Section 4: Differential Procedure Flashcards
What causes RBC agglutination?
Cold IgM
True or False: You want to count cells in the feather edge
False. Count in monolayer area further in slide
What’s the WBC estimate equation?
(Average # WBCs per 10 fields) X 2000 = WBCs/mm^3
Which objective do you use for WBC differential and counting?
Differential: 50x or 100x oil
Count: 50x oil
Which objective do you use for platelet count?
100x oil
What’s the platelet estimate equation?
(Average #platelets per 10 fields) X 20,000 = PLTS/mm^3
What’s the differential path called?
Battlement pattern!
What is normal RBC size?
~7 microns (7-10)
List some features used in cell identification
- Cell size
- N/C
- Nucleus size/shape
- Place of nucleus
- Cytoplasm (amount and color)
- Granules (color, presence, size)
What’s the total WBC (X 10^3/mm^3) count in adults, children and infants (birth to 12 months)?
Adults: 4.4-11.0
Children: 5.0-14.5
Infants: 6.0-17.5
Neutrophils increase during ______ and decrease during _____
Bacterial infection
Viral infection
Which is the biggest WBC?
Monocytes
ID the following for neutrophils:
Cell size
N/C ratio
Number of lobes
Chromatin pattern/color
Nucleoli
Cytoplasm color
Granules
10-16 uM
1:1
2-5 lobes connected by thin filament
Deep blue-purple coarsely chromatin
0 nucleoli
Pink cytoplasm
Fine violet-pink granules
ID the following in bands:
Cell size
N/C ratio
Number of lobes
Chromatin pattern/color
Nucleoli
Cytoplasm color
Granules
10-16 uM
1:1
Singular lobe, elongated narrow band shape
Deep blue-purple coarsely granular chromatin
0 nucleoli
Pink cytoplasm
Fine violet-pink specific granules
ID the following eosinophils:
Cell size
N/C ratio
Number of lobes
Chromatin pattern/color
Nucleoli
Cytoplasm color
Granules
10-16 uM
1:1
2 distinct nuclear lobes
Deep blue-purple coarsely granular chromatin
0 nucleoli
Pink cytoplasm
Large orange-red, uniform specific granules (bigger than PMN granules)
ID the following basophils:
Cell size
N/C ratio
Number of lobes
Chromatin pattern/color
Nucleoli
Cytoplasm color
Granules
10-16 microns
1:1
2 distinct nuclear lobes
Deep blue-purple coarsely granular chromatin
0 nucleoli
Abundant pale-blue cytoplasm
Coarse purple-black non-uniform, WATER-SOLUBLE GRANULES -> MAY DISSOLVE IN STAINING AND GIVE WATERCOLOR EFFECT AND BLUR NUCLEUS
True or False: you can differentiate between T and B cell on Wright’s stain smear
False
ID the following lymphocytes:
Cell size
N/C ratio
Number of lobes
Chromatin pattern/color
Nucleoli
Cytoplasm color
Granules
7-18 microns
4:1 (occasionally 3:1 especially if bigger lymph)
Round or indented eccentric nucleus with scanty cytoplasm
Homogeneous, coarse blue-purple chromatin that appears SMUDGED
NUCLEOLI POSSIBLE
Light to dark blue cytoplasm
Occasionally azurophilic (actually purple-pink) granules
ID the following monocytes:
Cell size
N/C ratio
Number of lobes
Chromatin pattern/color
Nucleoli
Cytoplasm color
Granules
12-20 microns (BIG BOIS)
2:1 or 1:1
Cerebriform or horseshoe-shaped nucleus
Central nucleus
Blue-purple, fine homogenous-looking chromatin (less distinct parachromatin)
0-2 NUCLEOLI
Abundant pale gray-blue cytoplasm, may see vacuoles
Many fine, dust-like red, uniform granules
What are nRBCs mistaken for in machines? What do they look like?
They’re mistaken for lymphs in automated machines. They have one round nucleus with no chromatin pattern and no granules. RBC sized so 7-10 microns
How can you best distinguish between nRBCs and lymphs?
nRBCs will be the same size as RBCs around it and have abundant cytoplasm. Lymphs, even small ones, will be bigger than RBCs and have greater N/C ratio than nRBCs
When do you correct the WBC count?
When nRBC count is greater than 5
What is the corrected WBC count equation?
(100 X uncorrected WBC)/(100 + nRBC)
When do you comment on RBC morphology? Which objective is used?
Always! Even if normal? 100x oil used
What are the 5 different types of platelet morphologies?
- Macro platelets
- Agranular platelets
- Abnormal PLT morphology
- PLT clumps
- PLT satellites (around neutrophils)
Note* can have macro agranular platelets
Which cells are not counted in 100-cell differential? Comments?
Smudge cells! Pyknotic cells! Comment on their presence if abundant
True or false: Differential final report should always total 100%
TRUE