(M) Week 7: CBC and other procedures I part 1 Flashcards
1
Q
the most common test performed in the hematology section
A
complete blood count
2
Q
CBC serves as a screening test to detect general ______________
A
infection
3
Q
CBC detects ___________ or cancer such as leukemia
A
malignancy
4
Q
This differentiates the different kinds of WBC such as neutrophils , leukocytes, monocytes, eosinophils, and basophils
A
differential count
5
Q
principle of CBC:
A
count the number of cells suspended in the blood
6
Q
what are the three methods to count CBC:
A
a. manual
b. semi-automated
c. fully-automated
7
Q
scatter plot or dot plot uses what to represent the values?
A
dots
8
Q
scatter plot / dot plot
what is the color used to represent neutrophils
A
yellow
9
Q
scatter plot / dot plot
what is the color used to represent lymphocytes
A
blue
10
Q
scatter plot / dot plot
what is the color used to represent monocytes
A
purple
11
Q
scatter plot / dot plot
what is the color used to represent eosinophils
A
green
12
Q
scatter plot / dot plot
what is the color used to represent basophils
A
white
13
Q
This is a chart that shows how many cells are present in your blood
A
histogram
14
Q
what does the horizontal axis in the scatter plot represent?
A
complexity of the cells
15
Q
what does the vertical axis in the scatterplot represent?
A
size of the cells
16
Q
Electrical impedance
the cells are being counted based on _________________ which will create electrical impulse
A
cell volume
17
Q
Electrical impulse is (directly / indirectly) proportional to the number of blood cells
A
directly
18
Q
T or F
blood is a great conductor of electricity
A
F (poor conductor of electricity)
19
Q
why does our blood need to be diluted?
A
to generate electricity
20
Q
what does optical scattering / flow cytometry use to measure the physical and chemical property ofa cell
A
light
21
Q
Forward angle scatter measures __________
A
cell size
22
Q
Side angle scatter measures __________ and __________
A
complexity and granularity
23
Q
what are the two units CBC results are reported in?
A
SI unit
Conventional unit
24
Q
flagging in test result only appears when patient’s test results are __________
A
abnormal
25
what was the hemacytometer taught in the rec lec?
improved neubauer
26
This prevents drying in the improvd neubauer
coverslip
27
what are the two chambers of the improved neubauer
upper chamber
lower chamber
28
how many large squares are in the improved neubauer
9 (1.00 mm2)
29
how many intermediate squares are in the improved Neubauer (WBC)
16 ( 0.0625 mm2)
30
how many intermediate squares are in the improved Neubauer (RBC)
25 ( 0.04 mm2)
31
how many tiny squares are in the improved neubauer
400 (0.0025 mm2)
32
The distance or depth of counting chamber
to the lower part of the coverslip
is _____________.
0.1 mm
33
what are the general steps of RBC count?
1. diluting the blood
2. charging the counting chamber
3. counting the cell
4. making calculations
34
what type of pipette is used for RBC and WBC dilution?
thoma pipette
35
how much blood is used for rbc and wbc count
0.5 ul
36
red cell diluent is aspirated up to what mark?
mark101
37
what is the standard dilution for rbc count?
1:200
38
what is the dilution range for the RBC thoma pipette
1:100 to 1:1000
39
what is the best RBC diluting fluid
Dacie's fluid / formol citrate
40
what is the composition of dacie's fluid
40% formaldehyde (10 ml)
3% w/v disodium citrate (990 ml)
41
diluting fluid not recommended as it promotes the growth of yeasts, and produces clumping of cells
Hayem's diluting fluid
42
T or F
Hayem's fluids can stand for long periods of time and has no corrosive effect
T
43
Hayem's fluid should not be used in cases of ______________ as it may further enhance the clumping and rouleaux formation of RBCs
hyperproteinatremia
44
this diluting fluid prevents rouleaux formation
Gower's solution
45
this diluting fluid has high specific gravity and stains WBC but supports the growth of fungi
Toisson's fluid
46
Gower's solution precipitates ___________ in cases of ______________ and _______________
proteins
hemoglobinemia and hyperglobulinemia
47
The following composes which type of diluting fluid?
1 g mercuric chloride
1.1 g sodium sulfate anhydrous / 10 g crystalline Na2 SO4
100ml distilled water
Hayem's diluting fluid
48
The following composes which type of diluting fluid?
12.5g sodium sulfate anhydrous C.P.
33.3mL glacial acetic acid
200 mL distilled water
gower's solution
49
The following composes which type of diluting fluid?
1g sodium chloride
8g sodium sulfate
30g glycerin
0.25g methyl violet
180mL distilled water
Toisson's fluid
50
The following composes which type of diluting fluid?
5g sodium sulfate
1g sodium chloride
20mL glycerin
1mL sodium Merthiolate (1:1000)
200mL distilled water
Bethell's fluid
51
this diluting fluid is:
used in emergency cases in the presence of rouleaux formation and autoagglutination of cells
stable and serves as a preservative
Normal saline solution (NSS) or Physiologic salt solution
52
The following composes which type of diluting fluid?
0.85g sodium chloride
100 mL distilled water
Normal saline solution (NSS) or Physiologic salt solution
53
how many grams of sodium citrate is needed to become a diluting agent?
3.8 g
54
RBC fluids should be ___________
isotonic
55
there should be __________ concentration of RBC diluting fluids to prevent falsely ___________ analytes
equal, decreased
56
pipette should be mixed by shaking
the pipette in any manner
except ________________________
along the longitudinal axis
57
____________ from the capillary system should be discarded as they do not contain cells
first few drops
58
In which area of the thoma pipetter are cells concentrated at?
bulb of the thoma pipette
59
why can't you charge all the blood in the pipetter?
causes overcharging -> falsely decreased count
60
at which objective are cells counted at?
high power objective
61
which squares are the RBCs counted at?
