hema: hematopoiesis, hemocytometer and quality control Flashcards
1
Q
Deals with the study of blood, blood-forming
organs and blood diseases.
A
Hematology
2
Q
Specialized body fluids that deliver
necessary substances such as nutrients and
oxygen to the cells and transports metabolic
waste products away from the same cells.
A
blood
3
Q
Process of cellular formation, proliferation,
differentiation and maturation of blood cells.
A
Hematopoiesis
4
Q
Organs and tissue areas in which blood cell
production or regulation occur
A
Hematopoietic tissues
5
Q
areas included in fetal hematopoiesis in Hematopoietic tissues
A
spleen, lymphatic tissues and bone marrow
6
Q
stages of hematopoiesis
A
mesoblastic, hepatic, & myeloid stages
7
Q
the primary site/s of hematopoiesis in mesoblastic stage
A
blood islands of the yolk sac of the human embryo
(as early as 19th day of gestation)
8
Q
Blood Cells formed in mesoblastic stage
A
Erythroblasts
9
Q
first blood cells formed by the first month of embryonic
life
A
erythroblasts
10
Q
Embryonic hemoglobin are formed:
A
- Gower I-2 zeta chains and 2 epsilon chains
- Portland- 2 zeta chains and 2 gamma chains
- Gower II- 2 alpha chains and 2 epsilon
chains
11
Q
primary site/s of hematopoiesis in hepatic stage
A
Fetal Liver
12
Q
Blood cells formed in hepatic stage
A
- erythrocytes still in production
- granulocytes and megakaryocytes:
3rd month of gestation - lymphocytes: 4th month of gestation
- monocytes: 5th month of gestation
13
Q
what begin a limited role as
secondary lymphoid organs in mid fetal life
A
spleen and lymph node
14
Q
fetal hemoglobin is produced during ___
A
4th month of gestation
15
Q
also in hepatic stage
A
HbF- 2 alpha chains and 2 gamma chains
16
Q
primary site/s of hematopoiesis in myeloid stage
A
bone
marrow
17
Q
adult hemoglobins are produced in myeloid stage
A
Hb-A1-2 alpha chains and 2 beta chains & Hb-A2-2 alpha chains and 2 delta chains
18
Q
becomes the only site
for RBC production, granulocytes,
monocytes, platelets and B lymphocytes at birth
A
bone marrow
19
Q
Hematopoiesis occurs in most bones but
primarily in ____
A
flat bones of the sternum, ribs, vertebrae, skull and pelvis
20
Q
principal source of production in adult
A
sternum and other flat bones
21
Q
major function of bone marrow
A
production and proliferation of blood cells
22
Q
3 Major Compartments of Cell Types of Marrow
Hematopoiesis:
A
stem cells, Progenitor (commited) cells, and Precursor cells-blast
23
Q
Known as pluripotential or multipotential cells
A
stem cells
24
Q
Retain the ability to differentiate into any cell
line
A
stem cells
25
Referred to as colony-forming units-spleen
(CFU-S)
stem cells
26
stem cells can differentiate into:
- multipotential stem cells which give rise to
non-lymphocytes
- Secondary multipotential stem cells which
give rise to primitive B or T lymphocytes
27
known as unipotential stem cells-differentiate into only one cell line(BFU,CFU-E,CFU-MEG and
CFU-GM)
Progenitor (commited) cells
28
forms (myeloblast, megakaryoblasts, erythroblasts)
Precursor cells-blast
29
what do Precursor cells-blast form
myeloblast, megakaryoblasts, erythroblasts
30
Primary cells, Having capability of self renewal and can differentiate into many specialized cells.
STEM CELLS
31
Designed to form a particular type of cell
Committed Pluripotent Hematopoietic Stem Cell or CPHSC
32
CPHSC give rise to 2 groups of cells
Lymphoid Stem Cells and Colony forming Blastocytes
33
Lymphocytes & Natural
killer cells
Lymphoid Stem Cells
34
Colony forming - E
Erythrocytes
35
Colony forming - M
Megakaryocytes
36
Colony forming - GM
Neutrophils, Eosinophils,
Basophils & Monocytes
37
Colony Forming Unit - E
● Proerythroblast
● Early normoblast
● Intermediate normoblast
● Late normoblast
● Reticulocyte
● Matured RBC
38
known as Erythrocytes
Red Blood Cells
39
shape of mature red blood cells
biconcave disks
40
disk size of RBC
Has a diameter of 6-8um and a thickness of
2um
41
amount of RBC in male
Male: 4.50-6.80 x 10^6/uL
42
amount of RBC in female
Female: 3.80-4.80 x 10^6/uL
43
lifespan of RBC
120 days
44
Blood cells that FIGHTS infection.
