Hematology Flashcards
Average volume of blood
5L
Percentage of blood in the body weight
7-8%
Germicidal soap is rubbed in the hands for ___ secs
15 secs
Rinsing of hands during hand washing
Downwards
Used to turn off the faucet when hand washing
Paper towels
Destroys pathogenic microorganisms in inanimate objects
Disinfection
Appropriate disinfectant
Household bleach or sodium hypochlorite
Dilution in sink disinfection
1:5-1:10
Destroy all forms of microbial life including spores
Sterilization
Concentration of oxalate
1-2 mg/ml of blood
Concentration of citrate
3.2 - 3.8 g/dL (0.105 or 0.129M)
Concentration of EDTA
1-2 mg/ml of blood or 1.5mg/ml
Concentration of fluoride
10 mg/ml of blood
Concentration of heparin
0.2 mg/ml of blood
Inversions for yellow, orange, green, lander, pink, gray
8
Number of inversions for red and gold
5
Number of inversions for light blue
3-4
Tourniquet should be applied ___ above the venipuncture sure and left no longer than 1 min
3-4 inches (7.5-10 cm)
Inner material that goes a temporary change in viscosity during the centrifugation process
Separator gel
Gauge for pediatric patients
23-25 gauge
Most common needle size for adult venipuncture
21 gauge
Length 1 inch
Most common skin cleanser
70% isopropyl alcohol
Used for sample collection for blood alcohol measurements
Benzalkonium chloride or non alcoholic anti-septic
Punctures should not be more than___ deep because of the risk of bone injury or possible infection (osteomyelitis)
2mm
Hemoglobin normal values
15-20 g/dl at birth
12-16 g/dl adult women
13-18 g/dl men
Reagents used in the cyanmethemoglobin method
Modified Drabkin’s reagent
donates cyanide to hemoglobin
Potassium cyanide
Converts Fe2 to Fe3
Potassium ferricyanide
Replaced the sodium bicarbonate (in the original drabkin’s reagent), shortens the reaction time from 15 minutes to 3 minutes
KH2PO4
Decreases the amount of turbidity resulting from abnormal proteins and improves RBC lysis
Nonionic detergent
sample for cyanmethemoglobin method
EDTA whole blood or capillary blood
Wavelength measured in cyanmethemoglobinn method
540 nm
the optical density of the solution is proportional to the concentration of hemoglobin, all forms of hemoglobin are measured except
sulfhemoglobin
Remedy for high WBC count and high plt count
Centrifuge the mixture and use the supernatant
Remedy for Hgb S and Hgb C
Dilute mixture 1:2 with water then multiply results by 2
Remedy for lipemic blood
Add 0.01 ml of patients plasma to 5.0 ml of HiCn reagent and use this mixture as the blank
measure functional hgb only
Blood oxygen Capacity (Gasometric or Van Slyke method)
1 hgb carries ___ of oxygen
1.34 ml
100 g Hb = ___ of Fe2
0.347 g
Used for blood donor screening
Copper sulfate method (Gravimetric method)
specific gravity of copper sulfate solution
1.053
drop of blood should be added from a height of about ___ cm in the copper sulfate method
1 cm
Reagent for acid hematin
0.1 N Hcl
Reagent for alkali hematin
0.1 N NaOH
formed by combination of hemoglobin with carbon monoxide
Carboxyhemoglobin
affinity of carbon monoxide to hgb than for oxygen
200x
color of carboxyhemoglobin
cherry red
peak absorbance of carboxyhemoglobin
576 nm
hgb wherein the ferrous ion has been oxidized to ferric state
Methemoglobin
type of hgb wherein most cases are acquired due to exposure to certain drugs and chemicals (nitrates, nitrites, quinones, chlorates)
Methemoglobin
Color of methemoglobin
Brown
peak absorbance of methemoglobin
630 nm
type of hgb though to be formed by the action of sulfonamides and aromatic amines
Sulfhemoglobin
color of sulfhemoglobin
mauve lavender
peak absorbance of sulfhemoglobin
618 nm
NV for HCt
45 - 60 % at birth
36 - 48% Females
40 - 55% Males
