DRYING BS

A
  1. Air Drying
  2. Use of low flame
  3. Use of oven
  4. Immersion in Methyl alcohol or absolute alcohol for 1 - 2 minutes
47
Q

STAINING OF BLOOD SMEARS
Composition:

48
Q

Tetramethylthionine; Trimethylthionine

A

Methylene blue

49
Q

(+) charged

A

Methylene blue

50
Q

Basic dye: DNA, RNA

A

Methylene blue

51
Q

(-) charged

52
Q

Acidic dye: hemoglobin, eosinophil granules

53
Q

ROMANOWSKY STAINS
Composition

A

 Buffer (pH: 6.4 – 6.8): Ionization
 Fixative: Methanol
 Wash water/Distilled water (NOT tap water)

54
Q

ROMANOWSKY STAINS

Types

A
  1. Wright
  2. Giemsa
  3. Modified Wright-Giemsa
  4. Leishman
  5. May-Grunwald
  6. Jenner
  7. MacNeal
55
Q

Wright’s Stain: PREPARATION

A

1g Wright’s powder
500 ml Acetone-free Methanol (Mallinckrodt methanol)

56
Q

1 wk at 37°C then RT/Ref T

A

Wright’s Stain:

57
Q

1 gm Giemsa powder/500 stain shortens the incubation

A

Wright’s Stain

58
Q

Wright-Giemsa Stain: PREPARATION

A

9g Wright’s powder
1g Giemsa powder
2,910 ml Acetone-free Methanol (Mallinckrodt methanol)

59
Q

Age for 30 days; shake 1/day
Incubate

A

Wright-Giemsa Stain

60
Q

Sorenson’s PO buffer: PREPARATION

A

9.5g 1L
Anhydrous monobasic K2PO4 Dist. Water

9.5g 1L
Anhydrous dilbasic Na2PO4 Dist. Water

61
Q

Mix according to pH desired

A

Sorenson’s PO buffer

62
Q

METHODS OF STAINING

A
  1. Rack Method
  2. Dip Method
  3. Automated Methods
63
Q

Macroscopic

A

pink to reddish-brown

64
Q

Erythrocytes:

A

salmon pink

65
Q

Platelets:

A

purple- blue to lilac cytoplasm with red-purple granules

66
Q

PMN:
Nuclei =
Cytoplasm =
Granules =

A

purple-blue

pinkish tan

pink to lilac

67
Q

Lymphocytes:

A

light blue cytoplasm

68
Q

Monocytes:

A

faint blue-gray cytoplasm with tiny red-purple granules

69
Q

Eosinophils:

A

with red-orange granules (pH meter)

70
Q

Basophils:

A

with dark purple granules

71
Q

PROCEDURE
1. Check slide identification
2. Perform patient specimen orientation 3. LPO-scan to review blood film
4. LPO-scan to review blood film
5. Oil Immersion Examination

72
Q

OTHER CRITERIA:
 50 Cells: WBC count is
 100 cells:

A

< 1 x 109/L

o > 10% Eosinophils
o > 2% Basophils
o > 11% Monocytes
o Lymphocytes > Neutrophils

Hematology 1 Discussion (11 decks)

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