Hematologic tests Flashcards
(149 cards)
1
Q
examined to determine the percentage of each type of leukocyte present
A
stained smear
2
Q
stained smear is examined to determine the percentage of each type of leukocyte present
A
LEUKOCYTE DIFFERENTIAL COUNT
3
Q
LEUKOCYTE DIFFERENTIAL COUNT SPECIMEN
A
Peripheral blood, bone marrow, or body fluid sediments
4
Q
should be present per oil immersion field.
A
8 to 20 platelets
5
Q
Examine at least ___ different fields,
A
10
6
Q
are recorded separately per 100 WBCs but not included in the total WBC count
A
Nucleated erythrocytes (nBCs)
7
Q
Count at least ___ leukocytes and express results as a percentage of total leukocytes
counted.
A
100
8
Q
A specimen containing form cellular elements, such as erythrocytes, is diluted in an isotonic
fluid to facilitate enumeration
A
RED BLOOD CELL COUNT
9
Q
RED BLOOD CELL COUNT specimen
A
Anticoagulated whole blood or capillary blood can be used. EDTA is the preferred
anticoagulant.
10
Q
RED BLOOD CELL COUNT Diluents
A
• Gower’s Solution
• Hayem’s Solution
• Dacie’s Fluid
• Normal Saline (0.85% NaCl)
11
Q
Retic Reference Interval
A
0.5-2.5
12
Q
NRBC Reference Interval
A
0
13
Q
WBC Reference Interval uL
A
3.6-10.6
14
Q
NEUT Reference Interval %
A
50-70
15
Q
Neut (ANC) Reference Interval uL
A
1.7-7.5
16
Q
LYMPH Reference Interval %
A
18-42
17
Q
LyMP Reference Interval uL
A
1.0-3.2
18
Q
mono Reference Interval %
A
2-11
19
Q
mono Reference Interval uL
A
0.1-1.3
20
Q
EO Reference Interval %
A
1-3
21
Q
EO Reference Interval uL
A
0-0.3
22
Q
BASO Reference Interval %
A
0-2
23
Q
Baso Reference Interval uL
A
0-0.2
24
Q
PLT Reference Interval uL
A
150-450
25
MPV Reference Interval fL
7.0-12.0
26
Segmented neutrophil nuclear shape
lobulated
27
Segmented neutrophil chromatin
very clumped
28
Segmented neutrophil cytoplasmic color
pink
29
Segmented neutrophil granules
many
30
Segmented neutrophil color of granules
pink, a few blue
30
band neutrophil nuclear shape
curved
30
band neutrophil chromatin
moderately clumped
31
band neutrophil cytoplasmic color
blue, pink
32
band neutrophil granules
many
32
lymphocyte chromatin
smooth
32
band neutrophil color of granules
pink
32
lymphocyte nuclear shape
round
32
lymphocyte cytoplasmic color
light blue
32
lymphocyte granules
few or absent
32
lymphocyte color of granules
red
32
monocyte cytoplasmic color
gray blue
33
monocyte nuclear shape
indented or twisted
33
monocyte chromatin
Lacy
33
monocyte color of granules
dusty blue
33
monocyte granules
many
34
eosinophil nuclear shape
lobulated
35
eosinophil chromatin
very clumped
36
eosinophil cytoplasmic color
granulated
37
eosinophil color of granules
orange
37
eosinophil granules
many
37
basophil nuclear shape
lobulated
38
basophil chromatin
very clumped
39
basophil cytoplasmic color
granulated
40
basophil granules
many
41
basophil color of granules
dark blue
42
WBC (leukocyte) count represents the number of WBCs per liter (L) or milliliter (mL) of blood
LEUKOCYTE COUNT
42
LEUKOCYTE COUNT specimen
Whole blood anticoagulated with EDTA or capillary blood
42
RED BLOOD CELL COUNT Standard Dilution
1:100 (Blood-to-diluent)
43
RBCs are counted in
five small squares of the large central square
44
LEUKOCYTE COUNT Diluents
* 1% buffered ammonium oxalate
* Weak acid solutions (3% acetic acid or 1% hydrochloric acid)
45
LEUKOCYTE COUNT standard dilution
1:20 (Blood-to-diluent)
46
WBCs are counted in the
four large corner squares (4 mm²)
47
measures the number of platelets in 1 liter (L) or 1 milliliter (mL) of whole blood.
