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mls 3H > Hema 2 Lab M1 > Flashcards

Hema 2 Lab M1 Flashcards

1
Q

Main disease associated with Eosinopenia

A

Cushing’s Syndrome or Hyperadrenalism

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2
Q

In a Diluting Fluid

What is the function of Propylene Glycol

A

Lyses RBCs

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3
Q

In the Neubauer chamber, where do we count the eosinophils?

A

9 Large Squares

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4
Q

Give me the components of Randolph’s Diluting Fluid

A

Phloxine, Propylene Glycol, & Calcium Chloride

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5
Q

State the step-by-step procedure of Absolute Eosinophil Count

A
  1. Draw well-mixed anticoagulated whole blood to the 1 mark of the WBC pipette.
  2. Wipe the outside portion of the pipette and draw the diluting fluid to the 11 mark.
  3. Mix for 10 minutes using a pipette shaker
  4. Expel the first 4 drops and fill both sides of the counting chamber.
  5. Allow the cells to settle for at least 3 minutes before counting.
  6. Count the eosinophils in the entire ruled area of both sides of the
    hemocytometer
  7. Get the average count and compute for the absolute count.
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6
Q

Give me the components of Manner’s Diluting Fluid

A

Phloxine, Urea, Trisodium citrate, & Distilled Water

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7
Q

In a Diluting Fluid

What is the function of Heparin

A

Inhibits leukocyte clumping

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8
Q

The formula for Absolute Eosinophil Count

A

Eosinophils/cu.mm = (number of eosinophils counted / 9) x 100

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9
Q

Main disease associated with Eosinophilia

A

Addison’s Disease or Hypoadrenalism

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10
Q

What is the test for the normal adrenal function that usually involves eosinophil count?

A

THORN’S TEST (Eosinophil Depression Test)

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11
Q

In a Diluting Fluid

What is the function of sodium carbonate

A

Lyses all WBCs except eosinophil

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12
Q

Eosinophils are high in terms of (1) _______ (give examples) & (2) _________ (alongside basophils)

A

(1) Respiratory diseases (ex. Pulmonary infiltrates, Hay Fever)
(2) Allergic reactions

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13
Q

In a Diluting Fluid

What is the function of Phloxine

A

Stains eosinophils red

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14
Q

Give me the components of a Phloxine Diluting Fluid

A

Phloxine, Propylene Glycol, Sodium Carbonate, & Distilled Water

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15
Q

Give me the components of the Pilot’s Solution

A

Phloxine, Propylene Glycol, Sodium Carbonate, Distilled Water, & Heparin

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16
Q

State three reasons why eosinophilia happens

A

Parasitic Infections
Allergic Reactions
Certain Leukemias

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17
Q

Increase or Decrease

What happens to the number of eosinophils when there is high level of cortisol?

A

Decrease

Cortisol induces apoptosis, meaning if high ang cortisol mo (due to stress or etc.) mababa eosinophil count mo due to apoptosis (cushing’s syndrome)

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18
Q

State the possible situations where basophil count increases

A

Allergic/Inflammatory Reactions
Hypersensitivity Reactions

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19
Q

Other name for Toluidine Blue Method

A

Cooper and Cruickshank Method

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20
Q

State the function of Cetylpirimidium Chloride

Part of the Principle of Cooper and Cruickshank Method

A

Lyses the erythrocytes and render basophilic granules insoluble

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21
Q

State the function of Ammonium sulfate

Part of the Principle of Cooper and Cruickshank Method

A

Used as a mordant to improve the staining qualities of toluidine blue

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22
Q

What does EDTA do?

Part of the Principle of Cooper and Cruickshank Method

A

Prevent platelet agglutination

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23
Q

What is the color of basophils under the Toluidine Blue Method?

A

Purple red metachromatically-stained cells

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24
Q

Reference Range of Basophil Count

A

0–2 x 10^9/L

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25
Q

State two purpose of Nitroblue Tetrazolium Test

A
  • Distinguish between systemic bacterial infections from non-bacterial infections
  • Detect neutrophil function defect
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26
Q

When the Neutrophils are incubated with colorless soluble dye (Nitroblue Tetrazolium), reduction produces ________ precipitates, and the number of neutrophils that reduced the dye is quantified.

