Unit 1 Flashcards
hematology
The study of cellular components of the blood
The study of Hematology includes
Cell Identification, blood forming organs, blood related disorders and lab tests
hemostasis
The study of the mechanisms that ensures the balance and order in the circulatory system
composition of whole blood
55% plasma, 45% cells
Name three anticoagulants used in hematology testing
EDTA
Sodium Citrate
Lithium Heparin
EDTA tube
Powdered anticoagulant that deactivates metal dependent enzymes, binds Ca++ to prevent clumping
sodium citrate tube
liquid anticoagulant, binds calcium, exact volume is important
blue tops have a ___:___
1:9
Microhematocrit (aka hematocrit)
The percentage of packed RBCs in a given volume of centrifuge blood
a quick screening test for anemia
microhematocrit
microhematocrit procedure
Fill 2 capillary tubes 3/4 full with EDTA whole blood or from fingerstick, seal one end with clay, place in centrifuge open end toward the center, interpret results with microhematocrit card, report the average as a percentage
What can cause a falsely increased microhematocrit result?
centrifuge speed too low
centrifuge spin time too short
poikilocytosis
what can cause a falsely decreased microhematocrit result?
tissue, severe edema, hemolysis, excessive anticoagulant, improper clay seal, cells are lost during centrifugation, excessively milking a fingerstick.
Reference range
A range considered include 95% of the normal population
critical range
lab tests that reflects a life-threatening situation
normal range for RBC in male
4.5 - 5.5
normal range for RBC in females
4.0 - 5.0
normal range for RBCs in newborns
3.9-5.9
RBC critical range
no critical range
Normal range for WBC in adults
4.5 - 11.0
normal WBC range for newborns
9.0-30.0
critical high WBC
more than 50.0
PLT’s are necessary for maintaining ____ in the circulatory system
hemostasis
PLT normal range
150-400
critical low PLT
less than 20
critical high PLT
More than 1,000
Normal HCT range for males
42%-52%
HCT normal range for females
36-46%
Critically Low HCT
< 20%
Critically high HCT
more than 60%
ESR
One hour measurement of the rate that RBCs settle from the plasma, used to demonstrate presence of inflammation
three phase of sedimentation
1.) aggregation phase
2.) sedimentation phase
3.) packing phase
aggregation phase
RBCs are allowed to come together and from rouleaux
sedimentation phase
aggregates fall out of solution
Packing Phase
RBCs aggregate pack closely together at the bottom of the tube
Rate of RBC settling in an ESR depends on:
increase levels of plasma proteins
protein composition of the plasma
decrease in zeta potential
size and shape of RBCs
RBC concentration
Macrocytes tend to settle____
faster
Microcytes tend to settle ______
Slowers
Poikilocytes are unable to form rouleaux and settle _______.
slower
A Higher RBC concentration results in a _________ ESR
Decreased
Causes of an elevated ESR
almost anything that causes inflammation (Infections, autoimmune diseases, pelvic inflammatory disease and pregnancy)
anemia, leukemias, Waldenstrom macroglobulinemia, multiple myeloma
ESR normal range for males
<50
>50
<50: 0-15 mm/hr
>50: 0-20 mm/hr
ESR normal range for females
<50
>50
<50: 0-20 mm/hr
>50: 0-30 mm/hr
what can falsely increase an ESR?
(meaning a higher number like 100 mm/hr)
Room temp is too warm
tilted tube
agitation
Which two stains are commonly used for PBS and BM stains?
Wright and Wright Giemsa stains
What can falsely decrease an ESR?
(like a result of 3mm/hr)
Room temp too cold
excessive anticoagulant
clotted sample
old sample
A wright stain is also know as?
Polychrome stain
Methylene blue - basic
Stains acidic Cellular components Like RNA (blue)
RBCs stain
Pink to salmon
In hematology the condenser is
All the way up
A good area is
1.) Monolayer of RBC’s
2.) Even distribution of RBC’s
3.) less than half of the RBCs are overlapping
WBC estimation procedure
find the average number of WBCs in 10 fields
multiply by 2,000
Normal RBC Morphology
Normocytic, normochromic
NC/NC
100x Peripheral blood Smear is for
1.) RBC morphology
2.) PLT estimation
3.) Manual WBC differential
RBC Morphology procedure
Done at the 100x objective and just looking at the general appearance of the RBC
PLT Estimation procedure
Cannot be done when platelets are clumped
Find the average number of platelets seen in 10 fields
multiply by 15,000
Manual WBC Differential
Microscopically differentiate the WBCs and note using the 100x objective and note any abnormalities
hypersegmented nuclei can be caused by
B12 or folate
WBC are involved in counteracting _______ & __________.
Foreign substances and disease
Adult WBC Count
4.5-11.0
WBC count >11.0 x10^ 3 is termed
Leukocytosis
WBC count <4.5 x 10 ^ 3 is termed
leukopenia
Newborn WBC count
9.0-30
Critical low WBC
<1.5
Critical High WBC
> 50.0
Critically high WBC is indicative of
fatal infection
critically low WBC indicates
leukemia