MTAP W2 (Hematology W10: Lab Evaluation) Flashcards by JHOANNA LYNN LUMBOY

CBC IS ALSO KNOWN AS

HEMOGRAM

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INCLUDES
1. ENUMERATION OF CELLULAR ELEMENTS
2. QUANTITATION OF HGB
3. STATISTICAL ANALYSES OF CELL APPEARANCES

CBC/HEMOGRAM

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PREVENTS PLATELETS FROM CLUMPING ON GLASS SLIDE MAKING IT MORE ACCURATE DURING FILM EVALUATION

EDTA

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SPECIMEN OF CHOUCE FOR EVALUATION OF BLOOD CELL MORPHOLOGY

ANTICOAGULANT-FREE BLOOD

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PERIPHERAL BLOOD FILM

EDTA BLOOD (PURPLE TOP)
MADE WITHIN – OF DRAWING THE SPECIMEN- HIGH QUALITY FILMS

2-3 HOURS

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ADVANTAGES
1. MULTIPLE SLIDES
2. PREP AT LATER TIME
3. AVOIDS PLT CLUMPING

EDTA

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PREFERRED EDTA TUBE WHEN MAKING PERIPHERAL BLOOD FILM

IT MIXES MORE EASILY WITH BLOOD

TRIPOTASSIUM EDTA/LIQUID FORM

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PERIPHERAL BLOOD FILM

EDTA TUBES THAT REMAIN FOR MORE THAN -

BLOOD CELL ARTIFACTS:
1. VACUOLATED NEUTROPHILS
2. ECHINOCYTIC RBCS
3. NECROBIOTIC LEUKOCYTES
4. SPHEROCYTES

5 HOURS

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PERIPHERAL BLOOD FILM

EDTA LEFT FOR 5 HOURS

BLOOD CELL ARTIFACTS (4)

VACUOLATED NEUTROPHILS
ECHINOCYTIC RBCS
NECROBIOTIC LEUKOCYTES
SPHEROCYTES

VENS

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PERIPHERAL BLOOD FILM

CAUSE PLATELET SATELLITOSIS

EDTA SPECIMEN

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PERIPHERAL BLOOD FILM

PLATELETS SURROUND OR ADHERE TO THE NEUTROPHILS

PLATELET SATELLITOSIS

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PERIPHERAL BLOOD FILM

PLATELET SATELLITOSIS:

FALSE DECREASE DUE TO ADHERANCE TO NEUTROPHIL

PSEUDOTHROMBOCYTOPENIA

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PERIPHERAL BLOOD FILM

PLATELET SATELLITOSIS:

FALSE INCREASE OF WBC, CLUMPS WILL BE READ AS WBC DUE TO ITS SIZE

PSEUDOLEUKOCYTOSIS

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PLATELET SPECIFIC AUTOANTIBODIES THAT REACH BEST AT RT ARE ONE OF THE MECHANISMS KNOWN TO CAUSE THIS PHENOMENON

PLATELET SATELLITOSIS

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PERIPHERAL BLOOD FILM

PLATELET SATELLITOSIS:

CORRECTION: RECOLLECT BLOOD SAMPLE USING -

3.2% NA CITRATE (BLUE TOP)

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PERIPHERAL BLOOD FILM

PLATELET SATELLITOSIS:

CORRECTION: RECOLLECT BLOOD SAMPLE USING 3.2 NA CITRATE

ADJUSTMENT MUST MULTIPLY TO -

PLATELET COUNT X 1.1

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PERIPHERAL BLOOD FILM

ADVANTAGE:
1. MADE AT PX SIDE
2. SOME ARTIFACTS MAY BE PREVENTED

ANTICOAGULANT-FREE BLOOD

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METHODS OF BLOOD FILM PREPARATION

EASIEST, MOST CONVENIENT, COMMONLY USED

MANUAL/PUSH-WEDGE METHOD

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METHODS OF BLOOD FILM PREPARATION

MANUAL WEDGE TECHNIQUE aka PUSH-WEDGE METHOD

USES SLIDE AS PUSHER/SPREADER
FILM SLIDE: 3X1 INCH (75 X25 MM)
ANGLE OF PUSHER/SLIDE: -

30-45 DEGREE

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METHODS OF BLOOD FILM PREPARATION

MANUAL WEDGE TECHNIQUE aka PUSH-WEDGE METHOD

BLOOD IS DROPPED AT ABOUT - FROM END OR FROSTED

0.25/ 1/4 INCH
1 CM

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METHODS OF BLOOD FILM PREPARATION

MANUAL WEDGE TECHNIQUE aka PUSH-WEDGE METHOD

DROP OF BLOOD: -

2-3MM

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METHODS OF BLOOD FILM PREPARATION

MANUAL WEDGE TECHNIQUE aka PUSH-WEDGE METHOD

DROP OF BLOOD: 2-3MM
LARGE AMOUNT OF BLOOD= - SMEAR

THICKER/LONGER

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METHODS OF BLOOD FILM PREPARATION

MANUAL WEDGE TECHNIQUE aka PUSH-WEDGE METHOD

DROP OF BLOOD: 2-3MM
SMALL AMOUNT OF BLOOD= -SMEAR

THINNER/SHORT

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METHODS OF BLOOD FILM PREPARATION

MANUAL WEDGE TECHNIQUE aka PUSH-WEDGE METHOD

SPEED OF SPREADER:
TOO FAST= - SMEAR

THICKER

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METHODS OF BLOOD FILM PREPARATION MANUAL WEDGE TECHNIQUE aka PUSH-WEDGE METHOD SPEED OF SPREADER: TOO SLOW= - SMEAR

THINNER

METHODS OF BLOOD FILM PREPARATION MANUAL WEDGE TECHNIQUE aka PUSH-WEDGE METHOD HEMATOCRIT OF PX: TOO HIGH (>60%) ANGLE SHOULD BE LOWERED AS LOW AS -

25 DEGREE

METHODS OF BLOOD FILM PREPARATION MANUAL WEDGE TECHNIQUE aka PUSH-WEDGE METHOD HEMATOCRIT OF PX: TOO LOW (>45%) ANGLE SHOULD BE RAISED -

>45 DEGREES

METHODS OF BLOOD FILM PREPARATION TOO THICK SMEARS PRESSURE: -

LOW

METHODS OF BLOOD FILM PREPARATION TOO THICK SMEARS ANGLE: -

HIGH

METHODS OF BLOOD FILM PREPARATION TOO THICK SMEARS SPEED: -

FAST

METHODS OF BLOOD FILM PREPARATION TOO THICK SMEARS SIZE OF BLOOD: -

LARGE

PERIPHERAL BLOOD FILM COVERSLIP METHOD OF BLOOD FILM PREPARATION - METHOD: GLASS SLIDE + COVERSLIP

BEACOM

PERIPHERAL BLOOD FILM COVERSLIP METHOD OF BLOOD FILM PREPARATION - METHOD: 2 COVER SLIP METHOD

EHRLICH METHOD

PERIPHERAL BLOOD FILM FEATURES OF A WELL-MADE WEDGE PBS FILM IS - LENGTH OF SLIDE

2/3-3/4

PERIPHERAL BLOOD FILM FEATURES OF A WELL-MADE WEDGE PBS THE FILM SHOULD BE - SHAPED NOT BULLET

FINGER

PERIPHERAL BLOOD FILM FEATURES OF A WELL-MADE WEDGE PBS SLIDE HELD UP TO THE LIGHT THIN PORTION MUST BE HAVE A - APPEARANCE

RAINBOW

PERIPHERAL BLOOD FILM FILM THAT IS - (COLOR) THAN NORMAL MAY INDICATE THAT THE PX HAS 1. INCREASED BLOOD PROTEINS 2. PLASMA CELL MYELOMA 3. ROULEAUX

BLUER

PERIPHERAL BLOOD FILM A - APPEARANCE TO THE FILM MAY INDICATE RBC AGGLUTINATION FOUND IN COLD HEMAGGLUTIN DISEASES

GRAINY

PERIPHERAL BLOOD FILM - ALL OVER THE FILM INDICATES INCREASED LIPID LEVELS

HOLES

PERIPHERAL BLOOD FILM SLIDES STAINED AFTER - OR LONGER TURN OUT TOO BLUE SHOULD ONLY BE STORED FOR -

1 WEEK

PERIPHERAL BLOOD FILM FILMS PRODUCED EVERY 30SEC

SYSMEX SP10

PERIPHERAL BLOOD FILM AUTOMATED SLIDE STAINERS

MIDAS AND HEMA TEK

PERIPHERAL BLOOD FILM DEMONSTRATES LE CELLS CONCENTRATES THE NUCLEATED CELLS PRESENT

BUFFY COAT SMEAR

PERIPHERAL BLOOD FILM USES BUFFY COAT SMEAR ON PATIENTS WITH EBC COUNT

<1X10^9/L

PERIPHERAL BLOOD FILM -BLOOD SMEAR USED FOR SCREENING OF BLOOD PARASIRES

THICK SMEARS

PERIPHERAL BLOOD FILM - STAIN USED FOR BM AND PBS

WRIGHT/ GIEMSA STAIN

PERIPHERAL BLOOD FILM FIXATIVE: -

METHANOL

PERIPHERAL BLOOD FILM ACTUAL STAINING DOES NOT OCCUR UNTIL - IS ADDED

BUFFER

PERIPHERAL BLOOD FILM -: STAINS ACIDIC PARTS OF CELL SUCH AS RNA

METHYLENE BLUE

PERIPHERAL BLOOD FILM -: STAINS BASIC PART OF CELL

EOSIN

PERIPHERAL BLOOD FILM OXIDIZE METHYLENE BLUE AND EOSIN STAINS NEUTRAL COMPONENT

THIZAINE-EOSINATE COMPLEX

PERIPHERAL BLOOD FILM BUFFER IS ADDED TO STAIN SHOULD BE -M

0.05M SODIUM PHOSPHATE

PERIPHERAL BLOOD FILM BUFFER ADDED TO STAIN FOR ATLEAST 24 HOURS

AGED DISTILLED WATER

MOST IMPORTANT PART OF STAINING

PH 6.4-6.8

PERIPHERAL BLOOD FILM PH FOR MALARIAL PARASITES

7.2

WELL STAINED PERIPHERAL BLOOD FILM MACRO: SHOULD BE (COLOR)

PINK TO PURPLE

WELL STAINED PERIPHERAL BLOOD FILM MICRO: RBC SHOULD APPEAR

ORANGE-SALMON PINK

WELL STAINED PERIPHERAL BLOOD FILM MICRO: WBC SHOULD BE

PURPLE TO BLUE

WELL STAINED PERIPHERAL BLOOD FILM MICRO: CYTOPLASM OF NEUTROPHILS SHOULD BE

PINK TO TAN WITH VIOLET GRANULES

WELL STAINED PERIPHERAL BLOOD FILM MICRO: EOSINOPHILS SHOULD HAVE - GRANULES

BRIGHT ORANGE

WELL STAINED PERIPHERAL BLOOD FILM EXCESSIVELY - (COLOR) STAIN 1. THICK 2. PROLONGED STAINING 3. INADEQUATE WASHING 4. TOO ALKALINE

BLUE

PERIPHERAL BLOOD FILM STAINING PROBLEM: FAILURE TO HOLD THE SLIDE -

HORIZONTALLY

COMPLETE BLOOD COUNT PERFORMED USING A - OR -

HEMACYTOMETER/ COUNTING CHAMBER

MOST COMMONLY USED HEMACYTOMETER

LEVY WITH NEUBAUER RULING

LEVY WITH NEUBAUER RULING COMPOSED OF -MMX-MM SQUARE COUNTING AREA SEPARATED BY AN H SHAPED MOAT

3X3MM TOTAL= 9MM2

LEVY WITH NEUBAUER RULING TOTAL VOLUMR OF ONE ENTIRE GRID OF HEMACYTOMETER IS

0.9MM3

LEVY WITH NEUBAUER RULING - EACH SECONDARY SQUARE EXCEPT CENTER

16 SQUARES

LEVY WITH NEUBAUER RULING CENTER SECONDARY SQUARES -

25 SQUARES

LEVY WITH NEUBAUER RULING READING OF PLATELETS

CENTER SQUARE 25 SECONDARY SQUARES

LEVY WITH NEUBAUER RULING READING OF RBC

CENTER SQUARE ONLY 4 CORNER AND CENTER OF SECONDARY SQUARES

LEVY WITH NEUBAUER RULING READING OF WBC

4 CORNER SQUARES 16 SECONDARY SQUARES

LEVY WITH NEUBAUER RULING CORNER SQUARES 16 SECONDARY SQUARES EACH WITH AREA OF -

0.0625 MM2

LEVY WITH NEUBAUER RULING CENTER SQUARE 25 SECONDARY SQUARES EACH WITH AREA OF -

0.04MM2

HEMACYTOMETER DEPTH: -

0.1MM

HEMACYTOMETER DEPTH FACTOR: -

1/10 OR 10

HEMACYTOMETER DISTANCE BETWEEN THE BOTTOM OF THE COVERSLIP AND SURFACE OF COUNTING AREA

DEPTH FACTOR

DILUTING PIPETTES COMPOSED OF STEM DIVIDED INTO - EQUAL PARTS WITH BEAD THAT AIDS IN MIXING THE DILUENT

10 EQUAL PARTS

DILUTING PIPETTES IN CALCULATING DILUTION, ONLY THE VOLUME CONTAINED IN THE - IS CONSIDERED

BULB

DILUTING PIPETTES RBC PIPETTE: - MARK/ TOTAL UNITS

101 MARK

DILUTING PIPETTES WBC PIPETTE: - MARK/ TOTAL UNITS

11 MARK

DILUTING PIPETTES RBC PIPETTE BULB: - UNIT

100 UNIT

DILUTING PIPETTES RBC PIPETTE STEM: - UNIT

1 UNIT

DILUTING PIPETTES RBC PIPETTE BLOOD DRAWN ON 0.5 MARK DILUTION: -

1:200

DILUTING PIPETTES RBC PIPETTE BLOOD DRAWN ON 1.0 MARK DILUTION: -

1:100

DILUTING PIPETTES RBC PIPETTE DILUENT IS DRAWN TO THE - MARK

101 MARK

DILUTING PIPETTES WBC PIPETTE BLOOD DRAWN ON 0.5 MARK DILUTION: -

1:20

DILUTING PIPETTES WBC PIPETTE BLOOD DRAWN ON 1.0MARK DILUTION: -

1:10

DILUTING PIPETTES WBC PIPETTE DILUENT IS DRAWN TO THE - MARK

11 MARK

DILUTING PIPETTES WBC PIPETTE VOLUME OF THE BULB

GENERAL FORMULA FOR MANUAL CELL COUNTS

TC= CC X DF/ AREA X 0.1

GENERAL FORMULA FOR MANUAL CELL COUNTS THE DIFFERENCE BETWEEN THE TOTAL CELLS COUNTED ON EACH SIDE SHOULD BE -

<10%

MANUAL CELL COUNT CONVENTIONAL UNIT

CELLS/UL CELLS/MM3

MANUAL CELL COUNT SI UNIT

CELLS/L

MANUAL CELL COUNT REPORTING RBC CONVENTIONAL UNIT

X10^6/MM3 X10^6/UL

MANUAL CELL COUNT REPORTING WBC/PLPATELETS CONVENTIONAL UNIT

X10^3/MM3 X10^3/UL

MANUAL CELL COUNT REPORTING RBC SI UNIT

X10^12/L

MANUAL CELL COUNT REPORTING WBC/PLATELETS SI UNIT

X10^9/L

WBC DILUTION: 1:20 OBJECTIVE: 10X (LPO) AREA COUNTED: -

4MM2

WBC DILUTION: 1:100 OBJECTIVE:10X (LPO) AREA COUNTED: -

9MM2

RBC DILUTION: 1:100 OBJECTIVE: 40X (HPO) AREA COUNTED: -

