(P) Horiba Pentra ES 60 Main Discussion Flashcards
1
Q
A
PENTRA ES 60
2
Q
T OR F
PENTRA ES 60 is a 5-differential hematology analyzer BUT may be a 7-differential hematology analyzer
A
T
3
Q
- Version of PENTRA ES 60 with open tube, old model
A
ABX Pentra 60
4
Q
- Version of Pentra 60 with closed tube and dedicated workstation
A
ABX Pentra 60C+
5
Q
Throughput of PENTRA ES 60
A
60 samples/hour
6
Q
Reagent compartment of PENTA ES 60 contains how many onboard reagents and how many diluent?
A
Onboard reagents: 4
Diluent 1:
7
Q
T or F
PENTA ES 60 has 26 parameters
A
T
8
Q
PENTA ES 60 has perfect differentiation of the 5 WBC sub-populations with?
what technology
A
Double
Hydrodynamic Sequential System Technology
9
Q
T or F
- aside from the 5 WBC (lymphocyte, monocyte, neutrophils, eosinophils, and basophils), atypical lymphocytes and large immature cells are also quantified
- 3 histograms for RBC, BAS/WBC, and PLT together with the 5 DIFF Matrix.
A
T
10
Q
T or F
In PENTRA ES 60 basophils are counted in the same channel where the other WBC reside
A
F (counted in a specific channel)
11
Q
High resolution matrix includes the determination of 2 additional subpopulations (% and #) which are?
A
Atypical lymphocytes and Large immature cells
12
Q
What does ES mean in PENTA ES 60?
A
Extended software
13
Q
Memory of PENTA ES 60?
A
10,000 results + graph
14
Q
T or F
PENTA ES 60 is a compact benchtop system
A
T
15
Q
- Small volumes
- Has barcodes to reflect the batch number and expiry date
- Waste level sensor
- Lysing agent is Cyanide free lyse
- Reagent level control
- Logs: to know when the reagents were installed
- Includes four internal and one external reagent
A
Reagents
16
Q
Reagents
T or F
Reagents come in large volumes and has barcodes to reflect the batch no. and expiry date
A
F (they come in small volumes)
17
Q
Reagents
What are the 4 internal reagents - located in the compartment
A
■ ABX Cleaner (1L)
■ ABX Eosinofix (1L)
■ ABX Basolyse I| (1L)
■ ABX Lysebio (0.4 L)
18
Q
What is the 1 external reagent?
A
■ ABX Diluent (10L or 20L)
19
Q
CBC mode has how many parameters?
A
12 parameters
20
Q
5 Differential mode has how many parameters?
A
26 parameters
Includes 5 WBC sub-populations, atypical lymphocytes, and large immature cells
21
Q
T or F
Reagents in PENTA ES 60 contains waste elvel sensor, and reagent level sensor
A
T
22
Q
What is the lysing agent used in PENTA ES 60?
A
Cyanide free lyse
23
Q
Sample used in PENTA ES 60
A
Whole Blood
24
Q
Requried amount of blood:
CBC: ?
CBC + DIFF: ?
A
CBC: 30 uL
CBC + DIFF: 53 uL
25
T or F
It is advantageous for pediatric and geriatric patients, given the
small amount of blood needed for sampling
T
26
* Horiba Medical Patent
* The five chambers make it more reliable in releasing test results
* Ideal for pediatric, oncology, or geriatric sample types or whenever a small sample volume is required
* The remaining volume may be used for additional analysis, such as sedimentation rate, smear, etc.
* It will avoid puncturing the patient again
* Blood split into precise aliquots
* Aliquots are attributed directly into pre-heated analysis chambers with a synchronized tangential flow of diluent for appropriate dilutions without a viscosity problem
Multi-Distribution Sampling System (MDSS™)
27
# Multi-Distribution Sampling System (MDSS™)
Familiarize the 5 chambers
* Raising chamber
* Hemoglobin chamber
* LMNE chamber
* RBC-platelet chamber
* WBC-Basophil chamber
27
28
# Multi-Distribution Sampling System (MDSS™)
T or F
The five chambers make it more reliable in
releasing test results
T
29
# Multi-Distribution Sampling System (MDSS™)
* What may be used for additional analysis, such as sedimentation rate, smear, etc.
