Flashcards in HEMA LEC - Intro Lecture Deck (58):
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• 2 Types of PMN
o PMN – mature and segmented
o Neutrophilic bands - immature
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– immature PMN
bands/ Neutrophilic bands
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o Shift to the left –
immature
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o Shift to the right -
mature
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• with bright orange granules filled with antihistamine
Eosinophils
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caused by bacterial infection
Neutrophilia:
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long term drug administration
Neutropenia:
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theoretical/unused, decrease of eosinophil
• Eosinopenia:
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allergy, parasitism, increase of eosinophils
• Eosinophilia:
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•
rare, hematologic disease (leukemia)
• Basophilia:
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With dark blue granules that obscure the nucleus
basophils
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• Big round nucleus, thin rim of cytoplasm
• Slightly larger than RBCs
lymphocytes
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• viral infection
Lymphocytosis:
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long term drug administration, immunodeficiency
Lymphopenia/lymphocytopenia
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• Phagocytosis, presentation of epitopes
monocytes
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• Macrophage in tissues
monocytes
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• Slightly larger than other WBCs
monocytes
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rare hematologic disorder
• Monocytosis:
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theoretical disease of monocytes
• Monocytopenia:
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• 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)
platelet
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platelet capable of
adhesion, aggregation, secretion
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• 2-4u, oval, anucleated, slightly granular
platelet
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• Reference range of plt
150 – 450 K/cu. Mm
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• High MPV means
regenerative BM response to platelet consumption
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inflammation, trauma
•
Thrombocytosis
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: consequence of treatment
Thrombocytopenia
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HEMATOLOGY TESTS/EXAMINATIONS
1. Erythrocyte Sedimentation Rate
2. Reticulocyte Count
3. Peripheral Blood Examination
4. Sickle Cell Testing
5. Osmotic Fragility Test (OFT)
6. Coagulation Tests include
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6. Coagulation Tests include
a. Prothrombin Time
b. Partial Thromboplastin Time
c. Fibrinogen
d. Factor Analysis
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ADVANCED HEMA PROCEDURES
1. BM Examination
2. Cytogenic analysis
3. Molecular assay
4. Cytochemical stains (differentiate abnormal cells)
5. Flow cytometry
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– decreased platelets, patients may have bleeding problems
-associated with dengue
Thrombocytopenia
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• Ex. haemophilia, sickle cell anemia, G6PD deficiency, thalassemias
Inherited haematological diseases
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Methods of Blood Collection
1. Skin puncture
2. Veni
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1. Skin puncture
• Blood sample collected = ?
peripheral blood instead of capillary blood
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• A mixture of capillary, venous, arterial blood with interstitial and intracellular fluid
•
peripheral blood instead of capillary blood
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peripheral blood Different from venous blood because of admixing of tissue juice which leads to the following: (levels of Hct, Hgb, RBC, Plt, WBC)
low Hct,, Hgb, RBC ct, Pit & high WBC
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disadv of skin punc (3)
• Less amount can be obtained
• Additional and repeated test cannot be done
• Hemolyses easily (rupture of RBC)
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skin punc sites
A. Finger (middle or ring)
B. Earlobe
C. Heel or big toe
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puncture sites
• lateral palmar surface perpendicular to fingerprints (will follow structure of fingerprints)
finger (middle or ring)
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• for less than 1 y/o
• Lateral portion of the plantar surface of the heel
heel
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puncture site
• Ideal for peripheral smears
finger (middle or ring)
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puncture sites
• Can be arteriolized by: heat (44C), slight flicking with index finger until definite flushing & chemical means (Trefuril paste)
earlobe
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puncture sites
• less free nerve ending, less pain, less tissue juice
• More free flow of blood
earlobe
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puncture sites
• Ideal when searching for abnormal cells (histiocytes in bacterial endocarditis)
earlobe
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Less intimidating puncture site
finger (middle or ring)
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puncture site that isAccessible and easy to manipulate
finger (middle or ring)
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D. Sites to Avoid
• Inflamed & pallor areas
• Cold & cyanotic areas
• Congested and edematous areas
• Scarred & heavily calloused areas
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lancet must pass through the
dermal subcutaneous junction
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length of lancet for newborns
not more than 2.4mm
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2. Venipuncture
• Blood sample collected =
venous blood
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manner of inserting a needle attached to a syringe to a palpable vein to collect blood for lab testing
veni
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most widely used blood sample in all lab tests not just in hematology
venous blood –
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• 3 factors involved in good collection
o Phlebotomist
o Patients and his/her veins
o Equipment needed
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Phlebotomy Complication
1. Vascular
2. Infection
3. Cardiovascular
4. Anemia
5. Neurological
6. Dermatological
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Venipuncture Complications
1. Local immediate
a. Hemoconcentration
b. Failure of blood to enter the syringe
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Venipuncture Complications
3. General delayed complication
a. Infections
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Venipuncture Complications
2. Local delayed
a. Hematoma
b. Thrombosis of the vein
c. thrombophlebitis
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Disadvantages of evacuated tube method
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
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