0.2MM2/ 5 SMALL SQAURES OF CENTER SQUARE

PLATELETS DILUTION: 1:100 OBJECTIVE: 40X PHASE CONTRAST AREA COUNTED: -

1MM2

WBC DILUTING FLUIDS

1. 1% AMMONIUM OXALATE 2. 1% HYDROCHLORIC ACID 3. 3% ACETIC ACID

RBC DILUTING FLUID

ISOTONIC SALINE

PLATELETS DILUTING FLUID

1% AMMONIUM OXALATE

MANUAL RBC COUNT ARE RARELY PERFORMED (2) CONCENTRATIONS ARE MORE DESIRABLE WHEN AUTOMATION IS NOT AVAILABLE

1. MICROHEMATOCRIT 2. HEMOGLOBIN

NORMAL RBC COUNT MALE: -/L

4.20-6.00 X10^12/L

NORMAL RBC COUNT FEMALE: -/L

3.80-5.20 X10^12/L

MANUAL RBC COUNT AREA OF COUNTING CHAMBER USED: 5 CENTER SQUARES EACH SQUARE: -

0.04MM

MANUAL RBC COUNT AREA OF COUNTING CHAMBER USED: 5 CENTER SQUARES 5 SQUARES: -

0.2MM2

MANUAL RBC COUNT MICROSCOPE OBJECTIVE: -

40X/ HPO

MANUAL RBC COUNT USUAL DILUTION: -

1:100

MANUAL RBC COUNT RBC DILUTING FLUIDS SHOULD BE - TO FACILITATE COUNTING AND PREVENT LYSIS OF RBCS

ISOTONIC

MANUAL RBC COUNT BEST DILUTING FLUID FOR RBC

DACIES/FORMOL CITRATE

MANUAL RBC COUNT RBC DILUTING FLUIDS (7)

1.DACIES/FORMOL CITRATE 2.3.8% SODIUM CITRATE 3.NSS 4.BETTHELL'S 5.HAYEM'S 6.TOISSON'S 7.GOWER'S

RBC PARAMETERS REPORTING RBC COUNT

RBCS X10^12/L

RBC PARAMETERS REPORTING HGB

g/dL

RBC PARAMETERS REPORTING HCT

% or L/L

RBC PARAMETERS REPORTING MCV

RBC PARAMETERS REPORTING MCH

RBC PARAMETERS REPORTING MCHC

g/dL

RBC PARAMETERS REPORTING RDW

AN IMPORTANT TOOL TO ASSESS BM'S ABILITY TO INCREASE RBC PRODUCTION IN RESPONSE TO ANEMIA

RETICULOCYTE COUNT

ERYTHROCYTE MATURATION SERIES LAST STAGE CAPABLE OF HGB SYNTHESIS

RETICULOCYTE

YOUNG RBC THAT LACKS NUCLEUS BUT CONTAINS RESIDUAL RNA TO COMPLETE PRODUCTION OF HGB

RETICULOCYTE

RETICULOCYTE SPENDS - IN THE BM

2 DAYS

RETICULOCYTE SPENDS - IN THE PERIPHERAL BLOOD BEFORE DEVELOPING INTO A MATURE RBC

1 DAY

RETICULOCYTE COUNT ADULT: -

0.5-1.5%

RETICULOCYTE COUNT NEWBORN: -

2-6%

RETICULOCYTE STAINED WITH -

SUPRAVITAL STAIN- NEW METHYLENE BLUE

RETICULOCYTE COUNT RATIO OF BLOOD AND STAIN

1:1

RETICULOCYTE COUNT INCUBATE AT RT FOR -

3-10MIN

RETICULOCYTE COUNT COUNT - RBCS UNDER - LENS

1000, OIO

RETICULOCYTE COUNT FOR ACCURACY, HAVE ANOTHER LABORATORIAN TO COUNT SHOULD AGREE WITHIN -

20%

RETICULOCYTE COUNT FORMULA

RETIC%= NO.OF RETIC X 100/ 1000 (RBCS COUNTED)

THE ACTUAL NUMBER OF RETICULOCYTES IN 1 LITER OR 1 MICROLITER OF BLOOD

ABSOLUTE RETICULOCYTE COUNT

ABSOLUTE RETICULOCYTE COUNT REFERENCE INTERVAL

20X109/L 115X109/L

ABSOLUTE RETICULOCYTE COUNT FORMULA

ARC= RETICS X RBC COUNT/100

IN SPX WITH LOW HEMATOCRIT, RETICULOCYTES MAY BE FALSELY -

ELEVATED

CORRECTED RETICULOCYTE COUNT AVERAGE NORMAL HCT -%

45%

CORRECTED RETICULOCYTE COUNT FORMULA

CRC= RETIC X (PX HCT/45)

CORRECTED RETICULOCYTE COUNT PX WITH HEMATOCRIT OF 35% SHOULD HAVE AN ALEVATED RETICULOCYTE COUNT OF - TO -% 35%=MILD ANEMIA