* It will avoid puncturing the patient again
Remaining volume
30
# Multi-Distribution Sampling System (MDSS™)
(1) Blood is split into?
precise aliquots
31
Aliquots are attributed directly into?
pre-heated analysis chambers
## Footnote
with a synchronized tangential flow of diluent for appropriate dilutions without a viscosity problem
32
T or F
Multi-Distribution Sampling System (MDSS™) provides perfect mizing and homogenization of blood with reagents but has viscosity problem
F (without viscosity problem)
## Footnote
this is because there are pre-heated analysis chambers with sychroznies tangential flow of diluent
33
T or F
PPENTRA ES 60 contains sampling shear-vavle to distribute samples in appropriate chambers
F (NO sampling shear-valve)
| No sampling shear-valve = no maintenance = no clogging
34
# RELIABLE RESULTS WITH PROVEN TECHNOLOGIES
Familiarize the technologies that PENTRA ES 60 employs
* RBC AND PLATELET COUNT: Electronic Impedance Variation Principle
* HGB MEASUREMENT: Spectrophotometry
* RBC INDICES: Calculation
* WBC AND DIFFERENTIAL COUNT: WBC/BAS count chamber, Optical Chamber
35
# RELIABLE RESULTS WITH PROVEN TECHNOLOGIES
* RBC AND PLATELET COUNT principle
* The sample is diluted in the chamber with **ABX DILUENT reagent** (current-conducting), mixed, and then pushed into a calibrated aperture.
* **Two electrodes** are placed on either side of the aperture and electric current continuously passes between the two electrodes.
* The pulses are amplified, channeled according to volume and threshold, grouped, and then mathematically calculated along with the calibration coefficients to give a final numerical value
| RBC AND PLATELET COUNT
Electronic Impedance Variation Principle
(EIV)
36
# RELIABLE RESULTS WITH PROVEN TECHNOLOGIES
is responsible for charging the cells
electrically
| RBC AND PLATELET COUNT principle: EIV principle
ABX diluent
37
# RELIABLE RESULTS WITH PROVEN TECHNOLOGIES
are placed on either side of the aperture and electric current continuously passes between them
| RBC AND PLATELET COUNT principle: EIV principle
Two electrodes
38
# RELIABLE RESULTS WITH PROVEN TECHNOLOGIES
Where electricity flows through. The cells passing through will be avoided by the
electricity.
| RBC AND PLATELET COUNT principle: EIV principle
Aperture
39
# RELIABLE RESULTS WITH PROVEN TECHNOLOGIES
As the cells pass through the aperture, they create (blank) in the electronic field between the two electrodes.
| RBC AND PLATELET COUNT principle: EIV principle
resistance (impedance)
40
# RELIABLE RESULTS WITH PROVEN TECHNOLOGIES
In terms of voltage:
The larger the cell = ?
The smaller the cell = ?
| RBC AND PLATELET COUNT principle: EIV principle
The larger the cell = the more resistance
The smaller the cell = the less resistance
41
# RELIABLE RESULTS WITH PROVEN TECHNOLOGIES
The pulses are amplified, channeled according to volume and threshold, grouped, and then are ?
| RBC AND PLATELET COUNT principle: EIV principle
mathematically calculated
## Footnote
with the calibration coefficients to give a final numerical value
42
# RELIABLE RESULTS WITH PROVEN TECHNOLOGIES
HGB MEASUREMENT principle
Spectrophotometry
43
# RELIABLE RESULTS WITH PROVEN TECHNOLOGIES
The newest developed reagent for RBC lysis and determination of hemoglobin.
| HGB MEASUREMENT: SPECTROPHOTOMETRY
ABX Lysebio: cyanide-free
44
# RELIABLE RESULTS WITH PROVEN TECHNOLOGIES
Which of the following is false regarding HGB MEASAUREMENT in horiba pentra es 60?
a. Does not contain cyanide
b. Could be thrown in regular waste (depends on national regulations)
c. both
d. neither
| HGB MEASUREMENT: SPECTROPHOTOMETRY
d. neither
45
# RELIABLE RESULTS WITH PROVEN TECHNOLOGIES
Familiarize the steps in HGB measurement
| HGB MEASUREMENT: SPECTROPHOTOMETRY
(1) By action of lysis agent contained in the reagent, hemoglobin is released.
(2) All the heme iron is oxidized and stabilized.
(3) Oxidation resulting complexes are measured through the
optical part of the first dilution chamber by spectrophotometry at a wavelength of 550nm.
(4) Result = Absorbency value x coef. of calibration.
