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Hematology 1 > (M) Week 7: CBC and other procedures I part 1 > Flashcards

(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

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2
Q

CBC serves as a screening test to detect general ______________

A

infection

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3
Q

CBC detects ___________ or cancer such as leukemia

A

malignancy

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4
Q

This differentiates the different kinds of WBC such as neutrophils , leukocytes, monocytes, eosinophils, and basophils

A

differential count

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5
Q

principle of CBC:

A

count the number of cells suspended in the blood

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6
Q

what are the three methods to count CBC:

A

a. manual
b. semi-automated
c. fully-automated

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7
Q

scatter plot or dot plot uses what to represent the values?

A

dots

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8
Q

scatter plot / dot plot

what is the color used to represent neutrophils

A

yellow

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9
Q

scatter plot / dot plot

what is the color used to represent lymphocytes

A

blue

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10
Q

scatter plot / dot plot

what is the color used to represent monocytes

A

purple

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11
Q

scatter plot / dot plot

what is the color used to represent eosinophils

A

green

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12
Q

scatter plot / dot plot

what is the color used to represent basophils

A

white

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13
Q

This is a chart that shows how many cells are present in your blood

A

histogram

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14
Q

what does the horizontal axis in the scatter plot represent?

A

complexity of the cells

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15
Q

what does the vertical axis in the scatterplot represent?

A

size of the cells

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16
Q

Electrical impedance

the cells are being counted based on _________________ which will create electrical impulse

A

cell volume

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17
Q

Electrical impulse is (directly / indirectly) proportional to the number of blood cells

A

directly

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18
Q

T or F

blood is a great conductor of electricity

A

F (poor conductor of electricity)

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19
Q

why does our blood need to be diluted?

A

to generate electricity

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20
Q

what does optical scattering / flow cytometry use to measure the physical and chemical property ofa cell

A

light

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21
Q

Forward angle scatter measures __________

A

cell size

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22
Q

Side angle scatter measures __________ and __________

A

complexity and granularity

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23
Q

what are the two units CBC results are reported in?

A

SI unit
Conventional unit

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24
Q

flagging in test result only appears when patient’s test results are __________

A

abnormal

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25
Q

what was the hemacytometer taught in the rec lec?

A

improved neubauer

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26
Q

This prevents drying in the improvd neubauer

A

coverslip

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27
Q

what are the two chambers of the improved neubauer

A

upper chamber
lower chamber

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28
Q

how many large squares are in the improved neubauer

A

9 (1.00 mm2)

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29
Q

how many intermediate squares are in the improved Neubauer (WBC)

A

16 ( 0.0625 mm2)

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30
Q

how many intermediate squares are in the improved Neubauer (RBC)

A

25 ( 0.04 mm2)

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31
Q

how many tiny squares are in the improved neubauer

A

400 (0.0025 mm2)

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32
Q

The distance or depth of counting chamber
to the lower part of the coverslip
is _____________.

A

0.1 mm

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33
Q

what are the general steps of RBC count?

A
  1. diluting the blood
  2. charging the counting chamber
  3. counting the cell
  4. making calculations
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34
Q

what type of pipette is used for RBC and WBC dilution?

A

thoma pipette

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35
Q

how much blood is used for rbc and wbc count

A

0.5 ul

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36
Q

red cell diluent is aspirated up to what mark?

A

mark101

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37
Q

what is the standard dilution for rbc count?

