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Hema 2 Lab M1 Flashcards

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1
Q

Main disease associated with Eosinopenia

A

Cushing’s Syndrome or Hyperadrenalism

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2
Q

In a Diluting Fluid

What is the function of Propylene Glycol

A

Lyses RBCs

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3
Q

In the Neubauer chamber, where do we count the eosinophils?

A

9 Large Squares

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4
Q

Give me the components of Randolph’s Diluting Fluid

A

Phloxine, Propylene Glycol, & Calcium Chloride

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5
Q

State the step-by-step procedure of Absolute Eosinophil Count

A
  1. Draw well-mixed anticoagulated whole blood to the 1 mark of the WBC pipette.
  2. Wipe the outside portion of the pipette and draw the diluting fluid to the 11 mark.
  3. Mix for 10 minutes using a pipette shaker
  4. Expel the first 4 drops and fill both sides of the counting chamber.
  5. Allow the cells to settle for at least 3 minutes before counting.
  6. Count the eosinophils in the entire ruled area of both sides of the
    hemocytometer
  7. Get the average count and compute for the absolute count.
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6
Q

Give me the components of Manner’s Diluting Fluid

A

Phloxine, Urea, Trisodium citrate, & Distilled Water

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7
Q

In a Diluting Fluid

What is the function of Heparin

A

Inhibits leukocyte clumping

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8
Q

The formula for Absolute Eosinophil Count

A

Eosinophils/cu.mm = (number of eosinophils counted / 9) x 100

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9
Q

Main disease associated with Eosinophilia

A

Addison’s Disease or Hypoadrenalism

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10
Q

What is the test for the normal adrenal function that usually involves eosinophil count?

A

THORN’S TEST (Eosinophil Depression Test)

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11
Q

In a Diluting Fluid

What is the function of sodium carbonate

A

Lyses all WBCs except eosinophil

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12
Q

Eosinophils are high in terms of (1) _______ (give examples) & (2) _________ (alongside basophils)

A

(1) Respiratory diseases (ex. Pulmonary infiltrates, Hay Fever)
(2) Allergic reactions

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13
Q

In a Diluting Fluid

What is the function of Phloxine

A

Stains eosinophils red

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14
Q

Give me the components of a Phloxine Diluting Fluid

A

Phloxine, Propylene Glycol, Sodium Carbonate, & Distilled Water

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15
Q

Give me the components of the Pilot’s Solution

A

Phloxine, Propylene Glycol, Sodium Carbonate, Distilled Water, & Heparin

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16
Q

State three reasons why eosinophilia happens

A

Parasitic Infections
Allergic Reactions
Certain Leukemias

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17
Q

Increase or Decrease

What happens to the number of eosinophils when there is high level of cortisol?

A

Decrease

Cortisol induces apoptosis, meaning if high ang cortisol mo (due to stress or etc.) mababa eosinophil count mo due to apoptosis (cushing’s syndrome)

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18
Q

State the possible situations where basophil count increases

A

Allergic/Inflammatory Reactions
Hypersensitivity Reactions

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19
Q

Other name for Toluidine Blue Method

A

Cooper and Cruickshank Method

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20
Q

State the function of Cetylpirimidium Chloride

Part of the Principle of Cooper and Cruickshank Method

A

Lyses the erythrocytes and render basophilic granules insoluble

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21
Q

State the function of Ammonium sulfate

Part of the Principle of Cooper and Cruickshank Method

A

Used as a mordant to improve the staining qualities of toluidine blue

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22
Q

What does EDTA do?

Part of the Principle of Cooper and Cruickshank Method

A

Prevent platelet agglutination

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23
Q

What is the color of basophils under the Toluidine Blue Method?