5 intermediate squares in the central ruled area
62
In the invertd L rule, the cells touching the boundary up to the secondline (will / will not) be counted
will be counted
63
This rule prevents double counting and inaccuracy of results
inverted L rule
64
T or F
manual RBC counts are still performed unlike WBC counts
F (wbc counts are still performed)
65
Please revisit the formula thanks
go
Shortcut: # RBC x 10000 (1:200)
66
T or F
The reference value may vary in the institution you're in and/or the protocol followed
T
67
dilution effect:
RBC counts are increased in cases of __________
while it is decreased in cases of ____________
dehydration
hydration
68
Which have higher cell counts?
newborns or adults?
newborns
69
which have higher cell counts?
male or fmales
males
70
why do males have higher cell counts?
due to testosterone
71
which have higher cell counts?
people living in:
a. higher altitudes
b. sea level
a
72
These increase / decrease erythrocyte count?
polycythemia
increase
73
These increase / decrease erythrocyte count?
pulmonary tuberculosis / pulmonary fibrosis
increase
74
These increase / decrease erythrocyte count?
acute poisoning
increase
75
These increase / decrease erythrocyte count?
anemia
decrease
76
These increase / decrease erythrocyte count?
after hemorrhage
decrease
77
WBC determination is present in what volume of blood?
1ul
78
how does the WBC thoma pipette differ from RBC thomapipette
bulb - smaller
bore - larger
mark at the short limb is 11
White colored bead
79
WBC diluent should be :
1.
2.
hypotonic
should color or stain the WBC nuclei
80
RBC are lysed in ____________ fluid
hypotonic
81
what are the two wbc diluents in the lec?
2-3% acetic acid
1% HCL + 1 drop of methyl violet or crystal violet
82
T or F
dilution of the blood for WBC count facilitate the counting process by hemolyzing the nucleated red cells
F (hemolyzing the mature RBC)
83
What is the dilution used for WBC count
1:20 dilution
84
what is the dilution range of the WBC thoma pipette
1:10 to 1:100
85
what type of anticoagulant should be used for WBC count
EDTA
86
what is the bead color for :
WBC thoma pipette
RBC thoma pipette
WBC- white
RBC- red
87
where should the blood sample be dropped in reference to the coverslip
edge of the coverslip
88
how many minutes should you wait before examining the counting chamber after charging?
1-2 minutes (let the cells settle first)
89
familiarize yourself with the steps in counting the cells
1. make a study of the uncharged counting chamber (for familiarization)
2. Let the cells settle for 1-2 minutes
3. Use LPO to locate and scan the ruled area
4. count within the 4 corner squares with 16 medium squares each
5. get the average when counting the lower and upper chamber
Take note of :
* allowable count
* inverted L rule
90
What is the consequence of overcharging
decreased cell count
91
what is the allowable difference for RBC
15-16
92
what is the allowable difference for WBC
10-12
93
If the results exceed the allowable difference, you must ________________________ or else the result is considered ___________--
repeat the procedure
invalid
94
for patients with leukemia or leukocytosis, you will need to (increase / decrease) the dilution up / down to ______ or ______
increase up to 100 or 200
* if WBC is greater than 30 or 100
95
What will happen to the WBCs if you do not increase the dilution ?
they will overlap, making it impossible to count
96
what pipette should you use instead of the WBC pipette if you increase the dilution
RBC thoma pipette
97
if the patient has leukopenia, you should (increase / decrease) the dilution factor to ______
1:10
98
What are you verifying whenever manual WBC count is performed?
count of cells released by the automatic cell analyzer
99
T or F
RBC manual count is done more frequently than WBC manual count
f (WBC)
100
dilution for leukopenia
1:10
101
dilution for leukocytosis
1:200 (if blood is up to 0.5)
1:100 (if blood is up to 1)
102
if 8 big squares are used (4 in each ruled area), change the area correction factor to __ or get the ________ of the counts made on the upper and lower chamber
8
average
103
normal value of adult
conventional unit
SI unit
4500 - 11000 /mm3
4.5 - 11 x 10^9 / L
104
normal value of infants
conventional unit
SI unit
10000 - 25000 / mm3
10 - 25 x 10 ^9 / L
105
normal value of 1 year olds
conventional unit
SI unit
8000 - 15000 / mm3
8 - 15 x 10 ^9 / L
106
hourly rhythm of number of WBCs
diurnal rhythm
107
WBC COUNT
diurnal rhythm:
__________ level is observed in the morning and goes _______ in the afternoon
low level
higher
108
T or F
food intake, moderate physical or emotional activity will cause a decrease in the number of leukocytes
F (increased leukocytes)
109
when is the highest peak in leukocytes observed?
after meals
110
when is the correction of WBC count done when examined in the blood smear
if there's 5 or more NRBC per 100 WBCs
111
T or F
blood smears is a direct count
F (indirect)
112
what is the formula for correction of wbc count
inc WBC count (L) x 100 / no. NRBC + 100
113
WBCs are characterized and differentiated according to ____________
cell type
114
significance of WBC differential count
determines origin of infection
115
familiarize yourself with the steps of leukocyte diff count
1. preparation of blood smear
2. staining of blood smear
3. differentiation of leukocytes
4. reporting of results
116
what is the principle of leukocyte blood smear
microscopy
117
what type of blood sample is needed for leukocyte differential count
EDTA whole blood from skin or venous puncture (preferred)
