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Hematology WSSU > Hematology Study Guide > Flashcards

Hematology Study Guide Flashcards

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1
Q

ESR Principle

A

Distance the RBCs fall after a specified time period (1hr). RBCs naturally repel; increased fibrinogen (acute phase reactant) reduce RBC charges which -> rouleaux formation

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2
Q

Sources of error for increased ESR

A
  • macrocytes/anemia
  • temperature >27C
  • tilt of 3 degrees - 30% of the EST
  • vibrations (centrifuge nearby)
  • hematological disorders that increase rouleaux formation
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3
Q

Sources of error for decreased ESR

A
  • poik/sickle cells/spherocytes (decrease rouleaux formation)
  • Temperature <20C
  • Excessive anticoagulant (shrinks cells)
  • Clotted specimen
  • time less than 1hr
  • Old sample >2hrs old (RBCs become spherical which inhibits rouleaux)
  • hematological disorders that prevent rouleaux formation
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4
Q

ESR purpose

A
  • determines a nonspecific response to tissue damage and inflammation
  • also used in differential diagnosis in addition to monitoring existing inflammatory disease
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5
Q

Retic % Formula

A

Retic % = Retic # / Total # of RBCs x 100

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6
Q

Corrected Retic Count Formula

A

corrected retic count = retic % x (patient Hct% / average Hct)

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7
Q

RPI formula

A

RPI = corrected Retic count / maturation time

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8
Q

Patient HCT % 40-45 maturation days

A

1

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9
Q

Patient HCT % 35-39 maturation days

A

1.5

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10
Q

Patient HCT % 25-34 maturation days

A

2

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11
Q

Patient HCT % 15-24 maturation days

A

2.5

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12
Q

Patient HCT % <15 maturation days

A

3

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13
Q

Structure of heme

A
  • 4 heme molecules: protoporphyrin IX + 1 iron atom (Fe ++)
  • each heme reversibly combines with one O2 molecule
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14
Q

Structure of globin

A
  • 4 globin chains (“tetramer”): 2 pairs of 2 different polypeptide chains
  • amino acid sequence determines the type of hemoglobin and its ability to take up and release O2
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15
Q

Fetal (F) Hemoglobin chains

A

2 alpha + 2 gamma

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16
Q

Adult (A-1) Hemoglobin chains

A

2 alpha + 2 beta

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17
Q

(A-2) Hemoglobin chains

A

2 alpha + 2 delta

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18
Q

Normal hemoglobin values for men

A

14 - 18 g/dL

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19
Q

normal hemoglobin values for women

A

12 - 15 g/dL

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20
Q

normal hemoglobin values for newborns

A

16.5 - 21.5 g/dL

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20
Q

MCV formula

A

MCV = Hct % x 10 / RBC count (x10^12/L)

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20
Q

Hct formula

A

HCT = RBC x MCV / 10

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21
Q

Iron deficiency anemia, thalassemia, sideroblastic anemia, other conditions of defective iron use, chronic infection or inflammation, unstable hemoglobin

A

microcytic; hypochromic RBC morph

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21
Q

MCH formula

A

MCH = Hb (g/dL) x 10 / RBC count (10^12/L)

