(M) Week 8: CBC and other procedures II part 1 Flashcards
1
Q
hemoglobin is the red iron-bearing protein contained within the ________________ in the normal blood
A
erythrocytes
2
Q
this can carry oxygen to and carbon dioxide from the tissues
A
hemoglobin
3
Q
Measuring the level of the hemoglobin concentration determines the ___________________ of the person’s blood
A
oxygen carrying capacity
4
Q
the clinical use of hgb determination is the same as hct determination which is to diagnose __________ and ____________-
A
anemia and polycythemia
5
Q
familiarize the four methods of hgb determination
A
- copper sulfate / specific gravity method
- Gasometric method (oxygen capacity method)
- chemical method (iron content method) e.g. Wong’s method
- colorimetric methods
6
Q
what is the specific gravity of copper sulfate used in the specific gravity method
A
1.052 and 1.054
7
Q
copper sulfate / specific gravity method
If the drop of blood shrinks, hgb level is (acceptable/unacceptable)
A
acceptable
indicates hgb level is greater pr equal to 12 g/dl
8
Q
copper sulfate / specific gravity method
If the drop of blood floats, hgb level is (acceptable/unacceptable)
A
unacceptable
indicates hgb level is below 12 g/dl
9
Q
What is the principle of copper sulfate method
A
specific gravity of blood against copper sulfate solution
10
Q
What is the principle of gasometric method / oxygen capacity method
A
oxygen capacity of hemoglobin is being determined
11
Q
What tool is used to measure the amount of oxygen in the gasometric method?
A
Van Slyke manometric apparatus
12
Q
how many ml is one gram of hemoglobin?
oxygen
A
1.34
13
Q
Gasometric method:
What reagent is used to lyse the blood and release its oxygen
A
saponin
14
Q
What is the principle of the chemical method
A
iron content of hemoglobin is determined
15
Q
how many percent is the iron content of 1 hgb
A
0.347% or3.47
16
Q
what is the formula to compute for the hemoglobin concentration in the blood
A
iron content (in mg/dl) / 3.47
17
Q
What are the two types of colorimetric method
A
- visual / direct methods
- indirect methods
18
Q
What are the tests under direct / visual matching methods
A
- Talquist scale
- hemoglobinometer
- acid hematin
- alkali hematin
19
Q
What are the tests under indirect methods
A
- Oxyhemoglobin
- carboxyhemoglobin
20
Q
match the principle to the method:
based on color comparison between the color of blood in the absorbent paper and color in the color chart
a. alkali hematin
b. hemoglobinometer
c. talquist scale
d. acid hematin
A
c
21
Q
Talquist scale manner of reporting
4.7 to 9.4 grams
A
actual anemia
22
Q
Talquist scale manner of reporting
10.9 to 12.5 grams
A
Suggestive Anemia
23
Q
Talquist scale manner of reporting
14.1 to 15.6 gram
A
normal
24
Q
what is the percentage error in talquist scale
A
30-50%
25
the principle of the dare hemoglobinometer is similar with ____________
refractometer
26
what is the percent error of the dare hemoglobinometer?
20-30%
27
match the principle to the method:
Lysis of red blood cell using acid reagent
(e.g. HCl) to liberate hemoglobin, which then
converts to methemoglobin, which is what is
measured in this method
a. alkali hematin
b. hemoglobinometer
c. talquist scale
d. acid hematin
d.
28
familiarize the pipetts used for acid hematin
Sahli’s Hellige (20 uL capacity) most common
Haden-Hausser
Sahli-Adams
Haldane
Newcomer
Osgood
29
what is the reagent used for acid hematin?
0.1 N HCl
30
in acid hematin, hemoglobin is converted to ___________________ using 0.1 N HCl
methemoglobin
31
acid hematin is verified uing what method?
cyanmethemoglobin
32
this direct method lyses with heat and uses NaOH as the reagent
Alkali Hematin
33
Oxymethemoglobin:
a photometric determination of hemoglobin done by measuring oxyhemoglobin
Sodium carbonate
34
Gasometric
T or F
Sodium carbonate is simple and quick, easily creates a stable HbO2 standard
F (no possibility of preparing a stable HbO2 standard)
35
Oxyhemoglobin test
A pulse oxygen saturation and pulse rate can be measured through the finger using a ____________________ monitor
photoelectric oxyhemoglobin
36
photoelectric oxyhemoglobin monitor is observed in what tool in the hospital
pulse oximeter
37
A test performed only when carbon monoxide poisoning is suspected
carboxyhemoglobin test
38
There should be a (high / low) carboxyhemoglobin concentration in the blood for normal individuals
low
39
When Carbon monoxide accumulates in our
blood, It has an increased affinity to
hemoglobin, about _______ times than oxgen
500
40
heavy smokers have a (higher / lower) RBC count due to carboxyhemoglobin
higher
41
This method measures the amount of oxygen using a Van Slyke manometric apparatus. The level of hemoglobin is determined by computation
Gasometric method
42
this is also known as the hemoglobincyanide method
Cyanmethemoglobin method
43
T o F
hemoglobin cyanide method can only be done manually
F (manually and automatically)
44
what is the reference method for hemoglobin determination
Cyanide hemoglobin
45
What solution is used for cyanmethemoglobin?
