1.1 Blood Smear Preparation Flashcards
(87 cards)
1
Q
It is required for the enumeration and checking of cellular elements
A
Peripheral blood film
2
Q
T or F
The peripheral blood film must be prepared immediately as possible
A
True
3
Q
The peripheral blood film mostly uses what techniques (using EDTA) and Wright-GIEMSA stain
A
Wedge technique
4
Q
Two-slide or Wedge menthol is also known as
A
Push-type wedge preparation
5
Q
It is the simplest and the most common method of smear preparation
A
Two-slide / wedge method
6
Q
It uses 2 slides:
- one for the the smear
- one that serves as a spreader
A
Wedge method / two slide methif
7
Q
In this method, Hugh-quality, beveled-edged microscope slides are recommended.
A
Wedge method/ two slide method
8
Q
It this wedge method type, spreader slide is pushed into the drop of blood and pulled along the length of the slide to make the film
A
Pulled-type
9
Q
Wedge method
The small drop of blood on the slide must be ____ and diameter and ____ from the end of the slide
A
2-3 cm in diameter
1 cm from the edge
10
Q
Wedge mehtid
Using the thumb and forefinger of the right hand, hold the end of the spreader against the surface of the smear slide at ____________ angle
A
30 - 45 degree angle
11
Q
What are the features of a properly made peripheral blood film (6)
A
- The film must cover 2/3 to 3/4 the length of the slide.
- The film is finger shaped. Slightly rounded at the feathery edge, not bullet shaped.
- The lateral edges of the film are visible.
- The film is smooth without irregularities, holes or streaks
- When the slide is held up to the light, the feathery edge/thin portion of the film has rainbow appearance.
- The whole drop of the blood is picked up and spread.
12
Q
What are some causes of unacceptable peripheral blood film?
A
- hesitation
- chipped/rough edge
- pushed too quickly
drop of blood was too small - drop of blood was not spread in the spreader slide
- dirt, grease, or elevated lipids
- uneven pressure
- time delay
13
Q
Many holes in the slide may be attributed to
A
Dirty slides or grease or elevated lipped
14
Q
What are the causes of a thin smear
A
- Small drop of blood
- angle is too small
- px has low hematicrut
15
Q
What are the causes of a thick smear
A
- big drop of blood
- angle is too high
- px has high hematocrit
16
Q
If the px has high hematocrit levels
A
Decrease the angle
17
Q
If the px has low hematocrit levels (px has polycythemia or is a newborn)
A
Increase the angke
18
Q
Ridges / waves in the slide are caused by
A
- hesitation = uneven spread
- too much oressure
19
Q
What causes chipped / rigged edge
A
- unreliable spreader slide
- spreader has stopped near the end of the slife
20
Q
A good film includes a 2 portions
A
Thick portion and think portion
21
Q
Moving the pusher slide forward too slowly accentuates ______________ by pushing larger cells, such as monocytes and granulocytes, to the very end and sides of the film
A
poor leukocyte distribution
22
Q
Slow drying like in humid environment will result to the formation of ______
A
Artifactual cells
23
Q
The slide may be labeled with a lead pencil on the ________ or __________
A
- Frosted edge
- thicker end of the blood film must be
24
Q
Why are balloons/markers not used when labeling slides
A
They may be washed out during staning
25
How can the thickness of the film be adjusted?
- changing the angle
- change of speed
- smaller/larger drop of blood was
26
Increasing the angle of the spreader slide will
Increase the thickness of the film
27
increasing the speed with which the spreader slide is pushed will
Increase the thickness of the film
28
It is an older technique that is now used only rarely for PBS, but it is sometimes still used for making **bone marrow** aspirate smear
Ehrlich’s Two-Coverglass method / Two-cover slip
29
It is used for making bone marrow aspirate smears since it requires only a small amount of sample
Ehrlich’s Two-Coverglass method / Two-cover slip
30
For ehrlich two cover glass method, no. 1 or 1 ½ cover glasses _________ square are recommended.
