[2S] UNIT 8 RBC Counting Flashcards by JULIA CASSANDRA RECCION

Q

The number of erythrocytes contained in 1 liter of blood is called?

A

Erythrocyte Number Concentration

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Q

T/F: The results of an RBC count can be used to help diagnose blood-related conditions, such as anemia, polycythemia and others

A

T

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Q

What tube should be used when collecting blood for RBC count?

A

EDTA - Anticoagulated blood

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Q

In traditional units, Erythrocyte Number Concentration is expressed as the?

A

number of cells per cubic millimeter

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Q

In traditional units, Erythrocyte Number Concentration is expressed as the number of cells per cubic millimeter and is called the?

A

Erythrocyte or Red Blood Cell Count

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Q

T/F: The RBC pipette has a wider bore

A

F; smaller

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Q

Aspirate up to?

A

0.5-1.0

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Q

Tube that retains cell morphology

A

EDTA/Lavender Top

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Q

5 tertiary squares (R squares) of the central secondary square

A

Hemacytometer

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Q

CHARACTERISTICS OF A GOOD RBC DILUTING FLUID

T/F: Must be a hypertonic solution

A

F; isotonic (balanced solute & solvent)

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Q

CHARACTERISTICS OF A GOOD RBC DILUTING FLUID

T/F: Must have a high specific gravity

A

T

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Q

CHARACTERISTICS OF A GOOD RBC DILUTING FLUID

T/F: Must be easy to prepare and cheap

A

T

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Q

CHARACTERISTICS OF A GOOD RBC DILUTING FLUID

T/F: Must be a good preservative

A

T

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Q

CHARACTERISTICS OF A GOOD RBC DILUTING FLUID

T/F: Must not have buffer action

A

F; must have buffer action

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Q

CHARACTERISTICS OF A GOOD RBC DILUTING FLUID

T/F: Must not initiate the growth of molds

A

T

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Q

COMPOSITION
- 40% solution of formaldehyde: 10.0 mL
- 3% W/V trisodium citrate: 990.0 mL

A

Dacie’s / Formol Citrate

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Q

Best RBC diluting fluid since cell shape is not altered

A

Dacie’s / Formol Citrate

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Q

Can be stored for long periods of time without growing fungi or molds

A

Dacie’s / Formol Citrate

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Q

COMPOSITION

○ Mercuric chloride, cp: 0.50 gm
○ Sodium chloride, cp: 1.00 gm
○ Sodium sulfate, cp crystalline: 5.00 gm
○ or anhydrous: 2.65 gm
○ Distilled water: 200.00 m

A

Hayem’s (Me SCared ASs Duck)

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Q

Allows growth of yeast

A

Hayem’s

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Q

Produces clumping of cells

A

Hayem’s

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Q

Can stand for long period

A

Hayem’s

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Q

No corrosive effect

A

Hayem’s

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Q

Prevents Rouleaux formation

A

Gower’s

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COMPOSITION ○ Glacial acetic acid: 16.65 gm ○ Sodium sulfate, cp crystalline: 6.25 gm ○ Distilled water: 100.00 ml

Gower’s

GOWER’S Stack of coins

Rouleaux formation

Precipitates protein in hemoglobinemia and hyperglobulinemia

Gower’s

GOWER’S Usually observed in infection (multiple myeloma, connective tissue disorders)

Rouleaux formation

COMPOSITION ○ Methyl violet: 0.025 gm ○ Sodium Chloride: 1.00 gm ○ Sodium sulfate: 8.00 gm ○ Glycerine: 30.00 gm ○ Distilled water: 200.00 ml

Toisson’s (MeV SCared SiS GanDa)

Stains WBC to aid in the differentiation of WBC from RBCs.

Toisson’s

Beginners are recommended to use this because WBC are easily identified.

Toisson’s

Supports growth of fungi

Toisson’s

Has high specific gravity

Toisson’s

Can stain WBC

Toisson’s

The use of distilling fluid should also be filtered from time to time to prevent the growth of fungi

Toisson’s

COMPOSITION ○ Sodium chloride: 1.00 gm ○ Sodium merthiolate, 1:1000 solution: 2.00 ml ○ Sodium sulfate, crystalline: 5.00 gm ○ Glycerine: 20.00 gm ○ Distilled water: 200.00 ml

Bethell’s (SCared So Much SiS GanDa)

Other name for normal saline solution

Physiologic Saline Solution

Used in emergency cases and excessive rouleaux formation and auto agglutinated cells

Normal Saline Solution / Physiologic Saline Solution

It is stable and serves as a preservative

Normal Saline Solution / Physiologic Saline Solution

COMPOSITION ○ Sodium Citrate ○ Distilled Water

3.8% Sodium Citrate

COMPOSITION ○ Sodium chloride ○ Distilled water

Normal Saline Solution / Physiologic Saline Solution

PROCEDURE T/F: The first step is to mix your EDTA tube or blood sample before aspirating.

