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Hematalogy Lecture > Unit 1: CBC Evaluation & Differential > Flashcards

Unit 1: CBC Evaluation & Differential Flashcards

1
Q

Electrical impedance

A

As cells pass through the orifice, they impede the electrical current, which is detected as an increase in resistance. Each cell causes a resistance pulse thus allowing for cell counting. In addition, the height of the resistance pulse is directly related to cell volume.

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2
Q

Machine that measures electrical impedance has what parts

A

External electrode
Aperture current
Internal electrode
Blood cell suspension

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3
Q

Electrical impendance graph

A

Frequency on Y axis
Mean cell volume on X axis

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4
Q

List the order of cells from left to right on the electrical impedance chart

A

1.) Lymphocytes= smallest, 2.) (monocytes, Basophilies, Eosinophilis= medium size), 3.) Neutrophils=largest

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5
Q

Size of lymphocytes

A

30-80fl

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6
Q

Monocytes

A

60-120fl

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7
Q

Basophils

A

70-130fl

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8
Q

Eosinophils

A

80-140fl

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9
Q

Neutrophils

A

120-250fl

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10
Q

At 50% frequency

RDW-CV=

A

Histogram width/ MCV

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11
Q

At 20% frequency

A

Something about RDW-SD please help

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12
Q

WBC reference range and test method

A

4.5-11.5*10^3/ul and test method is electrical impedance

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13
Q

RBC range and test method

A

4.6-6.0 *10^6/ul and test method is electrical impedance

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14
Q

Hgb range and test method

A

14.0-18.0*g/dl and test method is absorbance ( beers law 525nm)

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15
Q

Hct range and test method

A

Men: 40-54% and test method is calculations
Women: 36-48%

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16
Q

Calculation for Hct

A

(RBC * MCV)/ 10

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17
Q

What does Hct stand for

A

Hematocrit

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18
Q

MCV range and test method and formula

A

80-100fl and test method is derived from histogram

MCV= (Hct X 10)/RBC count (*10^12)

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19
Q

MCH range and testing method

A

26-32pg and testing method is calculation

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20
Q

What does MCH stand for

A

Mean corpuscular hemoglobin

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21
Q

MCH formula

A

( HGB/RBC) * 10

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22
Q

MCHC range and testing method

A

32-36% and testing method is calculations

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23
Q

RDW range and testing method

A

11.5-14.5% and testing method is derived from histogram

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24
Q

Platelets range and testing method

A

150-450 *10^3/uL and testing method is electrical impedance

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25
Q

What does MCHC stand for

A

Mean corpuscular hemoglobin concentration

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26
Q

MCHC formula

A

(HGB/[RBC*MCV]) *1000

Or

(Hgb/Hct)*100

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27
Q

Topic Optimal light scatter
Question- each cell flows in a

A

Single line through a flow cell

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28
Q

Topic optical light scatter
Question what device is focused

A

Laser device

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29
Q

Topic optical light scatter
Question- on striking cells, what does light do?

A

Light is scattered in different directions

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30
Q

Topic optical light scatter
Question- sensor captures and

A

Multiplies scatter

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31
Q

Topic optical light scatter
Question- what does FALS stand for and what does it represent

A

Forward angle light scatter and it represents the cell size

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32
Q

Topic optical light scatter
Question what does SS stand for and what does it represent

A

Side scatter and represents granularity

33
Q

topic 5- part differential
Question- cells sent through the blank

flow cells blank

A

Sent through the volume-conductivity scatter (VCS) and flow cell by hydrodynamic focusing for 5-part differential

34
Q

topic 5- part differential
Question- cell volume and conductivity measured by

A

Cell volume= impedance
Cell conductivity= by electromagnetic probe determines physical and chemical components

35
Q

topic 5- part differential
Question- light scatter characteristics

A
36
Q

Platelet satellitosis
Question in vitro phenomenon occurs when

A

Blood is collected with EDTA

37
Q

Platelet satellitosis
Question- causes what

A
  • low platelet count with automation- pseudothrombocytopenia
  • high white blood cell count ( due to clusters of platelets)- pseudoleukocytosis
38
Q

Platelet satellitosis
Question- possible resolution

A
  • collect sample in sodium citrate tube
  • perform WBC and plt counts on blue tube
39
Q

Platelet satellitosis
Question correction for what

A

Dilution factor= multiply by 1.1
I can’t see the number please help

40
Q

Blood smears stains types

A

Wright stain or Romanowsky

41
Q

The Romanowsky stain description

A

Hematology polychrome stain is a slide stain of more then one color

42
Q

The Romanowsky stain components

A

-Methylene or azure blue dye
- Eosin Y dye
- Absolute methanol

43
Q

Methylene or azure blue dye

A

Basic, and stains acidic

44
Q

Eosin Y dye

A

Acidic, and stains basic cell components ( eg. organelles and most proteins)

45
Q

Absolute methanol

A

Acts as a fixative to adhere cells to the glass

46
Q

Excessively blue or dark
Question- potential causes are

A

The potential causes- Prolonged staining, Inadequate washing, Thick blood smear, to alkaline stain and buffer.
Memorize- Too much stain, too little wash, too thick, too alkaline.

47
Q

Excessively pink or light
Question- then potential cause is

A

potential causes- Insuffcient staining, prolonged washing, and too high an acidity of stain or buffer
Memorize- too little stain, too much wash, too acidic

48
Q

Presence of precipitate
Question- potential causes

A

Unclean slides, drying during staining, inadequate filtration of stain.

