HEMA LEC - Intro Lecture Flashcards
• 2 Types of PMN
o PMN – mature and segmented
o Neutrophilic bands - immature
– immature PMN
bands/ Neutrophilic bands
o Shift to the left –
immature
o Shift to the right -
mature
• with bright orange granules filled with antihistamine
Eosinophils
caused by bacterial infection
Neutrophilia:
long term drug administration
Neutropenia:
theoretical/unused, decrease of eosinophil
• Eosinopenia:
allergy, parasitism, increase of eosinophils
• Eosinophilia:
•
rare, hematologic disease (leukemia)
• Basophilia:
With dark blue granules that obscure the nucleus
basophils
- Big round nucleus, thin rim of cytoplasm
* Slightly larger than RBCs
lymphocytes
• viral infection
Lymphocytosis:
long term drug administration, immunodeficiency
Lymphopenia/lymphocytopenia
• Phagocytosis, presentation of epitopes
monocytes
• Macrophage in tissues
monocytes
• Slightly larger than other WBCs
monocytes
rare hematologic disorder
• Monocytosis:
theoretical disease of monocytes
• Monocytopenia:
- Pieces of a bone marrow cell called megakaryocyte
- Function to stop bleeding by forming a plug and releases coagulation factors (controls hemostasis)
- Forms thrombus (clot)
platelet
platelet capable of
adhesion, aggregation, secretion
• 2-4u, oval, anucleated, slightly granular
platelet
• Reference range of plt
150 – 450 K/cu. Mm
• High MPV means
regenerative BM response to platelet consumption
inflammation, trauma
•
Thrombocytosis
: consequence of treatment
Thrombocytopenia
HEMATOLOGY TESTS/EXAMINATIONS
- Erythrocyte Sedimentation Rate
- Reticulocyte Count
- Peripheral Blood Examination
- Sickle Cell Testing
- Osmotic Fragility Test (OFT)
- Coagulation Tests include
- Coagulation Tests include
a. Prothrombin Time
b. Partial Thromboplastin Time
c. Fibrinogen
d. Factor Analysis
ADVANCED HEMA PROCEDURES
- BM Examination
- Cytogenic analysis
- Molecular assay
- Cytochemical stains (differentiate abnormal cells)
- Flow cytometry
– decreased platelets, patients may have bleeding problems
-associated with dengue
Thrombocytopenia
• Ex. haemophilia, sickle cell anemia, G6PD deficiency, thalassemias
Inherited haematological diseases
Methods of Blood Collection
- Skin puncture
2. Veni
- Skin puncture
• Blood sample collected = ?
peripheral blood instead of capillary blood
• A mixture of capillary, venous, arterial blood with interstitial and intracellular fluid
•
peripheral blood instead of capillary blood
peripheral blood Different from venous blood because of admixing of tissue juice which leads to the following: (levels of Hct, Hgb, RBC, Plt, WBC)
low Hct,, Hgb, RBC ct, Pit & high WBC
disadv of skin punc (3)
- Less amount can be obtained
- Additional and repeated test cannot be done
- Hemolyses easily (rupture of RBC)
skin punc sites
A. Finger (middle or ring)
B. Earlobe
C. Heel or big toe
puncture sites
• lateral palmar surface perpendicular to fingerprints (will follow structure of fingerprints)
finger (middle or ring)
- for less than 1 y/o
* Lateral portion of the plantar surface of the heel
heel
puncture site
• Ideal for peripheral smears
finger (middle or ring)
puncture sites
• Can be arteriolized by: heat (44C), slight flicking with index finger until definite flushing & chemical means (Trefuril paste)
earlobe
puncture sites
• less free nerve ending, less pain, less tissue juice
• More free flow of blood
earlobe
puncture sites
• Ideal when searching for abnormal cells (histiocytes in bacterial endocarditis)
earlobe
Less intimidating puncture site
finger (middle or ring)
puncture site that isAccessible and easy to manipulate
finger (middle or ring)
D. Sites to Avoid
- Inflamed & pallor areas
- Cold & cyanotic areas
- Congested and edematous areas
- Scarred & heavily calloused areas
lancet must pass through the
dermal subcutaneous junction
length of lancet for newborns
not more than 2.4mm
- Venipuncture
• Blood sample collected =
venous blood
manner of inserting a needle attached to a syringe to a palpable vein to collect blood for lab testing
veni
most widely used blood sample in all lab tests not just in hematology
venous blood –
• 3 factors involved in good collection
o Phlebotomist
o Patients and his/her veins
o Equipment needed
Phlebotomy Complication
- Vascular
- Infection
- Cardiovascular
- Anemia
- Neurological
- Dermatological
Venipuncture Complications
1. Local immediate
a. Hemoconcentration
b. Failure of blood to enter the syringe
Venipuncture Complications
3. General delayed complication
a. Infections
Venipuncture Complications
2. Local delayed
a. Hematoma
b. Thrombosis of the vein
c. thrombophlebitis
Disadvantages of evacuated tube method
Requires more time & skill on the part of the phlebotomist
Requires more equipment
More complications may arise
Difficult to do in infants, children & obese individuals
EVACUATED TUBE METHOD
Advantages
Large amount can be obtained
Can be transported and stored for future use
Additional & repeated tests can be done
Fastest method of collecting sample which requires various anticoagulation
Ideal for clinical chemistry & other serological tests
