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Hematology > Manual Test Methods > Flashcards

Manual Test Methods Flashcards

1
Q

What are characteristics of a good smear

A

smoot even film with feathered ends
minimum of 3cm in length
blood should not spill over the end or sides

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2
Q

What causes a smear to be too short

A

spreading the blood too quickly, angle of spreading slide greater than 30 degrees

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3
Q

What causes a smear to be too long

A

spreading the blood too slowly, angle of spreader is less than 30 degrees

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4
Q

What causes a smear to be too thin

A

drop of blood too small, patient has low HGB

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5
Q

What causes a smear to be too thick

A

drop of blood too large, patient abnormalities with viscous blood

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6
Q

What causes chattering or streaking in a smear

A

clots/clumps/debris on slide, blood drying out, glass edge not smooth

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7
Q

What does malaria protocol need

A

4 thin smears (2 stained, 2 unstained) and 4 thick smears

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8
Q

When is a buffy coat smear made

A

when the white blood cell count is too low for analysis on a routine smear or when bacteria/parasites are present

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9
Q

What is a buffy coat smear used for

A

to evaluate WBC morphology

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10
Q

When is a cytospin smear used

A

whenever a fluid has a WBC count above 5x10^6/L

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11
Q

What types of smears are used for bone marrows

A

push smears, squash smears and touch-prep smears

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12
Q

What are the components of a wright-giemsa stain

A

methylene blue, purified azure blue B, eosin

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13
Q

What fixative is used for the wright-giemsa stain

A

methanol

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14
Q

What is the pH of the wright-giemsa stain

A

6.8

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15
Q

What components are stained by the methylene blue and azure B in wright-giemsa

A

nucleic acids, RNA, DNA, neutrophil granules

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16
Q

What components are stained by the eosin in wright-giemsa

A

hemoglobin, eosinophil, neutrophil granules

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17
Q

What are the components of a May-Grunwald stain

A

eosin, methylene blue

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18
Q

What is the pH of a may-grunwald-giemsa stain

A

6.8

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19
Q

What does the May-grunwald component of the may-grunwald-giemsa stain

A

cytoplasm

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20
Q

What does the giemsa component of the may-grunwald-giemsa stain

A

nuclear and inclusions

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21
Q

What are the components of giemsa stain for malaria

A

eosin, purified azure B, methylene blue

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22
Q

What are common supervital stains

A

new methylene blue, brilliant cresyl blue, methyl violet, crystal violet, brilliant green

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23
Q

What is the principle of supervital stains

A

used to stain living and unfixed cells in vitro to demonstrate heinz bodies and reticulocytes

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24
Q

What are the components of the prussian blue iron stain

A

0.2N HCl, Potassium ferrocyanide

25
Q

What is the principle of the prussian blue iron stain

A

HCl splits ferric iron from hemosiderin and then the iron combines with potassium ferricyanide to form a blue complex

26
Q

What are considerations when viewing an iron stain slide

A

iron must be inside cells, extracellular iron is considered artifact

27
Q

What can cause increased iron stores

A

megaloblastic anemia, hemolytic anemia, sideroblastic anemia, anemia of chronic disease, lead poisoning, hemosiderosis

28
Q

What can cause decreased iron stores

A

iron deficiency anemia, polycythemia vera

29
Q

What is myeloperoxidase stain used for

A

stains primary granules in monocytes and myeloid lineage

30
Q

What is sudan black stain used for

A

stains primary and secondary myeloid granule lipids, weakly stains granules in monocytes

31
Q

What is periodic acd-schiff stain used for

A

stains glycogen compounds commonly found in lymphoid lineage cells

32
Q

What is non-specific esterase stain used for

A

stains non-specific esterase compounds in monocytes

33
Q

What is the Leukocyte Alkaline Phosphatase stain used for

A

cells are scored based on intensity of staining, higher intensity is seen in mature neutrophils or band cells

34
Q

What causes increased LAP scores

A

leukemoid reaction, multiple myeloma, hodgkins disease, myeloproliferative disorders, aplastic anemia

35
Q

What causes decreased LAP scores

A

chronic myelogenous leukemia, paroxysmal nocturnal hemoglobinuria. sickle cell anemia, myelodysplastic syndromes

36
Q

How does high pH effect staining

A

increased dissociation of methylene blue cause dark blue colour
RBC stain green/blue
neutrophils can appear toxic

37
Q

How does low pH effect staining

A

increased dissociation of eosin causing dark pink colour
RBC stain red/orange
WBC nuclei will be pale
eosin granules will be bright orange

38
Q

How does short stain time effect staining

A

pale slides

39
Q

How does long staining time effect staining

A

dark/overstained slides

40
Q

What are common artifacts in slides

A

debris, stain precipitate, water, thick smears, no blood smear left

41
Q

What is done under the 10x objective during smear analysis

A

check cell distribution and stain
WBC estimate
smear scan for rouleaux, smudge cells, fibrin strands, platelet clumps, large/abnormal cells, parasites

42
Q

What is done under the 50x objective during smear analysis

A

WBC differential and morphologies
Overview of RBC morph

43
Q

What is done under the 100x objective during smear analysis

A

PLT estimate and morphology
RBC morphology

44
Q

What is the calculation for % parasitemia or %retic

A

(square A/Square B) x (100/9)

45
Q

What is the calculation for corrected WBC

A

WBC count/(1+(nRBC/100))

46
Q

How many cells should be counted using a miller-occular

A

111 cells in square B

47
Q

What does transudate mean

A

an accumulation of fluid caused by a non-inflammatory circulation disturbance

48
Q

What are examples of disorders tha cause transudates

A

congestive heart failure, liver disease, renal disease, obstructive tumors

49
Q

What does exudate mean

A

an accumulation of fluid caused by an inflammatory condition

50
Q

What is done to a fluid once it is recieved in the lab

A

gross examination, WBC count, RBC count if requested, cytospin differential if indicated, crystals if requested

51
Q

What is done to a CSF once it is recieved in the lab

A

gross examination, cell count, cytospin differential if indicated

52
Q

What can cause cloudy and colourless CSF

A

high WBC count, presence of microorganisms

53
Q

What can cause coloured CSF

A

hemoglobin/RBC, increased proteins, bilirubin

54
Q

What is an ESR

A

a nonspecific test used as a marker for tissue damage or inflammation

55
Q

What causes increased ESRs

A

infection, rheumatoid arthritis, TB, cancer

56
Q

What is the principle of the ESR

A

when more acute phase reactants are present the zeta potenetial is reduced and RBC fall quicker than normal

57
Q

What can cause falsely increased ESR testing

A

increased rouleaux formation, decreased numbers of red cells, macrocytes, increased albumin

58
Q

What can cause falsely decreased ESR testing

A

abnormally shaped red cells, increased numbers of red/white cells, microcytes, increased fibrinogen, increased immunoglobulin

Hematology (7 decks)

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