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MLSCI 330 > Manual Test Methods > Flashcards

Manual Test Methods Flashcards

1
Q

why is a blood smear too short? and how do we fix it?

A

blood spread too quickly, and angle was greater than 30
so decrease angle

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2
Q

why would a blood smear be too long? how do we fix this?

A

blood spread too slowly and angle is less than 30
so increase angle

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3
Q

when blood smears are too thin

A

drop of blood too small; patient has low Hb

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4
Q

the malarial protocol requires:

A
  • 4 thin smears: 2 stained & examined in outine heme; 2 unstained to go to special heme
  • 4 thick smears: unstained and forwarded to special heme
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5
Q

samples with malarial workup require:

A

indication and travel history

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6
Q

when is a buffy coat smear made?

A
  • white cell count too low for analysis on routine PBS (WBC morph only)
  • bacteria and parasites that may have been observed/questioned on PBS
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7
Q

when is a cytospin differential indicated?

A

when the WB C count is above the reference range >5 x 10^6/L (fluid & CSF)
- this can aid in determining the cause of the increased WBC count
- mature red cells are not commented on
- PLTs not founded in CSF; this could indicate contamination (a bloody tap)

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8
Q

Wright-Giemsa

A
  • methylene blue, purified azure B, eosin
  • requires methanol, distilled water
  • pH 6.8
  • methylene blue and azure stain acidic (nucleic acids. RNA, DNA)
  • eosin stains basic = hemoglobin, eosinophil, granules
  • both stain neutrophil granules
  • distilled water =buffer to improve contrast
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9
Q

May-Grunwald-Giemsa Stain

A
  • MG = eosin, methylene blue
    Giemsa = eosin, purified azure B methylene blue
  • requires phosphate buffer and water
  • pH 6.8
  • MG = cytoplasmic (does not display inclusions and nuclear detail well)
  • Giemsa = nuclear stain
  • combo = nuclear and cytoplasmic staining
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10
Q

Giemsa stain for malaria

A
  • eosin, purified azure B, methylene blue
  • requires methanol, buffered phosphate buffer
  • pH 7.0-7.2
  • slides fixed in methanol and air-dried
  • stain in Giemsa (diluted in ph buffer) = nuclear detail
  • rinse and air dry
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11
Q

supravital stains

A
  • new methylene blue (retics, Heinz)
  • Brilliant cresyl Blue (retics, Heinz)
  • methyl violet (Heinz)
  • crystal violet (H)
  • brilliant green (H)
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12
Q

principle of supravital stains

A
  • used to stain living and unfixed cells in vitro to demonstrate Heinz and retics
  • 1:1 ratio ; inc at RT for 15mins)
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13
Q

Prussian Blue Iron stain

A
  • slides incubated in HCl and potassium ferricyanide after fixing in methanol
  • HCl splits ferric iron from hemosiderin
  • ferric iron combines with potassium ferricyanide = blue complex
  • ferritin cannot be demonstrated as it is too small
  • stains counterstained w safranin to increase contrast
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14
Q

T or F. In Prussian Blue Iron stain, any blue around there cells is considered an artifact

A

T! iron deposits must be inside cells
- iron stores may be increased in: megaloblastic anemia, hemolytic, sideroblastic, ACI, leads poisoning, hemosiderosis

  • decreased in IDA and PV
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15
Q

LAP stain increased in

A

leukemoid
Multiple myeloma
Hodgkin’s disease
PV
aplastic anemia

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16
Q

LAP stain

A
  • higher in bands and neuts and increases in activity with inflammation
  • contains naphthol phosphate, fast red violet salt, fast blue salt
  • requires acetone, hematoxylin solution for counterstain
17
Q

AP scores are decreased in

A

CML
PNH
sickle cell anemia
MDS

18
Q

pH too high

A
  • increase dissociation of methylene blue causing the stain to be too blue
  • RBC stain green/blue
  • neuts appear toxic
19
Q

pH too low

A
  • increased dissociation of eosin causing the stain to be very pink
  • RBCs stain red-orange
  • WBC nuclei will be pale
  • eosin granules will be increasingly bright orange
20
Q

what is a miller occular lens used for?

A

retic counts and malarial parasitemia levels
- sq A = larger

21
Q

transudate

A

accumulation of fluid caused by non-inflammatory circulatory disturbance (systemic disease)

22
Q

disorders that result in transudates

A
  • congestive heart failure (fluid backs up into tissues due to bad pumping)
  • liver disease (decreased albumin = decreased oncotic pressure)
  • renal disease (albumin loss = decreased oncotic pressure)
  • obstructive tumors (poor lymph drainage)
23
Q

exudates

A
  • accumulation of fluids caused by an inflammatory condition such as infection, malignancy, SE, or rheumatoid arthritis
  • accumulation of fluid in association with vascular wall damage
24
Q

lab examination of bodily fluids except CSF:

A
  • gross appearance (spun and unspun)
  • WBC count (TNC; RBC only reported if requested)
  • cytospin differential (if indicated by # of WBC present)
  • crystals (if ordered)
25
Q

lab examination of CSF

A
  • gross examination spun and unspun)
  • cell counts (WBC & RBC)
  • cytospin differential as indicated by number of WBC
26
Q

how many tubes are collected for CSF collection

A

3-4
- numbered
- cell count is done on the last tube
- physicians may request cell count on first and last tube to see if traumatic collection (only RBC count on the first tube)

27
Q

time best to do cell count on CSF sample

A

within 30 mins

28
Q

xanthochromia

A
  • orange/yellow colour indicating a breakdown of Hb to bilirubin after a cerebral hemorrhage
  • any degree of orange/yellow in supernatant = xanthochromia
  • spun appearance is used
29
Q

crystal examination in bodily fluids

A

aliquot of sample is spun down = sediment is analyzed

30
Q

increase in retics can be due to

A

blood loss or hemorrhage
hemolysis
hypoxia
hematinic injury

31
Q

when is a manual retic done?

A
  • present with an interference flag
  • relative result >30%
  • absolute result >90 x 10^9/L
32
Q

when is a manual retic done?

A
  • present with an interference flag
  • relative result >30%
  • absolute result >90 x 10^9/L
33
Q

manual retic count

A

miller occular is preferred
otherwise; 500 ciunted on each side buy 2 separate techs
#retics/500 + #retics/500
keep counting on last field even if it goes over 500

34
Q

describe principle of ESR

A

normal situations = RBCs take time to rouleaux due to zeta potential
but if inflammation = excess proteins minimize repulsion interactions so RBCs form rouleaux and fall quicker than normal

35
Q

abnormally shaped RBCs ESR

A

decreased (slower settling)

36
Q

increased number of red or white cells ESR

A

decreased (more crowding; thicker blood)

MLSCI 330 (9 decks)

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