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Hematology > Lecture 4 > Flashcards

Lecture 4 Flashcards

1
Q

What is Electronic Impedance?

A

Also know as the Coulter Principle, provides a 3 part diff made of Histograms.

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2
Q

What is Optical Scatter?

A

5 part diff made of scatter plots.

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3
Q

The number of voltage pulse in the Electronic Impedance is proportional to the what?

A

Number of cells.

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4
Q

The size of voltage pulse in the Electronic Impedance is proportional to the what?

A

The Size or volume of the cells.

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5
Q

The x axis in a Electronic Impedance histogram is what?

A

Cell Size

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6
Q

The y axis in a Electronic Impedance histogram is what?

A

Relative number of cells

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7
Q

What size aperture is the WBCs and HgB measured in?

A

It is measured in a large WBC aperture.

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8
Q

What size aperture is RBCs and PLTs measured in?

A

A smaller RBC/PLT aperture.

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9
Q

What happens when Protein Buildup on an Aperture?

A

There is a decreases flow of cell thru aperture and a increases electrical resistance which falsely low cell counts with falsely high cell volumes.

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10
Q

What happens when Coincidence Passage (Coincidence Counting) accrues?

A

More than one cell pulled through aperture at one time, resulting in a falsely high cell volume.

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11
Q

What is a CBC Histogram?

A

It is a plot of the size distribution of WBCs, RBCs, and platelets.

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12
Q

What is shown in a histogram?

A

Average size of cells, Distribution of cells around a mean, and Presence of abnormal cell populations

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13
Q

How is the WBC aperture measured?

A

A lyseing agent is added to this aperture and the then the cells are measured spectrophotometically.

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14
Q

What is directly Measured?

A

RBC, WBC, and HgB

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15
Q

What is Derived from The Histogram?

A

PLT, MVP (Mean PLT Volume), MCV and RDW

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16
Q

What is computed?

A

HCT, MCH, and MCHC

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17
Q

What are the 2 populations on a WBC histogram?

A

Lymphs, Mid cells, and Granulocytes

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18
Q

R0

A

Clumped PLT, “Y-axis takeoff”

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19
Q

R1

A

Clumped PLT, “Y-axis takeoff”, and NRBC

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20
Q

R2

A

Blasts and Atypical (reactive) Lymphs

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21
Q

R3

A

Increased number of bands or eosinophils

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22
Q

R4

A

High absolute granulocyte counts

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23
Q

RM

A

Abnormalities in multiple regions

24
Q

What can be estimated by looking at the RBC histogram by drawing a line from the peak to the X-axis.

A

MCV

25
Q

What does a “Broad-based” RBC histograms mean?

A

Anisocytosis and Correlates with a high RDW

26
Q

RBCs are sized as particles that are?

A

> = 36 fL

27
Q

35-90 fL

A

Lymphs

28
Q

90-160 fL

A

Mid cells

29
Q

160-450 fL

A

Granulocytes

30
Q

What is a Dimorphic RBC Population

A

Having two different populations of RBCs in the body at the same time and looks like a (Camel humps) because there are two RBC peaks on the histogram.

31
Q

Platelets are sized as particles between?

A

2-20 fL

32
Q

Interference in PLT counts

A

Dirt or debris in the diluent, Microcytic RBCs, Schistocytes (RBC fragments)

33
Q

Tailing Up

A

MCV is very low, suspect microcytic RBCs are the cause.

34
Q

What is a scatterplot?

A

It is a three-dimensional plot of cell populations. It is based upon VCS technology.

35
Q

What is VCS technology?

A

Volume: Cell sizing by electrical impedance
Conductivity: Uses a high frequency electromagnetic probe which reflects the nuclear, granular, and chemical properties of cells.
Light scatter: Cell surfaces features and internal structure.

36
Q

What gives you a 5 part diff?

A

A Scattergram or a Scatterplot

37
Q

Which type of Scatterplot is most used.

A

DF-1 (Discriminant Function -1)

38
Q

What is displayed on a DF-1?

A

X-axis: light scatter
Y-axis: volume
Basophils are not visible on DF-1 because they are located behind the lymphs.

39
Q

what are the other 2 types of scatterplots?

A

DF-2 and DF-3

40
Q

what are the Color Codes of the Scattergram?

A

Yellow (highest in number)
Red
Green
Blue (lowest in number)

41
Q

Bull’s moving average can only be done on what cells and why?

A

RBC and because they useally do not change much.

42
Q

What can Falsely increase a WBC count?

A

Heparin
NRBC
Platelet Clumps

43
Q

What can Falsely Decrease a WBC count?

A

Clotted specimen

Smudge cells

44
Q

What can Falsely increase a RBC count?

A

Giant platelet

Greatly elevated WBC

45
Q

What can Falsely Decrease a RBC count?

A

Microcytic RBCs (counted as plts)
Cold agglutinins
Clotted specimens

46
Q

What can Falsely increase a HgB count?

A

Lipemia

Greatly elevated WBC

47
Q

What can Falsely increase a Hematocrit count?

A

Hyperglycemia (600 mg/dL or greater) (Glucose causes the RBCs to swell)
Greatly elevated WBC

48
Q

What can Falsely increase a MCV count?

A

Hyperglycemia,
EDTA blood at room temperature > 6 hours
WBC > 50,000 WBC/uL

49
Q

What can Falsely increase a PLT count?

A 
Microcytic RBCs
RBC fragments (schistocytes)
50
Q

What can Falsely Decrease a HgB count?

A

Clotted specimen

51
Q

What can Falsely Decrease a Hematocrit count?

A

Clotted specimen

Hemolysis

52
Q

What can Falsely Decrease a PLT count?

A

Clotted specimen
Giant platelets counted as WBC
Platelet clumping, platelet satellitosis counted as WBC

53
Q

What is a Pre-Analytical Sources of Error?

A

Anything that happens before it gets into the Instrument.

54
Q

What is a Analytical Sources of Error?

A

Anything that happens while the test is being ran.

55
Q

What is Post-Analytical Sources of Error

A

Anything that happens after the sample has been ran.

56
Q

What are the 3 Types of Hematology Analyzers?

A

Beckman-Coulter
Sysmex
Cell-Dyn by Abbott Laboratories

57
Q

Agglutination

A

Clumping of RBCs

Hematology (9 decks)

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