Color

A

Blue-black formazan precipitates

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27
Q

State the interpretation

> 10 NBT

A

Positive neutrophils
Systemic bacterial infection

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28
Q

State the interpretation

<10 NBT

A

Positive Neutrophils
Normal Individuals

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29
Q

State the interpretation

Negative NBT

A

Congenital Defect of Neutrophil Function

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30
Q

It is an older technique used to diagnose acute leukemia.

A

Cytochemical Staining

  • It’s inexpensive
  • Can be used by the whole world
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31
Q

3 mostly used stains in diagnosing Leukemia based on affected cell lineage

A
  • Myeloperoxidase (MPO)
  • Sudan Black B (SBB)
  • Esterases
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32
Q

What is MPO and where is it found?

A

Myeloperoxidase

It is an enzyme found in primary granules of the WBCs

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33
Q

Myeloperoxidase is positive for what kind of cells? Also state the color.

A

Dark Brown

myeloblasts, promyelocytes, weak activity in
monocytes

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34
Q

What is SBB and where is it found?

A

Sudan Black B

Found in the lipid portion of primary and secondary granules

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35
Q

State the positive color for Sudan Black B and cells that are positive for this stain

A

BROWN to BLACK

myeloblasts, promyelocytes, weak activity in
monocytes

36
Q

Cells that are negative for MPO

A

lymphoid cells, megakaryocytes, immature RBCs

Red blood cells may stain diffusely brown because of pseudoperoxidase activity of hemoglobin

37
Q

Cells that are negative for SBB

A

lymphoid cells, megakaryocytes, immature RBCs

Same with MPO

38
Q

State the two Specific Esterases

A

Chloroacetate Esterase and Napthol AS-D Acetate

39
Q

Under the microscope you see a Bright Red Neutrophils and Mast Cells which is a positive result for a certain stain, what stain do you think the MedTech used?

A

Specific Esterase

Can be Chloroacetate Esterase and Napthol AS-D Acetate

40
Q

These esterases are mainly found staining the monocytes. What are these?

A

Nonspecific Esterase

41
Q

Give 2 Nonspecific Esterase

A

ANAE and ANBE

Alpha Naphthyl Acetate Esterase and Alpha Naphthyl Butyrate Esterase

42
Q

What cells are negative for Specific Esterase?

A

eosinophils, monocytes, lymphoid cells

43
Q

What cells are positive for Nonspecific Esterase? State the color.

A

Monoblast and Monocyte

Dark Red/ Reddish Brown color

44
Q

Esterase found in Neutrophils

A

Specific Esterase

45
Q

Esterase found in Monocytes

A

Nonspecific Esterase

46
Q

What cells are negative for Nonspecific Esterase?

A

granulocytes, megakaryocytes, lymphoid cells

47
Q

What do you need to add in the ANAE to differentiate monocytes from other cells that occasionally show positivity?

A

Sodium Fluoride

It inhibits the monocytic enzyme

48
Q

What is CRP?

A

Cyanide-Resistant Peroxidase

Peroxidase in eosinophils

Sodium cyanide is added to inhibit peroxidase in WBCs other than those found in eosinophils

49
Q

It is added to inhibit peroxidase in WBCs other than those found in eosinophils

A

Sodium Citrate

50
Q

What is TRAP

A

Tartrate-Resistant Acid Phosphatase

Inhibits acid phosphatase in leukocytes, except acid phosphatase isoenzyme 5

51
Q

Positive color for TRAP?

A

Purple to Dark Red

52
Q

What cells does TRAP stains?

A

hairy cells in hairy cell leukemia

Mnemonics: Harry is TRAP

Negative lahat maliban dito

53
Q

What cells does TRAP stains?

A

hairy cells in hairy cell leukemia

Negative lahat maliban dito

54
Q

What is PAS?

