labCE

Question 1

Nucleated RBC’s are most likely to be seen in the peripheral blood of which of the beta thalassemias?

Answer 1

Beta thalassemia major

Question 2

which unit contains the proper number of platelets from a random donor?

Answer 2

5. 8 X 10^10
   * Platelet concentrates are required to have a minimum of 5.5 x 1010 platelets/unit. Random donor platelet concentrates typically contains between 5.5 and 8.5 X 1010 platelets suspended in about 50 mL of plasma. This is approximately 70% of the platelets which were present in the original unit of whole blood collected by the donor.

Question 3

A hemacytometer platelet count was performed and the total platelet count was 356 X 10^9/L. Ten fields on the stained blood smear were examined for platelets and the results per field were as follows:
17, 16, 15, 20, 19, 17, 19, 16, 20, 18 This laboratory uses a “field factor” multiplication of 20,000 for manual platelet estimates.

What is the NEXT logical step in this evaluation?

Answer 3

Report the hemacytometers platelet count since it correlated well with the slide

• The average of the platelets counted on the peripheral smear = 17.7
  17. 7 x 20,000 = 354,000 x 106/L platelets

This number correlates with the original manual platelet count on the hemacytometer, therefore, the results should be released.

Question 4

What would be the logical first step to obtain correct values when the following results were obtained on an electronic particle counter in hematology for an alcoholic patient?

WBC 6,500/cu. mm
MCV 90.1 fL
RBC 4,550,000/cu. mm
MCH 39.6 pg
HGB 18.0 g/dl
MCHC 43.4%
HCT 41.5%

Answer 4

dilute the blood

*Lipemia can cause increased hemoglobin results on automated hematology analyzers since the hemoglobin measurement is performed spectrophotometrically. The lipemia in the sample causes a more turbid sample, leading to a falsely high reading during the hemoglobin determination.

Question 5

a definitive diagnosis of malaria can be made by

Answer 5

demonstrating the organism in peripheral blood (may require thick smears as well as conventional thin smears)

Question 6

The following results were obtained on arterial blood:

pH = 7.51
pCO2= 49 mmHg
HCO3 = 38.7 mEq/L
pO2= 85 mmHg

These results are compatible with:

Answer 6

metabolic alkalosis

*The pH of this patient sample is alkaline (>7.45), which is indicative of alkalosis. Since the HCO3 is increased (reference range 22-26 mEq/L) and is the alkaline buffer component of the body produced by our metabolic system, the condition is called Metabolic Alkalosis.

Question 7

remnants of erythrocyte nuclei, nuclear fragments, or aggregates of chromosomes are called:

Answer 7

howell-jolly bodies

*Howell-Jolly bodies are composed of DNA, usually left from the nucleus, that appears as a round, dark-staining inclusion in the cytoplasm of red blood cells. Howell-Jolly bodies can be found in various conditions including splenectomy and anemia.