22 mm
31
In the ehrlich’s two cover glass method, if done correctly, both coverslips will have quality smears that will appear similar to a ________ print.
thumb print
32
Making smears in coverslips (ehrlich’s two coverglass method) requires
Manual dexterity
33
One of the advantages of the Erlich’s method is that it requires _________ amount of bone marrow
Minimal amount
34
It produces an excellent leukocyte distribution which lends itself to more accurate determination of differential counts
Ehrlich’s Two-Coverglass Method
35
One of the disadvantages of the Ehrlich’s Two-Coverglass Method is that coverslips are
Fragile and prone to breakage when storing it
36
In the Ehrlich’s Two-Coverglass Method, the two coverslips must form a _______ figure to begin spreading the blood
16-slides figure
37
Blood films that combined the advantages of easy handling of the wedge slide and uniform distribution of cells of the cover glass preparation, may be made with special types of centrifuges known as
Spinner
38
This produces a uniform blood film, in which all cells are separated (a monolayer) and randomly distributed
Spinner slide
39
Smears prepared using this method have white blood cells that can be easily identified at any spot in the film
Spinner method
40
On a wedge smear, the disproportionate of **monocytes** occur at the _______
Tip of a the feathered edge
41
On a wedge smear, the neutrophils are seen just in from the
Feathered edge
42
On a wedge smear, both neutrophils and monocytes may occurs at the
Lateral edges of the film
43
It is an automated slide making and staining system
Sysmex SP-1000i
44
One of the features of the Sysmex SP-1000i is that it **adjusts the size of the drop of blood** used and the **angle and speed** of the spreader slide in making a wedge preparation
Dependent in hematocrit levels
45
In Sysmex SP-1000i, a film is produced for every
30 seconds
46
T or F
In the Sysmex SP-1000i, the slide comes with a printed label: patient name, number, and date
True
47
This automated smear preparation machine prepares slides automatically based on orders received from the LIS
DxH Slidemaker Stainer II Cellular Analysis system
48
This automated smear preparation machine create and stain smears from **capped whole blood tubes**, **open-top tubes** or **pediatric whole blood tubes**
DxH slidemaker Stainer II Cellular Analysis System
49
In the DxH Slidemaker Stainer II Cellular Analysis System, how many slides are made from a single 90 uL sample and from a single sample presentation
90 uL = 4 slides
1 sample = up to 12 slides
50
It can create multiple stain smear slides, according to any parameter results, such as a low WBC or Blast suspect flag
DxH Slidemaker Stainer II Cellular Analysis System
51
What is the anticoagulant of choice for hematology cell counts and cell morphology
EDTA (ethylenediaminetetraacetic acid)
52
What Romanowsky stains are used for staining of peripheral blood film
Pure weight stain or Wright-GIEMSA Stain
53
It is a methylalcholic solution of eosin & a complex mixture of thyocin (methylene blue, assure blue, etc.)
Romanowsky stain
54
Stain that is most commonly used for staining peripheral blood and bone marrow smears
Romanowsky stain
55
Romanowsky stains are polychrome stains that contain
Eosinophils and methylene blue
56
What are the two anticoagulant not allowed to be used when using wright’s stain
Heparin - causes blue bg
Oxalate & Fluoride - distort morphology
57
Heparin is not allowed when staining using Wright’s staining because it causes
Blue background
58
Oxalate & Fluoride are not allowed when staining using Wright’s staining because it causes
Distortion of morphology
59
Slides are manually smeared by dipping into the reagents found in coplin jar
Staining jar or dip method
60
Enumerate the steps of the Staining jar or dip method: Wright staining
1. Methanol - 30 seconds
2. Eosin - 6 seconds
3. Methylene blue - 4 seconds
Buffer solution/aged distilled water - 45 seconds
61
In the dip method, the fixative used to fix the cells to the glass slide is (1st step)
Methanol - 30 seconds Buffer solution
62
In the dip method, the seconds step involves free eosin which are acidic and stain basic cellular components such as
Hemoglobin or eosinophilic granules (appear red)
63
In the dip method, the third step involves free methylene blue which are basic and stain acidic cellular components such as
RNA (appear blue)
64
In the dip method, the 4th step requires ______________ or aged distilled water (distilled water placed in a glass bottle for at least 24 hours; pH 6.4 to 6.8)
- 0.05 M sodium phosphate (pH 6.4)
- aged distilled water (24 hrs) (pH 6.4 - 6.8)
65
In an optimally stained peripheral blood film, the RBCs should appear
Pink to sslmon
66
In an optimally stained peripheral blood film, the nuclei should appear
Dark blue or purple
67
In an optimally stained peripheral blood film, the cytoplasmic granules of neutrophils appear
Lavender to lilac
68
In an optimally stained peripheral blood film, the cytoplasmic granules of basophils appears
Dark blue to black
69
In an optimally stained peripheral blood film, the cytoplasmic granules of eosinophils appear
Red to orange
70
In an optimally stained peripheral blood film, the area between the cells should be
Colorless, clean, free of precipitated stain
71
The best staining results are obtained from freshly made slides that have been prepared within _________ hours of blood collection.
