rotation questions test Flashcards
normal values for wbc
5000-10,000
normal values for RBC
male- 4.7-6.1 million/cc
female- 4.2-5.4 million/cc
normal values for hgb
male 14-18 g/dl
female 12-16 g/dl
normal values for hct
males 42-52%
female-37-47%
normal values for platelets
150,000-400,000
normal values for retics
0.5-2%
avg 1
normal values for esr
male 0-15 mm/hr
female 0-20 mm/hr
what quick QC calculation can be used to check the accuracy of the RBC parameter as they are obtained from an automated counter
rbc x 3 = hgb
hgb X 3 = hct
factors which can increase ESR
pregnancy alcoholism cirrhosis hepatitis multiple myeloma anemia tilted tube specimen too warm infections
factors which can decrease ESR
sickle cell anemia
polycythemia
delay in preforming test
spherocytosis
what is the chief use of the osmotic fragility test
spherocytosis
what test is best to use to differentiate between homozygous and heterozygous sickle cell disease
hgb electrophoresis
how are retics stained
supravital stains
new methylene blue or brilliant cresyl blue
what is the use of the reticulocyte test to the doctor
used for monitoring anemia
in what conditions would one expect to see increased retic count
anemia
splenectomy
hemorrhage
in what conditions would one expect to see decreased reticulocyte count
aplastic anemia
bone marrow suppression
ineffective erythropoesis
what is the proper procedure for hct
blood is collected in heparin tube, seal one end, spin in microhct centrifuge to obtain packed cells, use macromethod of wintrobe or micromethod
what happens to the value if micro hct are spun too long
hemolysis- falsely decreased
what happens to the value if micro hct is not spun enough
cells will not pack - falsely increased
MCV
indicates RBC size
less than 80- microcytic
80-100 - normal
>100 macrocytic
MCHC
indicates degree of hypochromia
less than 32% increased hypochromia
with what conditions are burr cells associated
renal failure
kidney disease
in what condition is basophilic stippling freq. seen?
lead poisoning
with what condition are heinz bodies most closely associated
G6PD deficiency
how are basophillic stippling and recticulum differentiated
BS- romanowsky
retics- NMB
what is the best specimen to use for blood smears for RBC morphology
whole blood from EDTA tube
how can you adjust the color of wrights stain smear
adjust the pH
what is the most prominent feature in a blood smear from a patient with ABO HDN
spherocytes
how to calculate MCV
(hct/RBC) X 10
normal values for MCV
male 80-94
female- 81-99
how to calculate MCH
(hgb/RBC) X 10
normal values MCH
27-31 pico
how to calculate MCHC
(hgb/hct) X 100
normal values MCHC
32-36%
MCV increased
MCHC normal
macrocytic-normochromic liver disease b12 deficiency folate deficiency pernicious anemia alocholism
MCV decreased
MCHC decreased
microcytic- hypochromic iron deficiency anemia sideroblastic anemia thalassemia lead poisioning
MCV normal
MCHC normal
normocytic- normochromic
aplastic anemia
what is the appearance of the blood smear in IDA
small cells
lacking central pallor
serum iron decreased
TIBC increased
folic acid deficiency
large cells
normal central pallor
PA no neurological symptoms
what are the causes of aplastic anemia and what are the blood findings
marrow suppression failure of replacement exposure to chemicals, radiation pancytopenia normo-normo
what is a common characteristic of all hemolytic anemia
increased RBC destruction
what is an unusual finding that is the means of differentiating AIHA from other hemolytic anemias
positive DAT
what information is included in a CBC differential
RBC morphology
platelet estimation
diff of WBC
what is the most common WBC in a diff
seg
what is the most common WBC in children
lymph
what is the least common WBC
baso
what is the largest WBC
mono
what are other names for NRBCS
blast cells
rubricytes
prorubricytes
metarubricytes
is a plasma cell likely to be found in the PBS
no, normally about 1% of nucleated cells in bone marrow
what is the meaning of the term shift to the left
increase in immature granulocytes - blast, pro, myelo, meta, band
what is a shift to the right
increase in mature granulocytes- seg, hyper seg
how is a dx of hereditary elliptocytosis made
examining the PBS
atleast 25%
osmotic frag.
