Hematology Flashcards
Hemocytometer Cell Count
- Place the coverglass on the counting area, load the chamber with sample
- Let the counter sit in a humidified chamber for 5 min to allow the cells to settle
- Begin count, then calculate the number of cells/uL
WBC usually diluted 1:20, RBC 1:200
(# cells counted/ # WBC squares counted) x dilution factor x 10
WBC = (# cells/4) x 20 x 10
RBC = (# cells/ 0.2) x 200 x 10
Hematocrit
- Fill a capillary tube 3/4 with anticoagulated whole blood
- Plug one end of the tube with clay
- Place tube flat in the hct spinner with the plugged end facing toward the outside of the spinner
- Spin the tubes for 4 min at 10,000 RPM
- Remove and read
Normal male 42 to 52%
Normal female 36 to 46%
Hemoglobin
- Pipette 2 mL of reagent into blank, control, standard, and patient tubes
- Pipette 0.01 mL (10uL) of standard, control, or patient sample into their respective tubes, mix well
- Let tubes stand for 3 min
- Zero the spectrophotometer at 540 nm with the blank
- Read all tubes at 540 nm and record absorbances
(abs unknown/abs standard) x concentration of standard = hgb concentration (g/dL)
Normal male 14 to 17.4 g/dL
Normal female 12 to 16 g/dL
RBC Indicies
MCV (fL) = (Hematocrit/RBC count) x 10 Normal 80 to 100 fL MCH (pg) = (Hemoglobin/RBC count) x 10 Normal 28 to 34 pg MCHC (g/dL) = (Hemoglobin/hematocrit) x 100 Normal 32 to 36 g/dL
Differential
x10: scan the feathered edge, perform WBC estimate
x40: find ideal counting area
x100: perform WBC differential, cell morphology, platelet estimate
WBC estimate (10^3/uL) = (# WBC counted/5) x 0.2 x 10^3
Platelet estimate (10^3/uL) = (# PLT counted/5) x 15 x 10^3
Nucleated RBC correction = (WBC count x 100)/(NRBC counted per WBC + 100)
Normal
WBC 4.5 to 11 RBC male 4 to 5.5, female 4 to 5 Retic 0.5 to 2% of RBCs HCT male 42 to 52, female 36 to 46 HGB male 14 to 17.4, female 12 to 16 MCV 80 to 100 MCH 28 to 34 MCHC 32 to 36 PLT 150 to 400 Neutrophil 40 to 80% Lymphocyte 25 to 35% Monocyte 2 to 10% Eosinophil 0 to 5% Basophil 0 to 1%
Infection
Increased WBC
Neutrophils increased in bacterial
Lymphocytes increased in viral
Infectious Mononucleosis
Increased WBC
>20% atypical lymphs
Usually >50% total lymphs
Mild thrombocytopenia
Iron Deficient Anemia
Microcytic hypochromic anemia
Decreased HGB, HCT, RBC, MCV, MCHC
Increased RDW, PLT
Pencil cells, codocytes
Megaloblastic Anemia
Macrocytic anemia
Decreased WBC, RBC, HGB, HCT, PLT
Increased MCV, MCHC, RDW
Macro-ovalocytes, neutrophil hypersegmentation, Howell Jolley bodies, basophilic stippling, NRBCs, large platelets
Thalassemia Minor
Alpha: decreased HGB/MCV, increased RBC, microcytosis, codocytes
Beta: codocytes, basophilic stippling
Sickle Cell Anemia
Decreased RBC, HGB, HCT
Increased RDW, Retic
Sickle cells, codocytes, polychromasia
Hereditary Spherocytosis
Decreased HGB, HCT, MCV,
Increased retic
MCHC >36
Spherocytes
MAHA
Increased WBC, RDW, Retic
Decreased HGB, HCT, PLT
Normocytic normochronic
Polychromasia, NRBCs, Left shift, schistocytes
M0/M1
All myeloblasts, possible Auer rods
