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HEMATOLOGY 1 > Reticulocytes > Flashcards

Reticulocytes Flashcards

1
Q

Definition of Reticulocyte

A

Immature, non-nucleated RBC with >2 blue-stained granulofilamentous materials (reticulum) after supravital staining

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2
Q

Normal maturation time for reticulocytes in blood

A

1 day

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3
Q

Normal production of reticulocytes

A

50 x 10^9/L/day

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4
Q

Purpose of Reticulocyte Count

A

Effective assessment of RBC production by bone marrow; measure of effective erythropoiesis

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5
Q

Normal reference range for reticulocyte count in adults

A

0.5 to 1.5%

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6
Q

Normal reference range for reticulocyte count in newborns

A

1.8 to 5.8% (by 1-2 weeks of age, same as adults)

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7
Q

Increased reticulocyte count

A

First sign of accelerated erythropoiesis; observed in hemolytic anemias, iron deficiency anemia with therapy, thalassemia, sideroblastic anemia, acute and chronic blood loss

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8
Q

Decreased reticulocyte count

A

Observed in aplastic anemia and in conditions where bone marrow is not producing RBCs

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9
Q

Conditions associated with increased reticulocyte count

A

Hemolytic anemias, iron deficiency anemia with therapy, thalassemia, sideroblastic anemia, acute and chronic blood loss

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10
Q

Conditions associated with decreased reticulocyte count

A

Aplastic anemia, conditions with non-functioning bone marrow

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11
Q

Supravital Stains used for reticulocyte counting

A

New Methylene Blue, Brilliant Cresyl Blue

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12
Q

Purpose of Miller disk

A

Calibrated disk placed in the ocular of the microscope

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13
Q

Large Square (A) on Miller disk

A

Used for counting reticulocytes

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14
Q

Small Square (B) on Miller disk

A

Used for counting RBCs

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15
Q

Minimum number of cells to count for accurate reticulocyte count

A

112

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16
Q

Method for reticulocyte count

A

Routine Light Microscope Method, Calibrated Miller Disk Method, Flow Cytometry

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17
Q

Incubation time for Routine Light Microscope Method

A

3 to 10 minutes

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18
Q

Amount of blood and supravital stain in Routine Light Microscope Method

A

2 to 3 drops or around 50 μL each

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19
Q

Reticulocyte counting in Routine Light Microscope Method

A

Count 1000 RBCs under oil immersion (1000x magnification); reticulocytes counted as both RBC and reticulocyte

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20
Q

Calculation for Routine Light Microscope Method

A

Retic (%) = No. of Retics observed x 100 / 1,000 RBCs observed

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21
Q

Minimum RBCs to count in small square (B) for Calibrated Miller Disk Method

A

112 RBCs

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22
Q

Counting rule for reticulocytes in Square B (Calibrated Miller Disk Method)

A

A reticulocyte in square B is counted as both an erythrocyte and a reticulocyte

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23
Q

Total RBCs counted in Calibrated Miller Disk Method

A

1,008 RBCs (theoretically)

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24
Q

Computation for Calibrated Miller Disk Method

A

Retics(%) = (Total retics in Square A / (Total RBCs in Square B x 9)) x 100

25
Q

Most rapid, accurate, and precise method for reticulocyte count

A

Flow Cytometry

26
Q

Principle of Flow Cytometry for reticulocyte count

A

Counts reticulocytes based on optical scatter or fluorescence after treatment with fluorescent dyes or nucleic acid stains

27
Q

Test values in Flow Cytometry

A

Reported in absolute and relative terms

28
Q

Example of Flow Cytometry equipment

A

Sysmex R-3500

29
Q

Sysmex R-3500 uses this fluorescent dye

A

Auramine O (supravital fluorescent dye)

30
Q

How reticulocytes are categorized in Sysmex R-3500

A

Into low-fluorescence, middle-fluorescence, or high-fluorescence regions; less mature reticulocytes show higher fluorescence

31
Q

Sum of middle-fluorescence and high-fluorescence ratios

A

“Immature Reticulocyte Fraction (IRF)”

32
Q

Purpose of Immature Reticulocyte Fraction (IRF)

A

Indicates early erythropoiesis, a sensitive index of bone marrow erythropoietic activity

33
Q

IRF reflects

A

Quantity of reticulocytes with the highest RNA content

34
Q

Immature Reticulocyte Fraction (IRF) helps to indicate

A

Ratio of immature reticulocytes to total reticulocytes

35
Q

To distinguish types of anemias, use of IRF together with _____

A

ARC

36
Q

Brilliant cresyl blue in reticulocyte staining

A

Brilliant cresyl blue stains reticulocytes but shows too much unpredictability for routine use

37
Q

Adjusting dye to blood ratio for anemia or polycythemia

A

Increase blood proportion for low hematocrit, decrease for high hematocrit

38
Q

Time for reticulocyte staining

A

Staining should not be less than 10 minutes

not critical

39
Q

Effect of increased blood glucose or heparin to reticulocyte

A

pale staining

40
Q

Importance of mixing blood and stain well in reticulocytes

A

Reticulocytes settle on top of RBCs due to lower specific gravity

41
Q

Deep purple using NMB, nuclear fragments (DNA)

A

Howell Jolly Bodies

42
Q

Light blue-green, denatured and precipitated hemoglobin, usually at the peripheral edge of the RBC

A

Heinz Bodies

43
Q

Purple, small cluster of granules, confirmed with Wright or Prussian blue stain, hemosiderin in mitochondria

A

Pappenheimer Bodies

44
Q

Greenish-blue, multiple small dots, seen in alpha thalassemia

A

Hemoglobin H

45
Q

Actual number of reticulocytes in 1 liter of whole blood

A

ABSOLUTE RETICULOCYTE COUNT

46
Q

Corrects reticulocyte count to a normal Hct of 0.45 L/L for anemia degree

A

CORRECTED RETICULOCYTE COUNT

47
Q

Refines CRC, indicating erythrocyte production increase in anemias

A

RETICULOCYTE PRODUCTION INDEX

48
Q

Computation for ARC

A

ARC = (reticulocytes (%) x RBC count (x10^12/L))/100 x 1,000

49
Q

Reference range for ARC

A

20 to 115 X 10^9/L

50
Q

CRC formula

A

CRC = Retics (%) x (Hct in L/L / 0.45 L/L)

51
Q

RPI formula

A

RPI = Corrected Reticulocyte Count / Maturation Time in peripheral blood

52
Q

Hematocrit (%) 40 to 45 Maturation Time (Days)

A

1

53
Q

Hematocrit (%) 35 to 39 Maturation Time (Days)

A

1.5

54
Q

Hematocrit (%) 25 to 34 Maturation Time (Days)

A

2

55
Q

Hematocrit (%) 15 to 24 Maturation Time (Days)

A

2.5

56
Q

Hematocrit (%) <15 Maturation Time (Days)

A

3

57
Q

RPI

Generally indicates adequate bone marrow response

A

“RPI >3”

58
Q

RPI

Generally indicates inadequate bone marrow response

A

“RPI <2”

HEMATOLOGY 1 (27 decks)

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