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Hematology 1 > (M) Week 8: CBC and other procedures II part 2 > Flashcards

(M) Week 8: CBC and other procedures II part 2 Flashcards

1
Q

What is the reagent used in the New Methylene blue technique in dry method reticulocyte count

A

New Methylene blue

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2
Q

what reagent is used in the Cook, Meyer, and Tureen Method in dry method reticulocyte count

A

brilliant cresyl bleu

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3
Q

What is the reagent used in the Selverd’s method in dry method reticulocyte count

A

Brilliant Cresyl Blue

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4
Q

What are the microscopic wet methods of reticulocyte count

A
  1. light microscope method
  2. calibrated miller disk method
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5
Q

What reagent is preferred for Osgood-Wilhelm method

A

new-methylene blue

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6
Q

this is an optical aid inserted into the eyepiece of the microscope, allows for more accurate count

A

Miller disc

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7
Q

Miller disc

The disc ruling consists of a center
square containing a secondary square
ruled area that is ____ the area of the
larger square.

A

1/9

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8
Q

what is the computation for the miller disc method

A

%reticulocyte = no. of reticulocytes in large square x 100/ no. of rbc in small square x 9

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9
Q

What the automated method of reticulocyte count shown in the lecturer

A

Sysmex R - 1000

its like gawk gawk 3000 but reticulocytes

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10
Q

What is the principle of sysmex R-1000 for the determination of the percent reticulocyte and the absolute reticulocyte count

A

Sysmex R-1000

flow cytometry

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11
Q

What are the stains for reticulocyte count

A
  1. New methylene blue
  2. Brilliant cresyl blue
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12
Q

what is the composition of new methylene blue

A

1gm new methylene blue
80mL NSS
20mL 3% sodium citrate

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13
Q

increase / decrease in reticulocytes in blood

hemolytic anemia
lead poisoning
malaria
parasitic infections
blood intoxication

A

increase

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14
Q

increase / decrease in reticulocytes in blood

kala-azar
erythroblastic anemia
sickle cell anemia
relapsing fever
leukemia
splenic tumor

A

increase

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15
Q

increase / decrease in reticulocytes in blood

aplastic anemia
acute benzol poisoning
chronic infections
anaplastic crisis of hemolytic anemia

A

decrease

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16
Q

increase / decrease in reticulocytes in blood

pregnancy
at birth
menstruation

A

increase (physiologic)

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17
Q

What are the main sources of technical sources of technical error in reticulocyte count

A
  1. failure to mix the blood and stain completely
  2. presence of refractile artifacts
  3. increased blood glucose level
  4. presence of pappenheimer bodies, heinz bodies, and howell-jolly bodies
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18
Q

this is classically employed as an index of the presence of active diseases like tuberculosis, tonsilitis, rheumatic fever, and rheumatic heart disease

A

erythrocyte sedimentation rate

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19
Q

this is a non-specific test and results are affected by factors other than that of the blood cells and the plasma

A

erythrocyte sedimentation rate

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20
Q

erythrocyte sedimentation rate

The test depends on the fact that in the blood to which ___________ has been
added, the red corpuscles sediment until they form a packed column in the
lower part of the tube or container

A

anticoagulant

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21
Q

What are the stages in ESR

A
  1. initial period of aggregation / rouleaux formation
  2. stage of fast setting
  3. final period of packing
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22
Q

at what time mark does the rouleaux formation occur in ESR

A

First ten minutes

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23
Q

when does ESR fast setting occur?

A

40 minutes

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24
Q

when does the final period of packing occur in ESR

A

LAST TEN MINUTES

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25
Q

When do you check the values of ESR again?

A

after an hour

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26
Q

reading the result less than an hour may cause a false (increase / decrease) of the ESR value

A

decrease

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27
Q

reading the result beyond an hour may cause a false (increase / decrease) of the ESR value

A

increase

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28
Q

What is the importance of ESR

A
  1. Used as an index of the presence of an active infection
  2. measures the suspension stability of RBCs
  3. Indicates abnormal concentration of fibrinogen, globulin, and other plasma proteins
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29
Q

T or F

under normal state, RBCs do not stick together as they are negatively charged

A

T

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30
Q

T or F
when proteins (positively charged) are increased, it will facilitate the formation of Rouleaux

A

T

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31
Q

increased rouleaux will also increase/decrease the ESR value

A

increase

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32
Q

increased albumin will increase/decrease ESR

A

Decrease

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33
Q

which one is more preferred for ESR

a. Wintrobe-Landsberg
b. Wesetergren

A

B

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34
Q

type of ESR method that is harder to use as it should only be placed in an undisturbed surface

A

westergren

wintrobe-landsberg

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35
Q

Wintrobe-Landsberg vs Westergren

Tube bore (diameter)

A

WL: 3mm
WG: 2.5

36
Q

Wintrobe-Landsberg vs Westergren

Tube calibration

A

WL: 100mm
WG: 200mm

37
Q

Wintrobe-Landsberg vs Westergren

Tube length

A

WL: 115mm
WG: 300mm

38
Q

Wintrobe-Landsberg vs Westergren

Anticoagulant

A

WL: Hellen and Paul’s double oxalate (1 part citrate : 4 parts blood)
WG: 3.8 trisodium citrate

39
Q

Wintrobe-Landsberg vs Westergren

Number of reading

A

WL: one reading only (after one hour)
WG: Two readings (after on hour and after two hours)

