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Hematology 2 Lab > LABORATORY ACTIVITY 1 AND LABORATORY ACTIVITY 2 > Flashcards

LABORATORY ACTIVITY 1 AND LABORATORY ACTIVITY 2 Flashcards

1
Q

Direct Platelet Count Principle:

A

measures the ability of the capillaries to withstand increased stress

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2
Q

Significance if positive = presence of petechiae

A
  1. capillary weakness
  2. thrombocytopenia
  3. both
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3
Q

Increased vascular fragility:

A
  1. Repeated skin trauma
  2. Qualitative and quantitative platelet defects
  3. Vitamin C Deficiency
  4. Purpura
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4
Q

: A few petechial on the anterior part of the forearm

A

1+

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5
Q

: May petechial on the anterior part of the forearm

A

2+

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6
Q

: Multiple petechial over the whole arm and back of the hand

A

3+

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7
Q

: Confluent petechial on the arm and back of the hand

A

4+

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8
Q

Vascular fragility correlates [?] with the probability of bleeding. If a patient has an increased vascular fragility, he or she has a high chance of bleeding. This is because, if a patient encounters a multiple skin trauma, his or her blood vessels are damaged which is prone to the rupture and bleeding when exposed again to pressure.

A

directly

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9
Q

Direct Platelet Count

Purpose: [?]

A

To confirm if px is suffering from thrombocytopenia

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10
Q

Direct Platelet Count 2 Factors:

A

o Genetic/weak capillary
o Platelet – can be evaluated as a medtech

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11
Q

Automated may detect platelets as:

A

o WBC: Normal
o RBC: Ab Low ( plt confused as microsized, fragmented rbc, small sized rbc)
o Plt: Ab High

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12
Q

Ab Low ( plt confused as [?])

A

microsized, fragmented rbc, small sized rbc

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13
Q

Levy chamber with improved Neubauer ruling

A

Hemocytometer

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14
Q

Levy chamber with improved Neubauer ruling Features:

A
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15
Q

o 3x3 mm square counting area

A

9mm2

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16
Q

o (9) 1x1mm squares

A

1mm2

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17
Q

o (4) WBC squares is divided into 16 smaller squares

A

0.0625 mm2

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18
Q

o (1) RBC square is divided into 25 smaller squares

A

0.04mm2

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19
Q

o Coverslip vs counting surface

A

0.1mm

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20
Q

o Total volume of the entire grid

A

0.9mm3

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21
Q
  • used for counting blood cell
A

Hemocytometer

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22
Q

= 1 whole/large square (overall)

A

9 mm2

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23
Q

= 1 small (wbc square)

A

1 mm2

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24
Q

1 small (wbc square) o Volume =

A

1 mm3 x 0.1 = 0.1 mm3

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25
Q

= 1 smaller wbc square

A

0.0625 mm2

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26
Q

= 1 smaller wbc square o Volume =

A

0.0625 mm2 x 0.1 = 0.0625 mm3

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27
Q

= 1 smaller rbc square

A

1 mm2/25 = 0.04 mm2

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28
Q

= 1 smaller rbc square o Volume =

A

0.004 mm3/16

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29
Q

= 1 smaller rbc square o Area =

A

0.0024

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30
Q

= 1 smallest rbc square

A

0.04 mm2/16 = 0.0025

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31
Q

= 1 smallest rbc square o Volume =

A

0.025

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32
Q

Coverslip vs counting surface =

A

0.1mm3

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33
Q

Depth

A

0.1mm3

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34
Q

Used as height

A

0.1mm3

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35
Q

Total volume of the entire grid =

A

0.9mm3

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36
Q

Platelet count =

A
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37
Q

DF =

A
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38
Q

VCF =

A
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39
Q

Tocantins Method Reagent:

A

Rees-Ecker

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40
Q

is used to prevent adherence of blood cells to the thoma pipette to discharge equally in the hemocytometer

A

Sodium citrate

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41
Q

–fixative and preservative to prevent cells from floatingin the hemocytometer

A

Formalin

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42
Q

4 WBC squares

A

Tocantins Method

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43
Q

Brecker-Cronkite Method Reagent:

A

1% NH4 oxalate

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44
Q

5 RBC squares

A

Brecker-Cronkite Method

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45
Q

Tocantins Method
- anticoagulant

A

a. Sodium citrate

46
Q

Tocantins Method
- fixative

A

b. Formalin

47
Q

prevent premature lysis

A

b. Formalin

48
Q

(preserves both red cells and platelets)

A

b. Formalin

49
Q

Tocantins Method
- stains the platelets

A

c. BCB

50
Q

Light Microscopy Method

A

Tocantins Method

51
Q

Phase-Contrast Microscopy Method

A

Brecker-Cronkite Method

52
Q

Brecker-Cronkite Method Counting chamber:

A

Spencer - Briteline # 1475

53
Q

Platelets are counted in 5 R squares

A

Brecker-Cronkite Method

54
Q

Criteria for a good diluent:

A
  1. Should prevent plt adherence to glass
  2. Should prevent plt aggregation
  3. Should not promote premature plt lysis
  4. Should make plt visible in the microscope
55
Q

Advantage of Brecker-Cronkite over Tocantins

A
  1. Clearing of bg
  2. Plt is more distinguishable
  3. Label of pipette
  4. Moist chamber (15 minutes - reduce to 5 in the lab)
56
Q

Platelet is [?] of the size of the rbc

A

1/10th

57
Q

Normal:

A

150 – 450/uL

58
Q

abnormally low

A

• ＜ 100,000/ uL

59
Q
  • bleeding possible
A

• 30,000-50,000/ uL

60
Q
  • spontaneous bleeding
A

• < 30,000 u/L

61
Q
  • severe spontaneous bleeding
A

• < 5,000/uL

62
Q

In automated platelet count, platelets with large sizes may be confused as [?] and may cause increased values for the RBC count. However, this can be corrected by direct platelet count or manual counting since the appearance of the platelet and RBC can be differentiated.

A

red blood cells

63
Q

2 description of capillaries:

A

weak or strong

64
Q

The vascular system is composed of:

A

arterioles, capillary, blood vessel, vein artery

65
Q

Capillary is much smaller like [?], but bigger than [?]

A

artery and vein

arterioles

66
Q

[?], increase intravascular pressure, obstruct blood vessel

A

Pressure constricts

67
Q

Pressure:

A

100 mmHg for 5 minutes

68
Q

Applying pressure will constrict the blood vessels. The in-vitro pressure in the arm will increase the [?]

A

intravascular pressure

69
Q

Relationship of capillary wall and petechiae: The thinner the capillary, the [?] it is. Therefore, more petechiae is produced

A

weaker

70
Q

the more exposed to trauma, the more fragile the blood vessels are

A

Repeated skin trauma

71
Q

Qualitative: ex.

A

abnormal shape or function

72
Q

Quantitative:

A

number of platelet

73
Q

helps to promote integrity of blood vessel allowing smoother blood flow

A

Vitamin C Deficiency

74
Q

indication: haemorrhage

A

Purpura

75
Q

if the same vein keeps on breaking, it is prone to fragility

A

Purpura

76
Q

goes hand in hand w/ repeated skin trauma

A

Purpura

77
Q

Neubauer Depth

A

0.1 mm

78
Q

Neubauer Dimension

A

2 ruled areas; 3mm x 3mm each

79
Q

Neubauer Each side is divided into

A

9 equal squares

80
Q

Neubauer Volume

A

0.9 mm3 /sq

81
Q

Neubauer Total Volume

A

1.8 mm3

82
Q

hemolyses rbc in the background leaving wbc and platelets

A

1% NH4 oxalate

83
Q

Platelet is more distinguishable w/

A

wbc than an rbc

84
Q

Label of pipette
[?] is attached to the syringe barrel

A

Mouth piece

85
Q

To allows cells to settle

A

Moist chamber (15 minutes - reduce to 5 in the lab)

86
Q

CAPILLARY FRAGILITY TEST measures the ability of small capillaries to retain blood when subjected to

A

increased hydrostatic pressure and anoxia

87
Q

CAPILLARY FRAGILITY TEST

It is a non-specific evaluation to measure

A

capillary weakness and deficiencies in platelet number and function

88
Q

causes the capillaries to rupture which leads to bleeding and formation of petechiae.