Length of microhematocrit tube
75 mm
internal bore of microhematocrit tube
1.2 mm
volume of blood microhematocrit tube can hold
0.05 ml
microhematocrit centrifuge capable of __ RCF
10,000 - 15,000
Incomplete sealing (less than ____ mm), leads to falsely low hct results
4-6 mm
inadequate centrifugation (shorter than __ mins), leads to a falsely increased result
5 minutes
Allowing the tube to stand longer than __ minutes leads to a falsely increased result
10 minutes
Trapped plasma causes spun hct results to be ___ higher than electronic cell counter
1-3%
Increased amount of trapped plasma is found in:
Macrocytic anemia
Spherocytosis
Thalassemia
Hypochromic anemia
Sickle cell anemia
length of wintrobe tube
115 mm
internal bore of wintrobe tube
3 mm
NV for RBC count
5.0 - 6.5 x 1012/L - Newborns
3.6 - 5.6 x 1012/L - Females
4.2 - 6.0 x 1012/L - Males
RBC count diluting fluid
Gower
Eagle
NSS
Toison
Strong
Bethel
Hayem
Dacie
WBC NV
4.0 - 11.0 x 109/L - adults
10.0 - 30.0 x 109/L - Newborns
6.0 - 17.0 x 109/L - 1 year of age
in WBC count, allow the dilution to sit for __ minutes to ensure that the red blood cells have lysed
10 minutes
leukocyte counts should be performed within __ hours of dilution
3 hours
white count diluting fluids
2% acetic acid
1% HCl
Turk’s diluting fluid
formed when 5 or more nRBCs are present in the PBS
Corrected WBC Count
shape of the nucleus of band neutrophil
Elongates, curved, or sausage-shaped
cell that increases in shift to the left
band
shape of the nucleus of monocyte
horse-shoe shaped
appearance of the cytoplasm of monocyte
ground glass
Neutrophilia
Appendicitis
Myelogenous leukemia
Bacterial infection
Neutropenia
Decreased neutrophil production
Increased neutrophil destruction
Immune reactions
Sequestration
Eosinophilia
Allergies
Scarlet fever
Parasitic infections
Eosinopenia
Decreased production
Acute bacterial infection
ACTH administration
Monocytosis
Brucellosis
Tuberculosis
Subacute Bacterial Endocarditis
Typhoid
Rickettsial infections
Hodgkin’s disease
Gaucher disease
Monocytopenia
Glucocorticoids
Overwhelming infections that also cause neutropenia
Lymphocytosis
Viral infections
Whooping cough
Infectious mononucleosis
Lymphocytic leukemia
Lymphocytopenia
Long-term drug therapy
Immunodeficiency
Basophilia
Immediate hypersensitivity reactions
Hypothyroidism
Basopenia
Stress
Hyperthyroidism
Increased glucocorticoid levels
NV of MCV
80 - 100 fL
NV of MCHC
32 - 36 g/dl
NV of MCH
28 - 32 pg
NV of RDW
11.5% - 14.5%
Relationship of RDW to the variation in RBC size
Directly proportional
Disease associated with microcytic hypochromic
Anemia of chronic infection or inflammation
Thalassemia
IDA
Sideroblastic anemia
Defective iron use
“ATIS”
Disease associated with normocytic, normochromic
Apastic anemia
Hemolytic anemia
Acute blood loss anemia
Disease associated with macrocytic, normochromic
Liver disease
Myelodysplasias
Megaloblastic anemia
Size of the blood drop in manual wedge technique
2-3 mm
angle used in the manual wedge technique
30 - 45 deg or
25 - 40 deg
One of the qualities of a properly made wedge smear is the size of the film. it must be ___ of the slide
2/3 or 3/4
Factors that affect the thickness of a wedge smear
Pressure
Angle
Size of blood drop
Speed
Method of examination where the slide is moved from side to side
Cross-sectional or crenellation
Method of examination wherein the slide is moved from tail towards the head
Longitudinal method
Method of examination where it uses a pattern of consecutive fields beginning near the tail on a horizontal edge: count three consecutive horizontal edge fields, count two fields towards the center of the smear, count two fields horizontally, count two fields vertically to the edge
