Manual Methods

Question 1

PB smears need at least _ identifiers

Answer 1

PB smears need at least TWO identifiers: name and accession

Question 2

T or F: WBC diff and RBC morph is performed on albumin smears

Answer 2

FALSE; only WBC diffs are performed on albumin smears

Question 3

Samples with __ Hgb should dry longer to prevent water artifact

Answer 3

Samples with LOW Hgb (thin blood) should dry longer to prevent water artifact

Question 4

For malarial studies on a PB smear, what is checked when samples is received ?

Answer 4

• patient history to check previous positives / abnormal results
• determine whether initial exam or follow-up of treatment
• new positive= PATHOLOGIST NOTIFIABLE

Question 5

MALarial protocol requires what/ how many smears ?

Answer 5

• 4 thin smears; 2 stained/ unstained
• 4 thick smears; all two-drop smears, unstained

Question 6

What is a buffy coat smear for ?

Answer 6

• a concentrated cell prep when WBC count is too low for routine
• evaluates WBC cell morph + bacteria/ parasites queried on the PB smear

Question 7

Tube used for buffy coat smears

Answer 7

Wintrobe tube

Question 8

T or F: It is acceptable if buffy coat smear has RBCs

Answer 8

TRUE; It is acceptable if buffy coat smear has RBCs

Question 9

Which stain is used for malaria ?

Answer 9

Giemsa stain

Question 10

Which stain is used to demonstrate iron stores in bone marrows smears ?

Answer 10

Prussian Blue Iron stain:
- iron deposits are inside cells; extracellular iron is considered artifacts

Question 11

Wright-Giemsa Stain (Romanowsky)

Answer 11

• methylene blue + azure B (basic dyes) stain acidic RNA + DNA
• eosin (acidic dye) stains basic Hgb + eosinophils

Question 12

Formula: WBC correction for presence of nRBC

Answer 12

[Automated WBC x 100] / (100 + nRBC)

Question 13

Formula: Relative Retic Count

Answer 13

[#retics on slide 1 + #retics on slide 2]/ (500 + 500)

NOTE: up to ~500 RBCS are counted for each slide by separate techs

Question 14

How is a fluid count performed when there are crystals present?

Answer 14

• Interfering substances requires a manual fluid cell count
• Sample can be diluted using acetic acid to lyse all RBC as only WBC are reported (unless RBC are specified on requisition)

Question 15

Which of the following can be used to demonstrate heinz bodies?

a.
Prussian blue stain

b.
Brilliant green stain

c.
Wright’s stain

d.
May-Grunwald-Giemsa stain

Answer 15

b.
Brilliant green stain

Question 16

ESR Principle

Answer 16

• non-specific test for inflammation (Acute Phase Reactants; APR)
• increased APR (proteins) = reduced zeta potential = RBCs stack faster
• blood settles in Westergren tubes for 1 hour
• measures distance from bottom of plasma meniscus to the sedimented RBCs (mm)

NOTE: ESR is now replaced with CRP testing

Question 17

Calculate Manual Cell Count

Question 18

Manual CSF Cell Count: If <200 RBC/WBCs in all 9 squares, then..

Answer 18

count RBC/ WBCs in all 9 squares

Question 19

Manual CSF Cell Count: If >200 in all 9 squares, then..

Answer 19

count RBC/ WBCs in 4 corner squares labeled “W”

Question 20

Manual CSF Cell Count: If >200 RBC/ WBCs in 1 of 9 squares, then..

Answer 20

count RBC/ WBCs in 5 center small squares labeled “R”

Question 21

Which cells are reported in CSF ?

Answer 21

RBCs and WBCs

Question 22

Yellow or orange discoloration of CSF

Answer 22

Xanthochromia

Question 23

Lymphocytes can be increased in this type of infection

Answer 23

Viral Infections

Question 24

Transudates vs Exudates

Answer 24

Transudates = accumulation of fluid due to non-inflammatory systemic disease

Exudates = Accumulation of fluids caused by inflammatory conditions

Question 25

Conditions that cause transudates

Answer 25

heart, liver, renal disease

Question 26

Conditions that cause transudates

Answer 26

infection, malignancy, rheumatoid arthritis

Question 27

__ and __ can cause a cloudy CSF sample

Answer 27

HIGH WBC COUNT and MICROORGANISMS can cause a cloudy CSF sample

Question 28

What is used to dilute a CSF when performing the nucleated cell count?

Answer 28

Acetic Acid

Question 29

RBC interferences that increase ESR

Answer 29

- rouleaux - blood thinner - macrocytosis

Question 30

RBC interferences that decrease ESR

Answer 30

- abnormal shape - thick blood - microcytosis

Question 31

Effect of Increased levels of fibrinogen and immunoglobulin on ESR

Answer 31

decreased ESR - plasma proteins decrease negative charge of RBCs and reduce zeta potential

Question 32

Effect of Increased albumin on ESR

Answer 32

- decreased ESR

Question 33

Effect of Increased albumin, fibrinogen and immunoglobulins on ESR

Answer 33

INCREASED ESR

Question 34

Wright-Giemsa Stain

Answer 34

Methylene blue, azure B, Eosin

Question 35

May-Grunwald components of MGG stain

Answer 35

Methylene blue, eosin

Question 36

Components primarily stained by MGG

Answer 36

Cytoplasmic components

Question 37

Basic components of Wright-Giemsa

Answer 37

Methylene blue, azure B

Question 38

Stained by basic dyes

Answer 38

DNA/RNA

Question 39

Increased in pH during staining causes RBC to appear what color ?

Answer 39

Blue-green

Question 40

What do these stains all have in common: Methyl Violet, Brilliant Cresyl Blue, Crystal Violet, Brilliant Green

Answer 40

All SUPRAVITAL STAINS