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Unit 1 Flashcards

1
Q

hematology

A

The study of cellular components of the blood

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2
Q

The study of Hematology includes

A

Cell Identification, blood forming organs, blood related disorders and lab tests

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3
Q

hemostasis

A

The study of the mechanisms that ensures the balance and order in the circulatory system

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4
Q

composition of whole blood

A

55% plasma, 45% cells

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5
Q

Name three anticoagulants used in hematology testing

A

EDTA
Sodium Citrate
Lithium Heparin

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6
Q

EDTA tube

A

Powdered anticoagulant that deactivates metal dependent enzymes, binds Ca++ to prevent clumping

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7
Q

sodium citrate tube

A

liquid anticoagulant, binds calcium, exact volume is important

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8
Q

blue tops have a ___:___

A

1:9

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9
Q

Microhematocrit (aka hematocrit)

A

The percentage of packed RBCs in a given volume of centrifuge blood

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10
Q

a quick screening test for anemia

A

microhematocrit

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11
Q

microhematocrit procedure

A

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

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12
Q

What can cause a falsely increased microhematocrit result?

A

centrifuge speed too low
centrifuge spin time too short
poikilocytosis

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13
Q

what can cause a falsely decreased microhematocrit result?

A

tissue, severe edema, hemolysis, excessive anticoagulant, improper clay seal, cells are lost during centrifugation, excessively milking a fingerstick.

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14
Q

Reference range

A

A range considered include 95% of the normal population

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15
Q

critical range

A

lab tests that reflects a life-threatening situation

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16
Q

normal range for RBC in male

A

4.5 - 5.5

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17
Q

normal range for RBC in females

A

4.0 - 5.0

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18
Q

normal range for RBCs in newborns

A

3.9-5.9

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19
Q

RBC critical range

A

no critical range

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20
Q

Normal range for WBC in adults

A

4.5 - 11.0

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21
Q

normal WBC range for newborns

A

9.0-30.0

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22
Q

critical high WBC

A

more than 50.0

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23
Q

PLT’s are necessary for maintaining ____ in the circulatory system

A

hemostasis

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24
Q

PLT normal range

A

150-400

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25
Q

critical low PLT

A

less than 20

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26
Q

critical high PLT

A

More than 1,000

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27
Q

Normal HCT range for males

A

42%-52%

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28
Q

HCT normal range for females

A

36-46%

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29
Q

Critically Low HCT

A

< 20%

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30
Q

Critically high HCT

A

more than 60%

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31
Q

ESR

A

One hour measurement of the rate that RBCs settle from the plasma, used to demonstrate presence of inflammation

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32
Q

three phase of sedimentation

A

1.) aggregation phase
2.) sedimentation phase
3.) packing phase

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33
Q

aggregation phase

A

RBCs are allowed to come together and from rouleaux

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34
Q

sedimentation phase

A

aggregates fall out of solution

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35
Q

Packing Phase

A

RBCs aggregate pack closely together at the bottom of the tube

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36
Q

Rate of RBC settling in an ESR depends on:

A

increase levels of plasma proteins
protein composition of the plasma
decrease in zeta potential
size and shape of RBCs
RBC concentration

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37
Q

Macrocytes tend to settle____

A

faster

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38
Q

Microcytes tend to settle ______

A

Slowers

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39
Q

Poikilocytes are unable to form rouleaux and settle _______.

A

slower

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40
Q

A Higher RBC concentration results in a _________ ESR

A

Decreased

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41
Q

Causes of an elevated ESR

A

almost anything that causes inflammation (Infections, autoimmune diseases, pelvic inflammatory disease and pregnancy)
anemia, leukemias, Waldenstrom macroglobulinemia, multiple myeloma

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42
Q

ESR normal range for males
<50
>50

A

<50: 0-15 mm/hr
>50: 0-20 mm/hr

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43
Q

ESR normal range for females
<50
>50

A

<50: 0-20 mm/hr
>50: 0-30 mm/hr

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44
Q

what can falsely increase an ESR?
(meaning a higher number like 100 mm/hr)

A

Room temp is too warm
tilted tube
agitation

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45
Q

Which two stains are commonly used for PBS and BM stains?

A

Wright and Wright Giemsa stains

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46
Q

What can falsely decrease an ESR?
(like a result of 3mm/hr)

A

Room temp too cold
excessive anticoagulant
clotted sample
old sample

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47
Q

A wright stain is also know as?

A

Polychrome stain

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48
Q

Methylene blue - basic

A

Stains acidic Cellular components Like RNA (blue)

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49
Q

RBCs stain

A

Pink to salmon

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50
Q

In hematology the condenser is

A

All the way up

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51
Q

A good area is

A

1.) Monolayer of RBC’s
2.) Even distribution of RBC’s
3.) less than half of the RBCs are overlapping

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52
Q

WBC estimation procedure

A

find the average number of WBCs in 10 fields
multiply by 2,000

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53
Q

Normal RBC Morphology

A

Normocytic, normochromic
NC/NC

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54
Q

100x Peripheral blood Smear is for

A

1.) RBC morphology
2.) PLT estimation
3.) Manual WBC differential

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55
Q

RBC Morphology procedure

A

Done at the 100x objective and just looking at the general appearance of the RBC

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56
Q

PLT Estimation procedure

A

Cannot be done when platelets are clumped
Find the average number of platelets seen in 10 fields
multiply by 15,000

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57
Q

Manual WBC Differential

A

Microscopically differentiate the WBCs and note using the 100x objective and note any abnormalities

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58
Q

hypersegmented nuclei can be caused by

A

B12 or folate

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59
Q

WBC are involved in counteracting _______ & __________.