White Blood Cells
45
Ref. ranges of WBC
4.0 - 11.0 x 10^3
46
increased in WBC
Leukocytosis
47
decreased in WBC
Leukopenia
48
2 groups of WBC
Granulocytes and Agranulocytes
49
Normal Marrow Composition:
● 60% - granulocytes & precursors
● 20% - erythroid precursors
● 10% - Lymphocytes, Monocytes
● 10% - Unidentified or disintegrated cells
50
It is a technique used to enumerate the total
cell count in the BLOOD or other Biological
body fluids. This can be done either by using
a haemocytometer manually or by electronic
cell counter automatically.
Haemocytometry
51
hemo means?
blood
52
cyto means?
cells
53
meter means?
measurement
54
hemocytometer
an instrument used to count/measure the blood cell
55
purpose of hemocytometer
In certain pathologic conditions the value of
different types of cells may have variation.
Thus by counting the cells in the blood or
body fluids, it can be find out if an individual
is normal or not.
56
purpose of cell count (generally/broadly)`
● To find out normal and abnormal count of the
cell.
● To support and confirm clinical diagnosis of
the patient.
● To find out the response of the patient to the
treatment.
57
who invented hemocytometer?
Louis-Charles Malassez
58
who modified hemocytometer?
Neubauer
59
an instrument used for counting the
cells in blood or fluid.
hemocytometer
60
Haemocytometer Box, consist of a
special thick slides, cover slips, pipette, and diluting fluids
61
called Neubauer’s counting chamber, diluting fluids
special thick slides
62
used for diluting the blood with rubber tube with
different color plastic mouthpiece for drawing
blood or fluid in pipette.
RBC and WBC pipette
63
parts of diluting pipettes
stem cell, bulb, rubber tube and mouth piece
64
has capillary bore and well grounded conical tip.
stem cell
65
markings of stem cell
has only two markings of 0.5 in middle of stem & 1 at the junction of stem and bulb.
66
contains a rolling bead that helps in mixing the blood with diluting fluid and helps in quick identification of pipette
bulb
67
color of bulbs
WBC - White
RBC - Red
68
the bulb narrows again into a short stem to which a
long narrow rubber tube (25 to 30 cm) with red mouth piece in WBC is attached. These are used to suck blood and diluents to the pipette.
rubber tube and mouth piece
69
bead colors of rbc and wbc pipette
rbc = red
wbc = white
70
marked major calibrations of rbc and wbc pipette
rbc = 0.5, 1.0 and 101
wbc = 0.5, 1.0 and 11
71
bulb size of rbc and wbc pipette
rbc = larger
wbc = smaller
72
lumen size of rbc and wbc pipette
rbc = smaller
wbc = larger
73
capillary bore lumen of rbc and wbc pipette
rbc = narrow
wbc = wider
74
speed of rbc and wbc pipette
rbc = slow
wbc = faster
75
mouth piece color of rbc and wbc pipette
rbc = red
wbc = white
76
dilution in rbc and wbc pipette
rbc = up to 100 or 200 times
wbc = up to 10 or 20 times
77
diluents used in rbc and wbc counting
rbc = hyaem's fluid
wbc = turk's fluid
78
dilution factor for WBC and RBC counting
WBC: FV/IV = 10/0.5 = 20
RBC: FB/IV = 100/0.5 = 200
79
Sum-total of all the characteristics of a
product/service that has a bearing upon the
utilization of the product product/service to the entire
satisfaction of the consumer.
Quality
80
4a's in Quality
Acceptable, Accessible, Affordable and Appropriate
81
an activity to improve patient care by having the lab
monitor, its work to detect deficiencies &
subsequently correct them.
Total Quality Management (TQM)
82
to improve the patient care by placing the emphasis
on not to make mistakes in the first place.
Continuous Quality Improvement (CQI) /
Performance Improvement (PI)
83
external activities that ensure positive patient outcomes. It
measures what a lab can do to improve
reliability.
Quality Assurance (QA)
84
Principles of Quality management,
assurance, and control
● Total Quality Management of clinical
laboratory
● Control of pre-analytical variables
● Control of analytical variables
● External quality assessment & proficiency
testing programs
85
TQM also referred to as:
Total quality control (QC), total
quality leadership, continuous quality improvement,
quality management science or industrial quality
management.
86
The Universal principles of TQM are
1) Customer focus
2) Management commitment
3) Training
4) Process capability & control
5) Measure using quality-improvement tools
87
conformance to requirements
Quality
88
“Costs of conformance” + “Costs of non conformance”
Quality Costs
89
(WORK PROCESS) PHYSICIAN/HEALTHCARE PROVIDER
● Patient examination
● Patient testing
● Patient diagnosis
● Patient treatment
90
(WORK PROCESS) HEALTHCARE ADMINISTRATOR
● Processes for admission of patients
● Tracking patient services
● Discharge of Patients
● Billing for costs of service
91
(WORK PROCESS) LABORATORY DIRECTOR
● Processes for acquiring specimens
● Processes specimens
● Analyzing samples
● Reporting test results
92
(WORK PROCESS) LABORATORY ANALYST
● Acquiring samples
● Analyzing samples
● Performing quality control
● Releasing patient test results
93
TOTAL QUALITY MANAGEMENT FRAMEWORK
QLP, QC, QA, QI, QP
94
Includes analytical processess & the
general policies, prcatices, procedures that
define how all aspects of the work are done.