A

Decreased capillary resistance

89
Q

Procedure:

A

Rumpel-Leede Tourniquet Test

90
Q

Procedure:
1. Examine the (?) to make certain that no petechiae are present.
2. With a blood pressure cuff, apply (?) pressure to upper arm.
To those who do not have a blood pressure cuff, use a tourniquet or rubber/cloth strip instead. Apply the tourniquet not too tight, not too loose to employ just enough pressure.
3. Maintain pressure for (?).
4. Release cuff and wait for (?) before making a final reading.
5. Examine the (?) for petechiae.
Note: Disregard any petechiae within (?) of the blood pressure cuff (tourniquet) because this may be due to pinching of the skin by the cuff.
6. Count the number of petechiae and roughly interpret

A

forearm, hand, and fingers

100 mmHg

5 minutes

5 – 10 minutes

forearm, hands and fingers

½ inch

91
Q

Platelets are thin disks, (?) in diameter and (?) in volume.

A

2–4 μm

5–7 fL

92
Q

Platelets function primarily in (?) and in maintaining (?).

A

hemostasis

capillary integrity

93
Q

Platelet numbers must be sufficient for them to play their supportive role in (?).

A

hemostasis

94
Q

When evaluating a (?) that maybe traceable to platelets, the counting of platelets is an important and logical starting point

A

bleeding problem

95
Q

Light Microscopy:

A

Tocantins method

96
Q

Diluting fluid: Rees & Ecker fluid

A

Tocantins method

97
Q

RBC pipette

A

Tocantins method

98
Q

Sucking tube

A

Tocantins method

99
Q

Light Microscope

A

Tocantins method

100
Q

Diluting fluid: 1% ammonium oxalate (freshly prepared)

A

Phase-Contrast Microscopy

101
Q

Dilution vial

A

Phase-Contrast Microscopy

102
Q

Phase-Contrast Microscope (or Light Microscope used with subdued light

A

Phase-Contrast Microscopy

103
Q

Specimen Needed: (?) or First few drops from a (?) with freely flowing blood

A

EDTA-anticoagulated venous blood

deep skin puncture

104
Q

A. LIGHT MICROSCOPY:

A

Tocantin’s method

105
Q

B. PHASE-CONTRAST MICROSCOPY:

A

Brecker-Cronkite Method

106
Q

LIGHT MICROSCOPY: Tocantin’s method
1. Do a finger puncture or venipuncture with (?).
2. Draw first diluting fluid up to 0.5 mark of pipette then draw blood to exactly (?) and dilute to (?) with Rees and Ecker diluting fluid.
3. Gently mix, discard the first (?) and charge into a hemocytometer.
4. Place moist chamber (Petri dish with moistened filter paper) over the charged hemocytometer and stand for. (?).
5. Examine under high dry objective and count platelets in (?)).
6. Calculate as follows:

A

EDTA tube

0.5 mark; 101 mark

2 drops

15 minutes

4 large corner squares (“W” squares

Platelets/cu mm = number of platelets counted in 4 squares x DF x VCF

107
Q

From this point, the platelet count should be completed within (?) to avoid platelet disintegration.

A

30 minutes

108
Q

Both platelets and RBCs are preserved by the (?) fluid.

A

Rees and Ecker

109
Q

Platelets are much smaller than red cells ([?]the size of an RBC) and appear as round, oval or elongated particles which are highly refractile and stain light bluish.

A

1/10

110
Q

B. PHASE-CONTRAST MICROSCOPY: Brecker-Cronkite Method
1. Prepare a (?) dilution of the blood sample
2. Rotate on a mechanical mixer for (?) the vial containing the suspension.
3. Load (?) of the hemocytometer in the usual manner using a separate capillary tube for each side.
4. Cover the loaded hemocytometer with moist chamber for (?)to allow settling of platelets in one optical plane.
5. Count platelets in (?) of the central large square, (?) on each side of the chamber; or in (?) small squares, (?) on each side of the chamber; or in all (?) small squares, until at least (?) platelets have been recorded.
6. Calculate as follows:

A

1:100

10 – 15 minutes

both sides

15 minutes

10 small squares; 5; 20; 10; 50; 100

Platelets/cu mm = total number of platelets counted x DF x VCF

111
Q

Light Microscopy: Count platelets in

A

4 large/W squares (squares A,B,C,D)

112
Q

Phase-Contrast: Count platelets in

A

10 RBC/small squares (colored squares)

Hematology 2 Lab (7 decks)

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