Hema 1part 1. Flashcards
1
Q
Thoma RBC pipette markings
A
Markings
0.5, 1.0, 101
2
Q
THOMA RBC PIPETTE volume bulb
A
100
3
Q
THOMA RBC PIPETTE
Dilution range:
A
1:100 – 1:1000
4
Q
THOMA WBC PIPETTE markings
A
0.5, 1.0, 11
5
Q
THOMA WBC PIPETTE volume of bulb
A
10
6
Q
THOMA WBC PIPETTE Dilution range:
A
1:10 – 1:100
7
Q
What is the dilution if blood sample is aspirated up to the 0.5 mark and diluting fluid is aspirated up to the highest mark of the RBC pipet?
A
Dilution = S/TV =5/1000=0.005 1/200
8
Q
CELL ESTIMATE
1. FACTORS
WBCs
→ # of WBCs per field x_______
Platelets
→ # of platelets per field x _______
A
WBCs
→ # of WBCs per field x 2,000
Platelets
→ # of platelets per field x 20,000
9
Q
2 – 5 WBCs/hpf=
A
4,000 – 7,000 WBCs/uL
10
Q
4 – 6 WBCs/hpf
A
7,000 – 10,000 WBCs/uL
11
Q
6 – 10 WBCs/hpf
A
10,000 – 13,000 WBCs/uL
12
Q
– 20 WBCs/hpf
A
13,000 – 18,000 WBCs/uL
13
Q
0 – 49,000 /uL platelets
A
MARKEDLY DECREASED
14
Q
50,000 – 99,000 /uL platelets
A
MODERATELY DECREASED
15
Q
100,000 – 149,000 /uL platelets
A
SLIGHTLY DECREASED
16
Q
150,000 – 199,000 /uL platel
A
LOW NORMAL
17
Q
200,000 – 400,000 /uL platelets
A
Normal
18
Q
401,000 – 599,000 /uL platelets
A
SLIGHTLY INCREASED
19
Q
600,000 – 800,000 /uL platelets
A
MODERATELY INCREASED
20
Q
More than 800,00 /uL platelets
A
MARKEDLY INCREASED
21
Q
Cell counting principle
A
Coulter principle (electrical impedance or resistance)
22
Q
Number of pulses =
A
numbers of cells
23
Q
Height of the pulse =
A
size of the cell
24
Q
The criteria of the coulter counter of platelets? The size of
the cell should be_______
A
2 to 20 fL
25
BLOOD + ISOTONIC SALINE SOLUTON ratio
(1:6250)
26
Rbc count size
>36 fL
27
Possible sources of error in rbc count
Giant platelets
Platelet satellitism
Schistocytes / RBC fragments
Clots
Cold agglutinins
28
Rbc count histogram can derive:
→ Mean cell / corpuscular volume (MCV)
→ Red cell distribution width (RDW)
29
Calculated parameters in RBC Count
Mean corpuscular hemoglobin (MCH)
Mean corpuscular hemoglobin concentration (MCHC)
Hematocrit (HCT) / Packed red cell volume
30
Bernard-Soulier Syndrome & May- Hegglin Anomaly may cause?
false decrease
31
A clue when giant platelet is present =
check MPV (Mean Platelet Volume)
→ Increased MPV is a sign of giant platelets
32
In what condition will you see
many schistocytes?
→ Hemolytic anemia
→ Burn patients
33
A phenomenon where platelets surround a
WBC induced by EDTA
Platelet satellitism
34
Platelet satellitism will cause
The electric pulse will not count every platelet
that is surrounding the WBC (isang bilang lang)
and will be FALSELY DECREASED
35
Platelet satellitism remedy
use sodium citrate (light blue top)
36
Schistocyte / Schizocyte / RBC fragments will both affect:
→ RBC: false decrease
→ Platelet: false increase (RBC fragments
mistook for platelets)
37
Clots effect on RBC and PLT ct
Both false decrease
38
Are antibodies that will agglutinate RBCs at
cold temp. (room temp and below)
Cold agglutinins
39
PLATELET COUNT size
2-10 fL
40
Platelet histogram Can derive:
→ Mean platelet volume (MPV)
→ Platelet distribution width (PDW)
41
BLOOD + LYTIC / LYSING REAGENT_______
Characteristic of WBC diluting fluid SHOULD LYSE RBCs
(1:251)
42
WBC COUNT
>35 fL
43
WBC Count source of errors
Lyse-resistant RBCs
→ Sickle cells
→ Extremely hypochromic cells
→ Target cells
→ Nucleated RBCs
44
WBC DIFFERENTIAL lymphocytes NV
35-90fL
45
MONONUCLEAR CELLS NV
90-160 fL
46
GRANULOCYTES NV
160-450 fL
47
VCS Technology volume is measured via
pulse height
48
VCS Technology is MEASURED IN 2 WAYS:
→ SIDE SCATTER-
→ FORWARD SCATTER-
→ SIDE SCATTER-Internal Cell Complexity
→ FORWARD SCATTER-Size / Volume
49
WBC Differential Scatter plot x-axis
X-axis= Internal Cell Complexity
50
HEMOGLOBIN DETERMINATION
→ Spectrophotometric method:
Cyanmethemoglobin (HiCN)
51
HEMOGLOBIN DETERMINATION reagent that Converts hemoglobin into methemoglobin / hemiglobin (Hi)
Potassium ferricyanide
52
HEMOGLOBIN DETERMINATION reagent that Converts methemoglobin into cyanmethemoglobin
Potassium cyanide
53
HEMOGLOBIN DETERMINATION REAGENT that Shortens conversion time from 10–15 minutes into 3 minutes
Dihydrogen potassium
phosphate (KH2PO4)
54
HEMOGLOBIN DETERMINATION REAGENTSSuch as Sterox or Triton X; enhances lysis of RBCs
Non-ionic detergent
55
HiCN is measured at
540 nm
56
HiCN method measures all forms of hemoglobin except
sulfhemoglobin (SHb)
57
Can be corrected using a patient blank
Lipemia
58
Can be corrected by centrifuging test mixture and
testing hemoglobin on the supernatant fluid
Increased WBCs
59
Dilute hemoglobin with distilled water
HbS & HbC
60
Use of KH2PO4
Increased globulins
61
Causes no effect on hemoglobin methods
Overanticoagulation
62
INSTRUMENT / TECHNICAL ERRORS IN AUTOMATED CELL COUNTING: Most common
APERTURE PLUGS
63
APERTURE PLUGS may cause positive error if
Falsely increased
64
External electrical pulses/ power fluctuations
EXTRANEOUS ELECTRICAL PULSES
65
EXTRANEOUS ELECTRICAL PULSES can cause
positive error – falsely increased
66
EXTRANEOUS ELECTRICAL PULSES remedy
Uninterruptable Power Supply (UPS)
67
Presence of bubbles may be a result if the specimen is
mixed vigorously
68
Bubbles can cause
positive error – falsely increased
69
What happens if TWO cells pass through the aperture at
once?
