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FINALS HEMA LAB > Prt 1 > Flashcards

Prt 1 Flashcards

1
Q

INTRO
1. HgbS is fully soluble when _____ but becomes insoluble when oxygen level is ______
2. positive result:
- when they turn into ____ inside rbc = _____
- when they form ___ in the solution =
3. Other forms of sickling Hgb

A
  1. soluble = oxygenated; insoluble = deoxygenated
  2. positive result:
    - fluid crystals = cell to sickle
    - tactoid crystals = turbidity
    • HbC-Harlem
    • HbC-Ziguinchor
    • HbS-Travis
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2
Q

SCREENING METHOD

______: red blood cells take on a sickle-like shape when oxygen supply to the red cell is decreased

  1. aka
  2. resultant:
  3. ______ or ______ to prevent the entry of atmospheric oxygen
  4. repeat until what hour
    - readings are made at an hourly interval for ______
  5. report as
  6. positive result is diagnostic but does not distinguish between ____ & ______
A

SEALED WHOLE BLOOD METHOD

  1. SCRIVER & WAUGH
  2. Microscopic: SICKLED SHAPE CELL
  3. PETROLEUM JELLY or MELTED PARAFDIN
  4. 3rd hr
    - 2-3hra
  5. POSITIVE/ NEGATIVE
  6. HbS trait (AS) & HbS anemia (SS)
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3
Q

SCREENING METHOD

SODIUM METABISULFITE METHOD

  1. aka
  2. ______ or _____: reagent that removes the oxygen from blood sample
  3. resultant:
A
  1. DALAND AND CASTLE
  2. 2 % sodium metabisulfite or sodium bisulfate
  3. Microscopic: SICKLED SHAPE CELL
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4
Q

SCREENING METHOD

DITHIONITE SOLUBILITY TUBE TEST

  1. reagent
  2. specimen (3)
  3. red cells are lysed by ____ allowing Hgb to escape
  4. HbS polymerizes in the deoxygenated state and forms precipitate in _____
  5. resultant
  6. observe for turbidity by holding the tube ____ in front of card reader w/ _____
A
  1. sodium hydrosulfite (dithionite)
  2. blood w/ EDTA, heparin or sodium citrate
  3. saponin
  4. high-molarity phosphate buffer solution
  5. Macroscopic: TURBIDITY
  6. 2.5cm; black lines
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5
Q

SCREENING METHOD

an immunologic test

  1. HbA and HbS reagents contain ______ (__)
  2. specifically bind to amino acids at or near ____ of beta chain of
    - HbA
    - HbS
  3. positive result of HbS monloclonal when reacted w/ b chains of HbS
A

HEMOCARD HbA AND HbS

  1. monoclonal antibodies (IgG)
  2. 6th
    - glutamic acid
    - valine
  3. raspberry-like color
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6
Q

CONFIRMATORY TEST

_______: main method

  1. used to separate hemoglobin from one another
    - uses alkaline pH. (8.4-8.6)
    - uses acidic pH (6.2-6.4)
  2. measure the density of the bands created by the proteins to determine the concentration of each hemorrhoids
  3. 2more confirmatory test
A

Hemoglobin electrophoresis

  1. and electrophoresis
    - Cellulose acetate
    - citrate agar
  2. Densitometry
    • High performance liquid chromatography
    • Capillary electrophoresis
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7
Q

Intro to Reticulocyte:

  1. reticulocyte” is derived from the fact that the cell contains a small network of basophilic materials called
    - demonstrable only by ____
  2. In the peripheral blood they are called _____
    - when stained with
  3. any non-nucleated RBC that contains 2 or more blue-stained particles/________ materials
  4. Methods of staining:
    - ______ method
    - ______ method (_____)
  5. examples of supravitalstain (3)
  6. Procedure
    - in routine
    - in supravital
A
  1. reticulum
    - supravital stain
  2. Polychromatophilic cells
    - Romanowsky stain
  3. granulofilamentous
  4. Methods of staining:
    - wet method
    - dry method (Schilling’s method)
  5. new methylene blue, brilliant cresyl blue, Janus green
    6.
    - smear > fix > stain
    - stain > smear
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8
Q

METHOD: Light Microscope

Formula

A

(No. of Retics / 1000 RBcs observed) x 100

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9
Q

METHOD:

_____: uses mirror disc

  1. large square
  2. small square
    - ___ of the size of larger square
  3. formula
  4. fixed number of denominator
  5. reference value
    - adults
    - newborn/ <2 yrs old
A

MILLER DISC METHOD

  1. RETICULOCYTES
  2. RBCS
    - 1/9
  3. (retics in large square x 100) / (rbcs in small squares x 9)
  4. 450
  5. reference value
    - 0.5-1.5
    - 2.0-6.0
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10
Q

MILLER DISC METHOD notes:

  1. _____: is not advisable; morphology may be distorted by this
  2. Reticulocytes have _____; mix solution before preparing smear
  3. ______ inhibits staining
A
  1. distorted
  2. lower specific gravity
  3. Increased glucose
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11
Q

