Hematology Rotation Final Flashcards
Myeloblasts are MPO (pos/neg)
POS
MPO positive for?
Myeloblasts
True/False: PLT estimate with differential is not necessary if there was no PLT flag.
FALSE
Always do PLT estimate with manual differential
T/F: HJ and Pappenheimer bodies are stained with Wright
True
HLL is tartrate resistant T/F
TRUE
T/F: Methanol is used as a fixative
True
What cells are CD3+
All T cells
What cells are CD4+
T helper cells
What cells are CD8+
Cytotoxic T cells/suppressor cells
What cells are CD19+
B cells
What cells are CD34+
Blasts
What cells are CD45+
WBCs (Grans, monos, lymphs)
What cells are CD56+
NK cells
What is basophilic stippling made of?
RNA
What are pappenheimer bodies made of?
Iron
What are Howell-Jolly bodies made of?
DNA
What are Heinz bodies made of and what stain must you use to see them?
denatured hemoglobin; new methylene blue
What deficiency leads to pernicious anemia?
Vitamin B12
Oxalo acetate buffer lyses ______ in phase platelet counting.
RBCs
Atypical/reactive lymphs are indicative of? What do they look like?
Viral infection
- irregular nucleus, basophilic cytoplasm that take the shape of the surrounding RBCs, large
What RBC morphology are you expected to see in a patient with myelofibrosis?
Tear drop cells
What can cause eosinophilia?
Parasitic infection
Allergic rxn
Hodgkin’s Lymphoma
TRAP positive = ?
Hairy cell leukemia
What is expected to be seen in the peripheral smear of someone with pernicious anemia?
Hypersegmented neutrophils
Oval macrocytes
HJ bodies
Anisocytosis?
Differing size of cells
Poikilocytosis
Differing shape of cells
Transudate appearance
straw yellow, clear, no clots
Exudate appearance
red/pink/green/yellow, cloudy, clotted
Disease processes that elevate ESR?
anemia and leukemia
95% of CML patients have what?
Philadelphia chromosome
Which sysmex indices reports in percent?
MCHC
What does PLT clumping indicate?
Elevated WBC count
What should be done to fix PLT clumping?
Redraw in sodium citrate tube, compare with EDTA tube results
What is the blue reticulum found inside of reticulocytes?
RNA
What is the order of RBC maturation?
Pronormoblast
Basophilic normoblast
Polychromatic normoblast
Orthochromatic normoblast
Reticulocyte
Erythrocyte
Which stage of the RBC is the last go undergo mitosis?
Polychromatic normoblast
Which stage of the RBC is the last to have a nucleus?
Orthochromatic normoblast
Reference range for MCHC
29-37.5
What does an increased MCHC indiciate?
Spherocytes in peripheral smear, cold agglutinins, hemolyzed/icteric/lipemic
Abnormal electrolytes
What to do if MCHC <29?
Check chem results to see if they are abnormal or normal.
If abnormal, run 1:5 dilution.
What to do if MCHC >37.5?
Turbidity flag
Warm in water bath
If still high, 1:5 dilution
If still high, spun crit
How to calculate absolute eosinophils
eos x WBC / 100
Forward vs side scatter
Forward: size of cell
Side: complexity/granularity
What is the pink slide for in hematology?
PLT <100
What to do if MCV delta flags?
Take to blood bank to see if they have a blood type on file or if recently transfused
Transudate associated diseases
Systemic, outside body cavity (CHF)
Exudate associated diseases
More cells, inside body cavity (Inflammation/malignancy)
MSU crystals and associated disease
GOUT
Yellow horizontal, blue vertical
Needle-like crystals
CPPD crystals and associated disease
PSEUDOGOUT
Blue horizontal, yellow vertical
Rhomboid/square crystals
When would you make a cytospin for a body fluid?
WBC count CSF >5
WBC count >20 for other body fluids
What disease is associated with urine eosinophils?
Interstitial nephritis
Tech must count ____ cells in a bone marrow exam.
250
High HCT associated with?
Polycythemia vera
Low HCT associated with>
Anemia
What will be seen in a peripheral smear for multiple myeloma patient?
Rouleaux and plasma cells
What will be seen in a peripheral smear for a patient with myelofibroma?
Tear drop cells, shift to the left seeing immature granulocytes and nRBCs
What will be seen in a peripheral smear for a patient with sickle cell anemia?
Sickle cells, schistocytes, target cells
What will be seen in a peripheral smear for a patient with a thalassemia?
Hypochromic, microcytic RBCs, no immature cells, but LOTS of poikilocytosis (tear drops!!)
What will be seen in a peripheral smear for a patient with IDA?
Microcytic, hypochromic RBCs
No poikilocytes (normal morphology)
What will be seen in a peripheral smear for a patient with G6PD deficiency?
Blister cells
What will be seen in a peripheral smear for a patient with sickle cell anemia, not in a current crisis?
Target cells
What will be seen in a peripheral smear for a patient with megaloblastic anemia?
Oval macrocytes
Hypersegmented neutrophils
HJ bodies
What will be seen in a peripheral smear for someone with CLL?
Smudge cells
Lots of lymphs
What will be seen in a peripheral smear for someone with acute leukemia?
> 20% blasts
If auer rods present = AML
If no auer rods, cannot tell whether its AML or ALL
Increased lymphocytes + reactive lymphs = ?
Viral infection
Increased neutrophils with toxic granulation, dohle bodies, and vacuoles = ?
Bacterial infection
Acute vs chronic leukemia
Myeloid vs lymphoid leukemia
Acute = >20% blasts
Chronic = more myelocytes
Myeloid = auer rods present
Lymphoid = most all lymphs
What will you see in the peripheral smear of someone with Pelger-Huet Anomaly?
Neutrophils with 2 segments (eyeglasses)
What will you see in the peripheral smear of someone with Hairy cell leukemia?
Cytoplasmic projections
Low WBC
TRAP positive
What will you see in the peripheral smear of someone with hemoglobin C?
HGB C crystals (washington monument)
Target cells
How to perform PLT estimate for unknown
Count 8-10 fields near feathered edge
Average and multiply by 1.5, add zeros
What squares/how many are counted for a BF count?
Large middle square and four corner squares on each side of the hemacytometer making 10 squares total counted
Mesothelial cells
Line serous cavities
May be seen in BF, normal in small amounts, have fried egg appearance with hairy edges
Include in 100 cell BF diff
If the blood smear color is too pink, the stain is too….?
Acidic
If the blood smear color is too blue, the stain is too….?
Basic
Critical HGB
<7
Critical HCT
> 55
Critical WBC
> 50
Critical PLT
<20
What are the 3 principles of the Sysmex?
Hydrodynamic focusing
Flow cytometry
SLS-HGB
A synovial fluid is yellow, has high viscosity, and the WBC count was ~1000. What classification does it fall under?
Group I noninflammatory
A synovial fluid is yellow-green, with a 100,000 WBC count and a positive culture. What group does it fall under?
Group III septic
A synovial fluid is red with a 5,000 WBC count. What group does it fall under?
Group IV hemorrhagic