A

Periodic Acid Schiff

Stains Carbohydrates like Glycogen and Mucoproteins

55
Q

Positive cells and color for PAS

A

Magenta - Multiple Cell Types

56
Q

These cells are negative for PAS

A

normal erythroblasts & lymphoid cells (L1 & L2)

57
Q

What is LAP?

A

Leukocyte Alkaline Phosphatase

Enzyme in secondary granules of mature neutrophils

58
Q

What color is the Neutrophils stained with LAP

A

Black Brown

59
Q

Lap Score

No granules

A

0

60
Q

Lap Score

4+

A

Intense, cytoplasm is packed with granules (100%)

61
Q

Lap Score

Moderate (50-75%)

A

2+

62
Q

Lap Score

3+

A

Strong numerous (75%)

63
Q

Lap Score

1+

A

Faint, few granules (<50%)

64
Q

LAP Score Reference Range

A

30-100

65
Q
  • Leukemoid reaction (LR)
  • Chronic neutrophilic leukemia (CNL)
  • Bacterial infections
  • Polycythemia vera (PCV)
  • 3rd term pregnancy
  • CGL-blast crisis or with infection
A

Increase LAP Activity

66
Q

Give Results or Diagnosis

Decreased LAP Activity

A
  • Chronic granulocytic / myelogenous leukemia (CGL / CML) * Paroxysmal nocturnal hemoglobinuria (PNH)
  • Sideroblastic anemia
  • Eosinophilia
67
Q

LR & CML/CGL are the same in morphology, the only way to differentiate them is through _____

A

LAP Activity

68
Q

Primitive marker for lymphoblast but not for mature lymphoblast

A

Terminal Deoxynucleotidyl Transferase (TdT)

69
Q

What is TdT?

A

Terminal Deoxynucleotidyl Transferase

DNA polymerase inside cell nuclei

70
Q

TdT is positive in what cells?

A

T-Lymphoblasts (Acute Lymphoblastic Leukemia [ALL] L1 &
L2), pre-B cells

71
Q

TdT is negative in what cells?

A

myeloblasts, monoblasts, & ALL-L3

72
Q

What are the staining techniques to differentiate acute myeloid leukemia (AML) & acute lymphoblastic leukemia (ALL)

A

MPO, SBB, PAS, TdT

73
Q

It is used to used to differentiate monocyte & granulocyte cell linkages.

A

Esterase

74
Q

Reaction of AML in SBB

A

+

REVIEW ACUTE LEUKEMIA CYTOCHEMICAL REACTION CHART

75
Q

Reaction of ALL in MPO

A

-

REVIEW ACUTE LEUKEMIA CYTOCHEMICAL REACTION CHART

76
Q

Reaction of Megakaryocytic Leukemia in MPO, SBB, NASDA, ANBE, ANAE

A
          • +(localized)

respectively

REVIEW ACUTE LEUKEMIA CYTOCHEMICAL REACTION CHART

77
Q

MPO Positive or Negative

Auer rods found in leukemic blasts

A

Strongly MPO Positive

Auer Rods are found in primary or azurophilic granules

78
Q

Between MPO and SBB what is more sensitive for the early myeloid cells?

A

SBB

79
Q

What do you call the enzyme that accelerates the hydrolysis and synthesis of esters?

A

Esterase

80
Q

How many isoenzymes are present in leukocytes?

A

9

81
Q

Chloroacetate esterase is present in ____

A

Primary granules of the neutrophils

82
Q

Except for MPO, Auer Rods also show positivity in what type of cytochemical stain?

A

CAE

Chloroacetate Esterase

83
Q

A patient would be positive for Acute Monocytic Leukemia (AMoL) if ___% or more of the blast are nonspecific esterase positive and specific esterase negative

A

80%

84
Q

A patient would be positive for Acute Myelomocytic Leukemia (AMML) if __% shows monocytic differentiation using the sodium fluoride

A

20

85
Q

Differentiate ANAE and ANBE

A

Butyrate is more sensitive and more specific while Acetate can be mixed with sodium fluoride which inhibits the monocytic enzyme

mls 3H (12 decks)

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