A

1:200

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38
Q

what is the dilution range for the RBC thoma pipette

A

1:100 to 1:1000

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39
Q

what is the best RBC diluting fluid

A

Dacie’s fluid / formol citrate

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40
Q

what is the composition of dacie’s fluid

A

40% formaldehyde (10 ml)
3% w/v disodium citrate (990 ml)

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41
Q

diluting fluid not recommended as it promotes the growth of yeasts, and produces clumping of cells

A

Hayem’s diluting fluid

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42
Q

T or F

Hayem’s fluids can stand for long periods of time and has no corrosive effect

A

T

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43
Q

Hayem’s fluid should not be used in cases of ______________ as it may further enhance the clumping and rouleaux formation of RBCs

A

hyperproteinatremia

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44
Q

this diluting fluid prevents rouleaux formation

A

Gower’s solution

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45
Q

this diluting fluid has high specific gravity and stains WBC but supports the growth of fungi

A

Toisson’s fluid

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46
Q

Gower’s solution precipitates ___________ in cases of ______________ and _______________

A

proteins

hemoglobinemia and hyperglobulinemia

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47
Q

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

A

Hayem’s diluting fluid

48
Q

The following composes which type of diluting fluid?

12.5g sodium sulfate anhydrous C.P.
33.3mL glacial acetic acid
200 mL distilled water

A

gower’s solution

49
Q

The following composes which type of diluting fluid?

1g sodium chloride
8g sodium sulfate
30g glycerin
0.25g methyl violet
180mL distilled water

A

Toisson’s fluid

50
Q

The following composes which type of diluting fluid?

5g sodium sulfate
1g sodium chloride
20mL glycerin
1mL sodium Merthiolate (1:1000)
200mL distilled water

A

Bethell’s fluid

51
Q

this diluting fluid is:

used in emergency cases in the presence of rouleaux formation and autoagglutination of cells

stable and serves as a preservative

A

Normal saline solution (NSS) or Physiologic salt solution

52
Q

The following composes which type of diluting fluid?

0.85g sodium chloride
100 mL distilled water

A

Normal saline solution (NSS) or Physiologic salt solution

53
Q

how many grams of sodium citrate is needed to become a diluting agent?

54
Q

RBC fluids should be ___________

55
Q

there should be __________ concentration of RBC diluting fluids to prevent falsely ___________ analytes

A

equal, decreased

56
Q

pipette should be mixed by shaking
the pipette in any manner
except ________________________

A

along the longitudinal axis

57
Q

____________ from the capillary system should be discarded as they do not contain cells

A

first few drops

58
Q

In which area of the thoma pipetter are cells concentrated at?

A

bulb of the thoma pipette

59
Q

why can’t you charge all the blood in the pipetter?

A

causes overcharging -> falsely decreased count

60
Q

at which objective are cells counted at?

A

high power objective

61
Q

which squares are the RBCs counted at?

A

5 intermediate squares in the central ruled area

62
Q

In the invertd L rule, the cells touching the boundary up to the secondline (will / will not) be counted

A

will be counted

63
Q

This rule prevents double counting and inaccuracy of results

A

inverted L rule

64
Q

T or F
manual RBC counts are still performed unlike WBC counts

A

F (wbc counts are still performed)

65
Q

Please revisit the formula thanks

A

go

Shortcut: # RBC x 10000 (1:200)

66
Q

T or F

The reference value may vary in the institution you’re in and/or the protocol followed

67
Q

dilution effect:

RBC counts are increased in cases of __________
while it is decreased in cases of ____________

A

dehydration
hydration

68
Q

Which have higher cell counts?

newborns or adults?

69
Q

which have higher cell counts?

male or fmales

70
Q

why do males have higher cell counts?

A

due to testosterone

71
Q

which have higher cell counts?

people living in:
a. higher altitudes
b. sea level

72
Q

These increase / decrease erythrocyte count?

polycythemia

73
Q

These increase / decrease erythrocyte count?

pulmonary tuberculosis / pulmonary fibrosis

74
Q

These increase / decrease erythrocyte count?

acute poisoning

75
Q

These increase / decrease erythrocyte count?

anemia

76
Q

These increase / decrease erythrocyte count?

after hemorrhage

77
Q

WBC determination is present in what volume of blood?

78
Q

how does the WBC thoma pipette differ from RBC thomapipette

A

bulb - smaller
bore - larger
mark at the short limb is 11
White colored bead

79
Q

WBC diluent should be :
1.
2.