46
# RELIABLE RESULTS WITH PROVEN TECHNOLOGIES
Rearrange the steps of measurement of hbg of pentra es 60
a. Oxidation resulting complexes are measured through the optical part of the first dilution chamber by spectrophotometry at a wavelength of 550nm.
b. By action of lysis agent contained in the reagent, hemoglobin is released.
c. All the heme iron is oxidized and stabilized.
d. Result = Absorbency value x coef. of calibration.
| HGB MEASUREMENT: SPECTROPHOTOMETRY
B, C, A, D
47
# RELIABLE RESULTS WITH PROVEN TECHNOLOGIES
Wavelength of spectrophotometry in HGB MEASUREMENT
| HGB MEASUREMENT: SPECTROPHOTOMETRY
* 550 nm
48
# RELIABLE RESULTS WITH PROVEN TECHNOLOGIES
Principle for RDW, MCV, MCH, MCHC, MPV, PCT, PDW
| RBC INDICES
Calculation
49
# RELIABLE RESULTS WITH PROVEN TECHNOLOGIES
Principle for HCT
| RBC INDICES
Numeric Integration
50
# RELIABLE RESULTS WITH PROVEN TECHNOLOGIES
Identify what specific RBC indices
* calculation from the RBC histogram
* Erythrocyte abnormalities linked to Anisocytosis.
* Formula: (K X SD) / MCV
| RBC INDICES
RDW
51
# RELIABLE RESULTS WITH PROVEN TECHNOLOGIES
Identify what specific RBC indices
1. is directly calculated from the RBC histogram
2. HGB/HCT x 100 (g/dl)
3. HGB/RBC × 10 (in picogram)
a. MCV
b. MCH
c. MCHC
| RBC INDICES
1. A
2. C
3. B
52
# RELIABLE RESULTS WITH PROVEN TECHNOLOGIES
Identify what specific RBC indices
1. PLT (103 / mm3) x MPV (um3) / 10000
2. directly calculated from the PLT histogram
3. directly derived from the analysis of the platelet distribution curve
4. numeric integration of the MCV
a. PCT
b. PDW
c. MPV
d. HCT
| RBC INDICES
1. A
2. B
3. C
4. D
53
# RELIABLE RESULTS WITH PROVEN TECHNOLOGIES
* Principle of WBC/BAS COUNT
* cells enter the aperture where the electricity flows
* The size of the cell is directly proportional to the electricity's impedance (or resistance)
* use of ABX BASOLYSE II
| WBC/BAS COUNT
Electronic Impedance Variation Principle
54
# RELIABLE RESULTS WITH PROVEN TECHNOLOGIES
Reagent used in this technology which differentiated the BASOPHIL from the other WBCS
| WBC/BAS COUNT: EIV principle
ABX BASOLYSE Il
55
# RELIABLE RESULTS WITH PROVEN TECHNOLOGIES
Identify appropriate threshold
1. The nucleus of WBC populations
is counted
2. BAS are counted between this
a. electronic thresholds < BA2 > and
< ВА3 >
b. electric thresholds from 0 < BA 2>
| WBC/BAS COUNT: EIV principle
1. B
2. A
56
# RELIABLE RESULTS WITH PROVEN TECHNOLOGIES
WBC formula
| WBC/BAS COUNT: EIV principle
WBC = Number of cells counted within a specified time per
volume x WBC calibration coefficient.
57
# RELIABLE RESULTS WITH PROVEN TECHNOLOGIES
BAS formula
| WBC/BAS COUNT: EIV principle
BAS = Number of cells counted within a specified amount of
time per volume x WBC calibration coefficient in a percentage
as the total number of leukocytes (BAS and WBC nuclei)
58
# RELIABLE RESULTS WITH PROVEN TECHNOLOGIES
Familiarize the steps in LMNE count
| LMNE COUNT
1. Cytochemistry
2. Flow Cytometry
3. Results displayed in LMNE matrix
59
# RELIABLE RESULTS WITH PROVEN TECHNOLOGIES
Familiarize the steps thata re included in (1) Cytochemistry portion of LMNE ocunting
| LMNE count
1. 25 ul of whole blood is delivered into the LMNE chamber in a tangential flow of the reagent ABX Eosinoflix
2. Whole blood sample is incubated at a regulated temperature with ABX Eosinofix for 12 seconds
3. Sample is diluted in a current conductor diluen
60
# RELIABLE RESULTS WITH PROVEN TECHNOLOGIES
(1) Cytochemistry
* Volume of blood delivered into LMNE chamber
| LMNE count
25 uL of whole blood
61
# RELIABLE RESULTS WITH PROVEN TECHNOLOGIES
(1) Cytochemistry
1st step:
* Reagent used in cytochemistry
* staining reagent that stains the
**granulocytes using chlorazol black** (differentiates the granulocytes and agranulocytes)
| LMNE count
ABX Eosinoflix
62
# RELIABLE RESULTS WITH PROVEN TECHNOLOGIES
(1) Cytochemistry
2nd step:
* The whole blood sample is incubated at a regulated temperature
with ABX Eosinofix for how many seconds?