2-3%

CORRECTED RETICULOCYTE COUNT PX WITH HEMATOCRIT OF LESS THAN 25% COUNT SHOULD INCREASE TO - TO -% <25%= MODERATE ANEMIA

3-5%

GENERAL INDICATOR OF THE RATE OF ERYTHROCYTE PRODUCTION INCREASE ABOVE NORMAL IN ANEMIAS

RETICULOCYTE PRODUCTION INDEX

RETICS THAT ARE RELEASE FROM BM PREMATURELY ARE CALLED - USUALLY TO COMPENSATE ANEMIA

SHIFT RETICULOCYTES

SHIFT RETICS TAKES - TO - DAYS TO LOSE THEIR RETICULA

2-3 DAYS

RETICULOCYTE PRODUCTION INDEX FORMULA

RPI= CORRECTED RETIC COUNT/MATURATION TIME

THE PX - IS USED TO DETERMINE APPROPRIATE CORRECTION FACTOR

HEMATOCRIT

RETICULOCYTE PRODUCTION INDEX PX HEMATOCRIT VALUE % 40-45 CORRECTION FACTOR/MATURATION TIME/DAYS

RETICULOCYTE PRODUCTION INDEX PX HEMATOCRIT VALUE % 35-39 CORRECTION FACTOR/MATURATION TIME/DAYS

1.5

RETICULOCYTE PRODUCTION INDEX PX HEMATOCRIT VALUE % 25-34 CORRECTION FACTOR/MATURATION TIME/DAYS

RETICULOCYTE PRODUCTION INDEX PX HEMATOCRIT VALUE % 15-24 CORRECTION FACTOR/MATURATION TIME/DAYS

2.5

RETICULOCYTE PRODUCTION INDEX PX HEMATOCRIT VALUE % <15 CORRECTION FACTOR/MATURATION TIME/DAYS

RETICULOCYTE PRODUCTION INDEX ADEQUATE BM RESPONSE INDICATED BY AN RPI -

RETICULOCYTE PRODUCTION INDEX INADEQUATE ERYTHROPOIETIC RESPONSE IS SEEN WHEN THE RPI -

RETICULOCYTE COUNT DESIGNED TO REDUCE LABOR INTESIVE PROCESS DISC INSERTED INTO THE EYEPIECE OF MICROSCOPE

MILLER DISK

RETICULOCYTE COUNT 2 SQUARES SMALLER SQUARE 1/8

MILLER DISK

RETICULOCYTE COUNT MILLER DISK - SQUARE ISWHERE RETICS ARE COUNTED

LARGE SQUARE

RETICULOCYTE COUNT MILLER DISK - SQUARE IS WHERE RBCS ARE COUNTED

SMALL SQUARE 1/9

RETICULOCYTE COUNT MILLER DISK RBCS MINIMUM OF - CELLS SHOULD BE COUNTED IN SMALL SQUARE

112 CELLS

RETICULOCYTE COUNT MILLER DISK RBCS MINIMUM OF 112 CELLS IS EQUIVALENT TO - RED CELLS IN LARGE SQUARE

1008

RETICULOCYTE COUNT MILLER DISK FORMULA

RETICS= NO. OF RETICCS IN SQUARE A OR LARGE SQUARE X 100/ NO. OF RBCS IN SQUARE B OR SMALL SQUARE X 9

1. BLOOD LOSS 2. HEMOLYTIC ANEMIA 3. TREATMENT TO PERNICIOUS ANEMIA, FOLIC ACID DEFICIENCY OR IRON DEFICIENCY

INCREASED RETICULOCYTES

MANUAL WBC COUNT NORMAL WBC COUNT

4.0-11.0 X10^9/L

MANUAL WBC COUNT USUAL DILUTION

1:20

MANUAL WBC COUNT WBC DILUTING FLUIDS SHOULD BE - TO SWELL AND LYSE RBCS

HYPOTONIC

MANUAL WBC COUNT WBC DILUTING FLUIDS (4)

1. 1% AMMONIUM OXALATE 2. 1% HYDROCHLORIC ACID 3. 2-3% ACETIC ACID 4. TURKS DILUTING FLUID

MANUAL WBC COUNT ANTICIPATED WBC: 0.1-0.3 RECOMMENDED DILUTION:- TYPE OF PIPETTE: -

1:10, WBC

MANUAL WBC COUNT ANTICIPATED WBC: 3.1-30.0 RECOMMENDED DILUTION:- TYPE OF PIPETTE: -

1:20, WBC

MANUAL WBC COUNT ANTICIPATED WBC: >30.0 RECOMMENDED DILUTION:- TYPE OF PIPETTE: -

1:100, RBC

MANUAL WBC COUNT ANTICIPATED WBC: >100.0 RECOMMENDED DILUTION:- TYPE OF PIPETTE: -

1:200, RBC

MANUAL WBC COUNT MAKE A 1:20 DILUTION BY PLACING - UL OF BLOOD IN 475 UL OF WBC DILUTING FLUID

25UL

MANUAL WBC COUNT MAKE A 1:20 DILUTION BY PLACING 25 UL OF BLOOD IN -UL OF WBC DILUTING FLUID

475UL

MANUAL WBC COUNT ALLOW DILUTION TO SIT FOR - TO ENSURE RBC HAVE LYSED SOLUTION WILL TURN (-COLOR)

10MINS, CLEAR

MANUAL WBC COUNT CHARGE SIDES OF HEMACYTOMETER AT A -DEGREE ANGLE

MANUAL WBC COUNT AFTER CHARGING, PLACE IN CHAMBER FOR - TO SETTLE

10MINS

THE - ARE COUNTED AS WBCS BC THEY ARE INDISTINGUISHABLE WHEN SEEN IN HEMACYTOMETER

NRBCS

WBC SHOULD BE CORRECTED WHEN NRBCS ARE ADULT: - NRBC PER 100 WBC

WBC SHOULD BE CORRECTED WHEN NRBCS ARE NEWBORN: - NRBC PER 100 WBC

>10

CORRECTED WBC COUNT FORMULA

UWBCC X 100/ NRBCS + 100

WBC DIFFERENTIAL COUNT FOR ROUTINE TESTING, - SMEAR IS THE MOST WIDELY USED

WEDGE SMEAR

WBC DIFFERENTIAL COUNT SCANNING / COUNTING METHODS WBCS ARE COUNTED IN CONSECUTIVE FIELDS AS THE BLOOD FILM IS MOBED FROM SIDE TO SIDE

CROSS SECTIONAL/ CRENELLATION

WBC DIFFERENTIAL COUNT SCANNING / COUNTING METHODS WBCS ARE COUNTED IN CONSECUTIVE FIELDS FROM TAIL TOWARD THE HEAD OF THE SMEAR

