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Mercy CLS 6: Hematology > Lab Exam 2 > Flashcards

Lab Exam 2 Flashcards

1
Q

stains used for retic ct

what shows up in retics?

A

supravital stain
new methylene blue
brilliant cresyl blue
crystal violet

reticulum

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2
Q

usually retics lose their reticulum within —– hours of leaving the BM

A

10

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3
Q

retic RR
adult
baby

A

adult —0.5-2.0%
baby —2.5-6.5%

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4
Q

absolute retic calc

A

absolute = %retics(RBC)

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5
Q

sudden retic increase 3-4 days after acute hemorrhage

A

retic shower

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6
Q

very high glucose can affect…

A

appearance of reticulum in retics

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7
Q

methylene blue will also stain…

A

HJ bodies
heinz bodies

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8
Q

how to count retics

A
  • 100x
  • miller ocular
  • all RBCs in small square
  • all retics in large square
  • exactly consecutive fields
  • stop when you reach 112 RBCs
  • count 2 smears
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9
Q

47 retics = ——-% retics

A

4.7%

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10
Q

corrected retic takes into account that…

A

retics being released are sent into a smaller pool of blood in states of anemia

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11
Q

corrected retic calc

A

corrected retic = retic%(Hct/45)

normal Hct may also be taken from a table of norms

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12
Q

RPI calc

A

RPI = corrected retic/maturation time

maturation time from table

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12
Q

RPI takes into account that…

A

BM is releasing more retics than normal during anemia, and they take longer to mature in PB than normal retics, falsely elevating count

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13
Q

immature retic fraction (IRF) is used…

A

in place of RPI when performed on autoanalyzer

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14
Q

↑ IRF indicates…

may make ———- unnecessary

A

adequate BM response to anemia
cell recovery

transfusion

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15
Q

RET-He or CHr indicates…

equivalent to —– in RBCs

A

Hgb content of retics

MCH

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16
Q

hemoglobins migrate toward the ——

A

anode (+)

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17
Q

the most ———- charged hgbs are “fast”

