HSC HEMATOLOGY INTERVIEW Q'S Flashcards
What signifies anemia?
Decreased hemoglobin and hematocrit
What are the RBC indices of microcytic/hyperchromic anemias?
Low MCV, MCH and MCHC
What are the microcytic/hyperchromic anemias?
Iron deficiency, Beta Thalassemia, Alpha Thalassemia, Sideroblastic, anemia of chronic disease or inflammation
What are the RBC indices of macrocytic/normochromic anemias?
High MCV,MCH and normal MCHC
What are the macrocytic/hyperchromic anemias?
Megaloblastic anemia, Liver disease, alcoholism
What are the 2 types of megaloblastic anemia?
Folate deficiency and B12 deficiency
How do you identify hereditary spherocytosis?
Osmotic fragility test and hemolysis test, DAT=negative
What are the PBS features of Microangiopathic anemia?
NN anemia with thrombocytopenia, smear will show schistocytes.
What can affect Hemoglobin parameters?
Transfusion (high hgb), blood loss (low hgb), sample is diluted due to fluids, tubidity, anemia, polycythemia, etc.
List 4 examples of preanalytical errors
1) Hemolysis due to difficult collection - causes falsely decreasing results for RBC, HCT and APTT
2) Misidentification of a patient
3)Diluted sample- can falsely lower CBC results
4) Improper mixing of a sample, can cause clots which will affect results ex. lower platelet count
You need to return RBC back into inventory, what needs to be checked first?
Ports are intact not open and there are some remaining, no leakage, front label is intact, visual inspection (ex, colour and air bubbles), haven’t been out for longer than 1hr.
You have an MTP, stroke sample, CSF and the phone is ringing, what do you do first?
-Ignore the phone call
- Stroke sample–put it on quickly
- MTP (the first cooler of RBCs has to be ready within 15min of receiving the requisition) and prepare frozen plasma thaw 20-30min at 30-37 C
- Check back on the stroke sample to make sure the results went through and are valid
-CSF next
- Prepare the second cooler of plasma (has to be within 45min of req)
What factors affect PT?
Under filled tube (prolong results), coumadin/warfarin (high pt/inr), quick clot (check for clot, see if the patient was issued factor VIIa
What factors affect APTT?
Heparin (prolonged), clot, IV line (contamination), difficult collection (quick clot)
What happens if you get a Fib-RP lower than 1.5g/L?
Reflexes to generate Clauss Fibrinogen –more accurate quantitative measurement
What are the aspects of a good clot curve?
Has a baseline, acceleration, and plateau phase
RBC reference range
M: 4.60 -6
Fem: 4-5.4
WBC reference range
4.5-11.5
Hgb Reference range
M: 140-180
F: 120-150
Hct Reference range
M: 0.4- 0.54
F: 0.39 -0.49
MCV reference range
80-100 fL
MCH reference range
27-31
MCHC reference range
32-36
PLT reference range
150-450
PT reference range
11-13 sec
APTT reference range
20-30sec
When should a plasma replacement be done?
If the MCHC is >375 g/L, RBC should be within 5% of following replacement
When should a blood sample be warmed?
MCHC is greater than >375 and system flags RBC agglutinin, rerun the sample and warm it for a minimum of 15min at 37C