HEMA LEC - Intro Lecture

Question 1

• 2 Types of PMN

Answer 1

o PMN – mature and segmented

o Neutrophilic bands - immature

Question 2

– immature PMN

Answer 2

bands/ Neutrophilic bands

Question 3

o Shift to the left –

Answer 3

immature

Question 4

o Shift to the right -

Answer 4

mature

Question 5

• with bright orange granules filled with antihistamine

Answer 5

Eosinophils

Question 6

caused by bacterial infection

Answer 6

Neutrophilia:

Question 7

long term drug administration

Answer 7

Neutropenia:

Question 8

theoretical/unused, decrease of eosinophil

Answer 8

• Eosinopenia:

Question 9

allergy, parasitism, increase of eosinophils

Answer 9

• Eosinophilia:

Question 10

•

rare, hematologic disease (leukemia)

Answer 10

• Basophilia:

Question 11

With dark blue granules that obscure the nucleus

Answer 11

basophils

Question 12

• Big round nucleus, thin rim of cytoplasm

* Slightly larger than RBCs

Answer 12

lymphocytes

Question 13

• viral infection

Answer 13

Lymphocytosis:

Question 14

long term drug administration, immunodeficiency

Answer 14

Lymphopenia/lymphocytopenia

Question 15

• Phagocytosis, presentation of epitopes

Answer 15

monocytes

Question 16

• Macrophage in tissues

Answer 16

monocytes

Question 17

• Slightly larger than other WBCs

Answer 17

monocytes

Question 18

rare hematologic disorder

Answer 18

• Monocytosis:

Question 19

theoretical disease of monocytes

Answer 19

• Monocytopenia:

Question 20

• Pieces of a bone marrow cell called megakaryocyte
• Function to stop bleeding by forming a plug and releases coagulation factors (controls hemostasis)
• Forms thrombus (clot)

Answer 20

platelet

Question 21

platelet capable of

Answer 21

adhesion, aggregation, secretion

Question 22

• 2-4u, oval, anucleated, slightly granular

Answer 22

platelet

Question 23

• Reference range of plt

Answer 23

150 – 450 K/cu. Mm

Question 24

• High MPV means

Answer 24

regenerative BM response to platelet consumption

Question 25

inflammation, trauma | •

Answer 25

Thrombocytosis

Question 26

: consequence of treatment

Answer 26

Thrombocytopenia

Question 27

HEMATOLOGY TESTS/EXAMINATIONS

Answer 27

1. Erythrocyte Sedimentation Rate 2. Reticulocyte Count 3. Peripheral Blood Examination 4. Sickle Cell Testing 5. Osmotic Fragility Test (OFT) 6. Coagulation Tests include

Question 28

6. Coagulation Tests include

Answer 28

a. Prothrombin Time b. Partial Thromboplastin Time c. Fibrinogen d. Factor Analysis

Question 29

ADVANCED HEMA PROCEDURES

Answer 29

1. BM Examination 2. Cytogenic analysis 3. Molecular assay 4. Cytochemical stains (differentiate abnormal cells) 5. Flow cytometry

Question 30

– decreased platelets, patients may have bleeding problems | -associated with dengue

Answer 30

Thrombocytopenia

Question 31

• Ex. haemophilia, sickle cell anemia, G6PD deficiency, thalassemias

Answer 31

Inherited haematological diseases

Question 32

Methods of Blood Collection

Answer 32

1. Skin puncture | 2. Veni

Question 33

1. Skin puncture | • Blood sample collected = ?

Answer 33

peripheral blood instead of capillary blood

Question 34

• A mixture of capillary, venous, arterial blood with interstitial and intracellular fluid •

Answer 34

peripheral blood instead of capillary blood

Question 35

peripheral blood Different from venous blood because of admixing of tissue juice which leads to the following: (levels of Hct, Hgb, RBC, Plt, WBC)

Answer 35

low Hct,, Hgb, RBC ct, Pit & high WBC

Question 36

disadv of skin punc (3)

Answer 36

* Less amount can be obtained * Additional and repeated test cannot be done * Hemolyses easily (rupture of RBC)

Question 37

skin punc sites

Answer 37

A. Finger (middle or ring) B. Earlobe C. Heel or big toe

Question 38

puncture sites | • lateral palmar surface perpendicular to fingerprints (will follow structure of fingerprints)

Answer 38

finger (middle or ring)

Question 39

* for less than 1 y/o | * Lateral portion of the plantar surface of the heel

Answer 39

heel

Question 40

puncture site | • Ideal for peripheral smears

Answer 40

finger (middle or ring)

Question 41

puncture sites • Can be arteriolized by: heat (44C), slight flicking with index finger until definite flushing & chemical means (Trefuril paste)

Answer 41

earlobe

Question 42

puncture sites • less free nerve ending, less pain, less tissue juice • More free flow of blood

Answer 42

earlobe

Question 43

puncture sites | • Ideal when searching for abnormal cells (histiocytes in bacterial endocarditis)

Answer 43

earlobe

Question 44

Less intimidating puncture site

Answer 44

finger (middle or ring)

Question 45

puncture site that isAccessible and easy to manipulate

Answer 45

finger (middle or ring)

Question 46

D. Sites to Avoid

Answer 46

* Inflamed & pallor areas * Cold & cyanotic areas * Congested and edematous areas * Scarred & heavily calloused areas

Question 47

lancet must pass through the

Answer 47

dermal subcutaneous junction

Question 48

length of lancet for newborns

Answer 48

not more than 2.4mm

Question 49

2. Venipuncture | • Blood sample collected =

Answer 49

venous blood

Question 50

manner of inserting a needle attached to a syringe to a palpable vein to collect blood for lab testing

Answer 50

veni

Question 51

most widely used blood sample in all lab tests not just in hematology

Answer 51

venous blood –

Question 52

• 3 factors involved in good collection

Answer 52

o Phlebotomist o Patients and his/her veins o Equipment needed

Question 53

Phlebotomy Complication

Answer 53

1. Vascular 2. Infection 3. Cardiovascular 4. Anemia 5. Neurological 6. Dermatological

Question 54

Venipuncture Complications | 1. Local immediate

Answer 54

a. Hemoconcentration | b. Failure of blood to enter the syringe

Question 55

Venipuncture Complications | 3. General delayed complication

Answer 55

a. Infections

Question 56

Venipuncture Complications | 2. Local delayed

Answer 56

a. Hematoma b. Thrombosis of the vein c. thrombophlebitis

Question 57

Disadvantages of evacuated tube method

Answer 57

 Requires more time & skill on the part of the phlebotomist  Requires more equipment  More complications may arise  Difficult to do in infants, children & obese individuals

Question 58

EVACUATED TUBE METHOD | Advantages

Answer 58

 Large amount can be obtained  Can be transported and stored for future use  Additional & repeated tests can be done  Fastest method of collecting sample which requires various anticoagulation  Ideal for clinical chemistry & other serological tests