A

Foreign substances and disease

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60
Q

Adult WBC Count

A

4.5-11.0

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61
Q

WBC count >11.0 x10^ 3 is termed

A

Leukocytosis

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62
Q

WBC count <4.5 x 10 ^ 3 is termed

A

leukopenia

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63
Q

Newborn WBC count

A

9.0-30

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64
Q

Critical low WBC

A

<1.5

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65
Q

Critical High WBC

A

> 50.0

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66
Q

Critically high WBC is indicative of

A

fatal infection

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67
Q

critically low WBC indicates

A

leukemia

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68
Q

Granulocytes

A

neutrophils, eosinophils, and basophils

69
Q

Agranulocytes

A

Lymphocytes and monocytes

70
Q

The differential is used to determine

A

the different types of WBC present
if each cells type is present in normal proportions
if each cell type numbers are normal, increased or decreased
the presences of abnormal and/or immature WBCs

71
Q

Variation in the number of leukocytes occur with

A

infections
inflammation
hematologic and neoplastic disease
age
giving birth

72
Q

important numbers to consider in WBC diff

A

Total WBC count
relative differential (%) for all 5 cell types
Absolute count (#) for all 5 cell types

73
Q

define Relative %

A

Measure the percentage of each type of WBC out of 100 cells reviewed on a peripheral blood smear

74
Q

Formula for absolute #

A

Total WBC count x relative %of a cell counted

75
Q

Relative percentage of Neutrophils

76
Q

absolute count of neutrophils

77
Q

Increased relative neutrophilia is defined by what %

78
Q

absolute neutrophilia is indicated by a #

79
Q

<40% relative neutrophil is considered

A

relative neutropenia

80
Q

<1.8 x10^3/ul neutrophil is considered

A

absolute neutropenia

81
Q

relative % of neutrophils in newborns

82
Q

Other names for Neutrophil

A

Polymorphonuclear (PMN)
segmented neutrophil

83
Q

Relative % of neutrophils in 4-6 months old

84
Q

at what age does the WBC count gradually increase at

A

6 years old

85
Q

neutrophil physical characteristics

A

neutral blue or pink cytoplasm
2-5 lobes connected by a thin filament

86
Q

relative percentage for band neutrophil

87
Q

absolute count for band neutrophil

88
Q

An increased absolute count for bands is termed

89
Q

physical characteristics of bands are

A

neutral blue/pink cytoplasm
C, S or J shaped
no individual lobes

90
Q

Relative percentage for a eosinophil

91
Q

absolute count for eosinophil is

92
Q

A decreased absolute count for an eosinophil is termed

A

eosinocytopenia

93
Q

an increased absolute count for an eosinophil is termed

A

Eosinophilia

94
Q

Eosinophil physical characteristics

A

pink cytoplasm
segmented nucleus
red to orange granules

95
Q

relative percentage for a basophil

96
Q

absolute count for a basophil

97
Q

an increased absolute count for basophils is termed

A

basophilia

98
Q

a decreased absolute count for basophils is termed

A

basocytopenia

99
Q

basophils physical characteristics

A

light purple to colorless cytoplasm
segmented nucleus
abundant dark blue to purple granules

100
Q

give the relative percentage for lymphocytes

101
Q

give the absolute count for lymphocytes

102
Q

an increased absolute count for lymphocytes is termed

A

lymphocytosis

103
Q

A decreased absolute count for lymphocytes is termed

A

Absolute lymphopenia

104
Q

Lymphocytes physical characteristics

A

deep blue cytoplasm
small round or oval shaped nucleus
dense clumped purple chromatin in the nucleus
nucleus is roughly the size of a RBC
can have some small vacuoles
small granules are sometimes present

105
Q

Reactive lymphocytes characteristics

A

increased size
decreased N:C ratio
nucleus can vary in shape
cytoplasm frequently show small granules

106
Q

give the relative percentage of monocytes

107
Q

give the absolute count for monocytes

108
Q

an increased absolute count for monocytes is termed

A

monocytosis

109
Q

A decreased absolute count for monocytes is termed

A

monocytopenia

110
Q

physical characteristics of monocytes

A

nucleus is much larger than RBCs
variable shaped nucleus
blue-gray cytoplasm
vacuolated

111
Q

Platelets

A

A tiny, disc shaped piece of cell that is found in the bone marrow and spleen
they help form blood clots to slow or stop bleeding and to help wounds heel

