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Hematology 1 > (M) Week 8: CBC and other procedures II part 1 > Flashcards

(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

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2
Q

this can carry oxygen to and carbon dioxide from the tissues

A

hemoglobin

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3
Q

Measuring the level of the hemoglobin concentration determines the ___________________ of the person’s blood

A

oxygen carrying capacity

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4
Q

the clinical use of hgb determination is the same as hct determination which is to diagnose __________ and ____________-

A

anemia and polycythemia

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5
Q

familiarize the four methods of hgb determination

A
  1. copper sulfate / specific gravity method
  2. Gasometric method (oxygen capacity method)
  3. chemical method (iron content method) e.g. Wong’s method
  4. colorimetric methods
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6
Q

what is the specific gravity of copper sulfate used in the specific gravity method

A

1.052 and 1.054

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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

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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

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9
Q

What is the principle of copper sulfate method

A

specific gravity of blood against copper sulfate solution

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10
Q

What is the principle of gasometric method / oxygen capacity method

A

oxygen capacity of hemoglobin is being determined

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11
Q

What tool is used to measure the amount of oxygen in the gasometric method?

A

Van Slyke manometric apparatus

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12
Q

how many ml is one gram of hemoglobin?

oxygen

A

1.34

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13
Q

Gasometric method:

What reagent is used to lyse the blood and release its oxygen

A

saponin

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14
Q

What is the principle of the chemical method

A

iron content of hemoglobin is determined

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15
Q

how many percent is the iron content of 1 hgb

A

0.347% or3.47

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16
Q

what is the formula to compute for the hemoglobin concentration in the blood

A

iron content (in mg/dl) / 3.47

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17
Q

What are the two types of colorimetric method

A
  1. visual / direct methods
  2. indirect methods
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18
Q

What are the tests under direct / visual matching methods

A
  1. Talquist scale
  2. hemoglobinometer
  3. acid hematin
  4. alkali hematin
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19
Q

What are the tests under indirect methods

A
  1. Oxyhemoglobin
  2. carboxyhemoglobin
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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

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21
Q

Talquist scale manner of reporting

4.7 to 9.4 grams

A

actual anemia

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22
Q

Talquist scale manner of reporting

10.9 to 12.5 grams

A

Suggestive Anemia

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23
Q

Talquist scale manner of reporting

14.1 to 15.6 gram

A

normal

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24
Q

what is the percentage error in talquist scale

A

30-50%

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25
Q

the principle of the dare hemoglobinometer is similar with ____________

A

refractometer

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26
Q

what is the percent error of the dare hemoglobinometer?

A

20-30%

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27
Q

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

A

d.

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28
Q

familiarize the pipetts used for acid hematin

A

 Sahli’s Hellige (20 uL capacity) most common
 Haden-Hausser
 Sahli-Adams
 Haldane
 Newcomer
 Osgood

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29
Q

what is the reagent used for acid hematin?

A

0.1 N HCl

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30
Q

in acid hematin, hemoglobin is converted to ___________________ using 0.1 N HCl

A

methemoglobin

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31
Q

acid hematin is verified uing what method?

A

cyanmethemoglobin

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32
Q

this direct method lyses with heat and uses NaOH as the reagent

A

Alkali Hematin

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33
Q

Oxymethemoglobin:

a photometric determination of hemoglobin done by measuring oxyhemoglobin

A

Sodium carbonate

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34
Q

Gasometric

T or F
Sodium carbonate is simple and quick, easily creates a stable HbO2 standard

A

F (no possibility of preparing a stable HbO2 standard)

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35
Q

Oxyhemoglobin test

A pulse oxygen saturation and pulse rate can be measured through the finger using a ____________________ monitor

A

photoelectric oxyhemoglobin

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36
Q

photoelectric oxyhemoglobin monitor is observed in what tool in the hospital

A

pulse oximeter

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37
Q

A test performed only when carbon monoxide poisoning is suspected

A

carboxyhemoglobin test

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38
Q

There should be a (high / low) carboxyhemoglobin concentration in the blood for normal individuals

A

low

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39
Q

When Carbon monoxide accumulates in our
blood, It has an increased affinity to
hemoglobin, about _______ times than oxgen

A

500

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40
Q

heavy smokers have a (higher / lower) RBC count due to carboxyhemoglobin

A

higher

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41
Q

This method measures the amount of oxygen using a Van Slyke manometric apparatus. The level of hemoglobin is determined by computation

A

Gasometric method

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42
Q

this is also known as the hemoglobincyanide method

A

Cyanmethemoglobin method

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43
Q

T o F

hemoglobin cyanide method can only be done manually

A

F (manually and automatically)

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44
Q

what is the reference method for hemoglobin determination

A

Cyanide hemoglobin

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45
Q

What solution is used for cyanmethemoglobin?