A

negatively

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18
Q

controls the pH and carries the Hgbs through the gel medium

A

buffer

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19
Q

precipitates the Hgb into the gel to immobilize and prevent diffusion of bands

A

acid alcohol

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20
Q

allows visualization and densitometric scanning

A

stain

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21
Q

“fixes” stain to Hgb bands and washes stain from background

A

acetic acid

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22
Q

Hgb electro preferred sample

A

EDTA WB

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23
Q

alkaline gel and pH

A

cellulose acetate
8.4

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24
acid gel and pH
citrate agar 6.0-6.2
25
if Hgbs cannot be fully identified with alkaline and acid gels, use ---------- to ID
isoelectric focusing
26
uses gels with a pH gradient, and each Hgb migrates to point where pH is equal to pI
isoelectric focusing
27
alkaline gel buffer and stain
B2 buffer blue stain
28
acid gel buffer and stain
maleic acid buffer violet stain
29
A >97% A2 1.5-3% F <1%
normal
30
S 90% F 10% slight A2 no A
sickle cell disease
31
A 60% S 40%
sickle cell trait
32
C 95% F 5%
Hgb C disease
33
A 60% C 40%
Hgb C trait
34
S 50% C 50%
S/C disease
35
A most A2 3.5-7% F minor component
β thal minor
36
F 90% A2 10% A minor component
β thal major
37
alkaline gel migration pattern
+ A F SDGL CEOA2 =
38
acid gel migration pattern
+ C S AA2 F =
39
not recommended to quantitate by scanning
A2 F column chromatography instead
40
column chromatography procedure
- column has resin full of + charged molecules - buffer and pH levels are controlled to cause different Hgbs to bind to resin - elution buffer is added to remove Hgb A2, and other Hgb are retained - absorbance of A2 eluate fraction and total Hgb are read, and A2 is expressed as a percent
41
cause increased osmotic fragility
spherocytes burn patients AIHA
42
cause decreased osmotic fragility
target cells sickle cells hypochromic cells thalassemia
43
preferred osmotic fragility specimen
Na heparin
44
osmotic fragility % hemolysis calc
% hemolysis = (ODx - OD.85)(100)/(OD0) - (OD.85)
45
control OF patient should start hemolysis around -----% and end around -----%
0.45 0.35
46
elongated crystals of polymerized Hgb S
tactoids
47
causes for crises in sickle trait pts
- respiratory infection - anesthetsia - extreme exercise - congestive heart failure
48
preferred sickle solubility sample
EDTA WB
49
sickle solubility reagent
Na hydrosulfite/Na dithionite
50
sickle solubility test has -----% HgbS sensitivty
10
51
other sicklings Hgbs detected by solubility test
- Hgb C Harlem - Hgb C Georgetown - Hgb Memphis - Hgb Bart
52
sickle solubility false +
too many RBCs ↑ Hct ↑ protein
53
sickle solubility false =
Hgb S <10% multiple transfusions newborns
54
QC requirements for sickle solubility
- room temp reagent - pos and neg controls - correction of sample volume based on Hgb
55
preferred KB sample
EDTA WB
56
negative control for KB is...
normal male blood
57
positive controls for KB
1:10 and 1:20 cord blood + adult blood
58
in the KB test, cells are exposed to --------- which destroys Hgb A and leaves Hgb F
acid buffer
59
standard ESR method
Westergren method
60
2 forces at work during ESR test
- downward force of the RBCs - retarding force of the plasma
61
3 stages of settling in ESR
1. Initial aggregation (10 min)—rouleaux occurs 2. Fast, constant settling (40 min) 3. Final packing (10 min)—sedimentation slows
62
plasma factors that ↑ ESR
- ↑ fibrinogen - ↑ alpha and gamma globulins (↓ zeta potential of RBCs)
63
plasma factors that ↓ ESR
- extreme increase in plasma viscosity
64
RBC factors that ↑ ESR
- anemia - microcytes
65
RBC factors that ↓ ESR
- high RBC count - irregular shape (sickle, spherocyte) - macrocytes
66
preferred ESR specimen
EDTA or Na citrate WB
67
tube additive that falsely ↑ ESR
heparin
68
ESR specimen stability
12 hours refrigerated 8 hours room temp
69
ESR RR
male: 0-15 mm female: 0-20 mm
70
chief value of ESR (2)
- differentiate among diseases with similar sx - indicates extend of inflammatory response
71
how does temp affect ESR?
↑ temp (>27°) falsely ↑ ESR
72
examples of ESR used in differential dx
- bacterial infection, but not viral infection, ↑ ESR - MI with angina, but not angina without MI, ↑ ESR - RA, but not osteoarthritis, ↑ ESR
73
peak mono age
14-24
74
EBV transmission
infected saliva
75
EBV infects... protection mediated by...
B-cells, oropharynx, cervix T-cells
76
at risk for serious complications from EBV (eg B-cell tumors)
immunocompromised (AIDS, transplant)
77
EBV sx
- fever - pharyngitis - lymphadenopathy - lethargy - h/a - nausea - anoxia - severe: splenomegaly, hepatomegaly, jaundice
78
complications of EBV
- hepatitis - AIHA (anti-i cold agglutinin) - ↓ platelets - agranulocytosis - aplastic anemia (rare)
79
EBV lab findings
- ↑ WBC (12-25) with absolute lymphocytosis - >20% atypical lymphs - occasional immunoblasts, plasma cells - slight ↓ platelet
80
other causes of mono-like illnesses
- CMV - toxoplasma - viral hepatitis
81
rapid mono test is for the -------- Ab
heterophile
82
reacts with Ag common to multiple species
heterophile Ab
83
rapid mono test detects...
heterophile Ab which agglutinates sheep, horse or bovine RBCs
84
limitations of rapid mono test
false negative results in 10-20% of adults, 50% children <4yo
85
reflex test for rapid mono
if negative, do EBV serologies or repeat in 1 week if sx persist
86
disadvantages of EBV serologies
- more expensive - take longer
87
Ab detected in EBV serology tests
- VCA-IgM - VCA-IgG - EBNA - EBVEA
88
when does EBNA rise?
early convalescent period (recovery) and persists along with IgG
89
VCA
viral capsid antigen (EBV)

Mercy CLS 6: Hematology (25 decks)

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