Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

MEH > Lecture 6 > Flashcards

Lecture 6 Flashcards

1
Q

How do you interpret blood result values?

A

Inside the normal range could be abnormal for one patient while outside the range could be normal for another.

Due to reference range being values which 95% patients fall in. 2.5% normal are above and below

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

What factors influence normal range for an individual?

A

Co morbidities eg neutrophilia with a splenectomy

Age

Ethnicity

Sex

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

How do you interpret haematology results?

A

Interpret in light of clinical context and against previous FBCs.

Patient could have been stabbed. Patient could have a low RBC count but has improved since treatment started etc.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

What do you do if a haematology result is unexpected or doesnt fit with clinical scenario?

A

Get the test repeated

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

Pathology result process?

A

Collection

Delivery

Specimen analysis and reporting

Responsive action

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

Problems with specimen collection?

A

Specimen mixed up

Wrong bottle eg UE instead of FBC bottle

Mislabelling (wrong patient)

Poor technique

Blood pooling

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

Problems with delivery?

A

Too slow

Not at right temperature

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

Problems with analysis?

A

Specimen mix up in lab

Analyser malfunction

Analyser variability

Wrong test performed

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

Responsive action problem?

A

Not ordering add on tests in response to result

Not reviewing results eg at handover

Applying result to wrong patient

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

What do you do if the result is abnormal or unexpected?

A

Repeat

Treat symptoms first

Ring haematology and have clinical details ready

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

What are the turn around times for FBCs?

A

Urgent (a and E) 1 hour

Non urgent (wards) 4 hours

GP- 24 hours

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

What is the purpose of EDTA in the sample?

A

Prevents coagulation

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

FBC analyser technique?

A

Spectrophotometry

Light passed through sample and absorb acne is measured. Used to measure haemoglobin

Flow cytometry

Hydrodynamic focussing involves passing the cells through single file and a laser will hit the cells and degree of scatter used to estimate MCV

Flow cytometry differential

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

What FBC results will be higher in men?

A

RBC count and haematocrit

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

What conditions will suppress or increase your haematocrit?

A

Suppressed by anaemia and increased by polycythemia

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

Three parts of blood?

A

Plasma (water proteins hormones nutrients)

Buffs coat (WBCs and platelets)

Haematocrit ( RBCs)

17
Q

What can packed cell volume or haematocrit be used for?

A

Assess polycythaemia

Used for anaemia also but anaemia depends on a wider range of factors

18
Q

What can affect haemoglobin readings in the blood?

A

Bleeding, haemolysis, bone marrow disorder

Dehydration or diuretic

Turbidity of plasma- more turbid will absorb more light

Clotting- can only measure free cells

19
Q

Why can RBC count be more useful when looking at polycythaemia than haematocrit?

A

RBC number not influenced by hydration level etc whereas haematocrit will be as its a proportion

20
Q

What can result in a low RBC count?

A

Iron deficiency as iron is required to produce it

21
Q

Most important test for cause of anaemia?

A

Mean cell volume

22
Q

What is RBC distribution width?

A

Measure of the variation in size of RBCs.

23
Q

What is anisocytosis?

A

Term used to describe an increase in the variation in size between RBCs

24
Q

What is the use of RBC distribution width?

A

Used to assess cause of anaemia.

Eg iron deficiency new cells smaller

Thalassaemia usually normal as all cells smaller

Increased after blood transfusion as new cells bigger

25
Q

Mean cell haemoglobin?

A

Used in anaemia assessment.

Reduced in both iron deficiency and anaemia

Normal or increased in macrocyclic anaemia as larger RBCs

26
Q

Macrocyclic anaemia?

A

Larger RBCs

27
Q

Why is reticulocyte count useful?

A

Reticulocytes made in response to anaemia.

Be aware of a normal result as if haemoglobin is low reticulocyte count should be high to compensate

28
Q

When is a blood film used?

A

In the case of abnormalities.

A result outside normal range.
A result that has changed significantly since last time. Analyser thinks there are abnormal cells

29
Q

What to be aware of with blood film results?

A

Will often be delayed and should take note of any clinical comments and potential follow up steps

30
Q

RBC terms?

A

Microcytic (MCV) small RBCs

Macrocyclic (MCV) Big RBCs

Hypochromic (MCH) pale with less Hb

Hyperchromic (MCH) dense with more Hb

31
Q

Other RBC terminology?

A

See lecture

32
Q

What are schistocytes?

A

Red cell fragments as a result of haemolysis

33
Q

Malaria and FBCs?

A

Not picked up in blood test. Anaemia and thrombocytopenia would trigger a blood film as malaria causes low platelets, RBC and haemoglobin

34
Q

What can Howell-jolly bodies and Heinz bodies in RBCs indicate

A

Howell-jolly= splenectomy or impaired spleen as nuclear fragments left in cell

Heinz bodies= denatured haemoglobin

35
Q

FBC and iron deficiency

A

Low RBCs, Hb, MCV, MCHC

RBC distribution width will increase as new cells smaller than old ones

Reticulocytes low to normal as no iron to make them

Blood film will show hypochromatic RBCs, microcytic RBCs

36
Q

FBC and spherocytosis?

A

N or increased Hb for compensation.

Normal MCV
Increased RDW
Normal MCH
Increased MCHC

37
Q

What cells does B12 deficiency affect?

A

RBCs and Neutrophils

38
Q

What to be careful of when testing for platelet count?

A

Clotting will cause count to drop

39
Q

What can be used to prevent platelet clumping and ensure a more accurate reading?

A

Citrate (green tube) as EDTA can contribute to clumping

MEH (17 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions