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HEMATOLOGY > MIDTERM - laboratory evaluation part 2 > Flashcards

MIDTERM - laboratory evaluation part 2 Flashcards

1
Q

conditions for microcytic

A
  • MACROCYTIC ANEMIA

*disorder of iron metabolism
* Iron deficiency anemia
* Anemia of chronic disease
* Congenital hypochromic- microcytic
anemia w/ iron overload

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2
Q

Anemia with appropriate BM responses

A
  • Acute posthemorrhagic anemia
  • Hemolytic anemia
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3
Q

Anemia with Impaired Marrow Response

A
  • Marrow Hypoplasia
    • Aplastic Anemia
  • Marrow infiltration
    • Infiltration by malignant cells, myelofibrosis
  • Decreased Erythropoietin Production
    * Kidney and liver disease
    * Endocrine deficiencies
    * Malnutrition
    * Anemia of chronic disease
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4
Q

Macrocytic Anemia ( MCV l00-150 fl)

A
  • Cobalamin ( B12) Deficiency
    • Decreased ingestion
    • Competative Parasite
      * Fish tapeworm infestation
  • Folate Deficiency
    * Decreased ingestion
    * Lack of vegetable
    * alcoholism
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5
Q

Measures the average concentration of Hb.

A

Mean Corpuscular Hgb Concentration
MCHC

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6
Q

most valuable in monitoring therapy for anemia

A

Mean Corpuscular Hgb Concentration
MCHC

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7
Q

Indicates the mean or average volume of a red cell

A

Mean Corpuscular Volume ( MCV

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8
Q
  • Individual cell size is the best index for classifying anemias.
A

Mean Corpuscular Volume ( MCV

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9
Q

Index expresses the volume occupied by a single
erythrocyte and measures in cubic micrometers(
femtoliters) of the mean volume

A

Mean Corpuscular Volume ( MCV

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10
Q

Indicates whether the rbc size appears normal
,smaller than normal or larger than normal.

A

Mean Corpuscular Volume ( MCV

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11
Q

Decreased __ values signify that a unit volume of
packed RBCs contains less hb than normal

A

MCHC

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12
Q

Normal Value for mchc

A

: 32-36 g/dl

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13
Q

Hypochromic anemia (MCHC <30)

conditions

A
  • Iron deficiency
  • Microcytic anemia
  • Chronic blood loss anemia
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14
Q

Interfering Factors of mch

A
  • Hyperlipidemia falsely elevates the MCH
  • high heparin concentration falsely elevates
    MCH
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15
Q

degree of the anisocytosis

A
  • Red cell size Distribution Width
    (RDW)
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16
Q

Explanation of the test : Automated method of
measurement is helpful in investigation of some
hematologic disorders and in monitoring response to
therapy.

A

Red cell size Distribution Width
(RDW)

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17
Q

The __ is essentially an indication of the degree of
anisocytosis

A

RDW

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18
Q

Helpful in distinguishing uncomplicated
heterozygous thalassemia ( low MCV

A

rdw

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19
Q
  • use to asses erythropoietic activity of the bone marrow
A

Reticulocyte
Count

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20
Q
  • whole blood, anticoagulated with EDTA is stained with a
    supravital stain such as new methylene blue or brilliant cresyl blue
A

Reticulocyte
Count

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21
Q

% Reticulocyte formula

A

of reticulocytes/1000 RBCs observed x 100

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22
Q

red cell generation

A

retics count

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23
Q

is the actual number of reticulocyte in 1 liter of whole
blood

A

Absolute Reticulocyte Count (ARC)

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24
Q

Absolute Reticulocyte Count (ARC) ref range

A

25-75 x 109/L

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25
Q

in specimen with a low Hct, the percentage of
reticulocytes maybe falsely elevated because whole
blood contains fewer RBCs.

