PERIPHERAL BLOOD SMEAR

Question 1

Blood smears should be made within__ hours after collection of EDTA blood

Answer 1

3

Question 2

Correction for pseudothrombocytopenia

Answer 2

Recollect blood specimen using 3.2% sodium citrate

Question 3

Platelets adhere on the surface of WBCs

Answer 3

Platelet satellitosis

Question 4

Correction for pseudothrombocytopenia

Answer 4

Recollect blood specimen using 3.2% sodium citrate

Question 5

Platelets form large clumps

Answer 5

EDTA-induced platelet clumping

Question 6

Correction for pseudoleukocytosis

Answer 6

Recollect blood specimen using 3.2% sodium citrate

Question 7

Conversion factor for correction when recollecting with 3.2% sodium citrate

Answer 7

1.1

Question 8

Best for evaluation of blood cell morphology

Answer 8

Anticoagulant-free blood

Question 9

Methods of blood film preparation:

Answer 9

Two-glass slide method
Coverslip technique
Automated methods

Question 10

Most frequently used method in blood film preparation

Answer 10

Two-glass slide method (manual wedge technique)

Question 11

Angle between the 2 slides in manual wedge technique

Answer 11

30 to 45 degrees

Question 12

Too high angle equals

Answer 12

Thicker smear

Question 13

Size of the drop of blood in manual wedge technique

Answer 13

2-3 mm

Question 14

Distance of the drop from the margin

Answer 14

1 cm

Question 15

Larger drop of blood equals

Answer 15

Thicker smear

Question 16

Faster speed of the spreader equals

Answer 16

Thicker smear

Question 17

If too high hematocrit

Answer 17

Angle should be lowered as low as 25 degrees

Question 18

If too low hematocrit

Answer 18

Angle should be raised

Question 19

Scanning methods

Answer 19

Longitudinal (tail to head)
Battlement (back and forth serpentine)

Question 20

Characteristis of an ideal blood smear

Answer 20

Gradual transition from thick to thin area
2/3 to 3/4 the length of the film slide
Fingershaped
Visible lateral edges
Without irregularities, holes, or streaks
Feather edge has a rainbow appearance
Whole drop of blood is picked up and spread

Question 21

Coverslip techniques:

Answer 21

Glass slide-coverslip method (Beacom’s method)
Two-coverslip method (Ehrlich’s method)

Question 22

Coverslip technique is sometimes used for making what

Answer 22

Bone marrow aspirate smears

Question 23

Only advantage of using the coversli technique

Answer 23

Excellent WBC distribution

Question 24

Automated methods in making smears:

Answer 24

CellaVision HemaPrep
Centrifugal (Spinner) type
Coulter LH
Sysmex SP-10

Question 25

No power source necessary, portable, and semi-automated preparation of two blood films

Answer 25

CellaVision HemaPrep

Question 26

Uses approx. 0.2 mL of well-mixed anticoagulated blood

Answer 26

Centrifugal (Spinner) type

Question 27

Slide makers and stainers

Answer 27

Coulter LH and Sysmex SP-10

Question 28

Purpose of blood smear staining

Answer 28

Evaluation of cellular morphology

Question 29

Important solutions for blood smear staining:

Answer 29

Fixative: methanol Stain: Wright or Wright-Giemsa Buffer: 0.05M sodium phosphate or aged distilled water

Question 30

Defined as a stain which contains methylene blue and a halogenated fluorescein dye

Answer 30

Romanowsky-type stain

Question 31

Basic stain that colors the nucleus and some cytoplasmic structures a blue or purple color

Answer 31

Methylene blue

Question 32

An acidic stain that colors some cytoplasmic structures an orange-red color

Answer 32

Eosin

Question 33

Examples of Romanowsky-type stains

Answer 33

Wright Giemsa May-Grunwald

Question 34

Techniques of staining:

Answer 34

Manual Automated Quick

Question 35

RBC appearance in well-stained smear

Answer 35

Orange to salmon-pink

Question 36

WBC nuclei in well-stained smear

Answer 36

Purple to blue

Question 37

Neutrophil cytoplasm in well-stained smear

Answer 37

Pink to tan with violet to lilac granules

Question 38

Eosinophil granules in a well-stained smear

Answer 38

Bright-orange

Question 39

When RBCs are gray or blue; WBCs are too dark; and eosinophil granules appear gray, what are usually the causes

Answer 39

Stain/buffer is too alkaline/basic Inadequate rinsing Heparinized blood was used

Question 40

When RBCs are too pale or red and WBCs are barely visible, the usual causes would be

Answer 40

Stain/buffer is too acidic Underbuffering Over-rinsing

Question 41

Blood film bluer than normal

Answer 41

Patient has increased blood proteins

Question 42

Grainy appearance

Answer 42

RBC agglutination

Question 43

Holes all over the film

Answer 43

Patient has increased lipid levels

Question 44

Blue specks out at the feather edge

Answer 44

Markedly increased WBC counts and platelet counts

Question 45

10x objective

Answer 45

LPO

Question 46

40x objective

Answer 46

HPO

Question 47

100x or 50x

Answer 47

OIO

Question 48

Detect snowplow effect which will make the blood smear unacceptable

Answer 48

LPO

Question 49

Assess overall film quality and distribution of cells

Answer 49

LPO

Question 50

Locate rare abnormal WBCs

Answer 50

LPO

Question 51

Detect fibrin strands, rouleaux formation, and unexpected parasites

Answer 51

LPO

Question 52

Used to estimate total WBC count

Answer 52

HPO

Question 53

Multiplication factor for WBC count counted using 40x high-dry objective

Answer 53

2000

Question 54

Multiplication factor for WBC count counted using 50x oil immersion objective

Answer 54

3000

Question 55

Used to examine the nuclear details of the WBC

Answer 55

OIO

Question 56

Used for the tabulation of the actual WBC differential and estimation of platelet count

Answer 56

OIO

Question 57

Multiplication factor used for the estimation of the platelet count

Answer 57

20, 000

Question 58

Formula used for the estimation of platelet count of anemic patients

Answer 58

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

Question 59

Storage of blood smear slides

Answer 59

At least 7 days before proper disposal