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hematology > lab final > Flashcards

lab final Flashcards

1
Q

normal values of Hgb

A

in the teens

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2
Q

normal values of Hct

A

30s to 50s

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3
Q

normal MCHC

A

32-36

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4
Q

normal MCH

A

27-32

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5
Q

normal MCV

A

80-90

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6
Q

normal counts for Eos

A

150-300

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7
Q

normal counts for platelets

A

150,000-450,000

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8
Q

normal count for retics

A

0.5-2%

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9
Q

normal count for RBC

A

millions

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10
Q

normal count for WBC

A

5,000-10,000

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11
Q

what diluent was used in the manual counts of eosinophils

A

philoxine

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12
Q

what diluent was used in manual count for platelets

A

ammonium oxalate

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13
Q

what was used in the manual count for retics

A

new methylene blue

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14
Q

what was used in the manual count for RBC

A

saline/NaCl

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15
Q

what was used in the manual count for the WBC

A

acetic acid

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16
Q

what is the dilution ratio for eosinophils

A

1:32

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17
Q

what is the dilution ratio for platelets

A

1:100

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18
Q

what is the dilution ratio for retics

A

1:2

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19
Q

what is the dilution ratio for RBC

A

1:200

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20
Q

what is the dilution ratio for WBC

A

1:20

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21
Q

what is the principle of the sedimentation rate? (ESR)

A

measures the suspension stability of the red cells

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22
Q

what are the two methods of the ESR (sedimentation rate)?

A

westergren and wintrobe

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23
Q

what is the normal value in the ESR for males and females?

A

M: 0-15 mm/hr F: 0-20 mm/hr

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24
Q

how do you calculate MCV

A

mean corpuscular volume= average size of red blood cell (Hct/RBC in millions) X 10

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25
Q

how do you calculate MCH

A

mean corpuscular hemoglobin= concentration (Hgb/RBC in millions) X 10

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26
Q

how do you calculate MCHC

A

average amount of Hgb in RBC (w/v) (Hgb/Hct) X 100 (reported in %)

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27
Q

what is the principle of the osmotic fragility test?

A

Red cells are exposed to decreasing concentration of saline to observe the point of complete hemolysis

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28
Q

what conditions are associated with decreased OF?

A

sickle cell anemia thalassemia liver disease

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29
Q

what conditions are associated with increased OF?

A

hereditary spherocytosis

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30
Q

explain the principle of the tube solubility method for SCA screening?

A

expose the red cells to a reducing agent and hemoglobin S is insoluble positive test is cloudy/turbid (will not be able to see black lines behind tubes) negative test has no Hemoglobin S and is clear

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31
Q

how does a doctor use the reticulocyte count?

A

measure effective erythropoiesis evaluate/diagnose anemia

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32
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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33
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

cells counted X reciprocal of dilution (ex. 1/20 multiply by 20) X (1/volume counted)

volume of small square 0.004

large square 0.1

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34
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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35
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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36
Q

why do you need to perform coagulation testing within two hours after specimen collection?

A

results will be too high because of the loss of labile factors

need to do:spin down blood and refirgerate plasma

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37
Q

PT:

reagents used

normal range

system of coagulation

clinical use

A

thromboplastin CaCl mix

10-14 seconds

extrinsic system

monitor coumadin (warfarin) therapy

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38
Q

PTT reagents used

normal range

system of coagulation

clinical use

A

platelet substitute and CaCl

less than 35 seconds

intrinsic system

heparin therapy

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39
Q

compare the pirnciple of the fibrometer with that of the CoaDATA2000

A

fibrometer: when clot forms it completes circuit and turns off timer

CoaDATA2000: change in optical density detects the clot

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40
Q

what are two functions of the automatic pipette on the fibrometer

A

dispenses reagents turns on timer

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41
Q

what are two functions of the probe arm of the fibrometer?

A

holds the electrodes mixes the reagents senses the clot

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42
Q

what is the site of puncture and normal value for the duke method for bleeding time?

A

earlobe 1-3 minutes

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43
Q

what is the puncture site and normal value for the ivy method for bleeding time?

A

forearm 1-7 minutes

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44
Q

be able to list two tests that you think should be included in a screen for coag disorders and indicate why you chose each test

A

PT- check for extrinsic factors

PTT- checks for intrinsic factor

bleeding time- measures platelet function

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45
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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46
Q

what is the only factor that will give an increased thrombin time? (it will also be corrected by normal plasma, but not by either absorbed plasma or aged as there are usually insufficient amounts of it in absorbed plasma to correct a deficiency and it is not found in aged serum at all.)

A

fibrinogen (factor 1)

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47
Q

what test measures platelet function?

A

bleeding time

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48
Q

what test measures stage 1 of coagulation

A

PTT

49
Q

what test measures stage 2 of coagulation ?

A

PT

50
Q

what test measures fibrinolysis?

A

FDP, D-Dimer

51
Q

what are the factors of absorbed plasma

A

1, 5, 8, 11, 12 (lacks vitamin K, contains labile factors)

52
Q

what are the factors of aged serum

A

2, 7, 9, 10, 11, 12 (contains vitamin K, lacks labile factors)

53
Q

what are the factors of labile factors?

A

5, 8

54
Q

what are the factors of the Vitamin K dependent factors

A

2, 7, 9, 10

55
Q

use of PT and PTT substitution test

A

narrow down possible coagulation factors that are deficient

56
Q

why not perform a series of specific factor assays

A

expensive and time consuming

57
Q

what are some possible sources of error in coagulation testing?