A

Corrected Reticulocyte Count

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26
Q

A correction factor is used considering the average
normal Hct to be 45%

A

Corrected Reticulocyte Count

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27
Q

Corrected Reticulocyte Count ref range

A

Reference Range:
2-3%

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28
Q

signifies as well if bm will response in anemia

A

Reticulocyte Production Index
(RPI)

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29
Q

Increased Reticulocyte Count conditions

A
  1. Hemolytic anemia
  2. Lead poisoning
  3. Malaria
  4. Parasitic infections
  5. Blood intoxication
  6. Kala-azar
  7. Erythroblastic anemia
  8. Sickle cell anemia
  9. Relapsing fever
  10. Leukemia
  11. Splenic tumor
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30
Q

Decreased Reticulocyte
Count conditions

A
  1. Aplastic anemia
  2. Acute benzol poisoning
  3. Chronic infections
  4. Anaplastic crisis of hemolytic anemia
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31
Q

Physiologic Increase of Reticulocytes

A
  1. Pregnancy
  2. At birth
  3. Menstruation
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32
Q

refers to the speed of fall of the erythrocyte to settle
down from their plasma.

A

Erythrocyte Sedimentation Rate

33
Q

useful in monitoring the course of an existing
inflammatory disease or differentiating between
similar diseases.

A

Erythrocyte Sedimentation Rate

34
Q

2 ways of measurement of esr

A
  1. Measuring the length of fall from the top of the column of RBC in a specified period of time
  2. Determining the time required for the red cells to reach a specified point
35
Q

Phases or Stages in ESR

A

Agglomeration Phase
Phase of Fast Settling
Final Phase of Packing

36
Q

the agglomerates sink rapidly
- the rate of fall depends on size-
takes place for about 40 minutes

A

Phase of Fast Settling

37
Q

initial rouleau formation
few cells sink under gravity but the majority from agglomerates of various sizes
takes place during firsrt 10 mns

A

agglomeration phase

38
Q

Macromethods in esr

A
  1. Wintrobe-Landsberg Method
  2. Westergren Method
  3. Graphic and Cutler Method
  4. Linzenmeir Method
39
Q

Micromethods

A
  1. Micro Landau Method
  2. Smith Method
  3. Hellige-Volmer Method or Crista Method
40
Q

. plasma factors increasing esr

A

a. increased fibrinogen concentration
b. increased globulin concentration
c. cholesterol

41
Q

Red cell factors increasing esr

A

a. macrocytes
b. anemia
c. hemolysis

42
Q

. Plasma Factors decreasing esr

A

a. increased albumin
b. increased lecithin
c. defibrination

43
Q

red cell factors decreasing esr

A

a. microcytosis
b. more red cells
c. spherocytosis
d. increased sickle cells and poikilocytes

44
Q

extrinsic factors affecting esr

A
  1. long standing of blood since rbc tends to be spherical
  2. excess dry anticoagulant
  3. temperature below 20°C
  4. short sedimentation tube
  5. small bore of sedimentation tube
  6. more blood specimen
  7. presence of blood clots
  8. dirty glass wares
45
Q

Westergren’s Method’s ref range

A
  • Women : 0 – 20 mm/hr
    Men : 0 – 15 mm / hr
  • Children : 0 – 10 mm /hr
46
Q

Increased ESR conditions

A
  • All collagen disease , SLE
  • Infection , pneumonia
  • Inflammatory disease
  • Carcinoma , lymphoma
  • Toxemia
  • anemia
47
Q

Methods of Preparation of Blood Smears

A

Manual Method
– Wedge/Push/2-Glass Slide Method- the simplest and most commonly used

48
Q

the simplest and most commonly used manual method of smearing

A

Wedge/Push/2-Glass Slide Method

49
Q

Advantages of manual method

A

a.slides are not easily broken
b.easy to prepare
c.easy to label and transport
d.allows storages, even without cover slip
e.abnormal cells can easily be foun

50
Q

Characteristics of a Good Smear

A
  1. There should be a transition from thick to thin area.
  2. Smear should occupy ¾ of the length of the slide.
  3. Most have a smooth even surface, free from waves,
    ridges and holes.
  4. White blood cells should not be bunched at the end
    or edge of smear.
  5. It should have a feathery edge or tail.
51
Q

