(P) Horiba Pentra ES 60 Main Discussion Flashcards
PENTRA ES 60
T OR F
PENTRA ES 60 is a 5-differential hematology analyzer BUT may be a 7-differential hematology analyzer
T
- Version of PENTRA ES 60 with open tube, old model
ABX Pentra 60
- Version of Pentra 60 with closed tube and dedicated workstation
ABX Pentra 60C+
Throughput of PENTRA ES 60
60 samples/hour
Reagent compartment of PENTA ES 60 contains how many onboard reagents and how many diluent?
Onboard reagents: 4
Diluent 1:
T or F
PENTA ES 60 has 26 parameters
T
PENTA ES 60 has perfect differentiation of the 5 WBC sub-populations with?
what technology
Double
Hydrodynamic Sequential System Technology
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.
T
T or F
In PENTRA ES 60 basophils are counted in the same channel where the other WBC reside
F (counted in a specific channel)
High resolution matrix includes the determination of 2 additional subpopulations (% and #) which are?
Atypical lymphocytes and Large immature cells
What does ES mean in PENTA ES 60?
Extended software
Memory of PENTA ES 60?
10,000 results + graph
T or F
PENTA ES 60 is a compact benchtop system
T
- 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
Reagents
Reagents
T or F
Reagents come in large volumes and has barcodes to reflect the batch no. and expiry date
F (they come in small volumes)
Reagents
What are the 4 internal reagents - located in the compartment
■ ABX Cleaner (1L)
■ ABX Eosinofix (1L)
■ ABX Basolyse I| (1L)
■ ABX Lysebio (0.4 L)
What is the 1 external reagent?
■ ABX Diluent (10L or 20L)
CBC mode has how many parameters?
12 parameters
5 Differential mode has how many parameters?
26 parameters
Includes 5 WBC sub-populations, atypical lymphocytes, and large immature cells
T or F
Reagents in PENTA ES 60 contains waste elvel sensor, and reagent level sensor
T
What is the lysing agent used in PENTA ES 60?
Cyanide free lyse
Sample used in PENTA ES 60
Whole Blood
Requried amount of blood:
CBC: ?
CBC + DIFF: ?
CBC: 30 uL
CBC + DIFF: 53 uL
T or F
It is advantageous for pediatric and geriatric patients, given the
small amount of blood needed for sampling
T
- 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™)
Multi-Distribution Sampling System (MDSS™)
Familiarize the 5 chambers
- Raising chamber
- Hemoglobin chamber
- LMNE chamber
- RBC-platelet chamber
- WBC-Basophil chamber
Multi-Distribution Sampling System (MDSS™)
T or F
The five chambers make it more reliable in
releasing test results
T
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
Multi-Distribution Sampling System (MDSS™)
(1) Blood is 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
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)
this is because there are pre-heated analysis chambers with sychroznies tangential flow of diluent
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
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
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- 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)
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is responsible for charging the cells
electrically
RBC AND PLATELET COUNT principle: EIV principle
ABX diluent
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are placed on either side of the aperture and electric current continuously passes between them
RBC AND PLATELET COUNT principle: EIV principle
Two electrodes
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Where electricity flows through. The cells passing through will be avoided by the
electricity.
RBC AND PLATELET COUNT principle: EIV principle
Aperture
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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)
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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
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The pulses are amplified, channeled according to volume and threshold, grouped, and then are ?
RBC AND PLATELET COUNT principle: EIV principle
mathematically calculated
with the calibration coefficients to give a final numerical value
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HGB MEASUREMENT principle
Spectrophotometry
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The newest developed reagent for RBC lysis and determination of hemoglobin.
HGB MEASUREMENT: SPECTROPHOTOMETRY
ABX Lysebio: cyanide-free
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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
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.
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
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Wavelength of spectrophotometry in HGB MEASUREMENT
HGB MEASUREMENT: SPECTROPHOTOMETRY
- 550 nm
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Principle for RDW, MCV, MCH, MCHC, MPV, PCT, PDW
RBC INDICES
Calculation
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Principle for HCT
RBC INDICES
Numeric Integration
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Identify what specific RBC indices
- calculation from the RBC histogram
- Erythrocyte abnormalities linked to Anisocytosis.
