CBC Flashcards

1
Q

anticoagulant:

EDTA optimal conc

A

1.5mg per mL of blood

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2
Q

anticoagulant:

how many hours is blood valid in EDTA tube?

A

4 hours - room temp

24 hours - refrigerated (wbc, hct, plt)

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3
Q

anticoagulant of choice for platelet count

A

EDTA

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4
Q

why EDTA is preferred for platelet count?

A

EDTA prevents platelet aggregation

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5
Q

t or f. ESR should be set up within 4 hours of collection (room temp) or 6 hours (refrigerated)

A

false, 2 hours.

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6
Q

t or f. blood smear can be made from EDTA tube as long as they are made within 4 hours of blood collection.

A

false, 2 hours.

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7
Q

mean platelet volume normal range

A

6.8 to 10.2 fl

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8
Q

t or f. EDTA causes swelling of platelets (50% higher) during the first hour.

A

false

20% higher

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9
Q

insufficient EDTA
cause:
effect:

A
  • over-filled tube

- presence of clots

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10
Q
EDTA
color:
inversions:
lab section:
optimal conc:
action:
A
  • lavender top
  • 8 inversions
  • hematology
  • 1.5 mg per mL of blood
  • chelation of calcium
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11
Q
EDTA
color:
inversions:
lab section:
optimal conc:
action:
A
  • lavender top
  • 8 inversions
  • hematology
  • 1.5 mg per mL of blood
  • chelation of calcium
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12
Q

CBC other name

A

hemogram

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13
Q

RBC parameters (6)

A
RBC ct
Hgb
Hct
RBC indices
RDW
Retic ct
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14
Q

PLT parameters (2)

A

PLT ct

MPV

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15
Q
heparin
color:
inversions:
lab section:
optimal conc:
action:
A
  • green top
  • 8 inversions
  • chemistry, OFT, and ABG
  • 15-20 units per mL of blood
  • binds antithrombin (inhibits thrombin and factor Xa)
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16
Q

3 formulations of heparin

A
  • ammonium heparin
  • sodium heparin
  • lithium heparin
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17
Q
3.2% sodium citrate
color:
inversions:
lab section:
optimal conc:
action:
A
  • light blue top
  • 3-4 inversions
  • coagulation studies
  • AC:blood ratio = 1:9
  • chelation of calcium
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18
Q

reference method for Hgb determination

A

cyanmethemoglobin (HiCN) method

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19
Q

reagent used in HiCN method and its component

A

Drabkin’s reagent

  • potassium ferricyanide
  • potassium cyanide
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20
Q

HiCN principle

A

Hgb + KFeCN > methemoglobin + KCN > cyanmethemoglobin

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21
Q

potassium ferricyanide use:

potassium cyanide use:

A
  • converts hemoglobin to methemoglobin

- provides cyanide ions

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22
Q

HiCN is measured at what nm?

A

540 nm

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23
Q

all types of Hgb may be measured in HiCN except:

A

sulfhemoglobin

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24
Q

how many minutes should we allow for the full conversion of hemoglobin into cyanmethoglobin?

A

10 minutes at room temp

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25
Q
falsely elevated Hgb:
-high WBC and PLT ct
WBC > 20 000/uL
PLT > 700 000/uL
correction:
A
  • centrifuge

- measure Hgb at supernatant

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26
Q

falsely elevated Hgb:
-lipemia
correction:

A
  • add 0.01 mL of the patient’s plasma to 5 mL of the cyanmethemoglobin
  • use this as reagent blank
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27
Q

falsely elevated Hgb:

-Hgb S and Hgb C

A
  • make a 1:2 dilution with dH2O

- multiply the results from the standard curve by 2

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28
Q

falsely elevated Hgb:

-abnormal globulins

A

-add 0.1 g of K2CO3 to the cyanmethemoglobin reagent

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29
Q

t or f. cyanmethemoglobin reagent is not sensitive to light.

A

false. it is photosensitive

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30
Q

handheld system that can measure Hgb conc

A

HemoCue

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31
Q

Hgb normal range

children:

A

12-15 g/dL

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32
Q

Hgb normal range

adult female:

A

12-15 g/dL

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33
Q

Hgb normal range

adult male:

A

14-18 g/dL

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34
Q

another name for Hgb

A

respiratory pigment

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35
Q

1 g of Hgb can carry ___ mL of O2

A

1.34 mL

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36
Q

1 g of Hgb can carry ___ mg of iron

A

3.47

37
Q

complete component of adult Hgb molecule (4)

A
  • globin
  • protoporphyrin IX (PPIX)
  • ferrous iron
  • 2,3-BPG molecule
38
Q

examples of globin chains and their number of amino acids (6)

A

alpha - 141 aa
zeta - 141 aa

beta - 146 aa
epsilon - 146 aa
delta - 146 aa
gamma - 146 aa

39
Q

PPIX + ferrous iron =

A

heme

40
Q

transcribe 2,3-BPG

A

2,3-bisphosphoglycerate

41
Q

where is 2,3-BPG produced?

