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.
2
Q
Machine that measures electrical impedance has what parts
A
External electrode
Aperture current
Internal electrode
Blood cell suspension
3
Q
Electrical impendance graph
A
Frequency on Y axis
Mean cell volume on X axis
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
5
Q
Size of lymphocytes
A
30-80fl
6
Q
Monocytes
A
60-120fl
7
Q
Basophils
A
70-130fl
8
Q
Eosinophils
A
80-140fl
9
Q
Neutrophils
A
120-250fl
10
Q
At 50% frequency
RDW-CV=
A
Histogram width/ MCV
11
Q
At 20% frequency
A
Something about RDW-SD please help
12
Q
WBC reference range and test method
A
4.5-11.5*10^3/ul and test method is electrical impedance
13
Q
RBC range and test method
A
4.6-6.0 *10^6/ul and test method is electrical impedance
14
Q
Hgb range and test method
A
14.0-18.0*g/dl and test method is absorbance ( beers law 525nm)
15
Q
Hct range and test method
A
Men: 40-54% and test method is calculations
Women: 36-48%
16
Q
Calculation for Hct
A
(RBC * MCV)/ 10
17
Q
What does Hct stand for
A
Hematocrit
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)
19
Q
MCH range and testing method
A
26-32pg and testing method is calculation
20
Q
What does MCH stand for
A
Mean corpuscular hemoglobin
21
Q
MCH formula
A
( HGB/RBC) * 10
22
Q
MCHC range and testing method
A
32-36% and testing method is calculations
23
Q
RDW range and testing method
A
11.5-14.5% and testing method is derived from histogram
24
Q
Platelets range and testing method
A
150-450 *10^3/uL and testing method is electrical impedance
25
What does MCHC stand for
Mean corpuscular hemoglobin concentration
26
MCHC formula
(HGB/[RBC*MCV]) *1000
Or
(Hgb/Hct)*100
27
Topic Optimal light scatter
Question- each cell flows in a
Single line through a flow cell
28
Topic optical light scatter
Question what device is focused
Laser device
29
Topic optical light scatter
Question- on striking cells, what does light do?
Light is scattered in different directions
30
Topic optical light scatter
Question- sensor captures and
Multiplies scatter
31
Topic optical light scatter
Question- what does FALS stand for and what does it represent
Forward angle light scatter and it represents the cell size
32
Topic optical light scatter
Question what does SS stand for and what does it represent
Side scatter and represents granularity
33
topic 5- part differential
Question- cells sent through the blank
flow cells blank
Sent through the volume-conductivity scatter (VCS) and flow cell by hydrodynamic focusing for 5-part differential
34
topic 5- part differential
Question- cell volume and conductivity measured by
Cell volume= impedance
Cell conductivity= by electromagnetic probe determines physical and chemical components
35
topic 5- part differential
Question- light scatter characteristics
36
Platelet satellitosis
Question in vitro phenomenon occurs when
Blood is collected with EDTA
37
Platelet satellitosis
Question- causes what
- low platelet count with automation- pseudothrombocytopenia
- high white blood cell count ( due to clusters of platelets)- pseudoleukocytosis
38
Platelet satellitosis
Question- possible resolution
- collect sample in sodium citrate tube
- perform WBC and plt counts on blue tube
39
Platelet satellitosis
Question correction for what
Dilution factor= multiply by 1.1
I can’t see the number please help
40
Blood smears stains types
Wright stain or Romanowsky
41
The Romanowsky stain description
Hematology polychrome stain is a slide stain of more then one color
42
The Romanowsky stain components
-Methylene or azure blue dye
- Eosin Y dye
- Absolute methanol
43
Methylene or azure blue dye
Basic, and stains acidic
44
Eosin Y dye
Acidic, and stains basic cell components ( eg. organelles and most proteins)
45
Absolute methanol
Acts as a fixative to adhere cells to the glass
46
Excessively blue or dark
Question- potential causes are
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
Excessively pink or light
Question- then potential cause is
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
Presence of precipitate
Question- potential causes
Unclean slides, drying during staining, inadequate filtration of stain.