T

PROCEDURE T/F: After aspirating, do not wipe off the excess blood at the tip of the pipette

F; Wipe off excess blood at the tip of the pipette using a clean piece of tissue

PROCEDURE T/F: Draw the diluting fluid up to the 101 mark

T

PROCEDURE T/F: Mix the contents of the pipette while in vertical position

F; horizontal

PROCEDURE T/F: When mixing the contents of the pipette, secure the pipette by using your thumb and middle finger to make sure the contents are in homogenous solution by mixing it.

T

Dilution factors

100 or 200

PROCEDURE T/F: Place the thick coverslip. Before charging we must remember to place the thick coverslip and to make sure that the coverslip and counting chamber are free from dirt, thumb marks, tissue strands or any contamination.

T

PROCEDURE T/F: Before charging, do not reshake the pipette.

F; Before charging, make sure to reshake the pipette.

PROCEDURE T/F: We discard the first 5-6 drops because the mixture or solution present in the capillary stem, which is the first few drops of the diluted blood, are cell free.

T

CHARGE Angle of the pipette while charging

30-35 degrees

CHARGE Fill the counting chamber by capillary action or the?

Hanging Drop Technique

CHARGE Let the counting chamber stand for how many minutes

5-10 mins

SOURCES OF ERROR IN RBC COUNTING Did not discard the first few drops from the pipette

Operator’s Technical Errors

SOURCES OF ERROR IN RBC COUNTING Incorrect aspiration/dilution

Operator’s Technical Errors

3 Sources of Error in RBC Counting (Manual)

ERRORS DUE TO: - Materials / Equipment - Nature of Sample - Operator’s Technical Errors

SOURCES OF ERROR IN RBC COUNTING Overcharging / Undercharginh

Operator’s Technical Errors

SOURCES OF ERROR IN RBC COUNTING Presence of air bubbles upon charging

Operator’s Technical Errors

SOURCES OF ERROR IN RBC COUNTING Incorrect counting (did not exclude bottom/right)

Operator’s Technical Errors

SOURCES OF ERROR IN RBC COUNTING After charging, immediately stage the counting chamber in the microscope and start the count

Operator’s Technical Errors

SOURCES OF ERROR IN RBC COUNTING Presence of dirt or debris in coverslip/counting chamber

Errors Due To Materials / Equipment

SOURCES OF ERROR IN RBC COUNTING Use of old or unfiltered diluting fluid (may lead to growth of fungi/presence of yeast cells)

Errors Due To Materials / Equipment

SOURCES OF ERROR IN RBC COUNTING RBC pipette used was not clean and dry (red bead should be moving freely)

Errors Due To Materials / Equipment

2 Variations in Technique

RBC is markedly increased & decreased

2 VARIATIONS IN TECHNIQUE Increase the volume of aspirated blood. Compute for dilution accordingly

RBC is markedly decreased

2 VARIATIONS IN TECHNIQUE Decrease the volume of aspirated blood. Compute for dilution accordingly

RBC is markedly increased

2 VARIATIONS IN TECHNIQUE Use standard blood volume but increase the number of tertiary squares to count. Compute for the revised area factor accordingly

RBC is markedly decreased

CORRELATION 5 Pathologic Variation

PAHDS 1. Polycythemia 2. Anemia/Oligocythemia 3. Hemorrhage 4. Drugs 5. Secondary to other disorders/disease

CORRELATION: PHYSIOLOGIC VARIATION T/F: Men have higher counts than women

T

CORRELATION: PHYSIOLOGIC VARIATION T/F: Adults have higher counts than newborns

F; Newborns have higher counts than adults

CORRELATION: PHYSIOLOGIC VARIATION T/F: Dehydration and strenuous activities may result to decreased counts

F; increased

● Principle: Solution Turbidity ● The more turbid the solution, the more cells are present in the solution

Photoelectric Method

CORRELATION: PHYSIOLOGIC VARIATION T/F: Decreased counts in individuals living at higher altitudes

F; increased

3 other methods for RBC counting

Unopette System Photolelectric Method Automated Analyzers

Principle: Electronic Impedance/ Flow Cytometer/ Coulter principle

Automated Analyzers

Reference range for males

4.5-6.0 M/cumm

Reference range for females

4.0-5.5 M/cumm

Reference range for late pregnancy

3.0-5.0 M/cumm

Reference range at birth

7.0 M/cumm

Conversion of CU to SI

Conventional x 0.000001

S.I. unit for RBC count

x10^12/L