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Comprehensive Review > MODULE 1: COMPLETE BLOOD COUNT > Flashcards

MODULE 1: COMPLETE BLOOD COUNT Flashcards

1
Q

Complete Blood Count is previously known as

A

Full Blood Count

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2
Q

Hemoglobin concentration (WHO)

A

Hemoglobin

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3
Q

Erythrocyte Volume Fraction (WHO)

A

Hematocrit

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4
Q

Erythrocyte Number Concentration (WHO)

A

RBC count

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5
Q

Leukocyte number concentration (WHO)

A

WBC count

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6
Q

Leukocyte type number fraction (WHO)

A

Differential count

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7
Q

Thrombocyte Number concentration (WHO)

A

Platelet count

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8
Q

Hemoglobin reference range in male (Conventional)

A

14-17.5 g/dL

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9
Q

Hemoglobin reference range in female (Conventional)

A

12.3-15.3 g/dL

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10
Q

Hemoglobin reference range in male (SI)

A

140-175 g/L

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11
Q

Hemoglobin reference range in female (SI)

A

123-153 g/L

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12
Q

The conversion factor for hemoglobin

A

10

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13
Q

Used to diagnose and follow the treatment of anemia

A

Hemoglobin

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14
Q

Hemoglobin is increased in:

A

Polycythemia Vera, Morning, Smokers, Strenuous exercise, high altitude

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15
Q

Hemoglobin is decreased in:

A

Anemia, patients lying down

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16
Q

Cyanmethemoglobin method aka:

A

Hemiglobincyanide method

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17
Q

reference method approved by the CLSI

A

cyanmethemoglobin method

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18
Q

The cyanmethemoglobin method measure all forms of hemoglobin except:

A

Sulfhemoglobin

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19
Q

Converts hemoglobin into methemoglobin

A

Potassium ferricyanide

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20
Q

Converts methemoglobin to cyanmethemoglobin

A

Potassium cyanide

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21
Q

shortens conversion time from 10-15minutes to 3 minutes

A

Dihyrogen Potassium phosphate

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22
Q

enhances lysis of RBCs

A

Nonionic detergent

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23
Q

Specimen for hemoglobin determination

A

EDTA whole blood

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24
Q

Sources of error: can be corrected using a patient blank

A

Lipemia

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25
Q

Sources of error: can be corrected by centrifuging test mixture and testing hemoglobin on the supernatant fluid

A

Increased WBCs and platelets

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26
Q

Sources of error: dilute hemoglobin with distilled water

A

HbS and HsC

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27
Q

Sources of error: use of dihydrogen potassium phosphate

A

Increased globulins

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28
Q

Sources of error: causes no effect on hemoglobin determinations

A

Overanticoagulation

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29
Q

Hb is converted to oxyHb by shaking with aqueous NH4OH; imprecise

A

Oxyhemoglobin procedure

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30
Q

Uses HCl to convert Hb into acid hematin, followed by dilution with distilled water drop by drop until the color matches that of the standard (comparator block)

A

Acid Hematin test

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31
Q

Used by some automated instruments to convert Hb to SLS-methemoglobin. Does not generate toxic waste

A

Sodium lauryl sulfate

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32
Q

Volume of RBC expressed over the percentage of the total whole blood volume

A

Hematocrit

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33
Q

term recommended by the national committee for CLS

A

Packed cell vallume

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34
Q

Relationship of Hb to Hct (ratio); may vary with the cause of anemia and the effect on the RBC indices especially the MCV

A

1:3

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35
Q

Hematocrit reference range for male (Conventional)

A

41.5-50.4%

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36
Q

Hematocrit reference range for female (Conventional)

A

35.9-44.6%

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37
Q

Conversion factor for Hematocrit

A

0.01

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38
Q

Hematocrit reference range for male (SI)

A

0.415-0.504 volume fraction

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39
Q

Hematocrit reference range for female (SI)

