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
how do you calculate MCH
mean corpuscular hemoglobin= concentration (Hgb/RBC in millions) X 10
26
how do you calculate MCHC
average amount of Hgb in RBC (w/v) (Hgb/Hct) X 100 (reported in %)
27
what is the principle of the osmotic fragility test?
Red cells are exposed to decreasing concentration of saline to observe the point of complete hemolysis
28
what conditions are associated with decreased OF?
sickle cell anemia thalassemia liver disease
29
what conditions are associated with increased OF?
hereditary spherocytosis
30
explain the principle of the tube solubility method for SCA screening?
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
31
how does a doctor use the reticulocyte count?
measure effective erythropoiesis evaluate/diagnose anemia
32
state three reasons for performing a WBC differential
count and classify 100 WBCs observe RBC morphology diagnose patients conditions monitor therapy picture of general health
33
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
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
34
how could you vary the counting procedure if you had to count (manually) an extremely high WBC count?
use a red cell pipette to make a 1:100 or 1:200 dilution
35
name the most commonly used anticoagulant for blood specimens to be used for coagulation testing and be able to tell how it works
sodium citrate- binds calcium
36
why do you need to perform coagulation testing within two hours after specimen collection?
results will be too high because of the loss of labile factors need to do:spin down blood and refirgerate plasma
37
PT: reagents used normal range system of coagulation clinical use
thromboplastin CaCl mix 10-14 seconds extrinsic system monitor coumadin (warfarin) therapy
38
PTT reagents used normal range system of coagulation clinical use
platelet substitute and CaCl less than 35 seconds intrinsic system heparin therapy
39
compare the pirnciple of the fibrometer with that of the CoaDATA2000
fibrometer: when clot forms it completes circuit and turns off timer CoaDATA2000: change in optical density detects the clot
40
what are two functions of the automatic pipette on the fibrometer
dispenses reagents turns on timer
41
what are two functions of the probe arm of the fibrometer?
holds the electrodes mixes the reagents senses the clot
42
what is the site of puncture and normal value for the duke method for bleeding time?
earlobe 1-3 minutes
43
what is the puncture site and normal value for the ivy method for bleeding time?
forearm 1-7 minutes
44
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
PT- check for extrinsic factors PTT- checks for intrinsic factor bleeding time- measures platelet function
45
if normal plasma fails to correct an abnormal PT and PTT, what is the best explanation for the results?
circulating anticoagulant/ antibody to a clotting factor
46
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.)
fibrinogen (factor 1)
47
what test measures platelet function?
bleeding time
48
what test measures stage 1 of coagulation
PTT
49
what test measures stage 2 of coagulation ?
PT
50
what test measures fibrinolysis?
FDP, D-Dimer
51
what are the factors of absorbed plasma
1, 5, 8, 11, 12 (lacks vitamin K, contains labile factors)
52
what are the factors of aged serum
2, 7, 9, 10, 11, 12 (contains vitamin K, lacks labile factors)
53
what are the factors of labile factors?
5, 8
54
what are the factors of the Vitamin K dependent factors
2, 7, 9, 10
55
use of PT and PTT substitution test
narrow down possible coagulation factors that are deficient
56
why not perform a series of specific factor assays
expensive and time consuming
57
what are some possible sources of error in coagulation testing?
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
why should a doctor order presurgical coagulation screening test?
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
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?
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
if a patient has an increased PTT and increased bleeding time, what is the diagnosis and how could you prove it?
factor 8- Von Willebrand's disease prove with factor 8 assay or substitution test
61
what is the antidote for coumadin (warfarin)?
vitamin K
62
what is the antidote for heparin?
protamine sulfate
63
what is the INR and how is it used in the lab?
international normalized ratio regulates/ compares PTs done in different labs
64
what test did we do in lab that are used primarily in the diagnoses of finbrinolysis?
thrombowellco, D-dimer
65
Acute Lymphocytic Leukemia (ALL)
blast and lymphs
66
Acute monocytic Leukemia (AMoL)
blast and monos + esterase stains complete inhibition by fluoride
67
Acute myelocytic Lukemia (AML)
blast and mature granulocytes
68
Autoimmune hemolytic Anemia (AIHA)
spherocytes
69
Chronic lymphocytic Leukemia (CLL)
small mature clumpy lymphs older person smudge cells
70
chronic myelogenous leukemia (CML)
all stages of granulocytes increases bands alot of cells in bone marrow
71
hemophilia A
male bleeding of joints PTT increased absorbed plasma sex linked
72
idiopathic thrombocytopenic purpura (ITP)
coagulation test normal bleeding time increased decreased platelets
73
infectious mononucleosis (IM)
15-33 years atypical lymphs not found in bone marrow atypical lymphs in lymphnodes and PBS slight fever
74
iron deficiency anemia (IDA)
MCV less than 80 MCH less than 32 bone marrow no iron (no blue/green dye) precursors jagged edge hypochromic
75
pernicious anemia (PA)
hypersegs oval macrocytes low counts (decreased RBC WBC platelets) increased MCV neurological symptoms(tingling extremities) dividing cells
76
sickle cell anemia (SCA)
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
thalassemia major
microcytic hypochormic NRBCs howell jolly bodies bone marrow increased increased Hgb A2 and F increased iron target cells envelope cells
78
Von Willebrand's disease
factor 8 deficient PTT abnormal corrected increased bleeding time
79
promyelocyte blue cytoplasm and granules
80
basophilic stippling made of RNA seen in hemolytic anemia, thalassemia, SCA
81
target cells seen in liver disease
82
metamyelocyte nucleus is kidney bean shaped seen in bacterial infections and leukemoid reactions
83
myelocyte seen in CML
84
atypical lymphocytes
85
hypersegmented neutrophil seen in PA, megaloblastic anemia b12 deficiency
86
ovalocytes/elliptocytes hereditary elliptocytosis
87
sickle cell genotype : SS
88
dohle body light blue staining areas in neutrophil seen in bacterial infections, pregnancy, toxic states
89
spherocyte increased osmotic fragility
90
blast nucleoli lighter stained area
91
plasma cells MM
92
smudge cells seen in CLL
93
rubricyte
94
LE cell
95
metarubricyte NRBC seen in hemolytic anemia, SCA, thalassemia
96
basophil
97
multiple myeloma rouleaux
98
eosinophil reddish granules seen in parasitic infections and CML
99
pelger huet hyposegmented neutrophils dumbbell shaped nucleus bi lobed
100
hairy cell
101
segmented neutrophil
102
burr cells seen in chronic liver disease
103
band neutrophil
104
hemoglobin C crystals rectangular shaped crystals in hemoglobin C disease
105
toxic granulation of band neutrophil
106
auer rod because this is an auer rod and if it is present then you can eliminate lymphocytes
107
pappenheimer bodies made of iron
108
vacuole
109
hemogloin SC crystals hemoglobin SC disease
110
howell jolly bodies made of DNA seen in hemolytic anemia and thalassemia
111
schistocytes fragments of RBC seen in hemolytic anemia, severe burns, renal graft rejection
112
reitculocyte seen in erythrocyte maturation
113
microcytic-hypochromic IDA
114
polychromasia seen in effective treatment for anemia acute and chornic hemorrhage hemolysis neonates
115
acanthocytes "spurr" seen in severe liver disease, splenectomy, vitamin E deficiency
116
monocytes
117
lymphocytes
118
mott cells cancer?