Unit 4 Part 1 - Hematology, Coagulation Flashcards
the study of blood
hematology
deficiency of hemoglobin or RBC
anemia
section of lab that is concerned with the clotting mechanism of the blood
coagulation dept
tests for WBC, RBC, Hgb, Hct, indices, and differential
*only panel allowed, esp in hospitals
CBC (complete blood count)
determined the % of different types of WBCs (neuts, lymphs, monos, eos, basos) as well as RBC morphology and platelet # estimation
differential
an anticoagulant used in hematology tubes (lavender)
EDTA
EDTA means
ethylenediaminetetraacetic acid
used to determine if inflammation is present, also referred to as sed rate
ESR (erythrocyte sedimentation rate)
% by volume of RBCs in whole blood, also called PVC (packed cell count)
Hematocrit (Hct)
counting chamber for manual WBCs, RBCs, pltelets, sperm counts, etc.
Hematocytometer
section of the lab that studies blood cells, may include coagulation and urinalysis
hematology dept
the substance in RBCs that carry oxygen and CO2
hemoglobin
the stoppage of bleeding
hemostasis
cells involved in the clotting of blood
platelets
another term for platelets
thrombocytes
calculations to determine the size and contents of RBCs
red blood cell indices
cells containing hemoglobin that transports O2 to the body and CO2 away to the lungs
red blood cells
another term for red blood cells
erythrocytes
immature RBC
reticulocyte (retic)
cells involved in infection control and immunity
white blood cells
another term for white blood cells
leukocytes
main stain used in hematology for doing differentials
wrights stain
tests done in ____:
CBC - (WBC, RBC Hgb, Hct, indices, differential & platelet count)
Retic count
Sed Rate
Sickle cells
Eosinophil count
hematology
an increase in WBC, usually happens when a person has an infection
leukocytosis
a decrease in WBC, usually happens when the immune system is compromised
leukopenia
a sudden huge increase in WBC may indicate
leukemia
an increase in RBC may indicate
polycythemia
this test will tell if the patient has enough O2 carrying capacity
Hgb
oxygen binds to ___ on hemoglobin
heme
normal adult ranges for Hgb
Female: 120-160 g/L
Male: 140-180 g/L
test that reflects the relationship between the amount of RBCs and the amount of plasma in a blood sample
quick test for anemia and blood doping
Hct
normal adult ranges for Hct
Female: 0.35-0.47 L/L
Male: 0.4 - 0.52 L/L
increasing RBCs in blood to be able to carry more O2, allowing athletes improved performance
blood doping
MCV
mean corpuscular volume
increasing amount of RBC in blood to be able to carry more O2, allowing athletes to improve performance
blood doping
MCH
mean corpuscular hemoglobin
MCHC
mean corpuscular hemoglobin concentration
expresses the average volume of RBCs
expressed in femtoliters (fl)
normal value: 80-100 fl
MCV
estimates weight of hgb in RBC
expressed in picograms (pg)
normal value: 27-32 pg/cell
MCH
expresses the concentration of hgb in RBCs relative to their size
expressed in grams per deciliter (g/dl)
normal value: 32-37 g/dl
MCHC
most common anemia, caused by a decrease in iron which is needed for hgb production + TIBC
treatment: iron supplements
iron deficiency anemia
anemia caused by a lack of intrinsic factor in the digestive tract
treatment: Vit B 12 injections
pernicious anemia
required for the absorption of Vit B12, which is necessary for normal maturing of RBCs
intrinsic factor
anemia caused by the failure of bone marrow to produce enough RBCs as well as WBCs and platelets
treatment: bone marrow transplant
aplastic anemia
anemia caused by an excessive destruction of RBCs, often because they are deformed
causes jaundice due to increased amount of bilirubin in the blood
treatment: splenectomy
hemolytic anemia
may be done on automatic cell counter, or manually on a hematocytometer by counting all the platelets in the centre area
platelet count
normal values for platelet counts
150k - 450k per cubic ml
platelets are fragments of a ___
megakaryocyte
__ blood smear is often to detect malaria
thick
__ blood smear is often to perform a manual differential
thin
types of blood smears
thick
thin
to prepare this blood smear, place large drop of blood at centre of glass, and spread with the corner of another slide until size of dime and let it dry
thick blood smear
to prepare this smear, the push wedge method is used and takes a lot of practice
thin blood smear
the push wedge method involves 3 main steps:
approaching
adhesion
advancement
the adhesion step in the push wedge method involves the slider being held at
30-40 degree angle
a blood smear is too thin if the drop was too __, or the spreader was too __
small, low
a blood smear is too thick if the drop was too __, or the spreader was too __
large, high
a patient with ___ hemoglobin will make the smear look too __
low, thin
blood smears need to be prepared within __ from collection, and note that high humidity will prolong drying time
1 hr
the wright stain is left on a slide for 5 mins, and uses a ___ stain
polychromatic
the buffer in the wright stain is left for ___ the time of the wright stain
double
how to dry the wright stain?
