HEMATOLOGY Flashcards
What is the greek word of hematology?
-Haima = Blood
-Logos = Study/science
It is the preferred anticoagulant for plt ct. w/c CHELATES CALCIUM
EDTA
(Lavender top)
What will happen if the EDTA is INCREASED?
(Increased) EDTA = Shrinkage of cells = Hct = ESR (both decreases)
It is where plt adhere to neutrophils
Platelet satellitism
What is the ratio ESR tube? (anticoagulant to blood)
Ratio = 1:4 (Anticoagulant-to-Blood)
What tube is used for coagulation and platelet studies? ratio? factors it preserve?
-Citrate
(Light blue top tube)
-Ratio = 1:9 (Anticoagulant-to-Blood)
-Preserves labile factors V and VIII
What condition does the ff. result mean?
all are INCREASED
-Hct
-Excess Citrate = PT, APTT
Remedy?
-Polycythemic patients
-Remedy: Reduce the volume of citrate
It has a Double/balanced oxalate? Ratio?
-Oxalate( gray tube)
-Ratio = 2:3
shrink cells
Potassium oxalate (Paul-Heller’s)
swell cells
Ammonium oxalate (Wintrobe’s)
Anticoagulant for osmotic fragility test w/c inactivates of thrombin
Heparin
Why heparin is not used for bld film prep and coagulation?
Not for blood film preparation:
= Distorts cells
= Produces bluish background on Romanowsky’s stain
Not for coagulation
= Inhibits thrombin and all stages of coagulation
EDTA containing tubes
Lavender
Pink
White
Royal blue
Tan
What are the sites used for skin puncture?
- Fingertips
- Earlobe: less admixture w/ tissue juice, less pain, less free nerve endings
- Lateral portion of the plantar surface of the foot: <1 year old
What is the difference of skin puncture to venipuncture?
Difference from venous specimen:
(increase) WBCs
(decrease)Hgb, Hct, RBCs, platelet
Common gauge (needle)
19, 20, 21
Routine: 20g
Common length of needle
1-1.5 inches
Color coded hub (gauge)
18 = pink
21 = green
22 = gray
23 = blue/light blue/turquoise
Angle (Veni & BB)
Venipuncture: 15 degree
BB: 45 degree
10-20 degree once in the skin
Tourniquet RULES
- 3-4 inches above the site (7.5-10cm)
- Not exceed 1min/2mins
BP cuff as tourniquet
40-60 mmHg
Prolonged tourniquet application result
hemoconcentration
What will happen or effect of the ff. situations?
-crying
-lying down
-lying up
-Crying = (increase) cell count
-Lying down = hemodilution (PCV by 8%, WBC) (both decrease)
-Lying up = hemoconcentration
What to do if the px has an IV line?
Collect on the other arm
If both arms: Stop IV for 2mins
= Collect blood below the IV line
= Appropriate for all analytes except glucose and phosphorus
Cellular formation, proliferation, differentiation and maturation of blood cells
Hematopoiesis
3 phases of Hematopoiesis
- mesoblastic period
-hepatic period
-myeloid period
Occur in the 19th day of gestation
Loc?
Embryonic hemoglobins:
Mesoblastic period
Yolk salk = Erythropoiesis
Embryonic hemoglobins:
a. Gower 1 = Zeta2 + Epsilon2
b. Portland = Zeta2 + Gamma2
c. Gower 2 = Alpha2 + Epsilon2
Occur in the 3rd month of gestation
Loc?
Produce?
Hepatic period
Fetal liver = Granulopoiesis, Erythropoiesis, Megakaryopoiesis
Spleen, thymus, lymph nodes
Hemoglobin production:
a. HbF = Alpha2 + Gamma2
b. HbA1 = Alpha2 + Beta2
c. HbA2 = Alpha2 + Gamma2
Between 5th & 6th month of gestation persist throughout life.
loc?
-Myeloid period
-BM
principal source of hematopoiesis in adults
Sternum
1’ source of cell production (Hematopoiesis)
BM
Percentage of the ff. in adults?
HbA1 =
HbA2 =
HbF =
HbA1 = ≥95%
HbA2 = 1.5-3%
HbF = <2%
Percentage of the ff. in neonates?
HbF =
HbA =
HbF = 60-80%
HbA = 20-40%
What is the M:E ratio?
NV:
Infection:
Leukemia:
NV = 2:1 to 4:1 (Ave. 3:1)
Infection = 6:1
Leukemia = 25:1
Myeloid
Erythroid precursors
Neutrophilic
Eosinophilic
Basophilic
It is NOT included in the Myeloid
Erythroid precursors
Monocytic
BM Cellularity in adult
Normocellular marrow (Adult):
♫ Fat = 10-50%
♫ Hematopoietic elements = 40-60% (Ave. 50%)
What is recommended in a marrow differential?
Recommended that at least 500, preferably 1000 cells be counted for a marrow differential
Yellow BM?
Fats
Red BM?
Hematopoietic cells
Predominant cell (WBC) in adult BM (up to 32%)
Metamyelocyte/Juvenile granulocyte
Composed of <1% cells in BM
Stem cells
What is the diff. between OSTEOBLASTS & OSTEOCLASTS?
Osteoblasts
-Bone forming cells
-Confused w/ plasma cells
-Waterbug or comet appearance
Osteoclasts
-Bone destroying cells
-Confused w/ megakaryocytes
What are the markers included in the ff?
-T cells
-B cells
-Stem cell marker
-NK cells
-CALLA (Common ALL Antigen)
CD2, CD3 (T cells)
CD19, CD20 (B cells)
CD34 (Stem cell marker)
CD16, CD56 (NK cells)
CD10 (CALLA)
Produced by the kidney & primary regulator of erythropoiesis
Erythropoietin
Produced by kidney and liver & regulator of thrombopoiesis
Thrombopoietin
Multi-CSF (Colony Stimulating Factor) & stimulates hematopoietic cells
IL-3
Differentiate Immature & mature cell characteristics for Leukocytes
Immature cells
- larger
- (+) nucleoli
- chromatin: fine & delicate
- nucleus: large & round
- cytoplasm: dark blue/ basophilic (increase RNA)
- (-) granules
- increase N:C ratio
Mature cells
- smaller
- (-) nucleoli
- chromatin: coarse & clumped
- nucleus: round lobulated or segremented
- cytoplasm: light blue (decrease RNA)
- (+) granules
- decrease N:C ratio