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21
MCHC formula
MCHC = Hb (g/dL) x 100 / Hct %
22
Microcytic; hypochromic RBC morph
MCV(fL) <80 MCHC(g/dL) <32
23
hemolytic anemia, leukemia, metastatic malignancy, bone marrow failure, chronic renal disease
normocytic; normochromic RBC morph
23
normocytic; normochromic RBC morph
MCV(fL) = 80-100 MCHC(g/dL) = 32-36
23
Macrocytic; normochromic RBC morph
MCV(fL) = >100 MCHC(g/dL) = 32-36
23
Liver disease, myelodysplasias, megaloblastic anemias
macrocytic; normochromic RBC morph
24
MCHC def
mean cell hemoglobin concentration
25
MCV def
mean cell volume
26
MCHC normal value
32-36 g/dL
27
causes of MCHC >36g/dL
error in hemoglobin value due to high WBC count, lipemia, Hgb S/C, cold agglutinin, spherocytes
28
hemoglobin rule of 3
RBC x 3 = HGB
29
hematocrit rule of 3
HGB x 3 = HCT
30
hematocrit normal range for men
42-52%
31
hematocrit normal range for women
36-46%
32
hematocrit normal range for 1 year old
31-39%
33
Sources of error for decreased HCT
- improperly sealed capillary tubes - increased concentration of anticoagulant as a result of RBC shrinkage - blood loss (plasma is replaced faster than RBCs)
34
Sources of error for increased HCT
- fluid loss associated with dehydration
35
Sources of error for retic
- anemia or polycythemic - moisture in the air, poor drying of the slide
36
retic normal value in adults
0.5%-2.5%
37
retic normal value in infants
2-6%
38
hematocrit normal range for newborns
50-62%
39
MCV normal range
80-100 fL
40
Sources of error for increased MCV
cold agglutination or hyperglycemia
41
sources of error for decreased MCV
poor blood sample collection technique, high levels of lipids or abnormal proteins in the blood (like agglutinins or cryoglobulins), excessive white blood cell count, electrolyte imbalances (like hyponatremia), improper analyzer settings, and technical issues with the automated blood analyzer
42
RBC count normal value for men
4.7 - 6.1 cells/mcL
43
RBC count normal range for females
4.2 - 5.4 cells/mcL
44
platelet normal range
150-400
45
WBC count normal range
4.5 - 11 x 10^9/L
46
RDW normal range
11.5 - 15%
47
Causes of high RDW
- anemia - nutrient deficiency - infection - dysfunction in the production of red blood cells - shortened lifespan of red blood cells - premature release of reticulocytes
48
Normal adult MCH range
27-31 (pg/cell)
49
normal newborn MCH range
32-34 (pg/cell)
50
Causes of low MCH
- iron deficiency anemia - thalassemia - blood loss - major surgery
51
Causes of high MCH
- vitamin deficiency - alcohol abuse - under active thyroid - anemia caused by low levels of folic acid or vitamin B12
52
Electronic impedance principle
Based on the detection and measurement of changes in electrical resistance produced by cells as they traverse a small aperture the number and size of the pulses are directly proportional to the number and size of the cells being counted
53
Electronic impedance interpretation
the number and size of the pulses are directly proportional to the number and size of the cells being counted
54
Cell counting by Radio frequency (RF) principle
high voltage electromagnetic current (RF) flowing between both electrodes simultaneously and measures interior density (conductivity) of cells
55
Cell counting by optical scatter principle
hydroynamically focused sample stream is directed through a quartz flow cell past a focused light source (flow cytometry). Uses diffraction, reflection, and refraction of light waves.
56
What errors happen on hematology analyzers when WBC >50,000
Turbidity may increase Hgb, increased RBC, Hct and other indices may be inaccurate
57
What errors happen on hematology analyzers when cold agglutinins are present
Agglutinates are counted and sized as RBCs, decreased RBC, increased MCV, MCH, MCHC, Hct inaccurate
58
what errors happen on hematology analyzers when NRBCs are present
Can be mistaken for WBCs, falsely increases WBC count
59
What errors happen on hematology analyzers when lipemia is present
turbidity many affect HGB reading, may increase HGB, MCH, MCHC
60
What errors happen on hematology analyzers when hemolysis is present
RBCs are lysed, decreases RBC and HCT, increases MCH and MCHC
61
62
What errors happen on hematology analyzers when an old specimen was run
RBCs swell and platelets and WBCs degenerate, increases MCV, decreases platelet, auto diff count may be inaccurate
63
what errors happen on hematology analyzers when schistocytes and microcytes are present
Not counted as RBCs, may be counted as platelets, decreases RBC, HCT and indices may be inaccurate
64
what errors happen on hematology analyzers when resistant RBCs (HGB S or C) are present
RBCs dont lyse, counted as WBCs, increases WBC count, HGB is inaccurate
65
what errors happen on hematology analyzers when fragile WBCs are present
WBCs are damaged in analyzer, may be couted as platelets, decreases WBC count, may increase platelet count
66
Manual Count Formula
cells counted x DF x 10 / # of squares counted
67
Dilution Factor Formula
1 / x = blood volume / total volume
68
WBC Squares Volume
0.1
69
RBC Squares Volume
0.004
70
Basophilic stippling
RNA, lead poisoning
71
Pappenheimer bodies
non-heme iron granules, sideroblastic anemia, hemoglobin disorders, post-splenectomy
72
Reticulocyte
RNA, immature RBCs, accelerated erythropoiesis
73
Heinz bodies
denatured precipitated hemoglobin, G6PD deficiency, unstable hemoglobins
74
Cabot's Rings
remnants of the mitotic spindle, severe anemia
75
Hemoglobin Crystals (SC, CC)
crystallized abnormal hemoglobin, hemoglobin SC disease, hemoglobin C disease
76
Hemoglobinpathies
qualitative disorders involving amino acid substitutions
77
thalassemias
quantitative disorders involving decreased synthesis of globin chains
78
Corrected WBC Formula
Corrected WBC= NRBC Count x [100/(NRBC +100)]
79
Which CBC Parameters are measured directly?
RBC count and MCV
80
Principles of RBC Cell Maturation
- cell size decreases - RNA decreases (less basophilic cytoplasm) - hemoglobin increases - chromatin structure becomes more clumped to pyknotic - nuclear size decreases
81
erythropoiesis
The kidneys detect when there is a decrease in oxygen in circulation and secrete the hormone erythropoietin, which stimulates the bone marrow to produce more RBCs
82
RBC maturation order
proerythroblast basophilic erythroblast polychromatophilic erythroblast orthochromatophilic erythroblast retic RBC
83
WBC maturation order
Myeloblast Promyelocyte Myelocyte Meta Band Seg

Hematology WSSU (12 decks)

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