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Hematology > Laboratory Methods > Flashcards

Laboratory Methods Flashcards

1
Q

Causes of Shortened Clotting time

A

Premature Activation
* Contamination of tissue factor
* Use of Glass container
Hemolysis
Overfilling

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2
Q

Causes of Prolonged Clotting time

A

Polycythemia vera (Hct: >50%)
Underfilling
Overanticoagulation
Change in pH

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3
Q

Sodium Citrate
* Ratio:
* Concentration:
* Centrifugation:

A

Sodium Citrate
* Ratio (blood:anticoagulant): 9:1
* Concentration: 3.2% (preffered)
* Centrifugation: 2000 g for 10 minutes

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4
Q

Changes in pH can ________ clotting time

A

prolong

Loss of CO2 changes pH
Note: Should be unopened if testing not done

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5
Q

Prolonged tourniquet application - Statis can elevate ____ and ________ ; falsely decreases finrinolytic parameters and falsely ________ clotting time

A

Prolonged tourniquet application - Statis can elevate vWF and Factor VIII ; falsely decreases finrinolytic parameters and falsely shortened clotting time

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6
Q

Common gauge for hemostatis collection

A

20G

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7
Q

Can be used for platelet retension test

A

Heparin

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8
Q

Factor VII and XI

A

Prematurely activated at 4C

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9
Q

Modification of Lee and White Clotting time

A

Plasma Recalcification Test

Time required for blood to clot after Ca2+ is added

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10
Q

Reference Range - Plasma Recalcification Time
* PRP
* PPP

A

Reference Range - Plasma Recalcification Time
* PRP - 100-150 seconds
* PPP - 130-240 seconds

PRP should be 20 seconds faster than PPP

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11
Q

aPTT
* Sample:
* Reagent:
* NV:

A

aPTT
* Sample: Platelet poor plasma (PPP)
* Reagent: Phospholipid (platelin) + Activator + CaCl2
* NV: 20-45 seconds

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12
Q

Partial thromboplastin

A

Contains phospholipid (platelin) only and is a substitute for platelet factor 3

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13
Q

Activator in aPTT

A

Kaolin
Celite
Ellagic acid
Silica

Negatively charged particles that activate PF XII

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14
Q

Monitor Heparin therapy

A

aPTT

modification of partial thromboplastin time

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15
Q

Tests for Intrinsic Pathway

A

Lee and White
Plasma Recalcification time
aPTT

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16
Q

Activator - Activated Clotting Time

A

Diatomite

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17
Q

Test for Extrinsic Pathway

A

Prothrombin Time

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18
Q

PT
* Specimen:
* Reagent:
* NV:

A

PT
* Specimen: PPP
* Reagent: Thrombolastin (Simplastin) + CaCl2
* NV: 10-12 seconds

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19
Q

Therapy monitored in PT

A

Vitamin K antiagonist - Warfarin & Coumarin

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20
Q

INR

International Normalized Ratio

A

provide a standardized PT result and monitor warfarin/coumarin therapy

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21
Q

INR - Warfarin therapy

A

2.0 - 3.0

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22
Q

Manchester Reagent

Rabbit brain tissue thromboplastin

A

Most sensitive PT reagent

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23
Q

Steypven Test

a.k.a Russel Viper venom test

A

Detect deficiency in common pathway

Particularly deficiency in PF X

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24
Q

Stypven Test
* Reagent:
* Snake:
* NV:

A

Stypven Test
* Reagent: Russel’s viper venom
* Snake: Vipera russeli
* NV: 6-10 seconds

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25
Q

Bypass plasma factor VII and directly activate plasma factor X

A

Stypven Test

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26
Q

Stypven Test
* Abnormal:
* Normal:

A

Stypven Test
* Abnormal: Factor X
* Normal: Factor VII

Test also help distinguish between factor X and factor VII deficiencies

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27
Q

5M Urea Solubility test

a.k.a Dickhert’s Test

A

Detect deficiency in Factor XIII

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28
Q

5M Urea Solubility Test
* Reagent:
* Substitute:

A

5M Urea Solubility Test
* Reagent: 5M Urea
* Substitute: 1% monochloroacettic acid or 2% aceticacid

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29
Q

5M Urea Solubility Test
* Normal:
* Abnormal:

A

5M Urea Solubility Test
* Normal: Insoluble - F XIII is present
* Abnormal: Soluble - Deficiency in F XIII

A stable fibrin clot with FXIII is resistant to 5M urea

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30
Q

Thrombin Time

addition of exogenous thrombin to activate clot formation

A

Detect deficiency in **Fibribogen **in patient not undergoing heparin therapy

31
Q

Not indication for Heparin therapy patient

A

Thrombin time

32
Q

Thrombin Time

  • Sample:
  • Reagent:
  • Heparin
  • NV:
A

Thrombin Time

  • Sample: PPP
  • Reagent: Thrombin
  • Heparin: Affected
  • NV: 10-14 seconds
33
Q

Greatly Prolonged Thrombin Time

A

Hypofibrinogenemia

<100 mg/dL

34
Q

Prolonged in Thrombin Time

A

Hypofibrinogenemia
Dysfibrinogenemia
FDP
Heparin therapy

35
Q

Reptilase Test

A

Detect deficiency in **Fibribogen **in patient undergoing heparin therapy

36
Q

Reptilase Test

  • Reagent:
  • Heparin:
  • Snake:
  • NV:
A

Reptilase Test

  • Reagent: Reptilase in snake venom
  • Snake: Bothrops atrox
  • NV: 10-15 secopnds
37
Q

Enzyme found in Bothrops atrox venom that has similar activity to thrombin

A

Reptilase

38
Q

Greatly Prolonged in Reptilase Test

A

Dysfibrinogenemia

39
Q

Claus Factor I assay

A

Estimates functional fibrinogen level

40
Q

Claus factor I assay
* Specimen:
* Reagent:
* Dilution:
* Buffer:

A

Claus factor I assay
* Specimen: PPP
* Reagent: Bovine thrombin (50 NIH units/mL)
* Dilution:** 1:10**
* Buffer: Owren Buffer

41
Q

Tests for Primary Hemostasis

A

Bleeding Time
Capillary Resistance Test
Clot Retraction Test
Platelet Count
Platelet Adhesiveness
Platelet Aggregation

42
Q

Actual time it takes for a wound to stop bleeding

A

Bleeding Time

43
Q

Methods - Bleeding Time

Mnemonics: BleeDing IVY

A
  • Duke Method (Earlobe)
  • Ivy Method (Pressure cuff at 40 mmHg)
44
Q

Duke’s Method
* Site:
* NV:

A

Duke’s Method
* Site: Earlobe
* NV: <8 minutes

45
Q

Ivy Method
* Site:
* NV:

A

Ivy Method
* Site: Volar surface of the forearm
* NV: 3-6 minutes

uses filter paper strips after 2 minutes and again every after 30 sec.

46
Q

Positive Pressure Test

Capillary resistance test

A

Rumple Leed Test/Tourniquet Test

47
Q

Negative Pressure Test

Capillary resistance test

A

Hess Test/Suction Test

48
Q

Positive/Tourniquet/Rumple-Leed
* Tool:
* Application:
* Observe for petechiae:

A

Positive/Tourniquet/Rumple-Leed
* Tool: BP cuff
* Application: 5 minutes
* Observe for petechiae: after 5 minutes

49
Q

Negative/Suction/Hess Test
* Tool:
* Application:
* Observe for petechiae:

A

Negative/Suction/Hess Test
* Tool: Suction Cup (2 cm)
* Application: 1 minute
* Observe for petechiae: 5 minutes

50
Q

Brecher - Cronkite Method

A

Reference Method for Manual platelet count

51
Q

No. of RBCs in 1 Platelet
* Rodaks:
* Steininger:

