Hematology tests And Procedures Flashcards
Flow cytometry based test
Most sensitive and specific test to confirm the diagnosis of HS
EMA binding test or Eosin-5-Maleimide binding test
Rarely done
Inaccurate
RBC count, hemoglobin and ct are elevated in people living at higher altitude
Manual RBC Count
Recommended screening test for PK deficiency
PK flurescent spot test or Autohemolysis test
Confirmatory test for PK deficiency
Quantitative PK Assay
Recommended screening test for G6PD deficiency
G6PD flurescent spot test or Autohemolysis test
Confirmatory test for G6PD deficiency
Quantitative G6PD assay
Confirmatory test for Hereditary Spherocytosis
EMA binding test
Tests for Disseminated Intravascular Coagulation
D-dimer test
Prothrombin Fragment 1 + 2
Reference method of Hemoglobin Determination
Cyanmethemoglobin
Major components of Drabkin’s reagent in HiCN method
Potassium ferricyanide - Hb to Methemoglobin
Potassium cyanide - Provide cyanide ions
Cyanmethemoglobin Method is measured ______ nm except sulfhemoglobin
540 nm
Movement of changed particles in the electric field
Electrophoresis
Electrophoresis (Fastest hemoglobin)
Hb H = abnormal
Hb A1 or A = normal
Electrophoresis (Slowest hemoglobin)
Hb C, A2, E, C Harlem, O arab
Primary screening procedure to detect variant or abnormal hemoglobin
Cellulose acetate (pH 8.4-8.6)
Complementary procedure to cellulose acetate Hb electrophoresis
Confirm variant of hemoglobins
Differentiates hemoglobin S from D and G
Citrate Agar (pH 6.0 to 6.2)
Instrument used to determine packed cell volume
Red blood cells that have settled
Hematocrit
T or F:
In reading hematocrit, the third layer (buffy coat) is read but not the 2nd layer (plasma)
T
75 mm long
Inner bore = 1.2 mm
Can hold 0.05 ml of blood
Plug = 4 to 6 mm long
2 types = Red band (Heparin) and Blue Band (No anticoagulant)
Details for hematocrit tube
In doing hct determination, you must spin the sample for _______ mins at ______ rpm
5 mins
10,000 rpm
T or F:
After centrifugation, read the hematocrit. Results should agree within 1% or +- 0.1 L/L
T
Falsely INCREASED hct is due to these following errors
Dehydration
Hemoconcentration
Insufficient centrifugation
Buffy coat inclusion in reading
Falsely DECREASED hct is due to these following errors
Hemolysis
Improper sealing
Increased AC concentration
Introduction of excess interstitial fluid or tissue fluid
Used for checking validity of test results
Works only for normocytic, normochromic specimens
Rule of Third
Erythrocyte indices
Mean Cell Volume
Mean Cell Hemoglobin
Mean Cell Hemoglobin Concentration
Average volume of an individual RBC
Reference range: 80 to 100 fl
Mean Cell Volume
Average weight or amount of hemoglobin in an individual RBC
Reference range: 26 to 32 pg
Mean Cell Hemoglobin
Mean concentration of hemoglobin in the average RBC
Reference range: 31 to 37 g/dl or %
Mean Cell Hemoglobin Concentration
Increased hematocrit level above normal
Two kinds: Absolute polycythemia (Elevated total red cell mass) and Relative Polycythemia (Normal total red cell mass but increased hct)
Polycythemia
Type of Absolute Polycythemia
Primary marrow disorder
Panmyelosis
Absolute Polycythemia or Polycythemia vera or Polycythemia Rubra Vera
PV has ________ mutation
JAK2V61LF mutation
Hallmark of Polycythemia Vera
Plethora or florid or reddish skin
Treatment of choice in Polycythemia Vera
Therapeutic phlebotomy
T or F:
Therapeutic phlebotomy can be used for patients with Hereditary Chromatosis or Bronze Diabetes
T
Rate of fall of RBCs settling to the bottom of the tube
Distance inn that the RBCs fall in 1 hr
ESR or Erythrocyte Sedimentation Rate
T or F:
ESR is prone to errors
ESR has low specificity and sensitivity
T
Methods of ESR determination (4)
Westergren
Modified westergren
Wintrobe
VES-MATIC 20 instrument
Method of ESR determination
Results determined after 1 and 2 hours
Anticoagulant used = 3.8% sodium citrate
Westergren
Method of ESR determination
Results determined after 1 hr
Most commonly used
Anticoagulant used = EDTA
Diluent = 0.85% NaCl or 3.8% Na Citrate
Modified Westergren
ICSH
International Council for Standardization in Hematology
CLSI
Clinical Laboratory Standards Institute
Method of ESR determination
Results determined after 1 hr
Anticoagulant used = Double oxalate or EDTA
Wintrobe
Method of ESR determination
Bench top analyzer designed to measure ESR in 20 samples
18 degree slant of tubes with respect to the vertical axis
VES-MATIC 20 instrument
ESR
Modified Westergren
Reference range (Adult Males)
0 to 10 mm/hr
ESR
Modified Westergren
Reference range (Adult Females)
0 to 15 mm/hr
ESR
Wintrobe
Reference range (Adult Males)
0 to 9 mm/hr
ESR
Wintrobe
Reference range (Adult Females)
0 to 20 mm/hr
Red blood cells are diluted in 0 to 0.85% saline solutions
Amount of hemolysis at each concentration is determined
Anticoagulant used = Heparin
Osmotic Fragility Test
Normal value for OFT
Initial hemolysis = 0.45%
Complete hemolysis = .30%
Confirmatory test for PNH or Paroxysmal Nocturnal Hemoglobinuria
Flow Cytometry
Tests for PNH or Paroxysmal Nocturnal Hemoglobinuria
Ham’s Acidified Serum Test
Sugar H2O Test or Sucrose Hemolysis Test
Flow Cytometry
Most sensitive test for IDA
Serum Ferritin Test