A

0.359-0.446 volume fraction

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40
Q

reference manual method for microhematocrit method

A

Spun microhematocrit

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41
Q

Heparinized and used for non-anticoagulated whole blood

A

Red capillary tube

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42
Q

Plain and used when processing anticoagulated blood

A

Blue capillary tube

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43
Q

Microhematocrit tube forms a ____ with the tray of clay

A

90 angle

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44
Q

Clay plug should be _____ long

A

4-6mm

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45
Q

Should not be included for the microhematocrit reading

A

Buffy coat

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46
Q

Hematocrit results must agree within:

A

+/- 0.02 L/L

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47
Q

Layers of blood after centrifugation: Top of the tube

A

Fatty Layer

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48
Q

Layers of blood after centrifugation: Second layer

A

Plasma

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49
Q

Layers of blood after centrifugation: Third layer

A

Buffy Coat

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50
Q

Layers of blood after centrifugation: Bottom

A

Packed red cells

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51
Q

Falsely Low results (Hematocrit)

A

Incomplete sealing, Short sample, Over-anticoagulated blood, Hemolysis

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52
Q

Falsely elevated results (hematocrit)

A

Inadequate centrifugation, Allowing the tubes to stand after centrifugation before reading, Including buffy coat in the reading, Hemoconcentration, Abnormal RBC morphology leading to trapped plasma

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53
Q

small amount of plasma that remains in the RBC portion of spun HCT

A

Trapped plasma

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54
Q

Trapped plasma is increased in:

A

Sickle cell anemia, Hypochromic anemia, Spherocytosis, Macrocytosis, Thalassemia

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55
Q

Falsely elevated/low results (Hematocrit)

A

Insufficient mixing of blood, improper use of HCT reader

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56
Q

Uses the Wintrobe tube; no longer used; centrifuge WB @ 2000-2300g for 30 mins

A

Macrohematocrit method

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57
Q

Anticoagulants for macrohematocrit method

A

Oxalate, Heparin, EDTA

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58
Q

Does not directly measure HCT; Not affected by trapped plasma

A

Automated techniques

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59
Q

Directly measured by automated methods

A

MCV and RBC

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60
Q

Neubauer Counting Chamber total area

A

9 mm2

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61
Q

Neubauer counting chamber depth

A

0.1 mm

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62
Q

Neubauer Counting squares (WBC square area):

A

1 mm2

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63
Q

Neubauer Counting Square (Volume of Large square)

A

0.1 mm3

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64
Q

Neubauer Counting Square (RBC Square area)

A

0.04 mm2

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65
Q

Neubauer Counting square (Volume of small central square)

A

0.004 mm3

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66
Q

Speirs-Levy Counting chamber total area

A

10 mm2

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67
Q

Speirs Levy Counting chamber depth

A

0.02 mm

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68
Q

Speirs-Levy counting chamber total volume

A

2.0 mm3

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69
Q

used for eosinophil count because of its large volume

A

Speirs-Levy counting chamber

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70
Q

Fuchs-Rosenthal Counting Chamber Total area

A

16 mm2

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71
Q

Fuchs-Rosenthal Counting chamber depth

A

0.2 mm

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72
Q

Fuchs-Rosenthal Counting chamber total volume

A

3.2 mm3

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73
Q

used for eosinophil count because of its large volume (2nd chamber)

A

Fuchs-rosenthal counting chamber

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74
Q

Thoma RBC pipette bead color

A

Red

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75
Q

Thoma RBC pipette outstanding marks

A

0.5, 1, 101

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76
Q

Thoma RBC pipette bulb volume

A

100

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77
Q

Thoma RBC pipette dilution range

A

1:100, 1:1,000

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78
Q

Thoma WBC pipette bead color

A

White

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79
Q

Thoma WBC pipette outstanding marks

A

0.5, 1, 11

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80
Q

Thoma WBC pipette bulb volume

A

10

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81
Q

Thoma WBC pipette dilution range

A

1:10, 1:100

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82
Q

RBC Normal range in men (conventional)

