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Hemotology/Hemostasis > LAB EXAM FINAL > Flashcards

LAB EXAM FINAL Flashcards

1
Q

Matching RBC parameters with normal values - Hgb, Hct, MCH, MCHC, MCV

A 
Hgb-12-17
Hct- 30-50
MCH-27-32
MCHC-32-36
MCV-80-97
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2
Q

Match the cells for which we did manual counts with their normal values. (Eos, Plts, Retics, RBC, & WBC)

A

Eos-150-300
Platelets: 150,000-400,000
Retics:0.5%-2%
RBC: Millions

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3
Q 
Match the below with the dilution ratios we used for the manual counts
Eos
Plates
Retics
RBC
WBC
A 
Eos: 1:32
Platelets: 1:100
Retics: 1:2
RBC: 1:200
WBC: 1:20
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4
Q

What is the Principle of the sedimentation rate (ESR),

The two methods for measuring the ESR, and
the normal values for males and females

A

Principle: Measures the suspension stability of the red cells

Methods: Westgren and Wintrobe

Males: 0-15mm/hr

Females: 0-20mm/hr

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5
Q

Given the values for the RBC, Hgb, and Hct, calculate the RBC indices (MCV, MCH, MCHC).

A

MCV: mean corpuscular volume = average size of RBC (Hct/RBC in millions)x10

MCH: Mean corpuscular hemoglobin= Concentration (Hgb/RBC in millions)x10

MCHC: Average amount of Hgb in RBC (w/v)(Hgb/Hct) x100 (reported in %)

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6
Q

State the principle of the osmotic fragility test and be able to name a condition in which the
osmotic fragility is increased and one in which it is decreased

A

Principle: Red cells are exposed to decreasing concentration of sodium chloride to observe the point of complete hemolysis (make a graph of % hemolysis)

Decreased: Sickle cell anemia, thalassemia, liver disease

Increased: Hereditary Spherocytosis

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7
Q

Explain the principle of the tube solubility method for SCA screening.

A

Expose the red cells to a reducing agent and hemoglobin S in insoluble. Positive test is cloudy/turbid. Negative Test has no Hemoglobin S and is clear

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8
Q

How does a doctor use the reticulocyte count?

A

Measures effective erythropoiesis. Evlauate/Diagnose Anemia

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9
Q

State three reasons for performing a WBC differential

A

Count and classify 100 WBCs

Observe RBC morphology

Diagnose patients conditions

Monitor therapy

Picture of general health

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10
Q

Be able to show how you would calculate a total cell count (not a standard count) if you are given the dilution, the volume counted, and the number of cells counted

A

Number of cells counted (x) correction for dilution (x) correction for volume

Correction for dilution is the reciprocal of dilution 1:50= 50 (x) Correction for Volume is 1/Number of squares counted (x) volume of square

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11
Q

How could you vary the counting procedure if you had to count (manually) an extremely high WBC count?

A

Use a red cell pipette to make a 1:100 or 1:200 dilution

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12
Q

Name the most commonly used anticoagulant for blood specimens to be used for
coagulation testing and be able to tell how it works

A

Sodium citrate-binds calcium

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13
Q

Why do you need to perform coagulation testing within two hours after specimen Collection

A

The labile factor will start to decrease, clotting time will increase falsely.

After a delay-spin it down and refrigerate/freeze plasma (if machine broken) or redraw( if left out to long)

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14
Q

PT:

Rgts Used
Normal Range
System of Coagulation
Clinical Use

A

PT

Throboplastin/Ca Cl Mix
10-14 sec
Extrinsic
Monitor Coumadin Therapy

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15
Q

PTT
Rgts Used

Normal Range
System of Coagulation
Clinical Use

A 
PTT
Platelet Substitute and CaCl
Less than 35 sec
Intrinsic System
Heparin Therapy
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16
Q

Compare the principle of the Fibrometer with that of the CoaDATA 2000

A

Fibrometer: when clot forms it completes circuit and truns off timer

CoaDATA200:change in optical density detects the clot

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17
Q

Name two functions of the automatic pipette and two functions of the probe arm of the Fibrometer (noise maker)

A

Automatic Pipette: dispense reagents and turns on timer

Probe Arm: holds the electrodes, mixes the reagents. And senses the clot

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18
Q

Duke and Ivy method for bleeding time (site of puncture and normal values).

