Lecture 6 Flashcards
What are the turn around times for urgent/non-urgent/GP labs?
Urgent: 1 hour (A and E)
Non-urgent: 4 hours (ward patients)
GP: 24 hours
What do you class as abnormal results?
Results outside the normal range
-not always the case as normal range only includes 95% of the population
Significant fall in value
What are some normal range changes due to?
Age
Sex
Ethnicity
Co-morbidities
Whatdo you do if the FBC was unexpected?
Repeat test (as could be due to sampling/storage/lab errors)
What errors can occur in pathology results?
- specimen mix up
- wrong bottle
- poor technique
- pooling samples
- speciment delayed/not delivered
- wrong delivery method
- incorrect clinical details
- wrong test requested
- technical error
- right result applied to wrong patient
- results not reviewed
- reflex tests not carried out
What is a FBC?
Automated panel of tests to determine any haematological abnormalities
What is spectrophometry used to analyse in a FBC?
Amount of Hb
- amount of light absorbed by sample proportional to amount of absorbent compound in it
- hypotonic solution to lyse cells
- use calibration to determine sample concentration
What must FBC samples be placed in a tube with?
EDTA (ethylenediaminetetraacetic acid) and mixed
-EDTA chelates Ca2+ ions acting as an anticoagulant, as a clotted sample would be useless
What is important when taking a blood sample for UE analysis (urea/electrolyte)?
Never pour blood from an FBC tube into a UE tube.
-the K+ salt of EDTA would give a very high K+ reading
What is a WBC and how do you obtain it?
White blood cell count
Automated cell counting
-interruption of a beam of light/electrical current as a line of single cells flowing through a narrow tube
-after the RBC’s have been lysed
What is a RBC and how do you obtain it?
Red blood cell count
Measured the same as WBC count, except that the RBC’s aren’t lysed
(white cells will be counted but they are so low in number compared, they don’t affect reading)
What is haematocrit (HCT)?
Fraction of whole blood volume which consists of RBC’s
How is HCT measured?
Previously measured by centrifuging blood sample and comparing height of red cell fraction with height of sampleto give the packed cell volume (PCV)
Now
-multiplying average red cell size (MCV) by number of red cells per litre
What is the MCV and what is it useful for?
Mean cell volume
- average volume of red cells measured in femtolitres measured by analysers (amount of light/current impeded is proportional to size of cell)
- useful in detecting a microcytic/macrocytic anaemia
What is the MCH and how is it determined?
Mean cell haemoglobin
- average amount of Hb protein in an individual RBC
- calculated by dividing the Hb concentration in a given volume of blood by number of red cells in that volume
How is the platelet count measured?
Same as red and white cells.
Platelets are much smaller so can easily be distinguished by the analyser as they produce a much smaller signal