112
Q

Platelets are pieces of very large cells in the bone marrow called

A

Megakaryocytes

113
Q

PLT critical low

A

less than 20

114
Q

PLT critical High

A

more than 1,000

115
Q

Platelets physical characteristics

A

anucleate fragments of cytoplasm

116
Q

PLT circulate in peripheral blood for

117
Q

What are the two principles of cell counting currently used

A

1.) The coulter principle or impedance
2.) Optical light scatter

118
Q

The coulter principle

A

cells are suspended in an electrically conductive fluid, cells are pulled through a small aperture by a vacuum

119
Q

Describe how the the coulter principle works

A

Cells pass through the aperture and interrupt the electrical current because cells are poor conductors, this electrical resistance is measurable

120
Q

the number of pulses is proportional to the __________

A

number of cells counted

121
Q

Size of the pulse is proportional to the ___________

A

the size of the cell

122
Q

Optical light scatter

A

As a single blood cell passes through a beam of light the light will scatter

123
Q

Describe how the optical light scatter works

A

A single cell is struck by a focused laser beam, light scatter in all direction this light scatter patterns provides information about the cell structure, shape and complexity.

124
Q

A WBC count is generated through _________

A

VCS technology

125
Q

The V in VCS stands for

126
Q

the C in VCS stands for

A

Conductivity

127
Q

the S in VCS stands for

A

light Scatter

128
Q

Using VCS technology a WBC passes through an aperture and are hit by (3):

A

Electrical current
Radio waves
Laser beams

129
Q

Electrical current (DC)

A

cell volume and cell number

130
Q

Radio waves (AC)

A

conductivity and nucleus volume

131
Q

laser beam

A

Light scatter or complexity

132
Q

Routine hematology testing for EDTA

A

CBC, manual HCT, PBS, ESR, retic count, immunophenotyping by flow cytometry

133
Q

Routine testing for light blue top tubes (sodium citrate)

A

Platelet function, protime, partial thromboplastin time, anti-factor Xa, Coagulation factor studies

134
Q

Green top tubes routine hematology testing

A

Not appropriate for hematology testing

135
Q

define conductivity

A

A high frequency alternating current in the radio frequency range, Measures the volume of the nucleus

136
Q

what is the formula for correcting WBC count?`

A

(uncorrected WBC count) (100) / (# of nRBCs +100)

137
Q

In what case would we correct WBC?

A

When nRBCs are seen in high numbers the WBC count may be falsely increased

138
Q

Hematocrit is a calculated value from _____ and _____

A

MCV and RBC count

139
Q

How is hemoglobin measured?

A

Hemoglobin is directly measured

140
Q

What two methods are used to measure hemoglobin?

A

Cyanmethemoglobin
Sodium lauryl sulfate (SLS)

141
Q

What is considered the gold standard for measuring hemoglobin

A

Cyanmethemoglobin

142
Q

Explain how Cyanmethemoglobin measures hemoglobin

A

RBCs are lysed by diluting lytic reagent to release HGB
potassium ferricyanide is added: Potassium ferricyanide oxidizes all Fe2+ (ferrous) to Fe3+ (ferric) methemoglobin
MORE INFO CAUSE I DON’T UNDERSTAND

143
Q

define MCV

A

A measurement of the average RBC size
Mean corpuscular volume

144
Q

MCV formula

A

(HCT/RBC) X 10

145
Q

MCV normal range

146
Q

A MCV value of <80 is termed

A

microcytosis

147
Q

A MCV value of >100 fL is termed

A

Macrocytosis

148
Q

Define MCH

A

A calculation showing the average weight of hemoglobin in each RBC
Mean corpuscular hemoglobin

149
Q

MCH formula

A

(HGB/RBC) x 10

150
Q

MCH normal range

151
Q

A MCH value of <27 is termed

A

hypochromic

152
Q

Is there high values for MCH

A

No, because the RBC can only up to 40-45% of its volume

153
Q

Define MCHC

A

compares the weight of the hemoglobin to the volume of the cell
mean corpuscular hemoglobin concentration

154
Q

MCHC formula

A

(HGB/HCT) x 100

155
Q

normal MCHC values, termed

A

32-36 g/dL, normochromic

156
Q

hypochromic is represented by a value

157
Q

MCHC of >37

A

check the sample integrity

158
Q

RDW normal range

A

12.0-14.6%

159
Q

RDW is a measurement of how _______ or ______ the RBC are in size

A

homogenous ; heterogeneous

160
Q

Anisocytosis

A

Variation in size of RBCs

161
Q

RDW-CV

A

measure the deviation of the width of the curve on the RBC histogram

162
Q

erroneous causes of a high MCHC

A

RBC agglutination, hemolysis, lipemia

163
Q

erroneous causes of low MCHC

A

old sample, extremely high WBC count

164
Q

The Rules of 3

A

HGB x 3 = HCT +-3
RBC count x 3 = HGB +/-3

165
Q

How is a PLT count derived automated

A

any particle between 2-20 fL is counted as a platelet and plotted into a histogram

166
Q

Define MPV

A

Mean Platelet volume, similar to the MCV

167
Q

MPV normal range

168
Q

Lipemic samples can falsely elevate

A

HGB measurement and associated indices

169
Q

how to troubleshoot lipemic samples

A

Saline replacement and plasma blank

Hematology (1 decks)

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