A

4.5-5.9x 10^6/uL

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83
Q

RBC normal range in women (conventional)

A

4.5-5.1 x10^6/uL

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84
Q

RBC conversion factor

A

10^6

85
Q

RBC normal range for men (SI)

A

4.5-5.9x10^12/L

86
Q

RBC normal range for women

A

4.5-5.1x10^12/L

87
Q

RBC is higher in

A

newborns

88
Q

RBC is slightly decreased in

A

Childhood/adolescence and after 50 years of age

89
Q

RBC is highest in the ____ and lowest in the ____

A

Morning, evening

90
Q

RBC is increased in

A

Polycythemia, dehydration, and high alatitudes

91
Q

RBC is decreased in

A

anemia and other disorders

92
Q

not recommended due to poor precision

A

RBC count by manual method

93
Q

Dilution in polycythemia (Manual RBC count)

A

1:300

94
Q

Dilution in severe anemia (Manual RBC count)

A

1:100

95
Q

RBC diluting fluid should be isotonic to:

A

prevent lysis of RBCs

96
Q

RBC diluting fluids

A

Hayem’s NSS, Dacie’s, Toisson’s, Gower’s, Bethel,3-8% Na citrate

97
Q

If rule of 3 doesn’t fit consider:

A

Cloted sample, cold agglutinin, Lipemic and icteric sample

98
Q

WBC normal range (Conventional)

A

4.4-11 x10^3/uL

99
Q

WBC normal range (SI)

A

4.4-11.3 x 10^9/L

100
Q

WBC conversion factor

A

10^6

101
Q

WBC in newborns

A

higher, 10-30x10^9/L

102
Q

WBC in 1 year old

A

6-17x10^9/L

103
Q

WBC in adult

A

4-11x10^9/L

104
Q

highest in the afternoon, lowest in the morning

A

diurnal variation

105
Q

smoking, exercise, emotional stress, anxiety, release of epinephrine, pregnancy

A

Physiologic leukocytosis (without tissue damage)

106
Q

Bacterial infection, Appendicitis, Leukemia, HDN

A

pathologic leukocytosis

107
Q

Viral diseases, Typhoid fever, measles, brucellosis, RA, LE, liver cirrhosis, infectious hepatitis, radiation, drug therapy

A

Leukopenia

108
Q

Specimen used for manual WBC count

A

EDTA

109
Q

Unsatisfactory anticoagulant for manual WBC count

A

Heparin

110
Q

Performed as a check on the validity of electronic methods for calibration; back up method

A

manual WBC count

111
Q

Lyses the erythrocytes so that they will not obscure the leukocytes; must be refrigerated and filtered frequently

A

WBC diluting fluid

112
Q

Components of WBC diluting fluid

A

1% Ammonium Oxalate
2-3% Glacial Acetic Acid
1% Hydrochloric Acid
Turk’s solution

113
Q

dilution for WBC >30x10^9/L

A

1:100

114
Q

Dilution for WBC 100-300x 10^9/L

A

1:200

115
Q

Dilution for WBC <3.0 x10^9/L

A

1:10

116
Q

Failure to mix specimen before sucking
Failure to mix pipette with specimen
Bubbles in pipette

A

WBC False decrease

117
Q

Diluting fluid contaminated with blood
Bubbles in pipette (while sucking diluting fluid)
Drawing blood far past the appropriate mark

A

WBC False Increase

118
Q

Are not lyzed by WBC diluting fluid and will be counted as WBC

A

Nucleated RBCs

119
Q

Also don’t lyse in diluting fluid

A

Target cells and sickle cells

120
Q

Correct WBC count if >=

A

5 nRBC/1000 WBC

121
Q

Has better cell detail (Blood smear)

A

Faster film drying (thin)

122
Q

Will show contraction of cells

A

Slow film drying (thick)

123
Q

Blood smear should be made within ____ hours of collection from blood anticoagulated with EDTA

