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Hematology > Manual Hematology Methods > Flashcards

Manual Hematology Methods Flashcards

1
Q

Definition of Hematology

A

Study of cellular components of blood, cell ID, blood forming organs, blood related disorders, clotting mechanisms, lab tests

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2
Q

Definition of hemostasis

A

“Blood Balance”; a study of the mechanisms that the body employs to ensure balance and order in the circulatory system, coagulation system

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3
Q

Definition of Hematocrit

A

The percentage of packed red blood cells in a given volume of centrifuged blood; uses a small volume of blood in a capillary tube

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4
Q

Definition of Manual differential

A

Microscopically differentiate the white blood cells and note abnormalities, giving a percent of each type

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5
Q

Definition of a Buffy Coat

A

WBCs and platelets that form a layer on top of the RBCs after centrifugation

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6
Q

Definition of EDTA

A

Ethylenediaminetetraacetic acid, a powdered anticoagulant in lavender topped tubes, binds to Ca, gentle to cells

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7
Q

Definition of Na+ Citrate

A

Liquid anticoagulant, binds to Ca, 1:9 ratio (volume) is crucial

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8
Q

Definition of Zeta Potential

A

Charge on RBCs surface that keeps them from aggregating

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9
Q

Definition of Acute Phase Proteins

A

CRP, Fibrinogen

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10
Q

Definition of Rouleaux

A

A “stacking” of RBCs that occurs during the aggregation phase of ESR; and during certain infections

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11
Q

Definition of Trapped Plasma

A

Plasma stuck between RBCs in Hematocrit that cause a falsely increased reading

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12
Q

Microhematocrit Error Sources

A

Increased: trapped plasma (spun too slowly/not long enough, poikilocytosis)
Decreased: tissue fluids (edema), hemolysis, excess anticoagulants, bad clay seal

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13
Q

Microhematocrit Procedure

A

2 tubes with 3/4 EDTA/whole blood mix; seal end with clay; centrifuge; interpret on card, report avg. %

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14
Q

Phases of ESR

A
  1. Aggregation - RBCs form rouleaux
  2. Sedimentation - aggregates come out of sln
  3. Packing - aggregates pack together
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15
Q

ESR Procedure

A

1 ml EDTA/whole blood into well that contains .5 ml NaCl/Na Citrate; fill pipette to 0 mark with mix; leave in rack for hour; record mm’s of sedimentation

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16
Q

Causes of elevated ESR

A
  • Room is too warm (extreme)
  • Tilted tube
  • Sample was agitated
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17
Q

ESR Ranges

A

Kids: 0-10 mm/hr
Men 50: 0-20 mm/hr
Women 50: 0-30 mm/hr

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18
Q

Non-error causes of elevated ESR

A

Inflamm. proteins lower zeta potential which lets cells aggregate/sediment more easily; from infections, autoimmune diseases, PID, pregnancy, and neoplastic diseases

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19
Q

Characteristics of a well-made smear

A

Length of smear should be 1/2 - 3/4 length of slide; edges should be contained within slide; no scratches/holes, a homogeneous spread; dark to light

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20
Q

Wright stain components

A

Wright stain for 2 min; then add diluted Giemsa stain for 4 min, looking for metallic sheen; wash with DI for 30 sec; allow to dry

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21
Q

Polychrome

A

Different colors, stains that will differentiate cell types

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22
Q

Peripheral smear examination steps

A

Scan at 10x looking for odd distribution of cells; at 40x find a good area; 100x stay in good area and preform evaluations

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23
Q

WBC Differential procedure

A

Count 100 WBCs using the 100X oil objective lens, use “battlement” pattern

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24
Q

Platelet estimation procedure

A

Scan the side at 100X and find the average number of platelets seen in 10 different fields then multiply this number by 15,000

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25
Q

Why do we use the “battlement” pattern?

A

Neutrophils tend to gather on the outside while lymphocytes tend to remain in the center

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26
Q

Neutrophil characteristics

A

Blue pink or tan cytoplasm

2 to 5 lobes connected with a thin filament

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27
Q

Band neutrophil characteristics

A

Blue pink or tan cytoplasm

C or S shaped nucleus, no individual lobes

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28
Q

Eosinophil characteristics

A

Pink cytoplasm with a high amount of red or orange granules and a segmented nucleus

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29
Q

Basophil characteristics

A

Light purple to colorless cytoplasm highly granular (dark blue or purple) segmented nucleus

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30
Q

Lymphocyte characteristics

A

Most variable type, round or oval shaped nucleus with dense chromatin which is roughly the size of a RBC, they can have small vacuoles and granules
On a slide they can have the ballerina skirt appearance

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31
Q

Monocyte characteristics

A

Extremely large nucleus with variable shape, blue-gray cytoplasm and varied cytoplasmic borders (they’re considered pseudopods) and they are vacuolated

32
Q

Hemocytometer large square volume

A

0.1 ul

33
Q

Hemocytometer small square volume

A

0.004 ul

34
Q

Hemocytometer calculation formula

A

(# of squares counted)(Square volume)
= cells/mm3

35
Q

CBC definition

A

Gives counts, sizes, maturities, shapes, hemoglobin content, and differentials for WBCs, RBCs, PLTs