Platelet count
48
Platelet count specimen
Whole blood anticoagulated with EDTA
49
Platelet count diluents
* 1% ammonium oxalate
50
Platelet count standard dilution
1:100 (Blood-to-diluent)
51
Platelets are counted in
25 small squares located within the large center square (1 mm²)
52
Levy chamber with improved Neubauer ruling
HEMOCYTOMETER
53
Two raised surfaces
HEMOCYTOMETER
53
HEMOCYTOMETER totat area
9 mm²
54
Hemacytometer counting area each with a
3 mm × 3 mm square counting area
55
Raised surfaces are separated by an
H-shaped moat
56
is placed on top of the counting surfaces
Coverslip
57
The grid consists of
nine 1 mm x 1 mm squares
58
Used for WBC counts, each subdivided into 16 smaller squares.
Four corner squares
59
Used for RBC and platelet counts, subdivided into 25 smaller squares.
Center square
60
The smallest squares measure
0.2 mm × 0.2 mm (1/25 of the center square or 0.04 mm²)
61
One mm³ is equivalent to
1 microliter (mL)
62
The count per mL is converted to the count per liter (L) by multiplying by a factor of
106
63
Hemoglobin within RBCs primarily functions to:
-Transport oxygen to tissues.
- Carry carbon dioxide away from tissues.
64
HEMOGLOBIN DETERMINATION reference method
CYANMETHEMOGLOBIN (HEMIGLOBINCYANIDE) METHOD
64
Blood is diluted in an
alkaline Drabkin solution
65
alkaline Drabkin solution containing
-Potassium ferricyanide (K³Fe(CN)₆)
-Potassium cyanide (KCN)
-Sodium bicarbonate
-Surfactant
66
oxidizes hemoglobin (Fe²⁺) to methemoglobin (Fe³⁺)
Potassium ferricyanide
67
then converts methemoglobin to cyanmethemoglobin
Potassium cyanide
68
Hemoglobin (Fe²⁺) + K₃gFe(CN)₆ →
Methemoglobin (Fe³⁺)
69
Methemoglobin (Fe³⁺)) + KCN →
Cyanmethemoglobin
70
absorbs light at 540 nm, with absorbance directly proportional to hemoglobin concentration.
Cyanmethemoglobin
71
is not converted to cyanmethemoglobin and cannot be measured using this method.
Sulfhemoglobin
72
Sulfhemoglobin fractions above ___ are rarely encountered in clinical practice.
0.05 g/dL
72
SOURCES OF ERROR
-Light Sensitivity
-Turbidity Due to High WBC or Platelet Count
-A high WBC count (> 20 × 10⁹ /L) or high platelet count (> 700 × 10⁹/L) can cause turbidity and falsely high results.
73
can cause turbidity and falsely high results.
A high WBC count (> 20 × 10⁹ /L) or high platelet count (> 700 × 10⁹/L)
73
is light-sensitive and should be stored in a brown bottle or dark place.
Cyanmethemoglobin reagent
74
the reagent-specimen solution and measure the supernatant.
Centrifuge
75
measures the ratio of RBC volume to whole blood volume in a capillary or venous blood sample
Packed Cell Volume (PCV)
75
Clinical Uses of PCV: Used with hemoglobin concentration to calculate
Mean Corpuscular Hemoglobin Concentration (MCHC)
75
Clinical Uses of PCV:Used with the erythrocyte count to calculate
Mean Corpuscular Volume (MCV)
76
Clinical Uses of PCV: detects
anemia, polycythemia, hemodilution, and hemoconcentration.
77
quick visual check used when analyzing hemoglobin (HGB) and hematocrit (HCT) results
RULE OF THREE
78
RULE OF THREE applies only to
normocytic, normochromic RBCs
79
A discrepancy may indicate
abnormal RBC morphology or analytical error
80
RBC indices include :
Mean Cell Volume (MCV)
* Mean Cell Hemoglobin (MCH),
* Mean Cell Hemoglobin Concentration (MCHC)
81
Calculated parameters to determine the average RBC volume, hemoglobin content, and hemoglobin concentration.
RBC indices
82
RBC indices used for
-Quality control check.