A

Rapoport-Luebering Shunt of RBCs

42
Q

transient resident of hemoglobin

A

2,3-BPG

43
Q

purpose of 2,3-BPG

A

transfers oxygen to tissues

44
Q

primary functions of Hgb (3)

A
  • delivery of oxygen to the tissues
  • carry CO2 away to the lungs
  • binding, inactivation, and transport of NO
45
Q

Hct normal range

newborn

A

53-65%

46
Q

Hct normal range

adult females

A

35-49%

47
Q

Hct normal range

adult males

A

40-54%

48
Q

layers of centrifugated blood

A
  1. fatty layer
  2. plasma layer
  3. buffy coat
  4. packed RBC
49
Q

microhematocrit tube
length:
inner bore:
volume:

A
  • 75 mm long
  • 1.2 mm
  • 0.05 mL of blood
50
Q

red band microhct tube
AC:
used for:

A
  • heparin

- collection for non-AC blood

51
Q

blue band microhct tube
AC:
used for:

A
  • no anticoagulant

- collection for AC blood (EDTA)

52
Q
microhct procedure
blood volume to collect:
which side should blood enter:
which side should we seal:
sealing clay length:
microcentrifuge rpm and time:
margin of error:
A
  • 2/3
  • opposite side of color
  • seal at side of color
  • 4 to 6 mm
  • 10,000 rpm, 5 minutes
  • +/- 0.02 L/L
53
Q

falsely increased hct: (4)

A
  • dehydration
  • hemoconcentration
  • insufficient centrifugation
  • buffy coat was read
54
Q

falsely decreased hct: (4)

A
  • hemolysis
  • improper sealing
  • increased AC concentration
  • introduction of excess interstitial fluid
55
Q

purpose of rule of three in CBC

A

used for checking validity of test results

56
Q

limitation of rule of three in CBC

A

works only on normocytic, normochromic specimens

57
Q

rule of three
Hgb formula:
Hct formula:

A

3 x RBC ct = Hgb

3 x Hgb = Hct

58
Q

average volume of an individual RBC

A

mean cell volume (MCV)

59
Q

MCV formula

A

(HCT/RBC ct) x 10

60
Q

MCV normal range

A

80-100 fl

61
Q

average weight or amount of Hgb in an individual RBC

A

mean cell hemoglobin (MCH)

62
Q

MCH formula

A

(Hgb/RBC ct) x 10

63
Q

MCH normal range

A

26-32 pg

64
Q

what is not used in the classification of anemia?

A

MCH

65
Q

normal MCV, high MCH

what does this indicate?

A

falsely increased Hgb (technical error);

MCV and MCH should be paralllel

66
Q

mean concentration of hemoglobin in the average RBC

A

mean cell hemoglobin concentration (MCHC)

67
Q

MCHC formula

A

(Hgb/HCT) X 100

68
Q

MCHC normal range

A

31-37 g/dL

69
Q

hereditary spherocytosis MCHC

A

35-38 g/dL

70
Q

neutrophils

nucleus:
cytoplasm:
size:
progenitor:
major stimulatory cytokine:
A
  • 3-5 lobes
  • pink w/ violet granules
  • 9-15 um
  • granulocyte-monocyte progenitor
  • granulocyte colony-stimulating factor
71
Q

3 major functions of neutrophils

A
  • phagocytosis
  • generation of neutrophil extracellular traps
  • secretory function (transcobalamin I)
72
Q

eosinophils

nucleus:
cytoplasm:
size:
increases in:
primary granules:
secondary granules:
A
  • 2 lobes
  • bright orange granules
  • 9-15 um
  • allergies and helminthic infections
  • charcot-leyden crystal protein
  • major basic protein (core)
73
Q

which granules of eosinophil is responsible for neutralizing helminths?

A

major basic protein

74
Q

basophils

nucleus:
cytoplasm:
size:
progenitor:
major stimulatory cytokine:
A
  • difficult to observe
  • densely stained w/ purple-black granules
  • 10-16 um
75
Q

monocytes

nucleus:
cytoplasm:
size:

A
  • horseshoe-shaped, stringy chromatin, nuclear vacuoles may be present
  • ground-glass appearance (azure dust), blebs may be observed
  • 14-20 um
76
Q

lymphocyte

nucleus:
cytoplasm:
size:

A
  • round, deep-purple
  • scanty, sky-blue
  • 7-10 um
77
Q

4 types of WBC diff count

A
  • 100 cell diff
  • 200 cell diff
  • 300 or 400 cell diff
  • 50 cell diff
78
Q

routinely performed diff count

A

100 cell diff

79
Q

performed when the WBC ct is >40 000/uL

A

200 cell diff

80
Q

other cases that may need 200 cell diff (4)

A

> 10% eosinophils
2% basophils
11% monocytes
more lymphocytes than neutrophils (except in children)

81
Q

performed when the WBC ct is >100 000/uL

A

300 or 400 cell diff

82
Q

performed when the WBC ct is 1 000/uL

A

50 cell diff

83
Q

what smear is used for 50 cell diff?

A

buffy coat smear

84
Q

gives the number of specific WBC type per 100 WBCs; not as informative and accurate

A

relative count

85
Q

relative count % formula

A

(no of specific WBC type/100 WBCs counted) x 100

86
Q

relative count normal range

A
N = 51-67%
L = 25-33%
M = 2-6%
E = 1-4%
B = 0-1%
87
Q

gives the number of specific WBC type per uL; more informative and accurate

A

absolute count

88
Q

absolute count % formula

A

relative count x WBC count

89
Q

absolute count normal range

A
N = 1 600-7 260/uL
L = 960-4 400/uL
M = 180-880/uL
E = 45-440/uL
B = 45-110/uL