2 to 3 hrs
72
What could be the cause of this blood film appearance?
RBCs appear gray/blue/green (should be pink or salmon)
- stain or buffer is too **alkaline**
- inadequate rinsing
- prolonged staining
- **heparinized** blood sample
73
What could be the cause of this blood film appearance?
The nuclear chromatin appears deep blue to black (should be dark blue to purple)
- stain or buffer is too **alkaline**
- inadequate rinsing
- prolonged staining
- **heparinized** blood sample
74
What could be the cause of this blood film appearance?
Eosinophils granules are blue/gray not red - orange
- stain or buffer is too **alkaline**
- inadequate rinsing
- prolonged staining
- **heparinized** blood sample
75
What can you do to troubleshoot too alkaline slides, inadequate rinsing, prolonged staining, or heparinized blood sample
- staining for a shorter time or using less stain
and more diluent may correct the problem
- buffer may be too alkaline, and a new one with a lower pH should be prepared
- replace the reagents with new ones in its optimal state
76
What could be the cause of this blood film appearance?
RBCs appear too pale or bright
- stain or buffer too acidic (most common)
- underbuffering (time too short)
- over-rinsing
77
What could be the cause of this blood film appearance?
WBCs appear too dark
- Stain or buffer too alkaline (most common)
- Inadequate rinsing
- Prolonged staining
- Heparinized blood sample
78
What could be the cause of this blood film appearance?
Neutrophils are deeply overstated, large, and prominent
- stain or buffer is too **alkaline**
- inadequate rinsing
- prolonged staining
- **heparinized** blood sample
79
What could be the cause of this blood film appearance?
Nuclear chromatin appears pale blue
- stain or buffer too acidic (most common)
- Underbuffering (time too short)
- Over-rinsing
- exposure to acid fumes
80
What could be the cause of this blood film appearance?
WBCs are barely visible
- stain or buffer too acidic (most common)
- Underbuffering (time too short)
- Over-rinsing
- exposure to acid fumes
81
What could be the cause of this blood film appearance?
Eosinophils appear to have sparkling brilliant red granules
- stain or buffer too acidic (most common)
- Underbuffering (time too short)
- Over-rinsing
- exposure to acid fumes
82
What can you do to troubleshoot too acidic (most common), underbuffering, over-rinsing, exposure to acid fuse
- Prevent the exposure of stains or buffer to acid fumes as this may result to over acidic reagents
- Low pH of the buffer/methyl alcohol may lead to the development of formic acid as a result of oxidation on standing
- Replace the reagents with new ones in its optimal state
83
Inadequately stained red cells, nuclei, or eosinophilic granules may be due to
- under staining
- excessive washing
84
Presence of precipitates on the film due to
Unclean slides
85
What are other causes of problems for PBS
- failure to hold the slide horizontally during initial washing
- inadequate filtration of the stain
- permitting dust to settle con the slide/smear
86
Giemsa Stainer is an excellent stain for _____ parasite
Malarial parasite
87
What are other romanowsky-type stain other than wrights stain
- giemsa stain
- leishman’s syain (flagella)
- jenner’s
- may-grünwald
- macneal’s