Uses of Thin Smears

A
  1. WBC differential count
  2. Stained red cell examination
  3. Platelet count (indirect method)
  4. Reticulocyte count
  5. Siderocyte count
  6. Malarial parasite examination
  7. Thorough study of morphology of blood cells
52
Q

Requirements to Produce a Proper Blood Films

A
  1. Use of a chemically clean glass slides
    and cover glass.
  2. Use of not too large nor too small drop
    of blood.
  3. Work is done quickly before coagulation
    of the blood.
  4. Proper angle and pressure of the
    spreader.
53
Q

Methods of Drying the Blood Films

A
  1. Air drying
  2. Heating in the oven for a low flame
  3. Chemical drying in ethyl alcohol
    Fixatives
    for Blood Films
    Factors Affecting Thickness/Thinness of Smear
    Factors
  4. Size of the drop of blood used
    a. large drop
    b. small drop
  5. Methanol
  6. Absolute Ethyl Alcohol
  7. Absolute Ethyl Alcohol and Ether
  8. 1% solution of HgCl₂
  9. 1% Formali
54
Q

proper angle smear of smearing

A

35-45°

55
Q

Pressure exerted when pushing the
spreader against the stationary slide

heavy pressure

A

thin smear

56
Q

Speed of the spreader slide

too fast

A

thick smear

57
Q

preferred for bone marrow preparation

A

Cover Glass/Ehrlich’s Method

58
Q

even distribution of blood cells especially leukocytes is observed

A

Cover Glass/Ehrlich’s Method

59
Q

Disadvantages of cover glass method

A

a. cover glasses are easily broken
b. require chemically clean coverglass
c. difficult to prepare
d. difficult to label, stain and transport

60
Q

there is even distribution of cells but
yields limited blood smear.

A

Beacom’s Method/Cover Glass and Slide Method

61
Q

Automated Method for smearing

A

Spun Smear
Smear Prepared in Miniprep

62
Q

prepared in hemaspinner

A

Spun Smear

63
Q

Staining of Blood Smears

A

Wright’s Stain

2.giemsa stain
3. May-Grunwald’s stain
4. Leishman’s stain
5. Jenner’s stain
6. Panoptic stain
7. supravital stain

64
Q

combination of Romanowsky stain and another
stain

A

Panoptic stain

65
Q

considered polychrome stain

A

Wright’s Stain

66
Q

Wright’s Stain component

A

methylene blue
eosin

67
Q

– basic dye and stains
acidic cellular components

A

methylene blue

68
Q

acid dye and stains basic
(eosinophilic) cellular components

A

eosin

69
Q
  • buffer added to the stain
  • must have a pH of 6.
A

Sodium Phosphate

70
Q

it is the enumeration and determination of
relative proportion or percentage (%) of
each type of leukocyte in the peripheral or
venous blood.

A

Leukocyte Differential Count

71
Q

Steps in Leukocyte Differential Count

A
  1. Preparation of blood smear
  2. Staining of blood smear
  3. Differentiation of leukocytes
  4. Reporting of results
72
Q

Ways of Scanning Smears for Differential Count

A
  1. Strip or Horizontal Method
  2. Crenellation Method- cells are counted fro
  3. Exaggerated Battlement Method
  4. Two Field Meander Method
  5. Four Field Meander Method
73
Q

all the cells in a longitudinal strip from
head to end or tail of the cells are
counted.

A

Strip or Horizontal Method

74
Q

cells are counted from the upper part
of the smear, the lower part, then
sideways, then to the upper part until
100 cells are differentiated.

A

Crenellation Method

75
Q

Shift to the left

A
  • the presence of an increase in younger
    forms of leukocytes
76
Q

Shift to the left

A

seen in pyogenic infections

77
Q

Shift to the right

A

-the presence of an increase in older forms
of leukocytes

78
Q

Shift to the right

A

seen in megaloblastic anemia, pernicious
anemia, and in convalescence

79
Q
A

HEMATOLOGY (11 decks)

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