| LMNE count
12 seconds
## Footnote
* lyses rbc
* stains eos, granules, nuclei with chorazol black
* stabilizes wbc in original state
63
# RELIABLE RESULTS WITH PROVEN TECHNOLOGIES
(1) Cytochemistry
Which of the following are is/true about 2nd step in cytochemistry in terms of its incubation with ABX esoinoflix?
a. Lyses rbc
b. Stains eosin, cytoplasm, granules, and nuclei with agent: Brilliant Cresyl Blue
c. Stabilize RBCS in original state: 48 hours post draw stability
d. ALL
e. None
f. a and b
g. b and c
| LMNE count
a. Lyses rbc
## Footnote
B - stained with **chorazol black**
C - stabilizes **RBCS**
64
# RELIABLE RESULTS WITH PROVEN TECHNOLOGIES
(1)
3rd step:
Cytochemistry
After incubation, teh sample is diluted in?
| LMNE count
current conductor diluent
65
# RELIABLE RESULTS WITH PROVEN TECHNOLOGIES
(2) Flow Cytometry
* The prespared sample is injected through the flow cytometer?
| LMNE count
## Footnote
what specific system
DHSSTM (Double Hydrodynamic Sequential System)
66
# RELIABLE RESULTS WITH PROVEN TECHNOLOGIES
(2) Flow Cytometry
Identify if First or Second entry
* Cell volume measurement
* The dilution is aspirated through a calibrated aperture
* Two electrodes are placed on each side of the aperture
* Electric current passes through the electrodes
continuously
* When a cell passes through the aperture, electric resistance (or impedance) between the two electrodes increases proportionately with cell volume
* Related to cell volume and size
| LMNE count
First entry
67
# RELIABLE RESULTS WITH PROVEN TECHNOLOGIES
(2) Flow Cytometry
Identify if First or Second entry
* Analysis of the internal cellular structure by measuring the light absorbency of cells
* Related to absorbance and granularity of the WBCs
| LMNE count
Second entry
68
# RELIABLE RESULTS WITH PROVEN TECHNOLOGIES
(3) Results displayed in LMNE matrix
* LMNE matrix is obtained from?
| dalawa to
## Footnote
LMNE count
* IMPEDANCE measurement
* OPTICAL detection
69
# RELIABLE RESULTS WITH PROVEN TECHNOLOGIES
(3) Results displayed in LMNE matrix
Identify is X axis or Y axis
* Indicates a bigger sized cells
* Right side
* Monocytes are found here
| LMNE count
X axis
70
# RELIABLE RESULTS WITH PROVEN TECHNOLOGIES
(3) Results displayed in LMNE matrix
Identify is X axis or Y axis
* Related to the granularity of the cells
* Upper side
* Eosinophils are on upper side, Lymphocyte are at bottm
| LMNE count
Y axis
71
# RELIABLE RESULTS WITH PROVEN TECHNOLOGIES
(3) Results displayed in LMNE matrix
* What 4 subpopulations are perfectly separated because of the
high-definition system
| LMNE count
**L**ymphocyte, **M**onocytes, **N**eutrophils, **E**osinophils
72
# RELIABLE RESULTS WITH PROVEN TECHNOLOGIES
(3) Results displayed in LMNE matrix
* The quality of the resolution allows the counting of what 2 additional sub-populations
| LMNE count
* Large Immature Cells (LIC) - myelocytes, promyelocytes, large blasts.
* Atypical Lymphocytes (ALY) - large lymphocytes, activated
lymphocytes, and blasts.
