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HEMATOLOGY 1 > PBS > Flashcards

PBS Flashcards

1
Q

When should blood smears be made from EDTA blood?

A

Within 3 hours after collection

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2
Q

Advantages of EDTA blood smear

A

Multiple smears, delayed preparation, prevents platelet clumping

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3
Q

Disadvantages of EDTA blood smear

A

Platelet satellitism, EDTA-induced platelet clumping

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4
Q

What conditions can EDTA cause in PBS?

A

Pseudothrombocytopenia, pseudoleukocytosis

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5
Q

Correction for EDTA effects in PLT

A

Recollect using 3.2% Na Citrate, multiply platelet count by 1.1

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6
Q

Best specimen for evaluating cell morphology?

A

Anticoagulant-free blood

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7
Q

Advantages of anticoagulant-free blood

A

Prepared at patient’s side, prevents some artifacts

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8
Q

Disadvantages of anticoagulant-free blood

A

Platelet clumping (caused by glass), limited films can be made

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9
Q

Most frequently used blood film preparation method?

A

Two-glass slide method (Manual Wedge Technique)

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10
Q

What angle should be between the pusher and film slide?

A

30 - 45 degrees

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11
Q

Effect of too high angle of spreader?

A

Thicker smear

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12
Q

Effect of too low angle of spreader?

A

Thinner smear

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13
Q

Ideal size of blood drop for smear?

A

2-3mm

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14
Q

Effect of too large blood drop?

A

Thicker smear

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15
Q

Effect of too small blood drop?

A

Thinner smear

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16
Q

Distance from label when preparing smear?

A

1 cm away

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17
Q

Effect of too fast spreader speed?

A

Thicker smear

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18
Q

Effect of too slow spreader speed?

A

Thinner smear, poor WBC distribution

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19
Q

Effect of high hematocrit (Hct) correction in PBS?

A

Lower the angle (as low as 25 degrees)

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20
Q

Effect of low hematocrit (Hct) correction in PBS?

A

Raise the angle

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21
Q

How should the scanning method be done under microscope?

A

Longitudinal (tail to head) or battlement (back and forth serpentine)

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22
Q

What is the ideal transition of a blood smear from thick to thin area?

A

Gradual transition

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23
Q

How much of the film slide should the smear cover?

A

2/3 to 3/4 of the length of the film slide

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24
Q

What shape should the smear be?

A

Finger-shaped

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25
Q

What should be visible on the smear?

A

Lateral edges

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26
Q

What should the smear not have?

A

Irregularities, holes, or streaks

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27
Q

What appearance should the feather edge have?

A

Rainbow appearance

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28
Q

What problem occurs with Wedge method?

A

WBCs are unevenly distributed across the slide

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29
Q

Where are segmented neutrophils, monocytes, and eosinophils more visible?

A

In the feather edge and side edges

30
Q

Where are small lymphocytes more visible?

A

At the center of the film

31
Q

What is the purpose of blood smear staining?

A

Evaluation of cellular morphology

32
Q

What is the fixative used in blood smear staining?

A

Methanol

33
Q

What buffer solution is used for blood smear staining?

A

0.05 M NaPO4 at pH 6.4

34
Q

What is the pH range for blood smear staining?

A

6.4 to 6.8

35
Q

What is the commonly used stain for blood smears?

A

Wright/Wright Giemsa stain

36
Q

What is a Romanowsky-type stain?

A

A stain containing methylene blue and eosin B or eosin Y

37
Q

What is the function of methylene blue in staining?

A

It is a basic stain that colors the nucleus and some cytoplasmic structures blue or purple

38
Q

What structures are described as basophilic?

A

DNA or RNA

39
Q

What is the function of eosin in staining?

A

It is an acidic stain that colors cytoplasmic structures orange-red

40
Q

What structures are described as acidophilic?

A

Proteins with amino groups

41
Q

What are some examples of Romanowsky-based stains?

