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HEMA LEC MIDTERM > LABORATORY EVALUATION > Flashcards

LABORATORY EVALUATION Flashcards

1
Q

is the volume of packed RBCs that occupies
a given volume of whole blood.

A

hematocrit

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2
Q

Macromethods

A
  • Wintrobe Method
  • Haden’s Modification Method
  • Van Allen’s Method
  • Sanford – Magath Method
  • Bray’s Method
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3
Q

1.1% Na citrate

A

Haden’s modification method

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4
Q

Heparin

A

Bray’s Method

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5
Q

1.3% NA citrate

A

Sanford - Magath Method

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6
Q

Double oxalate

A

Wintrobe Method

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7
Q

Anticoagulated whole blood is centrifuged, and
the total volume of the red cell mass is
expressed as a percentage or a decimal
fraction

A

hematocrit

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8
Q

normal value of hematocrit in women

A

35 % - 49 %

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9
Q

normal value of hematocrit in men

A

42 % - 54 %

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10
Q

Clinical Implication

A
  1. Decreased values are indicator of anemia
  2. Hct may or may not be reliable immediately after
    even a moderate loss of blood or immediate
    transfusion
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11
Q

Increased Hct values occur in

A

⚫Erythrocytosis
⚫Polycythemia vera
⚫Shock , when hemocentration rise
considererably

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12
Q

Interfering Factors

A

⚫High altitude
⚫NV vary with age and gender
⚫Lower value in men and women older than 60
y/o
⚫Severe dehydration from any cause falsely raises
the hct

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13
Q

Sources of Error in Hematocrit Determination

A
  1. Speed and duration of centrifugation
    Decrease in centrifugal force will result in more trapped plasma
    in between red cells.
  2. Type and amount of anticoagulant
    Excess anticoagulant causes shrinkage of cells
  3. Integrity in the length and diameter of the tube
  4. Errors in the sample, improper techniques in the collection of venous and
    capillary blood.
  5. Failure to mix the blood properly before sampling
  6. Leakage of blood in the case of micro hematocrit.
  7. Errors in taking the reading and calculating the result
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14
Q

the process of enumerating blood cells

A

Hemocytometry

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15
Q

composed of two raised surfaces each in the shape of a
3-mm x 3-mm square separated by an H-shaped moat

A

Hemocytometry

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16
Q

represents the number of WBCs in 1 liter of whole blood

A

WBC count

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17
Q

unit for WBC ct

A

10^9/L

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18
Q

WBC Diluting Fluid

A
  1. 2-3% glacial acetic acid
  2. 1% HCl added with 1 drop of methyl violet or crystal violet
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19
Q

Criteria of Good WBC Diluting Fluid

A
  1. should be hypotonic
  2. should color/stain the nuclei of white blood cells
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20
Q

Reference Range for WBC ct:

A

4.5-11.5 x 10⁹/L

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21
Q

WBC Count must be corrected if 5 or more NRBCs are counted
on differential count since NRBCs present in the sample are not
lysed by the diluting fluid and counted as WBC

A

Corrected WBC Count

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22
Q

RBC ct formula

A

RBC Count = # of cells counted x area c.f. x depth c.f. x dilution factor

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23
Q

unit for RBC ct

A

10¹²/L

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24
Q

Reference Range for RBC ct:

A

Male: 4.6-6.0 x 10ˈ²/L
Female: 4.0-5.4 x 10ˈ²/L

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25
Q

RBC Diluting Fluids

A
  1. Hayem’s Fluid
  2. Gower’s Solution
  3. Toisson’s Fluid
  4. Dacie’s or Formol Citrate Solution
  5. Bethel’s Fluid
  6. NSS or Physiologic Salt Solution
  7. 3.8% Sodium Citrate
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26
Q

this is considered the best diluent.

It keeps for a long time and does not alter
the shape of the cells.

A

Dacies Fluid ( Formol Citrate)

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27
Q

component of dacies fluid

A

40 % formaldehyde - 10 ml
3% w/v disodium citrate - 990 ml

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28
Q

component of Hayem’s Diluting Fluid

A

Mercuric chloride - 1.0 gram

Sodium Sulfate Anhydrous - 4.4 grams

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29
Q

component of Gower’s Solution-

A
  • Sodium sulfate anhydrous - 12.5 grams
  • Glacial acetic acid - 33.3 ml
  • Distilled water - 200 m
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30
Q

prevents rouleaux formation

A

Gower’s Solution-

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31
Q

high specific gravity and stains the
WBC

A

Toisson’s Fluid

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32
Q

used in emergency cases,
used in the presence of rouleaux formation and
autoagglutination of cells.