49
Slide examination questions- macroscopic checking
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
Slide examination
10X objective
Overall assessment and focusing
51
Slide examination
40X objective
WBC estimate
52
Slide examination
100X objective
100X examination
- WBC differentiate count of 100 cells
- RBC and platelet morphology
- Platelets estimation
53
Slide examination
Question- interpret each result
Relative to the reference range
And correlate the interpretation with the blood smear
54
Normocyte
MCV 80-100fL ( same size as nucleus of lymphocyte approx)
- MCHC-32-36g/dL or 32-36%
55
Microcyte
MCV less then 80fl
Diseases IDA, sideroblastic anemia, thalassemia minor, chronic disease, lead poisoning, and hemoglobinophathies ( some of them at least)
56
Macrocytes
MCV of more then 100
Diseases- Liver disease, Vitamin B12 deficiency, Folate deficiency, Neonates.
57
Dimorphic population
RDW of more then 14.5%
- two populations of cells
- diseases- Transfusion, Myelodysplastic syndromes, Folate or Iron deficiency early in treatment
58
Hypochromic
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
Polychromatic
Blue to salmon color reflecting residual RNA
- diseases Acute and chronic hemorrhage
- hemolysis
- effective treatment for anemia
- neonates
60
Acanthocyte
Irregularly spaced projections that vary in width, length, number, and usually dense
- Abetalipoproteinemia
- severe liver disease
- splenectomy
- malabsorption
- hypothyroidism
- vitamin E deficiency
61
Burr cell (echinocyte creatnated cell)
Burr like erythrocyte with short evenly spaced projections
Diseases- uremia, pyruvate kinase deficiency, Microangiopathic hemolytic anemia, Neonates ( especially premature), Artifacts.
62
Spherocytes
Round to no central zone of pallor
Diseases- Hereditary spherocytosis, some hemolytic anemias, transfused cells, severe burns
63
Target cell (codocyte)
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
Sickle cell (drepanocyte)
Elongated cell with point on each end may be curved or S shaped, composed of hemoglobin S
Diseases- homozygous hemoglobin S disease
65
Hemoglobin C crystals
Hexagonal, usually one crystal per cell composed of hemoglobin C
- diseases- Homozygous hemoglobin C disease
66
Hemoglobin SC crystals
1-2 fingerlike projections, may look like a mitten, 1-2 crystals per cell, composed of hemoglobin SC
Disease- hemoglobin SC disease
67
Stomatocyte
Erythrocyte with slit like area of central pallor ( similar to mouth or stoma)
diseases- hereditary stomatocytosis, alcoholism, liver disease, Rh null phenotype, artifact
68
Elliptocyte
Cigar shaped
Ovalocyte- egg shaped
Diseases- Hereditary eliptocytosis or ovalocytosis, thalassemia major, IDA, megaloblastic anemias ( oval macrocyte), myelophthisic anemias.
69
Teardrop cell (dacryocyte)
Teardrop shape may have one blunt projection
- myelofibrosis with myeloid metaplasia, thalassemia, myelophthsic anemias, other causes of extramedullary hematopoiesis.
70
Schistocyte ( schizocyte)
Fragments erythrocyte many sizes and shapes
Diseases- Microangiopathic hemolytic anemia ( DIC), severe burns, HUS, TTP, and renal graft rejection
71
Rouleaux
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
Autoagglutination
Clumping of erythrocytes
Diseases- antigen, antibody reactions
73
Hyposegmentation
Location- nucleus
Description- bilobed or peanut shaped neutrophil with course chromatin
Diseases- pelger Huet anomaly, myeloproliferative or myelodysplastic disorders
74
Hyper-segmentation
Location- nucleus
Description- six or more lobes in neutrophil nucleus
Diseases- megaloblastic anemias. Chronic infections, and rarely inherited
75
Vacuoles
Location- cytoplasm
Description- circular area within the cytoplasm
Diseases- bacterial or fungal infections, poisoning, burns, chemotherapy, artifact
76
Dohle body
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
Toxic granulation
Cytoplasm of neutrophils
Prominent blue black granules of primary granules types
Diseases- Bacterial infections, poisoning, burns, Chemo, pregnancy, G-CSF therapy
78
Degranulation/ Agranulation
Cytoplasm
Decreased number of absence of specific granules
Infection or myelodysplastic syndromes
79
Auer rods
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
