Laboratory: Reticulocyte Count and Differential Cell Count Flashcards by Tristan Buenvenida

In infectious mononucleosis, what cell type may show an absolute increased in the blood?

Neutrophil

Lymphocyte

Monocyte

Eosinophil

Lymphocyte

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What is the troubleshooting done in reticulocyte counting if the patient has an unusual high hematocrit?

Smaller amount of blood is added

Larger amount of blood is added

Smaller amount of blood is added

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Manual differential count is performed to determine the absolute number of each type of white cell present in blood. True or False?

False

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Incubation requirement for reticulocyte counting

-4 C, 15 minutes

22 C, 15 minutes

37 C, 20 minutes

60 C, 20 minutes

37 C, 20 minutes

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In Miller Disk, the small area is used for counting

Reticulocytes

Mature RBC

Both

Neither

Both

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Reticulocyte contains remnant of _ which are present in large amount in the cytoplasm in the precursors which they were derived

RNA and DNA

DNA and Protein

RNA and Ribosome

DNA and Ribosome

RNA and Ribosome

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All are supravital stains, except:

New methylene blue

Brilliant cresyl blue

Wright’s

Pure azure B

Wright’s

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Corrected reticulocyte count is used if the patient has

Polycythemia

Abnormally low hematocrit

Leukocytosis

Presence of NRBC

Abnormally low hematocrit

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The most absolute and most preferred method/unit of reporting differential count

cells/L

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What is the purpose of reticulocyte count?

To help in monitoring anemic patients

To determine the state of erythropoietic activity

To diagnose infection or inflammation

To assess bone marrow activity

To help in monitoring anemic patients

To determine the state of erythropoietic activity

To assess bone marrow activity

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White cells are counted in consecutive fields from tail towards the head of the smear

Battlement Method

Cross-sectional Method

Longitudinal Method

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What is the distribution of WBC during infection?

Shift to the left

Shift to the right

Shift to the top

Shift to the bottom

Shift to the left

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In healthy adults, the predominant white cell is the neutrophil. True or False?

True

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An important diagnostic tool which reflects the effectiveness of the bone marrow in producing red cells

Differential cell count

RBC Count

WBC Count

Reticulocyte Count

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What objective is used in differential counting?

100x

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All conditions have high reticulocyte count, except:

IDA

Blood loss

Aplastic anemia

Hemolytic anemia

Aplastic anemia

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If there are 20 retics in 1000 red cells, what is the % retics?

2.0

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Coulter counter report the differential cell count in percent and also as an absolute count. True or False?

True

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These conditions indicate increase in _ or known as ?

Appendicitis
Myelogenous leukemia
Bacterial infections

Neutrophils
Neutrophilia

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These conditions indicate increase in _ or known as ?

Allergies and allergenic reactions
Scarlet fever
Parasitic infections
Eosinophilic leukemia

Eosinophils
Eosinophilia

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These conditions indicate increase in _ or known as ?

Viral infections
Whooping cough
Infectious mononucleosis
Lymphocytic leukemia

Lymphocytes
Lymphocytosis

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These conditions indicate increase in _ or known as ?

Brucellosis
Tuberculosis
Monocytic leukemia
Subacute bacterial endocarditis
Typhoid
Rickettsial infections
Collagen disease
Hodgkin’s disease
Gaucher disease

Monocytes
Monocytosis

The white cells are counted in consecutive fields as the blood film is moved from side to side

Cross-sectional or Crenellation Method

Ideal method if the smear is thin enough so that the white cells may be identified all the way to the beginning (head) of the smear

Longitudinal Method

Uses a pattern of consecutive fields beginning near the tail on a horizontal edge

Battlement Method

Automated differential counters report the cells in percent and also as the number of each cell type/ L of blood (absolute count). True or False?

True

When the differential shows an abnormal distribution of cell types, a _ may be performed

200-cell differential

The results from 200-cell differential are then averaged (divided by 2) and a notation must be made that 200 white cells were counted. True or False?

True

If the differential count shows the presence of immature granulocytes, this is termed as

Shift to the left

Refers to an increased number of hyper segmented neutrophils

Shift to the right

As the number of total cells counted increases, the amount of variability will _

Decreases

If NRBCs are seen enumerate them separately and reported as _

#NRBC/ 100 WBC

Reticulocyte is found in _ & _

Bone marrow Peripheral blood

Immature RBC that remains 24 hours in the circulation before they transform into mature RBC

Reticulocyte

Retics contain remnant of _ and _ which were present in large amount in the cytoplasm

Ribosome and RNA

An important diagnostic tool which reflects the effectiveness of the bone marrow in producing red blood cells

Retics Count

The normal value for reticulocyte count

0.5-1.5 per 100 RBCs 0.5% to 1.5% 25-75 x 10^9/L

Reticulocyte count help in monitoring anemic patients under treatments; determine the state of increased erythropoietic activity; assess bone marrow activity. True or False?

True

Corrected Reticulocyte count is calculated based on a normal hematocrit of

45%

Corrected Reticulocyte Count formula

Patient hematocrit/normal hematocrit times Retics count

The peripheral blood sample is stained with __

Supravital stain

Supravital stains are __ that have the ability to react with _ and _ of reticulocytes while it still alive

Basic dyes Ribosomes and nucleic acids

The nucleic acid-dye reaction forms a __ precipitate of granules and filaments

Blue

Examples of supravital stains

Pure azure B Brilliant cresyl blue New methylene blue

Total number of red cells is equal to

Reticulocytes and RBC in 10 fields

Retics count normal range in adults

0.5% - 1.5%

Retics count normal range in neonates

2.5% - 6.0%

Formula used for Retics counts in Miller Disk

A/B(9) x 100

___ and use of _ as anti-coagulant can cause reticulocyte to show pale staining

High Blood sugar Heparin

An automated procedure for counting retics using flow cytometry with fluorescent dyes produces slower yet precise and accurate results. True or False?

False Rationale: Automated procedure for Retics counting produces rapid, precise and accurate results

New Methylene Blue can stain inclusions such as

Holly-Jowell Bodies Heinz Bodies Pappenheimer Bodies Hemoglobin H

These conditions indicates _ retics count? Effective erythropoiesis Anemic patient under treatment Bone marrow assessment after bleeding

Increased

These conditions indicates _ retics count? Ineffective erythropoiesis Hypoproliferative condition

Decreased