A

drabkin’s solution

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46
Q

Drabkin’s soluion is made out of

A

potassium cyanide
potassium ferricyanide
sodium bicarbonate

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47
Q

Exposure to _________ deteriorates the Drabkin’s regent, causing a false _____________ in the hemoglobin values

A

light, decrease

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48
Q

What is the buffer solution in modified drabkin

A

dihydrogen potassium phosphate

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49
Q

What is the buffer in the original drabkin?

A

sodium bicarbonate

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50
Q

For cyanmethemoglobin

what is combined with hemoglobin to convert into methemoglobin

A

potassium ferricyanide

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51
Q

What apparatus is needed to record the cyanmethemoglobin?

A

spectrophotometer

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52
Q

at what wavelength is cyanmethemoglobin read?

A

540nm

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53
Q

All forms of hemoglobin may be measured using the cyanmethemoglobin method except

A

sulfhemoglobin

54
Q

what anticoagulant is used for samples that will udergo the cyanmethemoglobin method

A

EDTA

55
Q

what is the pH of the drabkin’s solution used in the cyanmethemoglobin method

A

7.0-7.4

56
Q

what is the formula for the cyanmethemoglobin method

A

c test / c standard = a test / a standard

57
Q

cyanmethemoglobin method reference values:

men

A

140-180 g/L

58
Q

cyanmethemoglobin method reference values

women

A

120-160 g/L

59
Q

cyanmethemoglobin method reference values

women in late pregnancy

A

85-140 g/L

60
Q

cyanmethemoglobin method reference values

newborn

A

150-200 g/L

61
Q

Minimum hemoglobin requirement of a potentional
blood donor:
o Men – At least _________
o Women – At least _________

A

o Men – At least 13.0 g/dL
o Women – At least 12.5

62
Q

Clinical significance (Increased / Decreased)

(hyperchromia) in polycythemia, dehydration, in poorly
compensated heart disease with cyanosis, and in changing from high to low
altitude.

A

increased

63
Q

Clinical significance (Increased / Decreased)

oligochromia

A

decreased

64
Q

the presence of free hemoglobin in the blood plasma

A

hemoglobinemia

65
Q

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

A

hemoglobinemia

66
Q

Sources of error

  1. cyanmethemoglobin is sensitive to ______
A

light

67
Q

cyanmethemoglobin storing conditions

A

in a dark amber bottle and store inside the cabinet

68
Q

high _______ , _________, and _________ can cause turbidity and falsely elevated results in the cyanmethemoglobin method

A

WBC, Platlets, and lipemia

69
Q

Difference beween chylomicrons and VLDL

these are the floating particles that occurs on plasma/serum let to stand on room temp or ref temp

A

chylomicrons

70
Q

Difference beween chylomicrons and VLDL

Ifthere are no floating particles or turbidity on a plasma/serum that was left to stand it is ____

A

VLDL

71
Q

this is the volume of packed RBCs that occupies a given volume of whole blood

A

hematocrit

72
Q

hematocrit is also kown as

A

packed cell volume (PCV)

73
Q

hematocrit is reported as __________ or _________

A

percentage or liters per liter

74
Q

if the hematocrit is represented in decimal form, the appropriate unit is

A

liter per liter (conventional unit)

75
Q

what is the standard RPM of the microhematocrit centrifuge

A

10k to 12k

76
Q

Hematocrit determination is used to diagnose ___________ or ___________

A

anemia or polycythemia

77
Q

T or F

Hct is higher in adults compared to children

A

F (children higher)

78
Q

individuals living in high altitude places have (high / low) HCT value

A

high

79
Q

smokers have (high/low) HCT values due to the presence of carboxyhemoglobin in their blood

A

high

80
Q

macro vs micro method of hct determination

method of blood collection

A

macro: venipuncture
micro: skin puncture

81
Q

macro vs micro method of hct determination

amount of blood

A

macro: larger
micro: smaller

82
Q

macro vs micro method of hct determination

relative centrifugal force

A

macro: 2,000 to 2,300 g
micro: 10,000 to 12,000 g

83
Q

macro vs micro method of hct determination

time of centrifugation

A

macro: longer , around 30 minutes
micro: shorter, 4-5 minutes

84
Q

macro vs micro method of hct determination

simplicity of technique:

A

macro: not simple
micro: simple

85
Q

macro vs micro method of hct determination

ESR

A

Macro: cannot be performed in the wintrobe tube
Micro: cannot be performed

86
Q

macro vs micro method of hct determination

spilling / leakage

A

macro: not common
micro: common

87
Q

macro vs micro method of hct determination

breakage of buffy coat

A

macro: not common
micro: common

88
Q

macro vs micro method of hct determination

separation of buffy coat

A

macro: complete
micro: not complete

89
Q

macro vs micro method of hct determination

cost of apparatus

A

macro: expensive
micro: cheaper

90
Q

familiarize the clinical significance of hct determination

A
  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
Q

What are the macromethods of hct determinatin

A
  1. Wintrobe Method
  2. Haden’s Modification
  3. Van Allen Method
  4. Sanford-Magath
  5. Bray’s
92
Q

what is the anticoagulant used in the wintrobe method

A

double oxalate

93
Q

The Wintrobe tube is filled up to what mark?

A

10 cm

94
Q

oxalated blood in wintrobe tube avoids ________

A

bubble formation

95
Q

Wintrobe method:

the wintrobe tube is centrifuged at 2500 rpm for ________ minutes

A

30

96
Q

Wintrobe method:
What are observed after centrifugation

A

fatty layer
plasma layer
buffy coat layer
PCV layer

97
Q

Macromethods of hematocrit determination

what is the anticoagulant of choice in Haden’s modification

A

1.1% sodium oxalate

98
Q

Macromethods of hematocrit determination

what is the anticoagulant of choice in the Van Allen method

A

1.6 sodium oxalate in distilled water

99
Q

What is the anticoagulant of choice in sanford-magath

A

1.3% sodium oxalate

100
Q

what is the anticoagulant of choice for Bray’s method

A

heparin

101
Q

What is the preferred anticoagulant for Adam’s micromethod

A

heparinized capillary hematocrit tube

102
Q

normal hematocrit value for men

A

40-55%`

103
Q

normal hematocrit value for women

A

36-48%

104
Q

normal hematocrit value for newborns

A

45-60%

105
Q

increase or decrease in hematocrit:

improper sealing of the capillary tube

A

decreased

106
Q

increase or decrease in hematocrit:

insufficient centrifugation

A

increased

107
Q

increase or decrease in hematocrit:

increased concentration of anticoagulant

A

decrease

108
Q

increase or decrease in hematocrit:

delay in reading results

A

increase

109
Q

increase or decrease in hematocrit:

after blood loss

A

decreased

110
Q

increase or decrease in hematocrit:

buffy coat should not be included in reading

A

increased

111
Q

increase or decrease in hematocrit:

tissue juice contamination during capillary puncture

A

decreased

112
Q

increase or decrease in hematocrit:

dehydration

A

increased

113
Q

what is the formula for MCV

A

hct x 10 / RBC count

114
Q

what is the formula for MCH

A

hgb x 10 / rbc count

115
Q

what is the formula for MCHC

A

hgb x 100 / hct

116
Q

rule of three only applies to speciments that have

A

normocytic normochromic RBCs

117
Q

what is the rule of three

A

hgb x 3 = hct ± 3

118
Q

this measures the degree of anisocytosis

indicates how varied the rbcs are in terms of size and volume

A

red blood cell distribution width

119
Q

these are young RBCs which are formed when the nucleus of the late normoblasts are lost through extrusion

A

reticulocyte

120
Q

used as an index of bone marrow activity, rbc production, and to monitor therapeutic measures for anemia

A

reticulocyte count

121
Q

what is the staining of rbcs in the dry method of reticulocyte count

A

gray-blue

122
Q

what is found in the the staining of reticulocytes in the dry method of reticulocyte count

A

deep blue filamentous web or granules within the cells

123
Q

Any cell that contains two or more particles of __________-stained materials is classified as a reticulocyte

A

blue

124
Q

Dry method

Count the reticulocytes seen in ___ successive fields of vision or while enumerating 1000 mature RBCs

A

10

125
Q

what is the computation for the reticulocyte %

A

Reticulocyte % = reticulocyte counted x 100 / 1000

126
Q

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

A

miller disk

127
Q

reticulocytes are counted in the large square and red cells in the small square in successive microscopic fields until at least _____ cells are counted

A

300

128
Q

Dry or wet method?

new methylene blue
Cook
Mayer
Tureen
Seiverd’s

A

dry

129
Q

what is the normal value of of MCHC

A

31-37%

130
Q

what is the normal reticulocyte range in adults

A

0.5-1.5%

131
Q

what is the normal reticulocyte range in newborns

A

2-6%

132
Q

what is the normal reticulocyte number of concentration

A

25,000 - 75,000 /mm3 or uL
25-75 x 10^9 / L

Hematology 1 (32 decks)

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