49
Q

Slide examination questions- macroscopic checking

A

Check for color of stain
- bluer then normal-patient may have increased blood proteins
- holes on slide- patient may have increased lipid levels ( lipemia)

50
Q

Slide examination
10X objective

A

Overall assessment and focusing

51
Q

Slide examination
40X objective

A

WBC estimate

52
Q

Slide examination
100X objective

A

100X examination
- WBC differentiate count of 100 cells
- RBC and platelet morphology
- Platelets estimation

53
Q

Slide examination
Question- interpret each result

A

Relative to the reference range
And correlate the interpretation with the blood smear

54
Q

Normocyte

A

MCV 80-100fL ( same size as nucleus of lymphocyte approx)
- MCHC-32-36g/dL or 32-36%

55
Q

Microcyte

A

MCV less then 80fl

Diseases IDA, sideroblastic anemia, thalassemia minor, chronic disease, lead poisoning, and hemoglobinophathies ( some of them at least)

56
Q

Macrocytes

A

MCV of more then 100

Diseases- Liver disease, Vitamin B12 deficiency, Folate deficiency, Neonates.

57
Q

Dimorphic population

A

RDW of more then 14.5%
- two populations of cells

  • diseases- Transfusion, Myelodysplastic syndromes, Folate or Iron deficiency early in treatment
58
Q

Hypochromic

A

MCHC of less then 32 g/dl or 32%
- the central zone of pallor must be greater than 1/3 the diameter of the cell before it is classified as hypo-chromic

  • diseases are IDA, thalassemias, sideroblastic anemia, lead poisoning, and chronic inflammation
59
Q

Polychromatic

A

Blue to salmon color reflecting residual RNA

  • diseases Acute and chronic hemorrhage
  • hemolysis
  • effective treatment for anemia
  • neonates
60
Q

Acanthocyte

A

Irregularly spaced projections that vary in width, length, number, and usually dense

  • Abetalipoproteinemia
  • severe liver disease
  • splenectomy
  • malabsorption
  • hypothyroidism
  • vitamin E deficiency
61
Q

Burr cell (echinocyte creatnated cell)

A

Burr like erythrocyte with short evenly spaced projections

Diseases- uremia, pyruvate kinase deficiency, Microangiopathic hemolytic anemia, Neonates ( especially premature), Artifacts.

62
Q

Spherocytes

A

Round to no central zone of pallor

Diseases- Hereditary spherocytosis, some hemolytic anemias, transfused cells, severe burns

63
Q

Target cell (codocyte)

A

Bulls eye, central concentration of hemoglobin surrounded by a colorless area with a perpherial ring of hemoglobin resembling bulls eye, can be bell or cup shaped

  • diseases- hemoglobinopathies, thalassemia, IDA, splenectomy, Obstructive liver disease
64
Q

Sickle cell (drepanocyte)

A

Elongated cell with point on each end may be curved or S shaped, composed of hemoglobin S

Diseases- homozygous hemoglobin S disease

65
Q

Hemoglobin C crystals

A

Hexagonal, usually one crystal per cell composed of hemoglobin C

  • diseases- Homozygous hemoglobin C disease
66
Q

Hemoglobin SC crystals

A

1-2 fingerlike projections, may look like a mitten, 1-2 crystals per cell, composed of hemoglobin SC

Disease- hemoglobin SC disease

67
Q

Stomatocyte

A

Erythrocyte with slit like area of central pallor ( similar to mouth or stoma)

diseases- hereditary stomatocytosis, alcoholism, liver disease, Rh null phenotype, artifact

68
Q

Elliptocyte

A

Cigar shaped
Ovalocyte- egg shaped

Diseases- Hereditary eliptocytosis or ovalocytosis, thalassemia major, IDA, megaloblastic anemias ( oval macrocyte), myelophthisic anemias.

69
Q

Teardrop cell (dacryocyte)

A

Teardrop shape may have one blunt projection

  • myelofibrosis with myeloid metaplasia, thalassemia, myelophthsic anemias, other causes of extramedullary hematopoiesis.
70
Q

Schistocyte ( schizocyte)

A

Fragments erythrocyte many sizes and shapes

Diseases- Microangiopathic hemolytic anemia ( DIC), severe burns, HUS, TTP, and renal graft rejection

71
Q

Rouleaux

A

Erythrocytes in rows or stacked like coins; increase proteins in patients with rouleaux may make the background of the slide appear blue

Diseases- increased concentration of globulins and paraproteins

72
Q

Autoagglutination

A

Clumping of erythrocytes

Diseases- antigen, antibody reactions

73
Q

Hyposegmentation

A

Location- nucleus

Description- bilobed or peanut shaped neutrophil with course chromatin

Diseases- pelger Huet anomaly, myeloproliferative or myelodysplastic disorders

74
Q

Hyper-segmentation

A

Location- nucleus

Description- six or more lobes in neutrophil nucleus

Diseases- megaloblastic anemias. Chronic infections, and rarely inherited

75
Q

Vacuoles

A

Location- cytoplasm

Description- circular area within the cytoplasm

Diseases- bacterial or fungal infections, poisoning, burns, chemotherapy, artifact

76
Q

Dohle body

A

Cytoplasm near periphery

Gray blue, round to oval single or multi per cell comprised of ribosomal RNA

Bacteria infections, poisoning, burns, chemotherapy, Mary-Hegglin anomaly, pregnancy

77
Q

Toxic granulation

A

Cytoplasm of neutrophils

Prominent blue black granules of primary granules types

Diseases- Bacterial infections, poisoning, burns, Chemo, pregnancy, G-CSF therapy

78
Q

Degranulation/ Agranulation

A

Cytoplasm

Decreased number of absence of specific granules

Infection or myelodysplastic syndromes

79
Q

Auer rods

A

Cytoplasm

Fused primary granules, usually rods, occasionally round, red in color, single or multiple per cell

Acute leukemia in leukemic, myeloblastic, and promyelocytes- FAB M1 to M6

Hematalogy Lecture (35 decks)

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