A

Wright stain, Giemsa stain, May-Grunwald stain

42
Q

What automated method for PBS does not require a power source?

A

CellaVision HemaPrep®

43
Q

What type of blood is used in centrifugal (spinner) type preparation?

A

0.2 mL of well-mixed anticoagulated blood

44
Q

What is a key advantage of the centrifugal (spinner) type method?

A

Even distribution of blood cells; consistent; fewer smudge cells

45
Q

Other types of automated methods for PBS preparation

A

Coulter LH, Sysmex SP-10

46
Q

Macroscopic characteristic of a well-stained blood smear

A

Pink to Purple

47
Q

RBC color in a well-stained blood smear

A

Orange to Salmon-pink

48
Q

WBC nuclei color in a well-stained blood smear

A

Purple-blue

49
Q

Neutrophil cytoplasm color in a well-stained blood smear

A

Pink to Tan (granules violet to lilac)

50
Q

Eosinophil granules color in a well-stained blood smear

A

Bright orange

51
Q

RBCs appearing gray or blue in smear

A

Staining buffer too basic, inadequate rinsing, heparinized blood used

52
Q

WBCs appearing too dark in smear

A

Staining buffer too basic, inadequate rinsing, heparinized blood used

53
Q

Eosinophil granules appearing gray in smear

A

Staining buffer too basic, inadequate rinsing, heparinized blood used

54
Q

RBCs appearing too pale or red in smear

A

Stain buffer too acidic, under buffering, over rinsing

55
Q

WBCs barely visible in smear

A

Stain buffer too acidic, under buffering, over rinsing

56
Q

Blood film appearing bluer than normal

A

Increased blood proteins (e.g., plasma cell myeloma)

57
Q

Grainy appearance on blood film

A

RBC agglutination (e.g., cold hemagglutinin disease)

58
Q

Holes in blood film

A

Increased lipid levels

59
Q

Blue specks at feather edge of blood film

A

Markedly increased WBC and platelet counts

60
Q

10x Objective Use in microscopic examination of PBS

A

Assess overall film quality, color, and cell distribution; locate rare abnormal WBCs; detect “snowplow” effect, fibrin strands, rouleaux formation, RBC agglutination, parasites; assess examination area

61
Q

Snowplow effect indication

A

More than four times the number of WBCs per field at the lateral edges or feather edge compared with the monolayer area

62
Q

Fibrin strands detection

A

Film should be rejected if present

63
Q

40x High-Dry or 50x Oil Immersion Objective Use

A

Examine areas where red cells have central pallor, are near each other but not overlapping; cells are appropriately stained; avoid feathered edge and thick part

64
Q

Feathered edge appearance under higher magnification

A

Red cells appear macrocytic, flattened, and lack central pallor; WBCs distorted

65
Q

Thick part appearance under higher magnification

A

Red cells appear microcytic and may form rouleaux

66
Q

Method for estimating total WBC count using 40x high-dry objective

A

Count leukocytes in 10 fields, find the average number of WBCs per field, then multiply by 2,000 to get estimated WBC count per μL

67
Q

Method for estimating total WBC count using 50x oil immersion objective

A

Count leukocytes in 10 fields, find the average number of WBCs per field, then multiply by 3,000 to get estimated WBC count per μL

68
Q

100x Oil Immersion Objective Use

A

Examine nuclear details of white blood cells; tabulate WBC differential; estimate platelet count

69
Q

RBC count per 100x OIF

A

200 to 250 RBCs per 100x OIF in normal smear

70
Q

Method for estimating platelet count using 100x oil immersion objective

A

Scan ten oil immersion fields, average platelets per field, multiply by 20,000 for estimated plt. ct. per μL

71
Q

Platelet estimate formula in significant anemia or erythrocytosis

A

Average number of platelets per field x total RBC count / 200

72
Q

Storage duration for blood smear slides

A

At least 7 days before proper disposal

HEMATOLOGY 1 (27 decks)

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