LONGITUDINAL

WBC DIFFERENTIAL COUNT SCANNING / COUNTING METHODS BEGGINING NEAR THE TAIL ON A HORIZONTAL EDGE

BATTLEMENT/TRACK/BACK AND FORTH SERPENTINE

WBC DIFFERENTIAL COUNT SCANNING / COUNTING METHODS MOST PREFERRED COUNTING METHOD

BATTLEMENT/TRACK/BACK AND FORTH SERPENTINE

WBC DIFFERENTIAL COUNT - DIFFERENTIAL COUNT IF PX WBC COUNT IS <1.0X10^9/L MULTIPLY RESULTS BY 2

WBC DIFFERENTIAL COUNT - DIFFERENTIAL COUNT ROUTINELY USED

100

WBC DIFFERENTIAL COUNT - DIFFERENTIAL COUNT OVER 10% EOSINOPHILS OVER 2% BASOPHILS OVER 11% MONOCYTES MORE LYMPO THAN NEUTRO EXCEPT IN CHILDREN

200

WBC DIFFERENTIAL COUNT - DIFFERENTIAL COUNT WHEN WBC COUNT IS HIGHER THAN 40X10^9/L

200

WBC DIFFERENTIAL COUNT - DIFFERENTIAL COUNT WHEN WBC COUNT IS >100X10^9/L

300-400

WBC DIFFERENTIAL COUNT NEUTROPHILS RELATIVE COUNT: -

50-70 1.7-7.5

WBC DIFFERENTIAL COUNT LYMPHOCYTES RELATIVE COUNT: -

18-42% 1.0-3.2

WBC DIFFERENTIAL COUNT MONOCYTES RELATIVE COUNT: -

2-11% 0.1-1.3

WBC DIFFERENTIAL COUNT EOSINOPHILS RELATIVE COUNT: -

1-3% 0-0.3

WBC DIFFERENTIAL COUNT BASOPHILS RELATIVE COUNT: -

0-2% 0-0.2

WBC DIFFERENTIAL COUNT TOTAL WHITE CELL COUNT ESTIMATION 4000-7000 WBC/UL

2-5 WBC/HPF

WBC DIFFERENTIAL COUNT TOTAL WHITE CELL COUNT ESTIMATION 7000-10000 WBC/UL

4-6 WBC/HPF

WBC DIFFERENTIAL COUNT TOTAL WHITE CELL COUNT ESTIMATION 10000-13000 WBC/UL

6-10 WBC/HPF

WBC DIFFERENTIAL COUNT TOTAL WHITE CELL COUNT ESTIMATION 13000-18000 WBC/UL

10-20 WBC/HPF

WBC DIFFERENTIAL COUNT TOTAL WHITE CELL COUNT ESTIMATION WBC PER FIELD X - IF USING HPO

2,000

WBC DIFFERENTIAL COUNT TOTAL WHITE CELL COUNT ESTIMATION WBC PER FIELD X - IF USING OIO

3,000

WBC DIFFERENTIAL COUNT PRESENCE OF IMMATURE GRANULOCYTIC CELLS LEUKEMIA, BACTERIAL INFX SHIFT TO THE -

LEFT

LIST OF SOME CONDITIONS ASSOCIATED WITH SPECIFIC INCREASE OF WBC -APPENDICITIS -BACTERIAL INFX -PANCREATITIS

NEUTROPHILIA

LIST OF SOME CONDITIONS ASSOCIATED WITH SPECIFIC INCREASE OF WBC -VIRAL INFX -INFECTIOUS MONONUCLEOSIS

LYMPHOCYTOSIS

LIST OF SOME CONDITIONS ASSOCIATED WITH SPECIFIC INCREASE OF WBC -THYPOID -RICKETSSIAL INFX -GAUCHERS

MONOCYTOSIS

LIST OF SOME CONDITIONS ASSOCIATED WITH SPECIFIC INCREASE OF WBC -ALLERGIES -PARASITIC INFX

EOSINOPHILIA

LIST OF SOME CONDITIONS ASSOCIATED WITH SPECIFIC INCREASE OF WBC -ALLERGIC REACTION -TYPE 1 HYPERSENSITIVITY

BASOPHILIA

HEMOGLOBIN DETERMINATION THE - METHOD FOR HGB DETERMINATION IS THE REFERENCE METHOD

CYANMETHEMOGLOBIN

TEST USED TO DIAGNOSE AND FOLLOW TREATMENT OF ANEMIA VARIES WITH 1. AGE 2. SEX

HGB DETERMINATION

HEMOGLOBIN DETERMINATION NORMAL VALUES: WOMEN: -

12-15 g/dL

HEMOGLOBIN DETERMINATION NORMAL VALUES: MEN: -

13.5-18 g/dL

HGB IS HIGHER IN THE - AND LOWER IN THE -

HIGH- MORNING LOW-EVENING

HEMOGLOBIN DETERMINATION - HGB STRENOUS MUSCULAR ACTIVITY SMOKER HIGH ALTITUDE

INCREASED

HEMOGLOBIN DETERMINATION - HGB ANEMIA AFTER 50 YRS OF AGE LYING DOWN DEHYDRATION

DECREASED

HEMOGLOBIN DETERMINATION COLORIMETRIC METHODS: USES HCL

ACID HEMATIN, DIRECT VISUAL

HEMOGLOBIN DETERMINATION COLORIMETRIC METHODS: USES NaOH

ALKALI HEMATIN, DIRECT VISUAL

HEMOGLOBIN DETERMINATION COLORIMETRIC METHODS: ACID HEMATIN HGB TURNS TO - HEMATIN

BROWN COLORED