A

No. of RBCs in 1 Platelet
* Rodaks: 25 RBCs
* Steininger: 10-40 RBCs

52
Q

Test for Platelet adhesiveness

A

Glass Bead Retention Test/Salzmann Method

normal platelet that have vWF will adhere and aggregate to the beads

53
Q

Platelet Aggregation Test

A

In vitro test to determine the ability of platelets to aggregate using aggregating agents which make sample becomes clearer and transmits more light as platelet aggregates

Aggregating agents: Epinephrine, Collagen, ADP, Restocitin

54
Q

Test - Determination of Lysis Time

A

Euglobulin Lysis Time

55
Q

Principle - Euglobulin Lysis Time

A

Euglobulin is a protein that is precipitated after plasma is diluted with water and acidified and clot is incubated at 37C

Diluted PPP + Acid = Euglobulin + Thrombin = Clot (incubated at 37C)

56
Q

Gelation

A

Clot formation indicating increased fibrinolysis

Test for secondary fibrinolysis (DIC)

57
Q

Protamine Sulfate Gelation Test
* Reagent:
* Principle:
* Result:

A

Protamine Sulfate Gelation Test
* Reagent: Protamine sulfate
* Principle: Paracoagulation
* Result: (+) Clot formation ; (-) No clot

Protamine replaces secondary degradation products

58
Q

Ethanol Gelation Test
* Reagent:
* Principle:
* Result:

A

Ethanol Gelation Test
* Reagent: 50% Ethanol
* Principle: Paracoagulation
* Result: (+) Clot formation ; (-) No clot

Ethanol causes soluble fibrin monomer to dissociate and then polymerizes

59
Q

Latex D-dimer assay

A

Specific test to intravascular fibrin formation and diagnose DIC

measure a specific FDP - D-dimer

60
Q

In D-dimer assay, it is already positive after ____ hours after DIC onset

A

In D-dimer assay, it is already positive after 4 hours after DIC onset

61
Q

Intravenous anticoagulant

A

Heparin

62
Q

Oral anticoagulant

A

Warfarin

63
Q

Heparin Therapy
* Action:
* Administration:
* Treatment:
* Therapy:

A

Heparin Therapy
* Action: Inhibit thrombin by enhancing anti-thrombin III
* Administration: Intravenous anticoagulant
* Treatment: Protamine sulfate
* Therapy: APTT and ACT

64
Q

Warfarin Therapy
* Action:
* Administration:
* Treatment:
* Therapy:

A

Warfarin Therapy
* Action: Antagonize Vitamin K and induce PIVKAs
* Administration: Oral anticoagulant
* Treatment: Vitamin K, FFP
* Therapy: PT

65
Q

Used during coronary artery bypass graft surgery and during cardiac catheterization and in several medical conditions.

A

Heparin Therapy

66
Q

Differentiate Leukemoid reaction vs. CML

A

Leukocyte Alkaline phosphatase (LAP) test

Increase: Leukemoid reaction; Decrease: CML

67
Q

Differentiate** AML and Monocytic leukemia **from ALL

A

MPO

68
Q

Differentiate AML & Myelomonocytic leukemia from ALL

A

Sudan Black B

stains Lipids on granulocyte

69
Q

Periodic Acid Schiff Test (PAS)

A

Diagnose DiGuglielmo’s Syndrome (M6)

70
Q

Differentiate Granulocytic from Monocytic cells

A

Naphthol AS-D Choroacetate esterase

Stain specific esterase

71
Q

Tartrate-resistant ACP (TRAP)

A

Diagnose Hairy cell leukemia

72
Q

Differentiate ALL from AML

A

Terminal deoxyribonucleotidyl transferase

73
Q

Fresh Capillary Blood

A

Recommended specimen in LAP test

74
Q

Heparinized whole blood

A

Recommended specimen in NBT

Hematology (6 decks)

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