A

hypotonic
should color or stain the WBC nuclei

80
Q

RBC are lysed in ____________ fluid

81
Q

what are the two wbc diluents in the lec?

A

2-3% acetic acid
1% HCL + 1 drop of methyl violet or crystal violet

82
Q

T or F

dilution of the blood for WBC count facilitate the counting process by hemolyzing the nucleated red cells

A

F (hemolyzing the mature RBC)

83
Q

What is the dilution used for WBC count

A

1:20 dilution

84
Q

what is the dilution range of the WBC thoma pipette

A

1:10 to 1:100

85
Q

what type of anticoagulant should be used for WBC count

86
Q

what is the bead color for :

WBC thoma pipette
RBC thoma pipette

A

WBC- white
RBC- red

87
Q

where should the blood sample be dropped in reference to the coverslip

A

edge of the coverslip

88
Q

how many minutes should you wait before examining the counting chamber after charging?

A

1-2 minutes (let the cells settle first)

89
Q

familiarize yourself with the steps in counting the cells

A
  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
Q

What is the consequence of overcharging

A

decreased cell count

91
Q

what is the allowable difference for RBC

92
Q

what is the allowable difference for WBC

93
Q

If the results exceed the allowable difference, you must ________________________ or else the result is considered ___________–

A

repeat the procedure
invalid

94
Q

for patients with leukemia or leukocytosis, you will need to (increase / decrease) the dilution up / down to ______ or ______

A

increase up to 100 or 200

  • if WBC is greater than 30 or 100
95
Q

What will happen to the WBCs if you do not increase the dilution ?

A

they will overlap, making it impossible to count

96
Q

what pipette should you use instead of the WBC pipette if you increase the dilution

A

RBC thoma pipette

97
Q

if the patient has leukopenia, you should (increase / decrease) the dilution factor to ______

98
Q

What are you verifying whenever manual WBC count is performed?

A

count of cells released by the automatic cell analyzer

99
Q

T or F

RBC manual count is done more frequently than WBC manual count

100
Q

dilution for leukopenia

101
Q

dilution for leukocytosis

A

1:200 (if blood is up to 0.5)
1:100 (if blood is up to 1)

102
Q

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

103
Q

normal value of adult

conventional unit
SI unit

A

4500 - 11000 /mm3
4.5 - 11 x 10^9 / L

104
Q

normal value of infants

conventional unit
SI unit

A

10000 - 25000 / mm3
10 - 25 x 10 ^9 / L

105
Q

normal value of 1 year olds

conventional unit
SI unit

A

8000 - 15000 / mm3
8 - 15 x 10 ^9 / L

106
Q

hourly rhythm of number of WBCs

A

diurnal rhythm

107
Q

WBC COUNT

diurnal rhythm:

__________ level is observed in the morning and goes _______ in the afternoon

A

low level
higher

108
Q

T or F

food intake, moderate physical or emotional activity will cause a decrease in the number of leukocytes

A

F (increased leukocytes)

109
Q

when is the highest peak in leukocytes observed?

A

after meals

110
Q

when is the correction of WBC count done when examined in the blood smear

A

if there’s 5 or more NRBC per 100 WBCs

111
Q

T or F
blood smears is a direct count

A

F (indirect)

112
Q

what is the formula for correction of wbc count

A

inc WBC count (L) x 100 / no. NRBC + 100

113
Q

WBCs are characterized and differentiated according to ____________

114
Q

significance of WBC differential count

A

determines origin of infection

115
Q

familiarize yourself with the steps of leukocyte diff count

A
  1. preparation of blood smear
  2. staining of blood smear
  3. differentiation of leukocytes
  4. reporting of results
116
Q

what is the principle of leukocyte blood smear

A

microscopy

117
Q

what type of blood sample is needed for leukocyte differential count

A

EDTA whole blood from skin or venous puncture (preferred)

Hematology 1 (32 decks)

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