A

Purple red metachromatically-stained cells

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24
Q

Reference Range of Basophil Count

A

0–2 x 10^9/L

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25
State two purpose of Nitroblue Tetrazolium Test
- Distinguish between systemic bacterial infections from non-bacterial infections - Detect neutrophil function defect
26
When the Neutrophils are incubated with colorless soluble dye (Nitroblue Tetrazolium), reduction produces ________ precipitates, and the number of neutrophils that reduced the dye is quantified. | Color
Blue-black formazan precipitates
27
# State the interpretation >10 NBT
Positive neutrophils Systemic bacterial infection
28
# State the interpretation <10 NBT
Positive Neutrophils Normal Individuals
29
# State the interpretation Negative NBT
Congenital Defect of Neutrophil Function
30
It is an older technique used to diagnose acute leukemia.
Cytochemical Staining ## Footnote - It's inexpensive - Can be used by the whole world
31
3 mostly used stains in diagnosing Leukemia based on affected cell lineage
- Myeloperoxidase (MPO) - Sudan Black B (SBB) - Esterases
32
What is MPO and where is it found?
Myeloperoxidase It is an enzyme found in primary granules of the WBCs
33
Myeloperoxidase is positive for what kind of cells? Also state the color.
Dark Brown myeloblasts, promyelocytes, weak activity in monocytes
34
What is SBB and where is it found?
Sudan Black B Found in the lipid portion of primary and secondary granules
35
State the positive color for Sudan Black B and cells that are positive for this stain
BROWN to BLACK myeloblasts, promyelocytes, weak activity in monocytes
36
Cells that are negative for MPO
lymphoid cells, megakaryocytes, immature RBCs ## Footnote Red blood cells may stain diffusely brown because of pseudoperoxidase activity of hemoglobin
37
Cells that are negative for SBB
lymphoid cells, megakaryocytes, immature RBCs ## Footnote Same with MPO
38
State the two Specific Esterases
Chloroacetate Esterase and Napthol AS-D Acetate
39
Under the microscope you see a Bright Red Neutrophils and Mast Cells which is a positive result for a certain stain, what stain do you think the MedTech used?
Specific Esterase ## Footnote Can be Chloroacetate Esterase and Napthol AS-D Acetate
40
These esterases are mainly found staining the monocytes. What are these?
Nonspecific Esterase
41
Give 2 Nonspecific Esterase
ANAE and ANBE ## Footnote Alpha Naphthyl Acetate Esterase and Alpha Naphthyl Butyrate Esterase
42
What cells are negative for Specific Esterase?
eosinophils, monocytes, lymphoid cells
43
What cells are positive for Nonspecific Esterase? State the color.
Monoblast and Monocyte Dark Red/ Reddish Brown color
44
Esterase found in Neutrophils
Specific Esterase
45
Esterase found in Monocytes
Nonspecific Esterase
46
What cells are negative for Nonspecific Esterase?
granulocytes, megakaryocytes, lymphoid cells
47
What do you need to add in the ANAE to differentiate monocytes from other cells that occasionally show positivity?
Sodium Fluoride ## Footnote It inhibits the monocytic enzyme
48
What is CRP?
Cyanide-Resistant Peroxidase Peroxidase in eosinophils ## Footnote Sodium cyanide is added to inhibit peroxidase in WBCs other than those found in eosinophils
49
It is added to inhibit peroxidase in WBCs other than those found in eosinophils
Sodium Citrate
50
What is TRAP
Tartrate-Resistant Acid Phosphatase Inhibits acid phosphatase in leukocytes, except acid phosphatase isoenzyme 5
51
Positive color for TRAP?
Purple to Dark Red
52
What cells does TRAP stains?
hairy cells in hairy cell leukemia | Mnemonics: Harry is TRAP ## Footnote Negative lahat maliban dito
53
What cells does TRAP stains?
hairy cells in hairy cell leukemia ## Footnote Negative lahat maliban dito
54
What is PAS?
Periodic Acid Schiff ## Footnote Stains Carbohydrates like Glycogen and Mucoproteins
55
Positive cells and color for PAS
Magenta - Multiple Cell Types
56
These cells are negative for PAS
normal erythroblasts & lymphoid cells (L1 & L2)
57
What is LAP?
Leukocyte Alkaline Phosphatase Enzyme in secondary granules of mature neutrophils
58
What color is the Neutrophils stained with LAP
Black Brown
59
# Lap Score No granules
0
60
# Lap Score 4+
Intense, cytoplasm is packed with granules (100%)
61
# Lap Score Moderate (50-75%)
2+
62
# Lap Score 3+
Strong numerous (75%)
63
# Lap Score 1+
Faint, few granules (<50%)
64
LAP Score Reference Range
30-100
65
* Leukemoid reaction (LR) * Chronic neutrophilic leukemia (CNL) * Bacterial infections * Polycythemia vera (PCV) * 3rd term pregnancy * CGL-blast crisis or with infection
Increase LAP Activity
66
# Give Results or Diagnosis Decreased LAP Activity
* Chronic granulocytic / myelogenous leukemia (CGL / CML) * Paroxysmal nocturnal hemoglobinuria (PNH) * Sideroblastic anemia * Eosinophilia
67
LR & CML/CGL are the same in morphology, the only way to differentiate them is through _____
LAP Activity
68
Primitive marker for lymphoblast but not for mature lymphoblast
Terminal Deoxynucleotidyl Transferase (TdT)
69
What is TdT?
Terminal Deoxynucleotidyl Transferase DNA polymerase inside cell nuclei
70
TdT is positive in what cells?
T-Lymphoblasts (Acute Lymphoblastic Leukemia [ALL] L1 & L2), pre-B cells
71
TdT is negative in what cells?
myeloblasts, monoblasts, & ALL-L3
72
What are the staining techniques to differentiate acute myeloid leukemia (AML) & acute lymphoblastic leukemia (ALL)
MPO, SBB, PAS, TdT
73
It is used to used to differentiate monocyte & granulocyte cell linkages.
Esterase
74
Reaction of AML in SBB
+ ## Footnote REVIEW ACUTE LEUKEMIA CYTOCHEMICAL REACTION CHART
75
Reaction of ALL in MPO
- ## Footnote REVIEW ACUTE LEUKEMIA CYTOCHEMICAL REACTION CHART
76
Reaction of Megakaryocytic Leukemia in MPO, SBB, NASDA, ANBE, ANAE
- - - - - +(localized) | respectively ## Footnote REVIEW ACUTE LEUKEMIA CYTOCHEMICAL REACTION CHART
77
# MPO Positive or Negative Auer rods found in leukemic blasts
Strongly MPO Positive | Auer Rods are found in primary or azurophilic granules
78
Between MPO and SBB what is more sensitive for the early myeloid cells?
SBB
79
What do you call the enzyme that accelerates the hydrolysis and synthesis of esters?
Esterase
80
How many isoenzymes are present in leukocytes?
9
81
Chloroacetate esterase is present in ____
Primary granules of the neutrophils
82
Except for MPO, Auer Rods also show positivity in what type of cytochemical stain?
CAE | Chloroacetate Esterase
83
A patient would be positive for Acute Monocytic Leukemia (AMoL) if ___% or more of the blast are nonspecific esterase positive and specific esterase negative
80%
84
A patient would be positive for Acute Myelomocytic Leukemia (AMML) if __% shows monocytic differentiation using the sodium fluoride
20
85
Differentiate ANAE and ANBE
Butyrate is more sensitive and more specific while Acetate can be mixed with sodium fluoride which inhibits the monocytic enzyme

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