40
Q

Normal values for Wintrobe-Landsberg

A

Men : 0-10 mm/hr
Women: 0-20 mm/hr

41
Q

Normal values for Westergen

A

Men: 0-15 mm/hr
Women: 0-17 mm’hr

42
Q

Wintrobe-Landsberg vs Westergren

Dilution

A

WL: no dilution
WG: 0.6 mL of sodium citrate to 1.4mL of blood

43
Q

Wintrobe-Landsberg vs Westergren

bottom of tube

A

WL: open
WG: flat and closed

44
Q

Wintrobe-Landsberg vs Westergren

correction for anemia

A

WL: applicable
WG: not applicable

45
Q

Wintrobe-Landsberg vs Westergren

additional tests

A

WL: hct, microglobulin determination, and icterus index
WG: none

46
Q

advantage of Wintrobe-Landsberg

A

smaller amount of blood needed

47
Q

advantage for Westergren method

A

most sensitive method for serial study of chronic diseases

48
Q

disadvantage of Wintrobe-Landsberg

A

large amount of blood is necessary

49
Q

disadvantage of Westergren

A

less sensitive due to shorter column

50
Q

What type of ESR method is preferred?

A

Wintrobe-Landsberg

51
Q

This method of ESR determination is the most sensitive

A

Westergren method

52
Q

This method of ESR is an accurate method in majority of the cases

A

wintrobe-landsberg method

53
Q

This method is considered the most sensitive for ESR determination. It can be used for the serial study of chronic diseases like tuberculosis and carcinoma.

A

Westergren method

54
Q

An automated ESR system that is fully automated for ESR determination

A

Automated ESR system by Vega Biomedical

55
Q

how many mL of blood is collected on an evacuated tube containing liquid sodium citrate

A

1mL

56
Q

how many minutes does a Ves-Matic analyzer take to produce results

A

Ves-Matic analyzer

20-25

57
Q

Automated ESR Ves-matic analyzer

can take 4 samples at one time

A

Mini-ves

58
Q

Automated ESR Ves-matic analyzer

can take 20 samples at one time and print results

A

Ves-Matic-20

59
Q

Automated ESR Ves-matic analyzer

can take 60 samples at one time, print results, and identifies sample by bar code

A

Ves-Matic 60

60
Q

Intrinsic / Extrinsic factors affecting ESR

Plasma factors
red cell factors

A

intrinsic

61
Q

Intrinsic / Extrinsic factors affecting ESR

Mechanical factors
Technical factors
Physical factors

A

extrinsic

62
Q

What are plasma factors that increase the rate of fall

A

increased fibrinogen concentration
increased globulin concentration
cholesterol

63
Q

What are red cell factors that increase the rate of fall?

A

macrocytes
anemia
hemolysis

64
Q

Intrinsic / Extrinsic factors
1. Temperature will increase rate of ESR above 27-degree C.
2. Longer sedimentation tube.
3. Larger bore of sedimentation tube
4. Inclination of tilting of sedimentation tube. ( A 3 degree will result in an error up to 30%)
5. Increased dilution of blood.
6. Presence of air bubbles within blood column.
7. Wet glasswares
8. Hemolysis

A

Extrinsic

65
Q

T or F

ESR is more constant in women

A

F (men)

66
Q

When does ESR begin to increase in pregnancy?

A

3rd to 4th month

67
Q

when does ESR return to normal in terms of pregnancy

A

It doesnt return until 3rd or 4th week postpartum

68
Q

In newborns ESR is (increased/decreased)

A

decreased

69
Q

In older adults, ESR is (increased/ decreased)

A

increased

70
Q

Comments and Sources of Errors

ESR is a non-specific indicator of ______________

A

tissue damage

71
Q

Comments and Sources of Errors

Conditions in which ___________________ is inhibited, such as sickle cell anemia; spherocytosis may be accompanied by a normal ESR or a low ESR

A

Rouleaux formation

72
Q

Comments and Sources of Errors

Blood must be fresh. Leaving the specimen for more than 2 hours at room temperature will cause RBC to become ____________, thus inhibits ___________________-

A

spherical
rouleaux formation

73
Q

Comments and Sources of Errors

whole blood specimens left overnight will result in (lower/higher) values

A

lower

74
Q

Comments and Sources of Errors

Slight tilting of the sedimentation tube will increase/decrease results

A

increase

75
Q

Comments and Sources of Errors

T or F
If area of reading is clear, read at the level where the full RBC density is apparent

A

F (hazy instead of clear)

76
Q

Comments and Sources of Errors

The presence of anemia ____________ ESR as a tool to diagnose disease process

A

invalidates

77
Q

Zeta sedimentation rate is performed using

A

zetafuge and special capillary tubes

78
Q

ZSR is dependent on the concentration of ___________________ and _____________

A

fibrinogen and gamma globulins

79
Q

What sample is used for ZSR?

A

EDTA-anticoagulated venous or capillary blood

80
Q

formula for ZSR

A

ZSR% = HCT% x 100 / Zetacrit

81
Q

ZSR reference range:

NORMAL

A

40-51%

82
Q

ZSR reference range:

borderline normal

A

51-54%

83
Q

ZSR reference range:

moderately elevated

A

60-64%

83
Q

ZSR reference range:

mildly elevated

A

55-59%

84
Q
A

Hematology 1 (32 decks)

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