LAB MLT 120 Final Flashcards
increased O-F
Hereditary Spherocytosis
decreased OF; room to expand
found in hemoglobinopathies
Thalessemia, Sickle cell anemia
target cells
SS
AS
sickle cell genotype
sickle cell trait
HJB is made of?
DNA
Basophilic stippling
RNA
Pappenhaimer bodies
Iron
hemolytic anemia
Burr cells
associated with Chronic renal disease
Hypersegs; 5 or more lobes
associated with PA
dark blue, scalloped edges
associated with IM
Atl
pale blue found in neutrophils
found in PBS if pregnant, in toxic state or have bacterial infection
toxic granulations
Dohle bodies
increased in CML, leukemoid reactions;
shift to left in immature cells
metamyelocytes
plasma cell-hof (halo)
multiple myeloma
auer rods in blast
not in lymphs, so no ALL
smudge cells
CLL
azurophilic granules
larger nucleus
decrease in CML
APL
promyelocyte
Hodkins
allergies
CML
parasitic infections
Eos
Used to diagnose
PBS
BM
pt history
increase MCV - 150
tingling-neuro
hyperseg
decreased WBC, RBC, plt
Pernicious Anemia
small pale cells
evidence of bleeding
MCV, MCHC - decrease
no blue/green on BM
IDA
non-specific esterase Positive
inhibited by flouride
BM: monoblasts
AMoL
all stages of granuloctyes
diff cells in diff stages
LAP - decreased
pt history
CML
Lymph
smudge cells
CLL
ATL’s
PBS differs from BM
IM
12-17
lowest female
highest male
Hgb
45 mid
Hct
27-32
MCH
32-36
MCHC
80-97
81-99
MCV
0-440
100-350
Eos
150,000-450,000
Plt
.5-2%
retics
5 mil
RBC
5,000-10,000
WBC
diluent for eos
Philoxine
diluent for Plt
ammonium oxalate
diluent for retics
supervital
New Methylene blue
sodium chloride
RBC diluent
Acetic acid
WBC diluent
1:32
eos
1:100
plt
1:2
retic
1:200
RBC
1:20
WBC
Principle of the sedimentation rate (ESR), the two methods for measuring the ESR, and the normal values for males and females
measures suspension stability of the red cells
Westergren, Winthrobe Methods
male 0-15 mm/hr
female 0-20 mm/hr
Given the values for the RBC, Hgb, and Hct, calculate the RBC indices (MCV, MCH, MCHC)
MCV is (Hct/RBC) x 10 MCH is (Hgb/RBC) x 10 MCHC is (Hgb/Hct) x 100 in W/V
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.
red cells are exposed to decreasing concentrations of sodium chloride to observe the point at which the red cells hemolyze. Plot % hemolysis against concentration of NaCl and observe the curve;
increase - hereditary spheroctytosis
decrease - target cells - sickle cell
Explain the principle of the tube solubility method for SCA screening.
Hgb S is insoluble and if exposed to reducing agent will precipitate out, causing turbidity; will not be able to see lines through tube
How does a doctor use the reticulocyte count?
measures effective erythroid poiesis
if BM is responding
diagnose anemia
State three reasons for performing a WBC differential
count and classify 100 WBC
diagnose disease
evaluate therapy
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 dilution reciprocal x (1/vol counted)
*1 sm square is 0.004 mm3
1 lg square is 0.1 mm3
How could you vary the counting procedure if you had to count (manually) an extremely high WBC count?
use RBC pipette 1:100 or 1:200
**WBC should not go higher than 1:33
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
Why do you need to perform coagulation testing within two hours after specimen collection?
results will increase due to loss of labile factors
should spin and refrigerate is cant test within 2 hours
thromboplastin/calcium-chloride
10-14 sec
extrinsic
monitor coumadin therapy
PT - Prothrombin time
calcium flouride, plt substitute
less than 35 sec
intrinsic
monitor heparin therapy
PTT - partial thrombin time
Compare the principle of the Fibrometer with that of the CoaDATA 2000
Fibrometer; formation of clot completes electrical circuit which turns off the timer
CoaDATA; turbidodensiturmetric method, clarity of specimen does not effect results
Name two functions of the automatic pipette and two functions of the probe arm of the Fibrometer
pipette; dispenses reagent, turns off timer
probe arm; hold electrodes in place, mixes reagent, senses clot
Duke and Ivy method for bleeding time (site of puncture and normal values).
Duke - earlobe; 1-3 min
Ivy - forearm; 1-7 min
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.)
PT - measures extrinsic
PTT - measures intrinsic
bleeding time - check plts
If normal plasma fails to correct an abnormal PT and PTT, what is the best explanation for the results
circulating anticoagulants (AB to clotting factor), not just factor deficiency
*normal plasma corrects deficiency
What is the only factor that will give an increased TT? ________________________________
(It will also be corrected by normal plasma, but not by either adsorbed plasma or aged as there are usually insufficient amounts of it in adsorbed plasma to correct a deficiency and it is not found in aged serum at all.)
Factor I
bleeding time
plt function
PTT
Stage I of coag
PT
Stage II of coag
Fibrinolysis
D-dimer
Absorbed plasma
Factors 5, 8, 11, 12
remove vitamin K dependent factors
Aged serum
Factors 2, 7, 9, 10, 11, 12
labile factors
5, 8
Vitamin K dependent factors
2, 7, 9, 10
Use of the PT and PTT substitution tests
Why not preform a series of specific factor assays?
narrow down possible deficiency factors
consuming and expensive
What are some possible sources of error in coagulation testing?
not right amount of anti-coagulant
expired reagents
specimen at RT too long
Why should a doctor order presugical coagulation screening tests?
“normal” may be drop below and cause pt to bleed
normal 50-150%
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?
different instruments, reagents, environments and other variables at different hospitals;
If a patient has an increase PTT and an increase PT, what is the diagnosis and how could you prove it?
Von Wilderbran disease, plt abnormality
Factor 8 assay
What is the antidote for coumadin?
For heparin?
Vitamin K
Protamine sulfate
What is the INR and how is it used in the laboratory?
International Normalized Ratio
to compare different pt’s results dome from different labs
What tests did we do in lab that are used primarily in the diagnosis of fibrinolysis?
D-dimer
Thrombo Wellco
surevital stain for retics
Wright’s stain
hyposegmentation of neutrophil
bilobed
dumb bell shaped
Pelger-Huet
not in ALL
pinkish-red rod shape inclusion
auer-rods
lighter staining nucleoli
blasts
damaged WBC
AB alters nucleus
engulfed phagocytosis - off center nucleus due to homogenous blob
LE cell