drabkin's solution
46
Drabkin's soluion is made out of
potassium cyanide
potassium ferricyanide
sodium bicarbonate
47
Exposure to _________ deteriorates the Drabkin's regent, causing a false _____________ in the hemoglobin values
light, decrease
48
What is the buffer solution in modified drabkin
dihydrogen potassium phosphate
49
What is the buffer in the original drabkin?
sodium bicarbonate
50
For cyanmethemoglobin
what is combined with hemoglobin to convert into methemoglobin
potassium ferricyanide
51
What apparatus is needed to record the cyanmethemoglobin?
spectrophotometer
52
at what wavelength is cyanmethemoglobin read?
540nm
53
All forms of hemoglobin may be measured using the cyanmethemoglobin method except
sulfhemoglobin
54
what anticoagulant is used for samples that will udergo the cyanmethemoglobin method
EDTA
55
what is the pH of the drabkin's solution used in the cyanmethemoglobin method
7.0-7.4
56
what is the formula for the cyanmethemoglobin method
c test / c standard = a test / a standard
57
cyanmethemoglobin method reference values:
men
140-180 g/L
58
cyanmethemoglobin method reference values
women
120-160 g/L
59
cyanmethemoglobin method reference values
women in late pregnancy
85-140 g/L
60
cyanmethemoglobin method reference values
newborn
150-200 g/L
61
Minimum hemoglobin requirement of a potentional
blood donor:
o Men – At least _________
o Women – At least _________
o Men – At least 13.0 g/dL
o Women – At least 12.5
62
Clinical significance (Increased / Decreased)
(hyperchromia) in polycythemia, dehydration, in poorly
compensated heart disease with cyanosis, and in changing from high to low
altitude.
increased
63
Clinical significance (Increased / Decreased)
oligochromia
decreased
64
the presence of free hemoglobin in the blood plasma
hemoglobinemia
65
What condition is commonly seen in cases of:
1. severe infection
2. sever burns and frost bite
3. poisoning with potassium chlorate and mushrooms
4. paroxysmal hemoglobinuria
5. hemolytic transfusion reactions
hemoglobinemia
66
Sources of error
1. cyanmethemoglobin is sensitive to ______
light
67
cyanmethemoglobin storing conditions
in a dark amber bottle and store inside the cabinet
68
high _______ , _________, and _________ can cause turbidity and falsely elevated results in the cyanmethemoglobin method
WBC, Platlets, and lipemia
69
Difference beween chylomicrons and VLDL
these are the floating particles that occurs on plasma/serum let to stand on room temp or ref temp
chylomicrons
70
Difference beween chylomicrons and VLDL
Ifthere are no floating particles or turbidity on a plasma/serum that was left to stand it is ____
VLDL
71
this is the volume of packed RBCs that occupies a given volume of whole blood
hematocrit
72
hematocrit is also kown as
packed cell volume (PCV)
73
hematocrit is reported as __________ or _________
percentage or liters per liter
74
if the hematocrit is represented in decimal form, the appropriate unit is
liter per liter (conventional unit)
75
what is the standard RPM of the microhematocrit centrifuge
10k to 12k
76
Hematocrit determination is used to diagnose ___________ or ___________
anemia or polycythemia
77
T or F
Hct is higher in adults compared to children
F (children higher)
78
individuals living in high altitude places have (high / low) HCT value
high
79
smokers have (high/low) HCT values due to the presence of carboxyhemoglobin in their blood
high
80
macro vs micro method of hct determination
method of blood collection
macro: venipuncture
micro: skin puncture
81
macro vs micro method of hct determination
amount of blood
macro: larger
micro: smaller
82
macro vs micro method of hct determination
relative centrifugal force
macro: 2,000 to 2,300 g
micro: 10,000 to 12,000 g
83
macro vs micro method of hct determination
time of centrifugation
macro: longer , around 30 minutes
micro: shorter, 4-5 minutes
84
macro vs micro method of hct determination
simplicity of technique:
macro: not simple
micro: simple
85
macro vs micro method of hct determination
ESR
Macro: cannot be performed in the wintrobe tube
Micro: cannot be performed
86
macro vs micro method of hct determination
spilling / leakage
macro: not common
micro: common
87
macro vs micro method of hct determination
breakage of buffy coat
macro: not common
micro: common
88
macro vs micro method of hct determination
separation of buffy coat
macro: complete
micro: not complete
89
macro vs micro method of hct determination
cost of apparatus
macro: expensive
micro: cheaper
90
familiarize the clinical significance of hct determination
1. It gives a rough estimate of the size or erythrocytes and the
concentration of erythrocytes but not the whole red cell mass.
