Section 1: Intro and Lab Safety

Question 1

Define hematology

Answer 1

Hematology is the study of blood cells and blood-forming tissues

Question 2

What is plasma versus serum?

Answer 2

Plasma = serum + clotting factors
Serum = plasma - clotting factors

Serum and plasma contain water, proteins, salts, hormones

Question 3

What does EDTA stand for? Color of tube? Function? Which hematological procedures would it be used.

Answer 3

It stands for Ethylenediaminetetraacetic acid

Lavendar (purple top) tube

Functions to chelate calcium ions and remove them so that blood doesn’t clot

Most commonly used in hematology procedures, such as CBC and differential count (WBC % count). Count WBC, RBC and PLT.

Question 4

Color tube of sodium citrate? Function? What’s special about it? Hematological procedures?

Answer 4

Light blue cap tube. Functions to also bind calcium and prevent clotting. Same hematological procedures as before. Substitutes for EDTA if patient is an EDTA blood clumper (platelets clump to each other) or if platelet satellites form around neutrophils. Has more anti-coagulant than EDTA so is diluted by filling tube all the way. Multiply by 1.1 to account for dilution factor

CBC report only WBCs and platelets

Cold platelet antibodies still a problem here

Question 5

Color tube of heparin? Function? Common hematological procedures?

Answer 5

Green cap tube. Functions to block clotting factors. CBC reports only WBC, RBC, and Hct (hematocrit)

Question 6

Describe EDTA clumpers, cause, problems to machine, and solution

Answer 6

Cause: EDTA causes platelets (or WBCs or RBCs) to agglutinate due to conformational change in membrane and start to look like WBCs to machine due to increased size. Not a true clot
Problem: machine reads platelet clumps as pseudothrombocytopenia and pseudoleukocytosis
Solution: Use sodium citrate instead

Question 7

Describe cold platelet antibodies cause, problems to machine, and solution

Answer 7

Cause: blood drawn into tube cools down such that Ab against platelets react and cause platelets to clump
Problems to machine: pseudothrombocytopenia reading
Solution: heat to body temp and immediately run test

Question 8

Describe platelet satellites cause, problems to machine, and solution

Answer 8

Cause: EDTA may cause platelets to clump around neutrophils
Problems to machine: pseudothrombocytopenia and pseudoleukocytosis because increase WBC to platelet ratio
Solution: Use sodium citrate instead

Question 9

Why are clotted samples unacceptable in hematology and hemostasis?

Answer 9

Automated machine can’t correctly read cell counts because clumps give pseudocytopenias. The. clotting factors make fibrin mesh that traps blood cells

Question 10

List the components of the complete blood count with proper reporting units and scientific notation

Answer 10

WBC X 10^3/mm^3

RBC X 10^6/mm^3

PLT (platelet count) X 10^3/mm^3

Question 11

Expand acronyms and define terms:

MCV
MCH
MCHC
RDW
MPV

Answer 11

Mean cell volume = Average cell size (fL)
Hematocrit X 10/RBC millions

Mean cell hemoglobin = Average Hbg weight per RBC (picograms, pg)
Hemoglobin X 10/RBC millions

Mean cell hemoglobin concentration = Average amount of RBC volume that Hbg occupies (% or g/dL)
(Hemoglobin/Hematocrit) X 100

Red cell distribution width = amount of red cell size variation (%)

Mean platelet volume =average platelet size (also fL maybe?)

Question 12

Define anisocytosis

Answer 12

Huge variability in RBC cell size in population

Question 13

Define accuracy

Answer 13

How close is measured value to true value

Question 14

Define precision

Answer 14

Consistent accuracy

Question 15

Reliability

Answer 15

Trustworthiness. Accuracy and precision

Question 16

Linearity

Answer 16

Values fall within linear range that can be reported

Question 17

Sensitivity

Answer 17

True positive rate

Question 18

Specificity

Answer 18

Can it detect true negatives

Question 19

What is method validation

Answer 19

Double check if new method yields accurate results

Question 20

What are lot to lot comparisons?

Answer 20

You test one lot for accurate results. Get a new lot and compare to previous lot for consistent and accurate results

Question 21

What are critical values?

Answer 21

Numbers that if too high or too low (outside standard range) and must be reported

Question 22

Delta checks

Answer 22

Comparing previous results with current results and seeing why they’re different

Question 23

Reference range development

Answer 23

Developing standard ranges for cell counts, differentials…etc so that we can distinguish between healthy and pathological states

Question 24

Control samples

Answer 24

They serve to test if a method worked as expected

Question 25

Proficiency/competency testing

Answer 25

Check to make sure the MLS tech skills meet requirements when conducting tests

Question 26

Continuing education/professional development

Answer 26

Make techs continue education (going to conferences and stuff) to improve skills

Question 27

Define (standard) universal precautions

Answer 27

Housekeeping (clean/disinfect/restock)
Electronics (keep them away during wet lab)
Laundry (
Fire hazards (fire extinguishers every 75 feet, checked monthly, maintained annually, everyone must do fire drill)
Chemical hazards (SDS, electronic version ok, no password protection or locked behind door)
Occupational hazards (electronic and needle punctures. Don’t recap needles)

Question 28

List potentially infectious materials in standard (universal precautions)

Answer 28

All human blood, body fluids, and tissues.

Question 29

Identify 4 occupational hazards in the lab

Answer 29

1. Fire
2. Chemical
3. Electrical
4. Health

Question 30

Describe the safe practices described in the “Occupational Exposure to Bloodborne Pathogens” standard

Answer 30

Wash the site of the needlestick or cut with soap and water.

Flush splashes to the nose, mouth, or skin with water.
Irrigate eyes with clean water, saline, or sterile irrigants. At least 15 min

Lab coats and clothing

Wash any exposed skin

Report incident to supervisor and fill out incident report

Question 31

What is the single most important practice to prevent infection

Answer 31

Handwashing

Question 32

Define SDS, list information contained on SDS, and determine when SDS will be
used in laboratory activities

Answer 32

Safety Data Sheet contains:
Section 1- product ID, manufacturer name, phone number, recommended use, restrictions for use
Section 2 - Hazards ID
Section 3- Composition/info on ingredients
Section 4 - First-aid measures
Section 5 - Fire-fighting measures (first aid treatment for exposure and symptoms of exposure
Will be used in lab with products that students should know how to safely use

Question 33

Name the specific practice during which most needle stick injuries occur

Answer 33

Phlebotomy

Question 34

Which cells suffer from cold reactive antibodies? Which is most common?

Answer 34

Ab to WBCs, RBCs, and PLTs. anti-RBC cold reactive Abs most common, so commonly see RBCs sticking together