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CML - Clinical Lab Methods > Hematology - Scut Monkey and Lecture No. 1 > Flashcards

Hematology - Scut Monkey and Lecture No. 1 Flashcards

1
Q

true or false; wbc is highest at birth and then tapers to adult levels by puberty

A

true

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2
Q

does hct always reflect the blood loss? why or why not?

A

no b/c plasma and rbc are lost in equal amounts during hemorrhage so the hct does not immediately reflect the loss sometimes not for 2 to 3 hours later

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3
Q

what determines cell age for PMNs?

A

the degree of nuclear lobulation (younger you are, less lobes you have)

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4
Q

more than 20 five-lobed cells/100 WBCs is indicative of what?

A

megaloblastic anemia

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5
Q

bacterial infection, toxemia and hemorrhage are indicative of what type of shift?

A

left shift

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6
Q

what are three common examples of right shift?

A

liver disease, megaloblastic anemia, iron deficiency anemia

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7
Q

what tube top color is used for a retic count?

A

lavendar

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8
Q

true or false: the retic count is part of cbc

A

nope; false

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9
Q

reticulocytes are juvenile rbc’s with remnants of what?

A

cytoplasmic basophilic RNA

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10
Q

bsophilia of the RBC cytoplasm on a Wright stain is indicative of the presence of what?

A

reticulocytes

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11
Q

what is the formula for the corrected reticulocyte count?

A

reported count x patients hct/normal hct

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12
Q

the corrected reticulocyte count is a great indicator of what?

A

erythropoietic activity

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13
Q

what is the normal corrected reticulocyte count typically about?

A

less than 1.5%

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14
Q

normal bone marrow responds to decrease in erythrocytes with an increase production of what?

A

retics

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15
Q

PMN depression when mild is referred to as what? when severe?

A

neutropenia; agranulocytosis

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16
Q

what is hematocrit really defined as?

A

The ratio of red blood cells to the total volume of blood.

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17
Q

what is known as the amount of hemoglobin in the average red cell?

A

MCH (mean corpuscular/cellular hemaglobin)

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18
Q

how do you define the MCV?

A

mean corpuscular volume/measure of the average red blood cell volume (i.e. size).

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19
Q

what is defined as the average concentration of Hbg in a given volume of red blood cells?

A

mean corpuscular hbg concentration (mchc)

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20
Q

hemoglobin/hematocrit is the formula for what?

A

mchc

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21
Q

the term poikilocytosis means what?

A

irregular RBC/wbc SHAPE

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22
Q

what does the term anisocytosis mean?

A

irregular RBC/wbc SIZE

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23
Q

only test used to monitor low molecular weight heparin.

A

anti-xa test (blue tube top); also used to monitor heparin therapy when PTT not available

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24
Q

test used to document neutralization of heparin

A

activated clotting time (ACT)

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25
Q

test for the presence of antibody on the patient’s cells and for the screening for autoimmune hemolytic anemia

A

Coombs test, direct

26
Q

test for antibodies against red cell antigens in the patient’s serum; check for cross-match before transfusion

A

coombs test, indirect

27
Q

what is the most common hereditary coagulation disorder in the US?

A

factor V leiden (activated protein c resistance)

28
Q

used to evaluate the extrinsic coagulation system.

A

PT

29
Q

used to evaluate the intrinsic coagulation system

A

PTT, aPTT

30
Q

what gauge needle should be used when collecting venous blood? if this is not available, should you go higher or lowe?

A

22 - higher

31
Q

why is it not advised to use small needles when trying to collect venous blood?

A

b/c small needles cause hemolysis

32
Q

routine cbc is collected in a tube of what coloring with what special ingredient added?

A

purple; EDTA

33
Q

how is the fresh blood collection to be shaken once collected with EDTA? why is this?

A

shaken gently back and forth as to avoid hemolysis

34
Q

most samples that are sent for coagulation are sent with what tube top coloring?

A

blue/citrate

35
Q

true or false: capillary heel and finger sticks can yield a falsely low hematocrit? what is the reading produced after milking these areas?

A

true; milking leads to readings that are falsely high

36
Q

true or false: wright stain blood smear is automatically done along with the automated cell count

A

false - must be requested

37
Q

what is the main reason to order a wright stain?

A

main advantage is that it identifies abnormal cells; in more detail, it provides a manual differential leukocyte count (useful for anemia and certain infections)

38
Q

mcv and hemoglobin concentration are two factors used to calculate what?

A

hematocrit

39
Q

true or false: an acute bleed will be normocytic for the first couple of hours.

A

true - will have normal hematocrit although volume measures will be dropping

40
Q

predominance of immature white cells is called _____ and can be indicative of the body responding to loss by increasing the rate of new cell production - while older cells are the ones being lost

A

shift to the left

41
Q

a predominance of cells with four or more lobes is called what?

A

shift to the right

42
Q

a single six or seven lobed PMN would be diagnostic for what?

A

megaloblastic anemia

43
Q

what do terms “bands”, “stabs” and “segs” refer to?

A

first two are immature wbc, the last references mature wbc

44
Q

about what percentage of bands being present would be indicative of a “left shift”

A

10 to 12%

45
Q

stress reaction can be indicated in a shift to the left or to the right?

A

right shift

46
Q

what is the presence of basophilia of the RBC cytoplasm on a Wright Stain called? (the presence btw is indicative of retics)

A

polychomasia

47
Q

what are the 7 differentials for an increased eosinophil count?

A

NAACP: neoplasm, allergies, asthma, addison’s, collagen-vascular disease, and parasites and pulmonary disease.

48
Q

what will steroids do the the level of eosinophils?

A

decrease

49
Q

what are subsets of lymphocytes most useful for diagnosing?

A

AIDS, leukemia, lymphoma

50
Q

true or false: a significant portion of the US population has a decreased lymphocyte count as their normal

A

true (22%)

51
Q

what is the most likely cause of >20% presence of atypical lymphs?

A

mononucleosis – other possible causes include CMV, toxo, or malignancy

52
Q

what is the most likely cause of lymphocytes being down (less than 20%)?

A

rickettsial infection, or common viral infections

53
Q

monocytes will be increased during what kind of infections?

A

bacterial infections such as subacute bacterial endocarditis, TB, etc.

54
Q

what is the approx. normal male hct? female?

A

40-54% and 37-47% | 50 to 60 and 40 to 50 if easier

55
Q

what does megaloblastic anemia do to MCH? what about iron deficiency anemia

A

increase; decrease

56
Q

what does severe prolonged dehydration do to mchc?

A

increases it

57
Q

this is known as the measure of degree of anisocytosis (the variation in size of rbc)

A

red cell distribution wideth

58
Q

abnormalities of function of this type of cell are assessed by bleeding time and platelet aggregation - what is the cell type?

A

platelets

59
Q

these type of cells are specific monoclonal antibodies

A

lymphocyte subsets

60
Q

when using lymphocyte subsets to diagnose AIDS, what is the marker you are looking for?

A

CD4/CD8 ratio less than one

CML - Clinical Lab Methods (6 decks)

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