2. It is used in the calculation of the blood indices.
3. The buffy coat obtained from the hematocrit tube has numerous uses.
4. Hematocrit is a good simple screening test for anemia.
5. Since the inherent error obtained in hematocrit is less as compared to
erythrocyte count
91
What are the macromethods of hct determinatin
1. Wintrobe Method
2. Haden’s Modification
3. Van Allen Method
4. Sanford-Magath
5. Bray’s
92
what is the anticoagulant used in the wintrobe method
double oxalate
93
The Wintrobe tube is filled up to what mark?
10 cm
94
oxalated blood in wintrobe tube avoids ________
bubble formation
95
Wintrobe method:
the wintrobe tube is centrifuged at 2500 rpm for ________ minutes
30
96
Wintrobe method:
What are observed after centrifugation
fatty layer
plasma layer
buffy coat layer
PCV layer
97
Macromethods of hematocrit determination
what is the anticoagulant of choice in Haden's modification
1.1% sodium oxalate
98
Macromethods of hematocrit determination
what is the anticoagulant of choice in the Van Allen method
1.6 sodium oxalate in distilled water
99
What is the anticoagulant of choice in sanford-magath
1.3% sodium oxalate
100
what is the anticoagulant of choice for Bray's method
heparin
101
What is the preferred anticoagulant for Adam's micromethod
heparinized capillary hematocrit tube
102
normal hematocrit value for men
40-55%`
103
normal hematocrit value for women
36-48%
104
normal hematocrit value for newborns
45-60%
105
increase or decrease in hematocrit:
improper sealing of the capillary tube
decreased
106
increase or decrease in hematocrit:
insufficient centrifugation
increased
107
increase or decrease in hematocrit:
increased concentration of anticoagulant
decrease
108
increase or decrease in hematocrit:
delay in reading results
increase
109
increase or decrease in hematocrit:
after blood loss
decreased
110
increase or decrease in hematocrit:
buffy coat should not be included in reading
increased
111
increase or decrease in hematocrit:
tissue juice contamination during capillary puncture
decreased
112
increase or decrease in hematocrit:
dehydration
increased
113
what is the formula for MCV
hct x 10 / RBC count
114
what is the formula for MCH
hgb x 10 / rbc count
115
what is the formula for MCHC
hgb x 100 / hct
116
rule of three only applies to speciments that have
normocytic normochromic RBCs
117
what is the rule of three
hgb x 3 = hct ± 3
118
this measures the degree of anisocytosis
indicates how varied the rbcs are in terms of size and volume
red blood cell distribution width
119
these are young RBCs which are formed when the nucleus of the late normoblasts are lost through extrusion
reticulocyte
120
used as an index of bone marrow activity, rbc production, and to monitor therapeutic measures for anemia
reticulocyte count
121
what is the staining of rbcs in the dry method of reticulocyte count
gray-blue
122
what is found in the the staining of reticulocytes in the dry method of reticulocyte count
deep blue filamentous web or granules within the cells
123
Any cell that contains two or more particles of __________-stained materials is classified as a reticulocyte
blue
124
Dry method
Count the reticulocytes seen in ___ successive fields of vision or while enumerating 1000 mature RBCs
10
125
what is the computation for the reticulocyte %
Reticulocyte % = reticulocyte counted x 100 / 1000
126
inserted in the eyepiece of the microscope which allows rapid estimations of large number of red cells by imposing two squares (one square is nine times the area of the other
square) onto the field of view
miller disk
127
reticulocytes are counted in the large square and red cells in the small square in successive microscopic fields until at least _____ cells are counted
300
128
Dry or wet method?
new methylene blue
Cook
Mayer
Tureen
Seiverd's
dry
129
what is the normal value of of MCHC
31-37%
130
what is the normal reticulocyte range in adults
0.5-1.5%
131
what is the normal reticulocyte range in newborns
2-6%
132
what is the normal reticulocyte number of concentration
25,000 - 75,000 /mm3 or uL
25-75 x 10^9 / L