Battlement method
important in helping to diagnose bleeding disorders
Platelet count
NR of Plt count
150,000 - 450,000 /uL
Thrombocytosis
Polycythemia vera
Idiopathic thrombocythemia
Chronic myelogenous leukemia
Splenectomy
Thrombocytopenia
Thrombocytopenia purpura
Aplastic anemia
Acute leukemia
Gaucher’s disease
Pernicious anemia
Smear sequesters ___ of platelets
20 - 30%
Mean platelet volume determination type of specimen
< 4 hours old specimen
reference method for platelet determination
Brecher-Cronkite method
Microscope used in the reference method of platelet determination
Phase microscopy
Dilution used for whole blood in the Brecher-Cronkite method
1% ammonium oxalate
Anticoagulant used to correct platelet satellitosis
Sodium citrate
Factor to multiply in using sodium citrate as the anticoagulant in platelet determination
1.1
Result of WBC and platelets in the Brecher-Cronkite method
Increased WBC, Decreased platelet
Method that uses a light microscope in plt determination
Tonkantin method
Diluent used in the Tonkantin method
Rees and Ecker diluent
Place charged hemocytometer in a moist chamber for __ minutes to allow the platelets to settle
15 minutes
Stain in the Rees and Ecker diluent
Brilliant Cresyl Blue
anticoagulant in the Rees and Ecker diluent
Sodium citrate
Preservative in the Rees and Ecker diluent
Formaldehyde
Normally, a reticulocyte spends __ days in the bone marrow, and 1 day in the peripheral blood
2-3 days
Supravital stain used in the reticulocyte count
New Methylene Blue
Used to assess the erythropoietic activity of the bone marrow
Reticulocyte count
NV of reticulocyte count
0.5 - 1.5%
time of incubation in the reticulocyte count method
3-10 minutes
How many RBCs are counted in the Retic count procedure
1000 RBCs
to improve accuracy, have another laboratorian count the other smear; values should agree within ___
20%
sources of error for retic count
Heinz bodies
Howell-Jolly bodies
Hgb H
Patients with a hematocrit of 35% are expected to have a corrected retic count of __
2-3%
In patients with a hematocrit of less than 25%, the count should increase to ___ to compensate for anemia
3-5%
Retics that are released from the bone marrow prematurely are called
shift reticulocytes
Reference range of adequate bone marrow response
> 3
Reference range of inadeqaute bone marrow response
<2
nonspecific measurement used to detect and monitor an inflammatory response
ESR
caused by an alteration in plasma protein concentration, this leads to a larger RBC mass and faster sedimentation velocity
Rouleaux formation
the single most important factor in determining ESR
Plasma composition
rouleaux and aggregation of the red blood cells are controlled primarily by the levels of __
Acute phase proteins
ESR is directly proportional to RBC mass and inversely proportional to ___
plasma viscosity
increased concentration of albumin will tend to __ ESR
lower
a tilt of 3 deg can cause ESR errors up to ___
30%
the use of refrigerated blood for ESR would __ ESR
Increase
__ ESR result due to lower temperature from air rushing out on opening the ref or freezer
falsely decreased
A __ ESR is attributable to vibrations from opening and closing the refrigerator doors
falsely increased
A ___ ESR because of the heat released from the refrigerator motor
falsely increased
Length of the Westergren tube
300 mm
Bore of the Westergren tube
2.55 mm
Calibration of the Westergren tube
0 - 200
NV of the Westergren tube
0 - 15 mm women
0 - 10 men
0 - 10 children
TUbe used in ESR that is more sensitive for patients with high ESR
Westergren
Length of the Wintrobe tube
115 mm
Bore of the Wintrobe tube
3 mm
Calibration of the Wintrobe tube
Left: ESR (0 - 100)
Right: Macrohematocrit (100- 0)