73
# RELIABLE RESULTS WITH PROVEN TECHNOLOGIES
Familiarize the advanatges of the technologies involved in LMNE count
| LMNE count
1. A **sequential system** (timing device) is applied between 2 measurements
2. **48 hour** post-draw stability
3. **ALY** and **LIC** flags give information about these abnormal subpopulations and better diagnostics
4. The **compact optical chamber** and the **flow cell technology** guarantee the accuracy, stability, and repeatability of the results
74
# RELIABLE RESULTS WITH PROVEN TECHNOLOGIES
IF YOU see this card matulog ka na eme, paki aral nalang yung descriptions nang bawat advantages ng technologies ng lMNE counting slamat
| LMNE count
thanks
75
# Software overview
* Monitor the reagents content in percentage
* Shows the expiration date of the reagen
Reagent’s Management
76
# Software overview
Two views available in worklist are
a. list with one analysis by line; detailed view of field of healthcareworker
b. list with one analysis by line; detailed view of field of patient
c. both
d. neither
| WORKLIST
b. list with one analysis by line; detailed view of field of patient
77
# Software overview
Arrange the steps in running a sample
a. Enter run tab
b. Select one order. Click the order holding Ctrl key
c. Click the worklist tab
d. Remove the tube when the light indicator stops flashing
e. Plunge the sampling needle into the specimen tube and press the
start bar
1. C
2. B
3. A
4. E
5. D
78
# Software overview
Identify the paramteror tab? which includes:
* Patient file
* Morphology Flags CBC and DIFF results (histogram and matrix); (RBC, Platelet, WBC, LMNE matrix)
* Result status indicator
* Suspected Pathology comments
* Analyzer alarms
Results display
79
# Software overview
If you see this card, paki-aral yung printouts thanks
ok arigtao namicheoso na ko
80
# Software overview
* each printout includes a header in two lines that can be defined in the six header fields in the settings
| Printing Flexibility
HEADER
81
# Software overview
Identify Printing option based on action
* Automatically print results after each analysis cycle
| Printing flexibility: Printing options
Step-by-step printing
82
# Software overview
Identify Printing option based on action
* Print results on the blank cycles (cycle son diluent during
startup)
| Printing flexibility: Printing options
Printing Blank Results
83
# Software overview
Identify Printing option based on action
* Print all the results
| Printing flexibility: Printing options
Unconditional Printing
84
# Software overview
Identify Printing option based on action
* Print only results within normal ranges, with no alarm nor
analysis rejection.
| Printing flexibility: Printing options
Printing Normal
Results
85
# Software overview
Identify Printing option based on action
* Print only results within normal ranges, with no alarm nor
analysis rejection.
| Printing flexibility: Printing options
Printing Normal
Results
86
# Software overview
Identify Printing option based on action
* with default analysis
* with alarms
* out of normal values
* out of panic values
| Printing flexibility: Printing options
Printing Abnormal
Results
87
# Software overview
Identify Printing option based on action
* one or two printouts each time a result is printed out
| Printing flexibility: Printing options
Number of copies
88
# Software overview
Identify Printing option based on action
* To print normality ranges on patient results
* To print Raw Values
* To print Histogram and Matrix Thresholds
* To print pathological messages.
| Printing flexibility: Printing options
Enable
89
# Software overview
T or F
You search results for a known patient in current worklist or archived
worklists
T
90
# Software overview
2 info you need to know to search for patient results?
Patient no. or Sample ID
91
# Software overview
QUALITY CONTROL AND CALIBRATION involves what following factors
* Controls
* QC export
* Levey-jennings graph
* XB quality control
* Repeatability
* Calibration
92
# Software overview
The quality control results may be exported from the instruments
to a?
| QUALITY CONTROL AND CALIBRATION
floppy disk in CSV format
93
# Software overview
QC results are displayed in a?
spreadsheet
94
# Software overview
* Graphical representation of quality control data.
* Based on the daily value for each control parameter, its target
value and range are plotted on a graph for a periodic review.
| QUALITY CONTROL AND CALIBRATION
Levey-Jenning Graph
95
# Software overview
* detects any deviation in the quality of results using patient data only
* This data monitoring is based on a BULL method and can be applied to a set of 9 parameters and 3 parameters
| QUALITY CONTROL AND CALIBRATION
XB Patient Quality Control
96
# Software overview
* Based on results obtained from **consecutive analyses** of the same fresh human normal blood sample
* CBC or DIFF tests can be done with a limit of 35 results per test
* If the variation coefficient in % is outside the user's set limits, the
value’s background turns red
| QUALITY CONTROL AND CALIBRATION
REPEATABILITY
97
# Software overview
| QUALITY CONTROL AND CALIBRATION
