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Blood Chemistry > Hematology / CBC / HM5 > Flashcards

Hematology / CBC / HM5 Flashcards

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1
Q

Causes of Hemolysis

A
  • Too much pressure / suction
  • Too small of a needle
  • Too much alcohol
  • Fishing for the Vein
  • Not removing needle when transferring to collection tube
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2
Q

Tube Fill Order

A

Citrate - Coagulation (VSPro)
No Additive - Chemistry (VS2)
Lithium Heparin - Chemistry (VS2)
EDTA - Hematology (HM5)

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3
Q

EDTA Contamination

A
  • Spurious hypocalcemia (Ca2)
  • Spurious hyperkalemia (K+)

Decreased calcium, increased potassium
(Too many bananas, not enough milk!)

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4
Q

Citrate Contamination

A

Decreased calcium without an effect on potassium

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5
Q

What Kind of Technology in the HM5

A

Impedance

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6
Q

How to HM5 Measures Blood (Process through the machine)

A 
Blood -> 
Dilution 1 (EOS) -> 
Dilution 2 (WBC / *HGB; uses spectrophotometry) 
Dilution 3 (RBC / MCV / PLT / MPV )

MCHC and HCT Are Calculation from Measured Parameters

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7
Q

Dilution Process

A

ETA Whole Blood (25ul) - >
Direct EOS Count (Dilute 1:160 with species dependent volume of lyse2, this destroys all cells but EOS)
Clean / Rinse Cycle
ETA Whole Blood (25ul) - >
Diluted 1:160
- Mixed with lyse 1:180 to measure WBC and HGB
- Mixed with Dilutent 1:32000 to measure RBC and PLT

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8
Q

ul

A

Microliter

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9
Q

Lyse

A

Causes Hemolysis

Lyse2 is a Dilute and Hemoltic Agent

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10
Q

Key Components of the HM5

A

Chamber - Mixing / Diluting of Blood
Aperture - Microscopic hole that carries and electric potential field across it (cells travel through this hole)
Measuring Tube - contains aperture; counting and sizing of cells happens here
Electrodes - one on either side fo the apeture to set up the apeture

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11
Q

HM5 Chamber

A

“Counting Chamber” - Mixing and diluting of the blood occurs here

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12
Q

Aperture

A

Microscopic hole that carries an electric potential field across it; cells travel from the counting chamber through this hole

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13
Q

Measuring Tube

A

Where cells are counted and sized after passing through the aperture

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14
Q

Electrodes

A

On either side of the aperture, sets up a electric field across the aperture

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15
Q

Impedance Technology

A
  • Blood is diluted with and isotonic solution to conduct a current
  • Aperture has electrodes on either side; causes isotonic solution to conduct electricity and allows a voltage to be measured on the aperture
  • Neutral cells pass through the aperture and emit a voltage based on their size
  • when a cell is passing the aperture a small change in electrical impedance causes voltage rise and produces rise and electrical pulse. The bigger the size of the cell, the higher the pulse.
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16
Q

Photometry

Spectrophotometry

A

Measures Hemoglobin HBG

  • passing light through WBC dilution and measuring transmitted light with a photo detector
  • the light intensity is logrithmically proportinal to concentration of hemoglobin
  • Standard across veterinary CDC analyzers and is very accurate

HGB = 1/3 of HCT ; this can be used as a quality assurance tool. Abnormalities like heinz bodies can affect the HGB reading.

17
Q

HCT % (Hematocrit)

A 
Calculated Value 
(RBC x MCV) / 10  [Wintrobe Index]

Sources of error

  • Delay before analysis
  • Sample not mixed adequately
18
Q

PCV (Packed Volume)

A

What percentage of blood is made my red blood cells

19
Q

Calculated Parameters in the HM5

A
  • HCT

- MCHC

20
Q

MCV Issues

A

Mean Cell Volume

Falsely increased due to delays in anaysis over time (RBC can undergo in vitro swelling)
Falsely decreased in too much EDTA and not enough blood
- EDTA is hypertonic and shrinks cells)

This will afect our HCT value

21
Q

MCHC

A

Mean Corpuscular Hemoglobin Concentration
[Mean concentration of HGB per RBC)
(HGB / HCT) x100

Anything that increases HGB or decreases HCT will falsely increase MCHC

  • increased; almost always an artifact (very rarely oxidative damage)
  • decreased; hemolysis or low blood/EDTA ratio
22
Q

Causes for Increased MCHC

A
  • Lipemia and ictreis due to spectral interferance
  • Under filled EDTA tube (increased EDTA to Sample Ration; decreases MCV and HCT which affect MCHC)
  • Heinz Bodies cause incomplete RBC lysis and affect RBC
  • Nucleated RBC
  • Oxyglobin
23
Q

Histrograms (Brief)

A

Graphical representation for cell distribution and cell counts

  • Verify Parameters
  • ID uncommon DZ processes
  • Provides quality control
24
Q

Thrombocytes =

A

Plateles

25
Q

Elements of a Histrogram

A

X - Axis (Horizontal) = Size of cells (increase from left to right) Measured in femtoliters
Y - Axis (Vertical) = Relative cell count, scaled according ot highest calue on histrogram, cannot compare peak heights among samples / run
Discriminator Bars = Run vertically, separate different cell types

26
Q

Cell Size Order (small to large)

A 
Plateles
RBC
Lymphocytes 
Granulocytes
Monocytes
27
Q

What 4 Histograms Appear

A

Platelet

28
Q

Platelet Histogram

A

PLT: smallest cells, prone to clumping

Typical curve looks like a Ski Slope (majority smaller in size with fewer large sizes PLTS)
Needs to trend upward and then back downward
Cat peak may not finish at the bottom of the Y Axis

A squiggly curve may indicate platelet clumping

29
Q

Platelet Clumping on Histogram

A
  • Squiggly line on platelet histogram instead of the ski slope curve
  • Decreased platelet
  • Increased MPV

Blood Chemistry (6 decks)

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