QLP - QUALITY LABORATORY PROCESS
95
emphasizes statistical control procedures, but also includes non-statistical check procedures
QC - QUALITY CONTROL
96
concerned primarily with broaders
measures & monitors of lab performance
(turnaround time, specimen identification,
patient identification, test utility)
QA - Quality Assessment
97
a structured problem solving process to
help identify the root cause of a problem & a
remedy for that problem.
QI - QUALITY IMPROVEMENT
98
provides the planning steps.
QP - QUALITY PLANNING
99
defines how quality is managed objectively with the scientific method or the PDCA cycle
FIVE Q
100
provides the planning step
QP
101
establishes standard processes
QLP
102
provides measures for check
QC and QA
103
provides a mechanism through which to act on those measures
QI
104
The main objective of a laboratory is to
provide reliable, timely, and accurate test results.
Quality System
105
QC + QA =
QUALITY ASSURANCE
106
Includes personnel,
instrumentation, document
control, reagent control and
corrective action.
Internal Quality Control (IQC)
107
External quality control is
important to ensure the
laboratory is performing to an
external standard.
External Quality Assurance (EQA)
108
● Audit, On-site
inspection
○ Internal
○ External
● Accreditation
MAN-DRIVEN
109
● Quality Assessment
○ Internal
○ External
○ Schematic
way: External quality Assessment
Scheme (EQAS)
MATERIAL-DRIVEN
110
refers to operational
techniques that must be included during
each assay run to verify that the
requirements for quality are met with
Quality control
111
refers to all those
planned and systematic activities to provide
confidence that the results given out by the
laboratory are correct
Quality assurance
112
ensure that the results
generated by the test are correct.
Quality Control
113
concerned with much more: that the
right test is carried out on the right specimen and that
the right result and right interpretation is delivered to
the right person at the right time.
Quality Assurance
114
purpose of quality assurance
maintenance of the overall quality of patient results
115
refers to the collection, transport and quality of specimen
pre-analytic
116
refers to the result accuracy, clerical errors, analytical errors and assay repeat rates
analytic
117
refers to the result reporting, record keeping for patient and QC
post-analytic
118
objectives of quality in lab
1. support provision of high quality health-care (reduce morbidity, mortality and economic loss)
2. ensure credibility of lab
3. generate confidence in lab results
118
laboratory errors cost in
time, personal effort and patient outcomes
119
coordinated activities to direct and control an organization with regard to quality
Quality Management System
120
the path of workflow
the patient -- test selection -- sample collection -- sample transport -- report creation -- report transport
121
Laboratory tests are influenced by
● Laboratory environment
● Knowledgeable staff
● Competent staff
● Reagents and equipment
● Quality control
● Communications
● Process management
● Occurence management
● Record keeping
122
errors which occur when non-analytical factors change concentration Of analytes
preanalytical variability
123
appropriate should be
requested & performed
test conducted
124
labeling of specimen
may improper; corrected by bar coding
patient identification
125
should be kept
minimum
TAT
126
entry of patient & test
details in lab registers & computers
laboratory logs
127
a substantial risk of
transcription error exists from manual entry
of data, even when results are double
checked; computerization reduces this error
transcription errors
128
essential to obtain meaningful
test result
patient preparation
129
container,
anticoagulant, time taken to send specimen
to lab, corrected by using vacutainer tubes &
collection of samples by lab personnel
specimen collection
130
critical for some tests
specimen transport
131
monitoring of the performance of the
centrifuge, container used for storage
specimen separation, aliquoting
132
variation from person to person.
Safety precautions for all specimens.
Throughout time to be monitored on the
weekly or monthly basis
personnel
133
must be controlled
carefully to ensure accurate measurements
by analytical methods
analytical variables
134
Clear concepts in relation to Analytical
methods
Calibration, trueness, accuracy,
precision, linearity, & limit of detection
135
Closeness of agreement b/n the
average value obtained from a large
series of results of measurements
and a true value
Trueness of measurements
136
The known, accepted value of a
quantifiable property
True Value
137
The difference b/n average value &
the true value
Bias
138
Result of an individual’s
measurement of a quantifiable
property
measured value
139
The closeness of the agreement b/n
the result of a measurement * a true
conc. of the analyte.
Accuracy
140
Closeness of agreement b/n
independent results of
measurements obtained under
stipulated conditions
Precision
141
The ability to maintain both precision and
accuracy
Reliabity
142
the relationship between
measured & expected values over the
analytical measurement range.
Linearity
143
highest measurement
result that is likely to be observed for a blank
sample.
Limit of Blank
144
lowest concentration of measurement that can be
consistently detected in ≥ 95% of samples
tested under routine laboratory conditions
and in a given sample matrix.
Limit of Detection
145
lowest actual amount of analyte that can be reliably
detected and at which the total error meets
the laboratory’s requirements for accuracy.
Limit of Quantification