- Formula: (K X SD) / MCV
RBC INDICES
RDW
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Identify what specific RBC indices
- is directly calculated from the RBC histogram
- HGB/HCT x 100 (g/dl)
- HGB/RBC × 10 (in picogram)
a. MCV
b. MCH
c. MCHC
RBC INDICES
- A
- C
- B
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Identify what specific RBC indices
- PLT (103 / mm3) x MPV (um3) / 10000
- directly calculated from the PLT histogram
- directly derived from the analysis of the platelet distribution curve
- numeric integration of the MCV
a. PCT
b. PDW
c. MPV
d. HCT
RBC INDICES
- A
- B
- C
- D
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- 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
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Reagent used in this technology which differentiated the BASOPHIL from the other WBCS
WBC/BAS COUNT: EIV principle
ABX BASOLYSE Il
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Identify appropriate threshold
- The nucleus of WBC populations
is counted - BAS are counted between this
a. electronic thresholds < BA2 > and
< ВА3 >
b. electric thresholds from 0 < BA 2>
WBC/BAS COUNT: EIV principle
- B
- A
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WBC formula
WBC/BAS COUNT: EIV principle
WBC = Number of cells counted within a specified time per
volume x WBC calibration coefficient.
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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)
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Familiarize the steps in LMNE count
LMNE COUNT
- Cytochemistry
- Flow Cytometry
- Results displayed in LMNE matrix
RELIABLE RESULTS WITH PROVEN TECHNOLOGIES
Familiarize the steps thata re included in (1) Cytochemistry portion of LMNE ocunting
LMNE count
- 25 ul of whole blood is delivered into the LMNE chamber in a tangential flow of the reagent ABX Eosinoflix
- Whole blood sample is incubated at a regulated temperature with ABX Eosinofix for 12 seconds
- Sample is diluted in a current conductor diluen
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(1) Cytochemistry
- Volume of blood delivered into LMNE chamber
LMNE count
25 uL of whole blood
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(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
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(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
- lyses rbc
- stains eos, granules, nuclei with chorazol black
- stabilizes wbc in original state
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
B - stained with chorazol black
C - stabilizes RBCS
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(1)
3rd step:
Cytochemistry
After incubation, teh sample is diluted in?
LMNE count
current conductor diluent
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(2) Flow Cytometry
- The prespared sample is injected through the flow cytometer?
LMNE count
what specific system
DHSSTM (Double Hydrodynamic Sequential System)
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(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
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(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
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(3) Results displayed in LMNE matrix
- LMNE matrix is obtained from?
dalawa to
LMNE count
- IMPEDANCE measurement
- OPTICAL detection
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(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
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(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
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(3) Results displayed in LMNE matrix
- What 4 subpopulations are perfectly separated because of the
high-definition system
LMNE count
Lymphocyte, Monocytes, Neutrophils, Eosinophils
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(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.
RELIABLE RESULTS WITH PROVEN TECHNOLOGIES
Familiarize the advanatges of the technologies involved in LMNE count
LMNE count
- A sequential system (timing device) is applied between 2 measurements
- 48 hour post-draw stability
- ALY and LIC flags give information about these abnormal subpopulations and better diagnostics
- The compact optical chamber and the flow cell technology guarantee the accuracy, stability, and repeatability of the results
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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
Software overview
- Monitor the reagents content in percentage
- Shows the expiration date of the reagen
Reagent’s Management
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
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
- C
- B
- A
- E
- D
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
Software overview
If you see this card, paki-aral yung printouts thanks
ok arigtao namicheoso na ko
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
Software overview
Identify Printing option based on action
- Automatically print results after each analysis cycle
Printing flexibility: Printing options
Step-by-step printing
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
Software overview
Identify Printing option based on action
* Print all the results
Printing flexibility: Printing options
Unconditional Printing
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
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
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
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
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
Software overview
T or F
You search results for a known patient in current worklist or archived
worklists
T
Software overview
2 info you need to know to search for patient results?
Patient no. or Sample ID
Software overview
QUALITY CONTROL AND CALIBRATION involves what following factors
- Controls
- QC export
- Levey-jennings graph
- XB quality control
- Repeatability
- Calibration
Software overview
The quality control results may be exported from the instruments
to a?
QUALITY CONTROL AND CALIBRATION
floppy disk in CSV format
Software overview
QC results are displayed in a?
spreadsheet
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
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
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
Software overview
QUALITY CONTROL AND CALIBRATION