→ 2 cells will be counted as one
This may cause a false decrease in the cell count
→ Cell size increase
Since 2 cells are counted into one, it would look like that particular
cell is increased in size
70
Methods of Blood Smear Preparation
→ Coverglass Method
→ Spinner/Spun Smear method
→ Wedge Method
71
Size of Slide for BLOOD FILM PREPARATION
1x3 inches
72
Drop of Blood for BLOOD FILM PREPARATION
2-3 mm
73
Distance of the drop from the frosted end of slide:
1 cm
74
Angle of the Spreader slide from the stationary slide:
25-45 degree angle
75
Thick smear is for detection of
Anemia
76
Thin smear: if the patient has
Polycythemia vera
77
DIRECTIONS FOR READING/ COUNTING CELLS
Cross-sectional or crenellation
Longitudinal or lengthwise
Battlement method
78
STAINS COMMONLY USED
ROMANOWSKY STAINS
79
ROMANOWSKY STAINS CONTAINS
Eosin, Methylene blue, Glycerine & Methanol
80
pH buffer for romanowsky stains
(Sorenson’s phosphate buffer): 6.4 – 6.8
81
Salmon pink
Erythrocyte
82
Purple-blue to lilac cytoplasm and red-purple granules
Platelets
83
Nuclei is blue-purple (purple in Henry)
Leukocyte
84
Orange granules (red orange in Henry)
Eosinophil
85
Pinking tan cytoplasm
Neutrophil
86
Gray-ground glass cytoplasm with many tiny red purple granules
Monocyte
87
Gray-ground glass cytoplasm with many tiny red purple granules
Monocyte
88
Blue
Bacteria
89
Light blue cytoplasm
Lymphocyte
90
Light blue cytoplasm
Lymphocyte
91
Includes Brilliant cresyl blue, New methylene blue, and Crystal violet
SUPRAVITAL STAINS
92
SUPRAVITAL STAINS includes
Brilliant cresyl blue, New methylene blue, and Crystal violet
93
Used to demonstrate Reticulocyte and Heinz bodies
Supravital stains
94
NEVER REPORT______ IN CBC
→ Different stain is used to visualize
→ Commonly, Romanowsky stains are used for CBC
RETICS
95
DO NOT REPORT________ IN WRIGHT-STAINED SMEAR
→ As they are not visible in that stain; only in supravital stains
HEINZ BODIES
96
Differentiates myeloid (+) from lymphoid (-)
PEROXIDASE / MYELOPEROXIDASE (MPO)
97
IN USING PEROXIDASE / MYELOPEROXIDASE (MPO) BLOOD SPX SHOULD BE
FRESHLY COLLECTED
98
Why does the specimen for MPO needed to be fresh?
→ Peroxidase is an ENZYME – there’s a tendency that the enzyme will
deteriorate if not fresh
99
Differentiates myeloid (+) from lymphoid (-)
SUDAN BLACK B
100
Even 2 to 3-week old sample can be used
SUDAN BLACK B
101
Differentiates lymphoid (+) from myeloid (-)
TERMINAL DEOXYNUCLEOTIDYL TRANSFERASE (TDT)
102
Non-specific (NSE)
ESTERASE
103
Non specific ESTERASE Include
Include:
Acetate esterase
Butyrate esterase
104
Specific (SE) includes
→ Includes:
Chloroacetate esterase
105
Specific (SE) includes
→ Includes:
Chloroacetate esterase
106
TARTRATE-RESISTAN ACID PHOSPHATASE (TRAP)
107
For iron-containing granules
→ Siderotic granules / Pappenheimer bodies
PRUSSIAN BLUE (PEARL’S)
108
Stains glycogen
PERIODIC ACID SCHIFF (PAS)
109
Stains glycogen
PERIODIC ACID SCHIFF (PAS)
110
→ Erythroleukemia (M6)
→ Gaucher disease
→ Acute lymphoblastic leukemia
111
LEUKOCYTE ALKALINE PHOSPHATASE increased
Leukemoid reaction
112
LEUKOCYTE ALKALINE PHOSPHATASE decreased
Chronic Myelogenous Leukemia / Chronic
Granulocytic Leukemia
113
LEUKOCYTE ALKALINE PHOSPHATASE NV
30 – 185