A

5

124
Q

Aka spreader-slide, push smear, 2 slide method

A

Wedge Blood Smear

125
Q

Smearer or spreader slide with ______________ is recommended

A

Chamfered or beveled corners

126
Q

Size of blood drop for wedge blood smear

A

2-3 mm in diameter, 0.25 inch

127
Q

Position of spreader slide (angle)

A

30-45

128
Q

Smear should terminate how many inches near the end of the slide

A

0.5

129
Q

Increasing the angle leads to (Blood smear)

A

thick smear

130
Q

Decreasing the angle leads to (Blood smear)

A

thin smear

131
Q

Decreased pressure
Increased angle of spreader slide
increased size of droplet of blood
increased speed of spreader

A

extremely thick smears

132
Q

Increased pressure
Decreased angle of spreader slide
decreased size of droplet of blood
decreased speed of spreader

A

extremely thin smears

133
Q

Area the smear should cover in the glass slide

A

2/3 to 3/4

134
Q

2 cover glass are used in this blood smear

A

Cover glass smear

135
Q

blood smear utilized extensively for BM exams

A

Cover glass smear

136
Q

Stimulates the manual spreader-type technique

A

Wedge (push) type

137
Q

drops of blood placed on center of slide and spun for a period of time

A

Centrifugal (spinner) type/Spun smear

138
Q

Used for finding reactive, immature or abnormal cells that are present in small numbers; In finding megaloblastic nucleated cells, hypersegmented neutrophils, plasma cells and tumor cells;Easier to locate bacteria or parasites

A

Buffy Coat smear

139
Q

Used when looking for blood parasites such as malaria

A

Thick and Thin blood film

140
Q

Thick smear

A

Detection

141
Q

Thin smear

A

Identification

142
Q

For best results of blood staining, blood should be stained for how many hours after collection

A

2-3

143
Q

stains present produce multiple colors when applied to cellular elements

A

Nonvital polychrome stain

144
Q

stains specific celuular components

A

nonvital monochrome stain

145
Q

used to stain specific cellular components in the living state; no fixatives are used in the staining process

A

supravital monochrome stain

146
Q

Routinely used to stain peripheral blood and BM smears

A

Romanowsky stain

147
Q

a basic dye, (+) charged, stains the acidic components of the cell (nucleus) blue/purple

A

Methylene blue

148
Q

an acidic dye, (-) charged, stains the basic components of the cells (cytoplasm) orange/pink

A

Eosin

149
Q

monobasic K phosphate, dibasic Na phosphate;

A

Buffer

150
Q

ph ideal for blood and BM staining

A

6.8

151
Q

pH used when looking for malarial parasites

A

7.2

152
Q

most commonly used routine peripheral blood smear which is oxidizes methylene blue and eosin

A

Wright’s stain

153
Q

combines eosin and methylene blue in methanol with glycerin;

A

Wright-Giemsa

154
Q

Manual staining method

A

Rack method, Dip (incubation) method

155
Q

Automated staining method

A

Platen type, Carousel type, Dip-type instruments

156
Q

RBC microscopic characteristic (good stain)

A

salmon-pink

157
Q

WBC nuclei microscopic characteristic (good stain)

A

purple-blue

158
Q

Platelets microscopic characteristic (good stain)

A

purple-blue to lilac with red-purple granules

159
Q

Eosinophils characteristics (good stain)

A

orange granules

160
Q

neutrophils (good stain)

A

pinkish tan cytoplasm

161
Q

monocytes (good stain)

A

gray ground glass cytoplasm with many tiny red-purple granules

162
Q

bacteria (good stain)

A

blue

163
Q

malarial parasites (good stain)