MILLER DISC METHOD notes: Inclusions confused with reticulocytes:

  1. granules containing iron
    - to further identify that this is iron containing bodies, stain with _____
    - ___ when stain with this ^
  2. nuclear remnants
    - stain with
  3. hgb h inclusion remedy: closely look at the appearance
    - hgb h = appears
    - Retics = appears
  4. Heinz bodies: look for _____ as this is often located in ______
  5. refractile when out of focus; granules in
    reticulocytes will disappear when out of focus
A
  1. Pappenheimer bodies
    - PRUSSIAN PERSIAN BLUE
    - SIDEROTIC GRANULES
  2. Howell-Jolly bodies
    - Romanowsky stain
    3.
    - hgb h = PITTED GOLF BALL
    - Retics = FILAMENTOUS STRUCTURE
  3. APPEARANCES; PERIPHERAL
  4. ARTIFACTS
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12
Q

METHOD:

_____: Refers to the actual number reticulocyte in 1 liter of whole blood

Formula

A

ABSOLUTE RETICULOCYTE COUNT

(Retics % / 100) x RBC count

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13
Q

METHOD:

_____: This corrects the reticulocyte count to a normal hematocrit to allow correction for the degree of patient anemia

  1. Aka
  2. Formula
  3. Reference value
    - when anemia is present
    - when anemia is absent
A

CORRECTED RETICULOCYTE COUNT

  1. RETICULOCYTE
    INDEX
  2. Retics x (Hct / 0.45)
    3.
    - depends on the degree of anemia
    - 1%
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14
Q

METHOD:

_____: General indicator of the rate of erythrocyte production is increased above normal in anemia

  1. Aka
  2. done if ____ is present, these are immature reticulocytes in circulation
  3. Formula
  4. More severe anemia = More ____ are released
  5. Reference value:
    - absence of anemia
    - more severe anemia
  6. Clinical significance of reticulocytes: increased in _____ & ______
A

RETICULOCYTE PRODUCTION INDEX

  1. SHIFT CORRECT
  2. SHIFT CELLS/ STRESSED CELLS
  3. Corrected Retics count x/Maturatiom time
  4. RBC
  5. Reference value:
    - 1
    - 3 or 4
  6. hemolytic and hemorrhagic anemia
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15
Q

MATURATION TIME (DAYS)

<15%
15-24
25-34
35-39
40-45

A

3.0
2.5
2.0
1.5
1.0

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16
Q

______: measures the ability of the RBCs to take in fluid without lysing

  1. used to detect ______, because they rupture in saline concentrations near the normal level
  2. may also detect ______, which, owing to their reduced hemoglobin content, are able to withstand osmotic stress and rupture only at very dilute saline conc
  3. diagnosis of _____ & _____ (hemolysis at ___ saline)
  4. specimen: ____ or _____
  5. normal result
    - pinkish tinge of solution with sediments of non-hemolyzed RBCs (____ saline)
    - homogeneously red solution (____ saline)
A

OSMOTIC FRAGILITY TEST

  1. spherocytosis
  2. target cells
  3. Hereditary Spherocytosis
    (HS) and other hemolytic anemias associated with
    spherocytes (hemolysis at 0.60% saline)
  4. heparinized blood or defibrinated blood
  5. normal result
    - Incomplete hemolysis: 0.45% saline
    - Complete hemolysis: 0.35% slaine
17
Q

OFT METHOD

  1. Whole blood is pipetted to each of a series of hypotonic saline solutions of graduated concentration
    - hemolysis is observed _____
  2. Hemolysis is determined spectrophotometrically
    - uses hypotonic solution w/ ____ at pH ____
    - detect mild forms of _____
    - spectro at _____
A
  1. SANFORD METHOD
    - visually
  2. DACIE’S METHOD
    - Phosphate; 7.4
    - Hereditary Spherocytosis
    - 540nm
18
Q

CLINICAL SIGNIFICANCE OF OFT

  1. Increased OFT (4)
  2. Decreased OFT (3)
A
    • hereditary spherocytosis
    • hemolytic anemias
    • severe G-6-PDH deficiency
    • pyruvate kinase deficiency
      2.
    • sickle cell anemia
    • thalassemia
    • severe iron deficiency anemia
19
Q

ABSOLUTE EOSINOPHIL COUNT

____: diluting fluid ratio
1. stains eosinophil red
2. lyse RBC
3. inhibits leukocytes clumping
4. enhances eosinophil granules staining
***
1. alternative stains (2)
2. specimen (2)
3. equipments: (2)
- ____ (___cu/mm)
- ____ (___cu/mm)
4. to prevent drying incubation (15 minutes)
- made up of ____ & _____

A

1:10
1. Phloxine
2. Propylene glycol
3. Heparin
4. Sodium carbonate
***
1. Pilot’s solution; Randolph’s stain
2. EDTA; heparinized; or capillary blood
3. WBC pipette or unopette
- Speirs-Levy (8.0 cu/mm)
- Fuchs-Rosenthal (6.2 cu/mm)
4. wet house chamber
- petri dish & moistened cotton

FINALS HEMA LAB (2 decks)

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