A

Duke-Ear, 1-3 Min

Ivy- Forearm, 1-7min

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19
Q

Be able to list two tests that you think should be included in a screen for coagulation disorders and indicate why you chose each test (i.e. checks intrinsic factors, checks plts, etc.)

A

PT- check for extrinsic factor

PTT- checks for intrinsic factor

Bleeding Time- measures platelet function

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20
Q

If normal plasma fails to correct an abnormal PT and PTT, what is the best explanation for the results?

A

Circulating anticoagulant/ antibody to a clotting factor

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21
Q

What is the only factor that will give an (increase)TT?

A

Fibrinogen (Factor I)

22
Q

Be able to name a test to measure Platelet function

A

Bleeding Time

23
Q

Be able to name a test to measure Stage I of coagulation

A

PTT

24
Q

Be able to name a test to measure Stage II of coagulation

A

PT

25
Q

Be able to name a test to measure Fibrinolysis

A

FDP, D-Dimer

26
Q

list the factors. absorbed plasma

A

I V VIII XI XII

1 5 8 11 12

27
Q

list the factors. aged serum

A

II VII IX X XI XII
contains Vit K lacks labile factors
2 7 9 10 11 12

28
Q

list the factors. labile factors

A

V VIII

5 8

29
Q

list the factors Vitamin K dependent factors

A

II VII IX X

2 7 9 10

30
Q

use of pt and ptt substitution test

A

narrow down possible coagulation factors that are deficient

31
Q

why not perform a series of specific factor assays

A

expensive and time consuming

32
Q

what are some possible sources of errors in coagulation testing

A

improper ratio of anticoagulant to blood
sit at room temp too long
expired reagents
hemolyzed specicimen

33
Q

why should a dr order pre surgical coagulation screening test

A

if patient has low-normal range, bleeding out could occur(if never had surgery) could decrease to a critically low level.
normal 50-100%
surgery decreased 30-40%
decreased less than 30% can bleed out

34
Q

why is it imprtant for a hospital to establish its own normal range for the pt and ptt and how would a dr utilize the information

A

each hospital uses different reagents, instruments, and has different pt population.
drs want pts to be 1.5-2.5 times normal range

35
Q

if pt has an increased bleeding time what is diagnosis and how could you prove it

A

Factor VIII Von Willeebrands disease

prove with factor VIII assay or substitution test

36
Q

what is the antidote for coumadin (Warfarin)

A

Vit K

37
Q

what is the antidote for heparin

A

Protamine sulfate

38
Q

What is the INR and how is it used in the lab

A

International Normalized Ratio

regulates/ compares PT done in different labs

39
Q

what test did we do in the lab that are used primarily in the diagnoses of fibrinolysis

A

FDP, D-Dimer

40
Q

Case studies Acute Lymphocytic Leukemia (ALL)

A

blast and lymph

41
Q

Case History Acute monocytic Leukemia (AMol)

A

blast and mono

42
Q

case studies Acute Myleocytic leukemia (AML)

A

blast and mature granulocytes

43
Q

case studies Autoimmune hemolytic anemia (AIHA)

A

spherocytes

44
Q

Case studies Chronic Lymphocytic leukemia CLL

A

small mature clumpy lymphs, older person, smudge cells

45
Q

Case studies Chronic myelogenous leukemia CML

A

all stages of granulocytes, increases bands, a lot of cells in the bone marrow

46
Q

case studies Hemophilia A

A 
Male 
bleeding joints
PTT increased
absorbed plasma
sex linked
47
Q

Case studies Idiopathic thrombocytopenia purpura (ITP)

A

coag test normal
bleeding time increased
decreased platelets

48
Q

case studies Infectious mono(IM)

A

15-35 yrs
atypicaL LYMPHS not found in bone marrow
atypical lymphs in lymphnodes and PBS
slight fever

49
Q

Case studies Iron deficiency anemia (IDA)

A 
MCV less than 80
MCH less than 32
no iron in bone marrow
precursers/jagged edge
hypochromic
50
Q

case studies Sickle cell anemia (SCA)

A

genotype SS

51
Q

Case studies Thalassemia MAJOR

A 
microcytic hypochromic
NRBCs
Howell jolly bodies
bone marrow Increased
increased iron
target cells and envelope cells
52
Q

case studies Von Willebrands disease

A

Factor VIII deficient
PTT abnormal corrected
increased bleeding time

Hemotology/Hemostasis (8 decks)

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