HEMOGLOBIN DETERMINATION COLORIMETRIC METHODS: ACID HEMATIN ACID HEMATIIN + DW MATCH COLOR

YELLOW-BROWN

HEMOGLOBIN DETERMINATION COLORIMETRIC METHODS: MOST RELIABLE AND RECOMMENDED METHOD FOR HGB

CYANMETHEMOGLOBIN, INDIRECT/PHOTOELECTRIC

HEMOGLOBIN DETERMINATION COLORIMETRIC METHODS: CYANMETHEMOGLOBIN USES - REAGENT

DRABKIN

HEMOGLOBIN DETERMINATION COLORIMETRIC METHODS: CYANMETHEMOGLOBIN COLOR INTENSITY: -

540 NM

HEMOGLOBIN DETERMINATION COLORIMETRIC METHODS: CYANMETHEMOGLOBIN ALL CAN BE MEASURED EXCEPT FOR - HEMOGLOBIN

SULFHEMOGLOBIN

HEMOGLOBIN DETERMINATION COLORIMETRIC METHODS: CYANMETHEMOGLOBIN OVERANTICOAGULATION - RESULTS

DOES NOT EFFECT

HEMOGLOBIN DETERMINATION COLORIMETRIC METHODS: CYANMETHEMOGLOBIN TURBIDITY WILL CAUSE - RESULTS

FALSELY ELEVATED

HEMOGLOBIN DETERMINATION COLORIMETRIC METHODS: CYANMETHEMOGLOBIN converts Hemoglobin (w/ ferrous iron) to methemoglobin

POTASSIUM FERRICYANIDE

HEMOGLOBIN DETERMINATION COLORIMETRIC METHODS: CYANMETHEMOGLOBIN converts methemoglobin to cyanmethemoglobin

POTASSIUM CYANIDE

HEMOGLOBIN DETERMINATION COLORIMETRIC METHODS: CYANMETHEMOGLOBIN improves lysis of RBC and decrease turbidity

NON IONIC DETERGENT

HEMOGLOBIN DETERMINATION COLORIMETRIC METHODS: CYANMETHEMOGLOBIN allows the solution to be read after 3 minutes

DIHYDROGEN POTASSIUM PHOSPHATE

HEMOGLOBIN DETERMINATION SPECTROPHOTOMETER: 540NM SET -% TRANSMITTANCE

100%

HEMOGLOBIN DETERMINATION DILUTION

1:251

HEMOGLOBIN DETERMINATION STANDARD HGB CURVE HEMOGLOBIN VALUE (G/DL)

X-AXIS ABSCISSA

HEMOGLOBIN DETERMINATION STANDARD HGB CURVE OPTICAL DENSITY (ABSORBANCE)

Y-AXIS ORDINATE

HEMOGLOBIN DETERMINATION TURBIDITY=FALSELY ELEVATED DUE TO

HIGHER ABSORBANCE

HEMOGLOBIN DETERMINATION REMEDY: Centrifuge then read the absorbance of supernatant

High WBC count (>20x109 /L) High platelet count (>700 x109 /L)

HEMOGLOBIN DETERMINATION REMEDY: make a 1:1 dilution with distilled water then multiply result by 2

Presence of Hb S or Hb C

HEMOGLOBIN DETERMINATION REMEDY: Use patient blank (0.01ml patient plasma + 5ml Drabkin’s reagent)

Lipemic sample

HEMOGLOBIN DETERMINATION REMEDY: Increase alkalinity of the hemiglobincyanide reagent by adding potassium carbonate then repeat determination.

Abnormal globulins

HEMOGLOBIN DETERMINATION If the drop sinks, its SG - that of copper sulfate

EQUAL/EXCEEDS

HEMOGLOBIN DETERMINATION If the drop rises, its SG - that of copper sulfate

LESS

HEMOGLOBIN DETERMINATION SPECIFIC GRAVITY OF COPPER SULFATE

1.053

HEMOGLOBIN DETERMINATION ACCEPTABLE DROP OF BLOOD WILL SINK WITHIN 15SEC IF HB CONC IS -

>12.5 G/DL

HEMOGLOBIN DETERMINATION -METHOD VAN SLYKE OXYGEN CAPACITY METHOD

GASOMETRIC METHOD

HEMOGLOBIN DETERMINATION -METHOD KENNEDY’S , WONG’S

CHEMICAL METHOD for IRON CONTENT

HEMOGLOBIN DETERMINATION 1 G OF HGB= -OXYGEN

1.34 ML

HEMOGLOBIN DETERMINATION 1 G OF HGB= -IRON

3.47 MG

- IS ABOUT 3X OF HGB VALUE

HEMATOCRIT

APPLIES ONLY ON NORMOCYTIC NORMOCHROMIC RBCS DISCREPANCY= FIRST INDICATION OF ERROR

RULE OF THREE

RULE OF THREE HCT

HGB X 3

RULE OF THREE HGB

RBC X 3

HCT/PCV REPORTED AS -

36% OR 0.36 L/L

HEMATOCRIT DETERMINATION ADULT MALES:

CU: 40-54% SI: 0.40-0.54 L/L

HEMATOCRIT DETERMINATION ADULT FEMALES:

CU: 35-49% SI: 0.35-0.49 L/L

HEMATOCRIT DETERMINATION NEWBORN

CU: 53-65% SI: 0.53 TO 0.65 L/L

HEMATOCRIT DETERMINATION -HCT ANEMIA HEMODILUTION

DECREASED

HEMATOCRIT DETERMINATION - HCT POLYCYTHEMIA HEMOCONCETRATION

INCREASED

HEMATOCRIT DETERMINATION DIRECT METHOD (MACROMETHOD) METHOD: WINTROBE AND LANDSBERG ANTICOAGULANT: -

DOUBLE OXALATE

HEMATOCRIT DETERMINATION DIRECT METHOD (MACROMETHOD) METHOD: VAN ALLEN, HADEN, SANFORD ANTICOAGULANT: -

SODIUM OXALATE

HEMATOCRIT DETERMINATION DIRECT METHOD (MACROMETHOD) METHOD: BRAY ANTICOAGULANT: -

HEPARIN

HEMATOCRIT DETERMINATION DIRECT METHOD (MACROMETHOD) SPEED OF CENTRIFUGATION

2000-2300G FOR 30MINS

HEMATOCRIT DETERMINATION DIRECT METHOD (MACROMETHOD) WINTROBE TUBE: RED USED FOR - - AT TOP

ESR, 0 AT TOP

HEMATOCRIT DETERMINATION DIRECT METHOD (MACROMETHOD) WINTROBE TUBE: WHITE USED FOR - - AT TOP

HEMATOCRIT, 10 AT TOP

HEMATOCRIT DETERMINATION DIRECT METHOD (MACROMETHOD) WINTROBE TUBE LENGTH: -

11.5 CM/115MM

HEMATOCRIT DETERMINATION DIRECT METHOD (MACROMETHOD) WINTROBE TUBE BORE: -

3.0 MM

HEMATOCRIT DETERMINATION DIRECT METHOD : - SPX WHOLE BLOOD USING K2 EDTA OR CAPILLARY BLOOD

ADAM

HEMATOCRIT DETERMINATION DIRECT METHOD: ADAM - THOUGHT TO CAUSE 2-3% DECREASE IN HCT

K3 EDTA

HEMATOCRIT DETERMINATION CAPILLARY TUBE/MICROHEMATOCRIT TUBE LENGTH: -

7-7.5CM 70-75MM

HEMATOCRIT DETERMINATION CAPILLARY TUBE/MICROHEMATOCRIT TUBE BORE

1-1.2MM IN DIAMETER

HEMATOCRIT DETERMINATION CAPILLARY TUBE/MICROHEMATOCRIT TUBE CAN HOLF UP TO - OF BLOOD

0.05ML

HEMATOCRIT DETERMINATION CAPILLARY TUBE/MICROHEMATOCRIT TUBE PLUG: -

4-6MM

HEMATOCRIT DETERMINATION CAPILLARY TUBE/MICROHEMATOCRIT TUBE TYPE WITH - BAND= WITH ANTICOAGULANT HEPARIN

RED

HEMATOCRIT DETERMINATION CAPILLARY TUBE/MICROHEMATOCRIT TUBE TYPE WITH - BAND= WITHOUT ANTICOAGULANT

BLUE

HEMATOCRIT DETERMINATION CAPILLARY TUBE/MICROHEMATOCRIT TUBE CENTRIFUGE FOR - AT RCF 10,000-15,000XG

5 MINUTES

HEMATOCRIT DETERMINATION CAPILLARY TUBE/MICROHEMATOCRIT TUBE CENTRIFUGE FOR 5 MINS AT RCF -

10,000-15,000 XG

HEMATOCRIT DETERMINATION CAPILLARY TUBE/MICROHEMATOCRIT TUBE AFTER CENTRIFUGATION HCT MUST BE READ WITHIN -

10MINS

LAYERS OF SPUN HEMATOCRIT Normall, layer is barely visible In the presence of lipidemia, layer several mm thick

TOP LAYER FATTY LAYER

LAYERS OF SPUN HEMATOCRIT Normally pale yellow and fairly clear Excessive hemolysis results in cherry red color Jaundice produces a deep yellow color

SECOND LAYER PLASMA

LAYERS OF SPUN HEMATOCRIT Normally less than 1 mm thick Thick layer when white cell count exceeds 10,000 cu/mm Packed platelets are found in upper part layer

THIRD LAYER BUFFY COAT

LAYERS OF SPUN HEMATOCRIT Volume (packed) is read as hematocrit

FOURTH LAYER PACKED RED CELL

ERRORS IN MICROHEMATOCRIT RESULTS FALSE - HCT HEMOCONCENTRATION DEHYDRATION INSUFFICIENT CENTRIFUGATION TIME BUFFY COAT IS READ ALLOWING TUBE TO STAND LONGER

FALSE INCREASE

HEMATOCRIT DETERMINATION TRAPPED PLASMA MAY CAUSE HCT TO FALSELY INCREASE AS MUCH AS -%

1-3%

THESE ARE CALCULATED TO DETERMINE AVERAGE VOLUME AND HGB CONTENT AND CONCENTRATION OF RBC IN SAMPLE

RBC INDICES

SERVES AS QUALITY CONTROL CHECK USED FOR INITIAL CLASSIFICATION OF ANEMIA

RBC INDICES

RBC/ WINTROBE INDICES 32-36 G/DL

NORMOCHROMIC

RBC/ WINTROBE INDICES <32

HYPOCHROMIC

RBC/ WINTROBE INDICES >36

HYPERCHROMIC

RBC/ WINTROBE INDICES AN MCHC BETWEEN 36-38 G/DL SHOULD BE CHECKED FOR -

SPHEROCYTES

RBC/ WINTROBE INDICES MCHC >38 CAUSED BY -

COLD AGGLUTININ

RBC/ WINTROBE INDICES MCHC >38= COLD AGGLUTININ INCUBATE SPX AT

37C, 15MINS

RBC/ WINTROBE INDICES MCV: <80 MCHC: <32

MICROCYTIC, HYPOCHROMIC

RBC/ WINTROBE INDICES MCV: 80-100 MCHC: 32-36

NORMOCYTIC, NORMOCHROMIC

RBC/ WINTROBE INDICES MCV: >100 MCHC: 32-36

MACROCYTIC, NORMOCHROMIC