36
Q

Definition of VCS

A

Volume, conductivity, and light scatter used to analyze WBC differentials

37
Q

Absolute count

A

The actual number of certain type of cell

38
Q

Relative count

A

The percentage of a certain type of cell as compared to the total

39
Q

Levy-Jennings chart

A

A visual representation of the performance of the analyzer, results of controls are recorded and plotted onto graphs

40
Q

Definition of Delta check

A

An automatic check performed by the laboratory information system to notify the tech the significant differences between recent test results

41
Q

Definition of quality assurance

A

Process of ensuring that the final results we report are correct, everything that we do to make sure our answers are right

42
Q

Definition of quality control

A

Measures retake daily or during each shift during every test to ensure that the test is working properly and that our answers are right

43
Q

RBC count ranges

A

Male: 4.5-5.5 x 10^6/ ul
Female: 4-5 x 10^6 ul

44
Q

Hematocrit ranges

A

Male: 42-52%
Female: 36-46%

45
Q

Hemoglobin ranges

A 
Highest Hgb levels are found in newborns
Male: 14.7-17.4 g/ul
Female: 12-16 g/ul
Critical values
Male: >20
Females <7
46
Q

Rule of three

A

RBC count x3 is roughly equal to hemoglobin +/- 3
Hemoglobin x3 is roughly equal to Hematocrit +/-3
“RBC x 3 = Hgb x 3 = Hct”

47
Q

MCV range

A

Mean corpuscular volume

normal range 80-100fL

48
Q

MCH range

A

Mean corpuscular hemoglobin normal range 28-34 pg

49
Q

MCHC Range

A

Mean corpuscular hemoglobin concentration

normal range 32-36 g/dL

50
Q

RDW range

A

Red cell distribution width

normal range 12-14.6%

51
Q

WBC count ranges

A

Adult: 4.5-11 x 10^3/ul
Newborn: 9-30 x 10^3/ul
Critical high: >50 x 10^3/ul
Critical low: <1.5 x 10^3/ul

52
Q

Neutrophil count ranges

A

Absolute: 1.8-7 x 10^3/ul
Relative: 40-80%

53
Q

Lymphocyte count ranges

A

Absolute: 1-4.8 x 10^3/ul
Relative: 25-35%

54
Q

Monocyte count ranges

A

Absolute: .1-.8 x 10^3/ul
Relative: 2-10%

55
Q

Eosinophil count ranges

A

Absolute: 0-.4 x 10^3/ul
Relative:0-5%

56
Q

Basophil count ranges

A

Absolute: 0-.2 x 10^3/ul
Relative: 0-1%

57
Q

Band neutrophil count ranges

A

Absolute: 0-.7 x 10^3/ul
Relative: 0-5%

58
Q

Platelet count range

A

150-450 x 10^3/ul

59
Q

MPV range

A

Mean platelet volume

6.8-10.2 fL

60
Q

Definition of the Coulter principle

A

Cells pass-through an aperture which momentarily impedes electronic flow allowing them to be counted and sized

61
Q

Definition and testing methods of hemoglobin

A

Molecule inside RBCs that carries oxygen and CO2, ring with central Fe and Globin which combines with mRNA
Directly measured by the cyanmethemoglobin test methodology

62
Q

Cyanomethemoglobin method

A

RBCs are lysed to release hemoglobin, potassium ferricyanide is added to make methemoglobin which combines with cyanide ions, solution is then measured with a spectrophotometer

63
Q

VCS technology

A

Works like a flow cytometer, using current, radio waves, and laser beam.
Current: creates a pulse comparable to cell volume
Radio waves: penetrate cell mem and measure nucleus volume
Laser Beam: structure, shape, granularity, nuclear lobarity

64
Q

MCV Equation

A

(HCT/RBC) x 10

65
Q

MCH Equation

A

(HGB/RBC) x 10

Low will be hypochromic, cannot be too high since the amount of hemoglobin is limited by the size of the cell

66
Q

MCHC Equation

A

(MCH/MCV) x 100

67
Q

Relative values equation

A

Total WBC count

68
Q

Correcting WBC count equation

A

# of nRBCs + 100

69
Q

+++++

A

Results exceeds instrument linearity, too high of a value, dilute and re-run sample

70
Q
A

“total voteout”, 2 of the 3 counts do not match, caused by a dirty aperture, clotted sample, or a short sample

71
Q

…..

A

Incomplete computation, due to +++++ or —–

72
Q

R flag

A

An abnormal result, check out patient history, then redraw if necessary

73
Q

Definition of Shift

A

Sudden change in values that remains consistent

74
Q

Definition of Trend

A

A gradual change in the same direction

75
Q

Reticulocyte Calculation

A

1000 RBCs
= % Retics

Or:
# of Reticulocytes counted x 100
———————————————
RBC x 9

76
Q

Corrected Reticulocyte Count

A

45%
= Correct Retic %

Hematology (17 decks)

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