what are the distinguishing characteristics of hodgkins
slow relentless progression
leukemoid rxc with eos
reed-sternberg cells
what are the normal features of a smear from a new born that would be considered abnormal in an adult
NRBC
polychromasia
young WBC
how would you describe a downy type ATL as it appears on a wrights stain smear
eccentric nucleus dense chromatin may have vacuoles abundant smooth cytoplasm scallops RBC HUGS THEM ballerina skirt
at what stage of development does diff of granules of a granulocyte take place
myelocyte
how is the metas diff from myelo
kidney bean shape - meta
procedure for preforming total eos count
whole blood is diluted with staining solution
use max light
count entire ruled area of both sides on low power
calculation is total # cells X 10 / 1.8 mm cubed
neaubauer hemocytometer
with what conditions are increased eos count assocaited
parasites
allergies
skin disorders
splenectomy
normal value for CSF cell count
adults 0-5
0 RBCs
neonates 0-30
0 RBC
what test is the best measure of the erythroid activity of the bone marrow
retic count
what conditions cannot be absolutely diagnosed without a bone marrow aspirate
myeloproliferative disorders aplastic anemia lymphoma tumors leukemia pernicious anemia
what is the chief use of the LAP
diff leukemoid rxc from CML
why is it necessary to correct a WBC count if more than five NRBC are present and how is the correction made
false increase of WBC count
LOOK IN NOTES
incidence of leukemia in various age groups
chronic - old
acute- young
what is a typical picture in the pBS in acute leukemia
severe normo-normo anemia
decreased RBC
thrombocytopenia
increased immatures
at the time of DX which leukemia freq presents with greatly increased platelet count
CML
blood picture
AML
large number myeloblasts scattered segs no intermediate cells severe N/N anemia polychromasia NRBC thrombocytopenia large bizarre platelets
BP
ALL
> 60% lympho blasts
severe N/N
thrombocytopenia
BP CML
increased leukocytosis increased all stages granulocytes increased eos increased baso increased platelets at first later decreases N/N
BP CLL
60-95% small mature lymphs
increased smudge cells
icnreased eos
all stages granulocytes
hodgkins
not terribly abnormal or specific mild anemia thrombocytopenia leukocytosis usually granulocytes, esp eos decreased lymphs
following spelnectomy
pappenheimer bodies howell jolly bodies cabot rings target cells aniso/poik increased platelets
megaloblastic anemia
normochormic RBC aniso poik macro ovalocytes pancytopenia hyper segs right shift
polycythemia vera
N/N may become micro-hypo increased RBC occasional NRBC immature grans baso stippling increased eos and basos large bizarre platelets and clumping
myelofibrosis
moder N/N polychromasia NRBC aniso poik WBC n-increased with left shift plts increased at first later decreased LARGE BIZARRE
DIC
thrombocytopenia micro platelets leukocytosis schistocytes decreased retics
AIHA
N/N macro- poly spherocytes NRBC schistocytes acanthocytes burr cells RBC being eaten by macrophages WBC increased with left shift
thalassemia major
severe micro hypo aniso poik poly many NRBC RBC inclusions increased WBC left shift
thalassemia minor
mild micro-hypo polychromasia target cells occ NRBC baso stip
MULTIPLE MYELOMA
N/N rouleaux WBC normal to decreased occasional plasma cells NRBCS increased lymphs, eos, immature granulocytes
infectious mono
slight leukocytes
ATL
rare to few immature lymphs
how do you do an indirect plt count and how do you report out this
count plts in 5 fields on high power and times it by 4
AD
INC
DEC
how are PNH and PCH dx and diff
PCH- extrinsic D-L antibody extracorpuscular defect
dx by DL test
PNH- intrinsic acquired sensitive to complement
dx by HAMMS test or sugar water test
which layer of the blood is used to make an LE prep
buffy coat
which group of disorders is classified by using the FAB system of classification
acut leukemias
what is the use of the KB technique
measures of fetal cells in maternal blood stream used for RH - mothers
which age group has the highest values for the RBC paramteres
Newborns
what is the coultier principle for cell counting
interruption of alight source as it passes through a flow cell
how would you obtain a blood specimen from a patient who has IV solutions in both arms
go below the IV