A

Normal Saline Solution

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33
Q

Criteria of Good RBC Diluting Fluid

A
  1. Must be an isotonic solution
  2. Has a good preservative
  3. Does not initiate the growth of molds
    and yeast
  4. With a high specific gravity
  5. With buffer action
  6. Cheap and easy to prepare
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34
Q

the value of the hematocrit should be three times the value of
hemoglobin

A

rule of three

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35
Q

Indices define the size and Hb content of the RBC
and consist of the mean corpuscular volume

A

Red Blood Cell
Indices

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36
Q

Individual cell size is the best index for classifying
anemias.

  • Index expresses the volume occupied by a single
    erythrocyte and measures in cubic micrometers(
    femtoliters) of the mean volume
  • Indicates whether the rbc size appears normal
    ,smaller than normal or larger than normal.
A

Mean Corpuscular Volume

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37
Q

Normal Value of MCV

A

80-100 fl

38
Q

Formula of MCV

A

MCV = Hct (%) x 10 / RBC in million

39
Q

Measures the average concentration of Hb.
* most valuable in monitoring therapy for anemia

A

Mean Corpuscular Hgb Concentration

40
Q

Normal Value of MCHC

A

32-36 g/dl

41
Q

Formula of MCHC

A

Hb (g/dl) x 100 / Hct (%)

42
Q

Automated method of
measurement is helpful in investigation of some
hematologic disorders and in monitoring response to
therapy.

A

Red cell size Distribution Width

43
Q

normal value of RDW

A

11.5 – 14.5 CV of red cell size

44
Q

Clinical Implication of RDW

A

Helpful in distinguishing uncomplicated
heterozygous thalassemia ( low MCV

45
Q

use to asses erythropoietic activity of the bone marrow
- whole blood, anticoagulated with EDTA is stained with a supravital stain such as new methylene blue or brilliant cresyl blue

A

reticulocyte count

46
Q

reticulocyte formula

A

% Reticulocyte = # of reticulocytes/1000 RBCs observed x 100

47
Q

is the actual number of reticulocyte in 1 liter of whole
blood

A

Absolute Reticulocyte Count (ARC)

48
Q

reference range for ARC

A

25-75 x 109 /L

49
Q

in specimen with a low Hct, the percentage of
reticulocytes maybe falsely elevated because whole
blood contains fewer RBCs.

A

Corrected Reticulocyte Count

50
Q

Increased Reticulocyte Count

A
  1. Hemolytic anemia
  2. Lead poisoning
  3. Malaria
  4. Parasitic infections
  5. Blood intoxication
  6. Kala-azar
  7. Erythroblastic anemia
  8. Sickle cell anemia
  9. Relapsing fever
  10. Leukemia
  11. Splenic tumor
51
Q

Decreased Reticulocyte
Count

A
  1. Aplastic anemia
  2. Acute benzol poisoning
  3. Chronic infections
  4. Anaplastic crisis of hemolytic anemia
    Physiologic Increase of Reticulocytes
  5. Pregnancy
  6. At birth
  7. Menstruation
52
Q

refers to the speed of fall of the erythrocyte to settle
down from their plasma.
- useful in monitoring the course of an existing
inflammatory disease or differentiating between
similar diseases.

A

Erythrocyte Sedimentation Rate

53
Q

2 ways of measurement

A
  1. Measuring the length of fall from the top of the
    column of RBC in a specified period of time
  2. Determining the time required for the red cells to
    reach a specified point
54
Q
  • initial period of aggregation
  • few cells sink under gravity but the majority form
    agglomerates (rouleaux ) of various sizes.
  • takes place during the first 10 minutes
A

Agglomeration Phase

55
Q
  • the agglomerates sink rapidly
  • the rate of fall depends on size
  • takes place for about 40 minutes
A

Phase of Fast Settling

56
Q
  • the rate of settling is slow owing to clogging of the
    agglomerates
  • takes place during the last 10 minutes
A

Final Phase of Packing

57
Q

Macromethods for ESR determination

A
  1. Wintrobe-Landsberg Method
  2. Westergren Method
  3. Graphic and Cutler Method
  4. Linzenmeir Method
58
Q

Micromethods for ESR determination

A
  1. Micro Landau Method
  2. Smith Method
  3. Hellige-Volmer Method or Crista Method
59
Q

Factors that Influence ESR

A

A. Intrinsic factors
1. Plasma factors
2. Red cell factors
B. Extrinsic factors
1. mechanical factors
2. technical factors
3. physical factors

60
Q

Factors that Increased the Rate of Fall

A

A. Intrinsic factors
1. plasma factors
a. increased fibrinogen concentration
b. increased globulin concentration
c. cholesterol
2. Red cell factors
a. macrocytes
b. anemia
c. hemolysis

61
Q

Factors that Decrease Rate of Fall

A

A. Intrinsic factors
1. Plasma Factors
a. increased albumin
b. increased lecithin
c. defibrination
2. Red Cell Factors
a. microcytosis
b. more red cells
c. spherocytosis
d. increased sickle cells and poikilocytes
B. Extrinsic Factors
1. long standing of blood since rbc tends to be spherical
2. excess dry anticoagulant
3. temperature below 20°C
4. short sedimentation tube
5. small bore of sedimentation tube
6. more blood specimen
7. presence of blood clots
8. dirty glass wares

