HEMA LEC - Intro Lecture Flashcards Preview

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Flashcards in HEMA LEC - Intro Lecture Deck (58):
1

• 2 Types of PMN

o PMN – mature and segmented
o Neutrophilic bands - immature

2

– immature PMN

bands/ Neutrophilic bands

3

o Shift to the left –

immature

4

o Shift to the right -

mature

5


• with bright orange granules filled with antihistamine

Eosinophils

6

caused by bacterial infection

Neutrophilia:

7

long term drug administration

Neutropenia:

8


theoretical/unused, decrease of eosinophil

• Eosinopenia:

9

allergy, parasitism, increase of eosinophils

• Eosinophilia:

10


rare, hematologic disease (leukemia)

• Basophilia:

11

With dark blue granules that obscure the nucleus

basophils

12

• Big round nucleus, thin rim of cytoplasm
• Slightly larger than RBCs

lymphocytes

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• viral infection

Lymphocytosis:

14

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

30

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

Thrombocytopenia

31


• 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

34

• 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

36

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

40


puncture site
• Ideal for peripheral smears

finger (middle or ring)

41

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

earlobe

42

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

earlobe

43

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

earlobe

44

Less intimidating puncture site

finger (middle or ring)

45

puncture site that isAccessible and easy to manipulate

finger (middle or ring)

46

D. Sites to Avoid

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

47

lancet must pass through the

dermal subcutaneous junction

48

length of lancet for newborns

not more than 2.4mm

49

2. Venipuncture
• Blood sample collected =

venous blood

50

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

veni

51

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

venous blood –

52

• 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

54

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

57

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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EVACUATED TUBE METHOD
Advantages

 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

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