A

sky blue cytoplasm and red purple chromatin

164
Q

3-part differential

A

granulocytes, lymphocytes, monocytes

165
Q

5-part differential

A

neutrophils, eosinophils, basophils, lymphocytes, monocytes

166
Q

relative value of neutrophil, segmented

A

50-70%

167
Q

absolute value of neutrophil, segmented

A

1.8-7.8 x10^9/L

168
Q

relative value of neutrophil, band

A

0-5%

169
Q

absolute value of neutrophil, band

A

0-0.70 x10^9/L

170
Q

relative value of eosinophil

A

1-3%

171
Q

absolute value of eosinophil

A

0-0.45 x10^9/L

172
Q

relative value of basophil

A

0-2%

173
Q

absolute value of basophil

A

0-0.20 x10^9/L

174
Q

relative value of lymphocyte

A

18-42%

175
Q

absolute value of lymphocyte

A

1.0-4.8 x10^9/L

176
Q

relative value of monocyte

A

2-11%

177
Q

absolute value of monocyte

A

0-0.80 x10^9/L

178
Q

Percentage of cells counted; Conventional reporting (Differential count)

A

Relative count

179
Q

Actual number of cells/L of blood; Preferred and more accurate method of reporting

A

Absolute count

180
Q

WBC count for 2-5 cells/HPF

A

4-7 x10^9/L

181
Q

WBC count for 4-6 cells/HPF

A

7-10 x10^9/L

182
Q

WBC count for 6-10 cells/HPF

A

10-13 x10^9/L

183
Q

WBC count for 10-20 cells/HPF

A

13-18 x10^9/L

184
Q

Increased immature WBC, blast to stab

A

Shift to the left

185
Q

Increased mature neutrophils (segmenters)

A

Shift to the right

186
Q

WBCs are counted in consectuve fields as the blood film is moved from side to side

A

Ceoss sectional or crenllation

187
Q

Ideal method if the smear is thin enough; WBCs are counted in consecutive fields from tail toward the head of the smear

A

Longitudinal

188
Q

Uses a pattern of consecutive fields beginning near the tail on a horizontal edge; count 3 consecutive horizontal edge fields, count 2 fields toward the center of the smear, count 2 fields horizontally, count 2 fields vertically to the edge

A

Battlement

189
Q

useful in the morphologic characterization of anemia

A

RBC indices

190
Q

MCV convetional units

A

80-96 um3

191
Q

MCV SI units

A

80-96 fL

192
Q

MCH Conventional

A

27.5-33.2 pg

193
Q

MCH SI unit

A

27.5-33.2 pg

194
Q

MCHC conventional

A

33.4-35.5%

195
Q

MCHC SI

A

0.334-0.355

196
Q

Indicates average volume of RBC

A

mean corpuscular volume

197
Q

seen in megaloblastic anemia, hemolytic anemia with reticulocytosis, liver disease and normal newborn

A

Macrocytic RBC (>96 fL)

198
Q

seen in IDA, Thalassemia, sideroblastic anemia and lead poisoning

A

Microcytic RBC (<80 fL)

199
Q

average content (weight) of Hb in the RBC; less valuable than the MCV and MCHC

A

Mean corpuscular Hemoglobin

200
Q

MCH is increased in

A

macrocytic anemia

201
Q

MCH is decreased in

A

microcytic anemia and hypochromic anemia

202
Q

Average concentration of Hb in each individual RBC in g/dL

A

Mean corpuscular hemoglobin concentration

203
Q

Hyperchromia (>35.5%) is seen in

A

presence of spherocytes

204
Q

Hypochromia (<33.4%) is seen in

A

IDA and thalassemia

205
Q

percentage of MCHC that should not occur

A

> 38%

206
Q

percentage of MCHC should not occur; lipemic plasma or abnormal Hb (S or C0

A

<22%

207
Q

Indicates degree of anisocytosis; determined from the RBC histogram

A

Red blood cell distribution width

208
Q

normal value of RDW

A

12-17%

209
Q

seen in IDA, post-transfusion, post-treatment, idiopathic sideroblastic anemia, in the presence of two concurrent deficiencies

A

Increased RDW

Comprehensive Review (2 decks)

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