A

improper ratio of anticoagulant to blood

sit at room temp too long

expired reagents

hemolyzed specimens (shortens clotting time as tissue factor is present lipemia

58
Q

why should a doctor order presurgical 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 start to bleed out

59
Q

why is it important for a hospital to establish its own normal range for the PT and PTT and how would a doctor utilize this information?

A

each hospital uses different reagents, instruments, and has different patient population doctors want patients to be 1.5 to 2.5 times the normal range

60
Q

if a patient has an increased PTT and increased bleeding time, what is the diagnosis and how could you prove it?

A

factor 8- Von Willebrand’s disease prove with factor 8 assay or substitution test

61
Q

what is the antidote for coumadin (warfarin)?

A

vitamin K

62
Q

what is the antidote for heparin?

A

protamine sulfate

63
Q

what is the INR and how is it used in the lab?

A

international normalized ratio regulates/ compares PTs done in different labs

64
Q

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

A

thrombowellco, D-dimer

65
Q

Acute Lymphocytic Leukemia (ALL)

A

blast and lymphs

66
Q

Acute monocytic Leukemia (AMoL)

A

blast and monos

+ esterase stains

complete inhibition by fluoride

67
Q

Acute myelocytic Lukemia (AML)

A

blast and mature granulocytes

68
Q

Autoimmune hemolytic Anemia (AIHA)

A

spherocytes

69
Q

Chronic lymphocytic Leukemia (CLL)

A

small mature clumpy lymphs older person smudge cells

70
Q

chronic myelogenous leukemia (CML)

A

all stages of granulocytes increases bands alot of cells in bone marrow

71
Q

hemophilia A

A

male bleeding of joints PTT increased absorbed plasma sex linked

72
Q

idiopathic thrombocytopenic purpura (ITP)

A

coagulation test normal bleeding time increased decreased platelets

73
Q

infectious mononucleosis (IM)

A

15-33 years

atypical lymphs not found in bone marrow

atypical lymphs in lymphnodes and PBS

slight fever

74
Q

iron deficiency anemia (IDA)

A

MCV less than 80 MCH less than 32 bone marrow no iron (no blue/green dye) precursors jagged edge hypochromic

75
Q

pernicious anemia (PA)

A

hypersegs oval macrocytes

low counts (decreased RBC WBC platelets)

increased MCV

neurological symptoms(tingling extremities)

dividing cells

76
Q

sickle cell anemia (SCA)

A

genotype: SS

small pale cells

some evidence of bleeding

decreased MCV

decreased MCHC

iron stain of bone marrow will have no blue/green no iron

77
Q

thalassemia major

A

microcytic hypochormic NRBCs howell jolly bodies bone marrow increased increased Hgb A2 and F increased iron target cells envelope cells

78
Q

Von Willebrand’s disease

A

factor 8 deficient PTT abnormal corrected increased bleeding time

79
Q
A

promyelocyte

blue cytoplasm and granules

80
Q
A

basophilic stippling

made of RNA

seen in hemolytic anemia, thalassemia, SCA

81
Q
A

target cells

seen in liver disease

82
Q
A

metamyelocyte

nucleus is kidney bean shaped

seen in bacterial infections and leukemoid reactions

83
Q
A

myelocyte

seen in CML

84
Q
A

atypical lymphocytes

85
Q
A

hypersegmented neutrophil

seen in PA, megaloblastic anemia b12 deficiency

86
Q
A

ovalocytes/elliptocytes

hereditary elliptocytosis

87
Q
A

sickle cell

genotype : SS

88
Q
A

dohle body

light blue staining areas in neutrophil

seen in bacterial infections, pregnancy, toxic states

89
Q
A

spherocyte

increased osmotic fragility

90
Q
A

blast

nucleoli lighter stained area

91
Q
A

plasma cells

MM

92
Q
A

smudge cells

seen in CLL

93
Q
A

rubricyte

94
Q
A

LE cell

95
Q
A

metarubricyte

NRBC

seen in hemolytic anemia, SCA, thalassemia

96
Q
A

basophil

97
Q
A

multiple myeloma

rouleaux

98
Q
A

eosinophil

reddish granules

seen in parasitic infections and CML

99
Q
A

pelger huet

hyposegmented neutrophils

dumbbell shaped nucleus

bi lobed

100
Q
A

hairy cell

101
Q
A

segmented neutrophil

102
Q
A

burr cells

seen in chronic liver disease

103
Q
A

band neutrophil

104
Q
A

hemoglobin C crystals

rectangular shaped crystals in hemoglobin C disease

105
Q
A

toxic granulation of band neutrophil

106
Q
A

auer rod

because this is an auer rod and if it is present then you can eliminate lymphocytes

107
Q
A

pappenheimer bodies

made of iron

108
Q
A

vacuole

109
Q
A

hemogloin SC crystals

hemoglobin SC disease

110
Q
A

howell jolly bodies

made of DNA

seen in hemolytic anemia and thalassemia

111
Q
A

schistocytes

fragments of RBC

seen in hemolytic anemia, severe burns, renal graft rejection

112
Q
A

reitculocyte

seen in erythrocyte maturation

113
Q
A

microcytic-hypochromic

IDA

114
Q
A

polychromasia

seen in effective treatment for anemia

acute and chornic hemorrhage hemolysis

neonates

115
Q
A

acanthocytes

“spurr”

seen in severe liver disease, splenectomy, vitamin E deficiency

116
Q
A

monocytes

117
Q
A

lymphocytes

118
Q
A

mott cells

cancer?

hematology (9 decks)

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