62
Q

Westergren’s Method normal value

A
  • Men : 0 – 15 mm / hr
  • Women : 0 – 20 mm/hr
  • Children : 0 – 10 mm /hr
63
Q

Different Tests That Use Blood
Smears

A
  1. Leukocyte differential count
  2. Morphologic study of normal and
    abnormal white cells, red cells and
    platelets
  3. Reticulocyte counts
  4. Platelet count (indirect method)
  5. (LE) Lupus Erythematosus cell
    examination
  6. Bone marrow examination
64
Q

the simplest and most commonly used method for preparation of smear

A

Wedge/Push/2-Glass Slide Method

65
Q

advantages of Wedge/Push/2-Glass Slide Method:

A

a. slides are not easily broken
b. easy to prepare
c. easy to label and transport
d. allows storages, even without cover slip
e. abnormal cells can easily be found

66
Q

Characteristics of a Good Smear

A
  1. There should be a transition from thick to thin area.
  2. Smear should occupy ¾ of the length of the slide.
  3. Most have a smooth even surface, free from waves,
    ridges and holes.
  4. White blood cells should not be bunched at the end
    or edge of smear.
  5. It should have a feathery edge or tail.
67
Q

Uses of Thin Smears

A
  1. WBC differential count
  2. Stained red cell examination
  3. Platelet count (indirect method)
  4. Reticulocyte count
  5. Siderocyte count
  6. Malarial parasite examination
  7. Thorough study of morphology of blood cells
68
Q

Requirements to Produce a Proper Blood Films

A
  1. Use of a chemically clean glass slides
    and cover glass.
  2. Use of not too large nor too small drop
    of blood.
  3. Work is done quickly before coagulation
    of the blood.
  4. Proper angle and pressure of the
    spreader.
69
Q

Methods of Drying the Blood Films

A
  1. Air drying
  2. Heating in the oven for a low flame
  3. Chemical drying in ethyl alcohol
70
Q

Fixatives for Blood Films

A
  1. Methanol
  2. Absolute Ethyl Alcohol
  3. Absolute Ethyl Alcohol and Ether
  4. 1% solution of HgCl₂
  5. 1% Formalin
71
Q

Factors Affecting Thickness/Thinness of Smear

A
  1. Size of the drop of blood used
  2. Angle of the spreader slide against the stationary slid
  3. Pressure exerted when pushing the
    spreader against the stationary slide
  4. Speed of the spreader slide
72
Q

large drop

A

thick smear

73
Q

small drop

A

thin smear

74
Q

heavy pressure
smear

A

thin smear

75
Q

light pressure

A

thick smear

76
Q

too fast

A

thick smear

77
Q

too slow

A

thin smear

78
Q

preferred for bone marrow preparation
- even distribution of blood cells
especially

leukocytes is observed

A

Cover Glass/Ehrlich’s Method

79
Q

Disadvantages of cover glass method

A

a. cover glasses are easily broken
b. require chemically clean coverglass
c. difficult to prepare
d. difficult to label, stain and transport

80
Q

there is even distribution of cells but
yields limited blood smear.

A

Beacom’s Method/Cover Glass and Slide Method

81
Q

Automated Method

A
  1. spun smear
  2. Smear Prepared in Miniprep
82
Q

considered polychrome stain

A

Wright’s Stain

83
Q

component of wright’s stain

A
  • methylene blue
  • eosin
  • sodium phosphate
84
Q

staining of blood smear

A

● Wright’s stain
●Giemsa’s stain
● May-Grunwald’s stain
● Leishman’s stain
● Jenner’s stain
● Panoptic stain- combination of Romanowsky stain
and another stain
● Supravital stain

85
Q

used to stain and inspect living cells which have
been removed from the body

A

supravital stain

86
Q

combination of Romanowsky stain and another
stain

A

panoptic stain

87
Q

it is the enumeration and determination of
relative proportion or percentage (%) of
each type of leukocyte in the peripheral or
venous blood

A

Leukocyte Differential
Count

88
Q

Ways of Scanning Smears for Differential Count

A
  • Strip or Horizontal Method
  • Crenellation Method
  • Exaggerated Battlement Method
  • Two Field Meander Method
  • Four Field Meander Method
89
Q

cells are counted from the upper part
of the smear, the lower part, then
sideways, then to the upper part until
100 cells are differentiated

A

Crenellation Method

90
Q
  • the presence of an increase in younger
    forms of leukocytes.
  • seen in pyogenic infections
A

Shift to the left

91
Q
  • the presence of an increase in older forms
    of leukocytes
  • seen in megaloblastic anemia, pernicious
    anemia, and in convalescence
A

Shift to the right

HEMA LEC MIDTERM (4 decks)

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