Routine Hematology Tests Flashcards
Most common cause of inaccurate errors
Pre-analytical- Blood collection error
Control samples are run to assure the reliability to of test results and can detect: A) pre-analytical errors B) wrong patient identification C) analytical errors D) a partially clotted EDTA sample
C) Analytical Errors
(Ballpark) Normal White Count
4-11 K/uL
(Ballpark) Normal HGB
12-17 g/dL
(Ballpark) Normal Platelet Count
> 150 K/uL
Control samples are run to assure the reliability of test results and can detect what?
Analytical errors
You RBC is 5.0. What is your HGB and HCT%
5.0 x 3 = 15 HGB
15 x 3 = 45% HCT
Luekopenia
Decreased WBC Count
-decreased production, increased use
Lukocytosis
Increased WBC Count
-increased production, shift/psuedo
WBC Count
total # of white blood cells; does NOT distinguish WBC types
varies by age
RBC Count
total # of red blood cells
Hemoglobin
photometric measurement of Hgb concentration in red cells
RBC Indices: MCH
Mean Cell Hemoglobin
varies with RBC size and Hgb content
parallels changes in MCV
RBC Indices: MCHC
Mean Cell Hemoglobin Concentration
average Hgb concentration per RBC (hypo chromic or normochromic)
RBC Indices: RDW
Red Cell Distribution Width
index of RBC size variation
low (10-14%): uniform RBC size, homogenous
high (>14%): variation in RBC size, ANSIOCYTOSIS, heterogeneous
T/F Lymphocytes are the most common in adults and neutrophils are the most common in children.
False. Neutrophils - adults; Lymphocytes - children
Thrombocytopenia
decreased platelet count
-decreased production, increased use/destruction
Thrombocytosis
increased platelet count
-increased production, post-splenectomy
Differentials include
WBC differential that classifies WBC type Cell morphology (blood smear)
Reticulocyte Count
measures rate of RBC production by the pone
retics appear as polychromasia
Reticulocytopenia
decreased absolute Retic count
-decreased RBC production
Reticulocytosis
increased absolute Retic count
- increased RBC production (increased EPO)
- good indicator for hemolytic anemias
Erythrocyte Sedimentation Rate
rate red cells settle as blood stands in a tube
- under normal conditions, red cells do not form rouleaux and fall slowly
- fibrinogen most often responsible for increased ESR
Increased/Abnormal ESR:
Acute and chronic infections Chronic inflammatory disorders Malignancies Tissue Necrosis Anemia of chronic disease
NORMAL REFERENCE RANGES VALUES VARY, ESTABLISHED BY INSTITUTION
1) WBC Adult
2) Newborn
3) Children (1-10y)
4) (10-20y)
1) 4.0-11.0 x 103/uL or K/uL or K/cmm
2) 9.0-30.0 x 103/uL
3) (1-10y) 6.0-17.0 x 103/uL
4) 4.5-13.5 x 103/uL
A patient’s RBC count is 5.00 million/cmm with red cells that are normal in size and
hemoglobin content. When estimated, the approximate hemoglobin and hematocrit values
would be:
a. HGB 12.0 g/dl and HCT 36.0 %
b. HGB 13.0 g/dl and HCT 39.0 %
c. HGB 15.0 g/dl and HCT 45.0 %
c
Which of the following lab values obtained on an adult male would be described or classified as a microcytic anemia? a. HGB 9.0 g/dl and MCV 62.2 fl b. HGB 10.5 g/dl and MCV 120.0 fl c. HGB 7.2 g/dl and MCV 90.2 fl d. HGB 14.5 g/dl and MCV 75.5 fl
a
Which of the following statements is correct?
a. A high RDW value indicates uniform RBC size and a homogeneous population of
red cells.
b. A low RDW value indicates “anisocytosis” due to wide variations in RBC size and a
heterogeneous population of red cells.
c. A normal MCV value (82.0 to 98.0 fl) may be erroneous when the RDW value is
over 22.0 %.
c
TRUE or FALSE. “Poikilocytosis” refers to rigid or damaged red cells that deviate from
the normal, deformable RBC shape, e.g. schistocytes which suggest RBC destruction.
True
Which of these WBC differential results are considered normal findings in an adult?
a. 60% lymphocytes
b. 3% blasts
c. 55% neutrophils
d. 1 nucleated red cell per diff
c
- Which of the following is an expected ESR result for an adult female recently diagnosed
with rheumatoid arthritis?
a. An abnormally increased erythrocyte sedimentation rate (ESR) due to elevated
levels of positive acute phase reactants such as fibrinogen.
b. A normal or decreased erythrocyte sedimentation rate (ESR) due to depletion of
complement in the inflammatory process.
c. Unable to predict the ESR value in this situation due to interference by rheumatoid
factor.
a