air dry naturally
wright staining problems:
too blue - stain/buffer too __, time too __, smear too ___
alkaline, long, thick
wright staining problems:
too pink - stain/buffer too __, time too __
acidic, short
wright staining problems:
too light - stain/buffer __, time too __, washing too __
improper ratio, short, long
one step wright stains contain the ___ already dissolved in the stain
buffer
1-step wright stain is done on __ or __
staining rack or coplin jars
in 1-step wright stain, the slides are stained in the undiluted stain and differentiated by decolorizing in
purified water
when staining bone marrow smears, times for 1-step wright stain are __
doubled
advantages of using an automatic linear stainer
reduce repetitive motion, bending injuries
slides can be continuously loaded
save space and money
3 parts to the differential
- WBC differential count
- RBC morphology
- Platelet estimation
1st part of the differential, counts the # of neuts, lymphs, monos, eos and basos in 100 WBCs
WBC differential count
immature neutrophils have a
band
2nd part of the differential, which looks at RBCs to see if they are normal
look at size, amount of hgb and shape
RBC morphology
normal RBC size is called
normocytic
too small RBC size is called
microcytic
too large RBC size is called
macrocytic
variation in RBC sizes is called
anisocytosis
normal amount of Hgb in RBC is called
normochromic
not enough amount of Hgb in RBC is called
hypochromic
too much amount of Hgb in RBC is called
hyperchromic
variation of RBC shapes is called
poikilocytosis
___ kills off the RBCs that aren’t normal
spleen
occurs when air pressure becomes too high, and RBCs become deformed
sickle cells
3rd part of the differential, estimates platelet count and morphology
platelet estimation
when platelets clump together, the machine will count it as one platelet
platelet satellitism
increase in platelets indicate a
clotting problem
decrease in platelets indicate a
bleeding problem
increased neut count could indicate a
bacterial infection
increased lymph count could indicate a
viral infection
increased eos count count indicate a
parasite infection or allergy
myeloid leukemia is when the bone marrow produces too many ___ WBCs
immature
acute lymphatic leukemia is when the bone marrow produces too many ___ WBCs
mature
malaria goes into __ and multiplies until it bursts
RBCs
found in hemolytic anemia and causes poor surface area on RBCs
no biconcave, too solid and no squishy
spherocytes
RBCs with nucleus still in the blood stream
nucleated red cell
caused by Epstein-Barr virus
infectious mononucleosis
retic counts are stained with
methylene blue (15 mins)
counts number of retics in 100 RBCs, normal about 1%
retic count
increased retics may indicate
blood loss
decreased retics may indicate
anemia
manual method used for ESR, tube is 100 mm long and has smaller diameter than other method
wintrobe method
wintrobe method for ESR is allowed to stand undisturbed for ___ so the plasma can settle
1 hr
wintrobe method for ESR is expressed in
mm
wintrobe method normal value for ESR
1-30 mm
manual method used by most labs for ESR, tube is 200 mm long and has larger diameter than other method
westergren method
nasal smears are stained with
wright stain
collected by asking patient to blow nose to bring mucous into nostrils, given swab for each nostril and is labeled accordingly
nasal smear
normal blood volume
approx. 4.73 L
normal WBC
5000-9000 x 10^9 /L
normal RBC
4.5-5.5 x 10^12 /L
normal platelet
150-450 x 10^9 /L
autoantibodies produced by persons infected with Mycoplasma pneumonia (atypical pneumonia) or with autoimmune hemolytic anemia
react with RBCs at temperatures below body temp
kept warm using heat block when collected, and put in incubator for 30 mins
cold agglutinins
proteins that precipitate when cold, handled same way as cold agglutinins
cryofibrinogen and cryoglobulin
is a process that causes bleeding to stop
hemostasis
3 things that happen when a vessel is injured
- vessel contracts
- platelets are initiated to form a clot
- clotting factors convert fibrinogen to fibrin
first step of hemostasis
vessel contracts
second step of hemostasis
platelet plug is formed
third step of hemostasis
initiation
in the second step of hemostasis, platelets stick together to form a temporary seal to cover the break in the ___
vessel wall
in the third step of hemostasis, coagulation reinforces the platelet plug with ___ that acts as molecular glue
fibrin threads
endothelial cell damage expose a glue-like substance called ___ that causes platelets to stick to the damaged tissue
von Willebrand factor
hemostasis starts within ___ of injury
10-15 seconds
floating clots are also called
thromboembolism
treatment for thromboembolism involves drug therapy such as ___ to dissolve the clot
streptokinase
a clot-dissolving enzyme called tPA
tissue plasminogen activator
putting the patient on anticoagulant therapy such as __ can also help with treatment of thromboembolism
heparin
a drug that interferes with platelet aggregation and is used to prevent clotting
aspirin
lab tests done for ___
PT/INR
PTT
Fibrinogen
Thrombin
coagulation
a substance found in blood that when activated is converted to thrombin
prothrombin
INR
international normalization ration
PTT
partial thromboplastin time
is converted to fibrin
fibrinogen
PT
prothrombin time
a fibrin degradation product
small protein fragment present in the blood after a blood clot is degraded by fibrinolysis
D-dimer
contains two crosslinked D fragments of the fibrin protein
D-dimer
there are __ factors in a coagulation cascade
12
Factor I
Fibrinogen
Factor II
Prothrombin
Factor III
Tissue thromboplastin
Factor IV
Ionized Ca
2 coagulation pathways
extrinsic
intrinsic
coagulation test to measure extrinsic pathway
PT
coagulation test to measure intrinsic pathway
PTT
upon introduction of cells, particularly crushed or injured tissue, coagulation is activated and a fibrin clot is rapidly formed
extrinsic pathway
activated by trauma inside the vascular system, and is activated by platelets, exposed endothelium, chemicals, or collagen
intrinsic pathway
DIC
disseminated intravascular coagulation
when body’s blood clotting mechanism are activated throughout the body instead of being localized at an area of injury
small clots form throughout the body and uses up clooting factors (finite)
results in clotting symptoms or more bleeding
DIC
tests used to detect ___
PTT
D-dimer
Fibrinogen L=level
Platelet count
PT
DIC
a decrease in Factor VIII causes
hemophilia A