-Initial classification of anemias
82
average volume of the RBC
MEAN CELL VOLUME
83
femtoliters (fL) or 10⁻¹⁵L
MEAN CELL VOLUME
84
average weight of hemoglobin in a RBC
MEAN CELL HEMOGLOBIN
85
picograms (pg) or 10⁻¹² g
MEAN CELL HEMOGLOBIN
86
average concentration of hemoglobin in each individual RBC
MEAN CELL HEMOGLOBIN CONCENTRATION
87
grams per deciliter (g/dL) or prev. %
MEAN CELL HEMOGLOBIN CONCENTRATION
88
last immature stage of RBCs
RETICULOCYTE COUNT
89
2 days in the bone marrow and 1 day in peripheral blood
RETICULOCYTE COUNT
90
Contain remnant cytoplasmic RNA, mitochondria, and ribosomes
RETICULOCYTE COUNT
91
Used to assess erythropoietic activity in the bone marrow
RETICULOCYTE COUNT
92
RETICULOCYTE COUNT sample
Whole blood anticoagulated with EDTA
93
RETICULOCYTE COUNT stain
Supravital stain (e.g., new methylene blue)
94
containing two or more particles of blue stained granulo filamentous material
Nonnucleated RBC
95
Count ____ under the oil immersion objective lens (1000 x total magnification)
1000 RBCs
96
MILLER DISC structure
2 squares
96
are included in the total RBC count
Reticulocytes
96
MILLER DISC Smaller square:
1/9 the area of the larger square
97
Improve precision in reticulocyte counting by reducing the labor intensive process of counting large numbers of RBC
MILLER DISC
98
MILLER DISC Larger square:
Used for reticulocyte counting
99
Miller disc: RBCs are counted in the
small square
100
This is equivalent to _____ in the larger square, meeting CAP (College of American Pathologists) hematology standards for manual reticulocyte counts (≥1000 RBCs)
1008 RBCs
100
Miller disc: Reticulocytes are counted in the
larger square
100
Minimum Cell Count:
* At Least ____must be counted in the smaller square.
112 RBCs
101
is the actual number of reticulocytes in 1 L or 1 mL of blood
ABSOLUTE RETICULOCYTE COUNT
102
Applied for samples with low hematocrit → falsely elevated count
CORRECTED RETICULOCYTE COUNT
103
Shift reticulocytes → released prematurely from the bone marrow
RETICULOCYTE PRODUCTION INDEX
104
Anticoagulated blood is allowed to stand at RT undisturbed for 1 hr and RBC fall distance is measured in millimeters
ERYTHROCYTE SEDIMENTATION RATE
105
Normal RBCs have a relatively small mass and settle slowly
ERYTHROCYTE SEDIMENTATION RATE
106
ERYTHROCYTE SEDIMENTATION RATE detect and monitor inflammatory conditions
Rheumatoid arthritis
Infections
Certain malignancies
107
ERYTHROCYTE SEDIMENTATION RATE ↑in：
Pregnancy
Anemia
Older age
108
ESR Sources of error causing falsely increased results:
Tilted column, vibration, increased room temperature
109
ESR Sources of error causing falsely decreased results:
Bubbles in ESR column, Low room temperature Narrow ESR column diameter
109
Directly proportional to RBC mass and inversely proportional to plasma viscosity
ERYTHROCYTE SEDIMENTATION RATE
109
Low specificity and sensitivity
ERYTHROCYTE SEDIMENTATION RATE
110
ESR methods
* Modified Westergren Erythrocyte Sedimentation Rate
* Wintrobe Erythrocyte Sedimentation Rate
111
Modified Westergren Erythrocyte Sedimentation Rate Column height
200 mm
112
Modified Westergren Erythrocyte Sedimentation Rate bore diameter
2.55mm
112
Modified Westergren Erythrocyte Sedimentation Rate sensitivity
more sensitive to highly elevated ESRs
112
Wintrobe Erythrocyte Sedimentation Rate column height
100 mm
113
Wintrobe Erythrocyte Sedimentation Rate bore diameter
3.0 mm
114
Wintrobe Erythrocyte Sedimentation Rate sensitivity
more sensitive to mildly elevated ESRs
115
1. Rouleaux formation -
First 10 minutes
115
PHASES OF ESR
1. Rouleaux formation -
2. Settling / Sedimentation -
3. Packing -
115
3. Packing -
Last 10 minutes
116
2. Settling / Sedimentation
- 40 minutes
