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2.2 Haematology > Lab Information I forget > Flashcards

Lab Information I forget Flashcards

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1
Q

Define MCV and how is it calculated

A

Mean corpuscular volume
The average volume of a red blood cell expressed in femtolitres

Haematocrit x10/RBC

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2
Q

What is MCH and how is it calculated

A

Mean corpuscular haemoglobin
The average weight of haemoglobin per red blood cells

Hb/RBC

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3
Q

What is MCHC and how is it calculated?

A

Mean corpuscular haemoglobin concentration
The average Hb in a given volume of blood in grams/litre

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4
Q

What is MCHC and how is it calculated?

A

Mean corpuscular haemoglobin concentration
The average Hb in a given volume of blood in grams/litre

Hb x 100/Hct%

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5
Q

How do we measure haemoglobin

A

Drabkins method/cyanmethaemoglobin method -> red colour spectrophotometry

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6
Q

Define haematocrit

A

A measurement of the proportion of blood that is made up of red cells

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7
Q

What causes microcytic and hypochromic rbcs

A

Iron deficiency
Thalassaemia

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8
Q

What is the Wright Stain

A

A polychromatic stain consisting of buffered solutions of methylene blue and eosin

Type of Romanowsky stain

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9
Q

What is a howell jolly body

A

DNA remnant

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10
Q

What is basophilic stiplling

A

Denatured RNA

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11
Q

What is basophilic stiplling

A

Denatured RNA

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12
Q

What are siderotic granules

A

Iron

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13
Q

What are heinz bodies

A

Oxidised denatured Hb

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14
Q

What is Turks solution

A

Stain used when counting WBC using a haemocytometer

Stain contains gentian violet and 6% acetic acid, gentian blue stains wbcs while acetic acid lysis rbcs

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15
Q

What is the romanowksy stain

A

A series of blue/red stains where the blue binds to acidic substances and the red binds to neutral or basic substances

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16
Q

What anaemias will increase reticulocytes
(5)

A

Thalassaemia
Pernicious anaemia after treatment
Iron deficiency anaemia after treatment
Haemolytic anaemias -> spherocytosis
Sideroblastic anaemia

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17
Q

What conditions will decrease reticulocyte counts

A

Aplastic anaemia (no new cells)
Untreated pernicious anaemia
Megaloblastic anaemia
Untreated iron deficiency anaemia
Anaemia of chronic infection
Chemotherapy

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18
Q

How do we investigate hereditary persistance of HbF

A

The Kleihaeuer Betke test

acid elutes HbA

HbF stains dark pink

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19
Q

What primary techniques are used to investigate haemoglobinopathies

A

HPLC

Isolectric focusing IEF

Hb electrophoresis

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20
Q

What secondary techniques are used to investigate Haemoglobinopathies

A

Hb electrophoresis

HPLC

Sickle solubility test

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21
Q

What is the principle behind HPLC

A

Different variants have different retention times

Hb is absorbed into column and eluted by means of a gradient of increasing ionic strength

Exchange column contains small spheres of silica which are modified to be weakly cationic

An anticoagulated specimen is lysed and diluted in buffer and injected into column

Hb is absorbed into column and eluted by means of a gradient of increasing ionic strength

Eluate passes through a photometer which measures changes in absorbance

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22
Q

What is the principle behind Hb electrophoresis

A

HBE utilises the charged properties of normal Hb and its variants to replicate characteristic mobility patterns on both alkaline and acidic gels

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23
Q

What is the principle of the sickle solubility test

Study These Flashcards
A

HbS is insoluble in the deoxygenated state in a high molarity phosphate buffer (sodium hydrosulfite)

The crystals that form refract light and cause the solution to be turbid, can’t see through

24
Q

Thin blood film

Study These Flashcards
A

Stained with Giemsa stain at pH 7.2

Used to determine % parasitaemia count

Used to determine species of parasite

Used to note the different stages of development seen

25
Thick blood film
Stained with fields stain Used to detect the presence of the parasite Useful in low grade parasitaemias
26
Sensitivity
A tests ability to determine the patient cases correctly
27
Sensitivity
A tests ability to determine the patient cases correctly True positive/(true positive + false negative)
28
Specificity
A test's ability to determine the healthy cases correctly True negative/(true negative + false positive)
29
Five main stages to the development of a granulocyte
Myeloblast Pro-myelocyte myelocyte Meta-myelocyte Granulocyte
30
Precision
How well a series of measurements agree with each other It is the closeness of agreement between independent test results obtained under stipulated conditions
31
Accuracy
How well a measurement agrees with an accepted value It is the closeness of the agreement between the result of a measurement and a true value of the measurement
32
Deviation index
is a statistical tool used to assess the accuracy and precision of laboratory test results. It helps evaluate how closely the measured values obtained in the laboratory align with the expected or target values. 1 or lower is really goos 1-2 is satisfactory 2-3 is borderline 3 may indicate a problem
33
Coefficient of varation
The coefficient of variation (CV) is a statistical measure used to assess the relative variability or dispersion of a dataset in relation to its mean. It is expressed as a percentage and provides a standardized measure of dispersion that allows for comparison between datasets with different means A measure of precision CV = (Standard Deviation / Mean) * 100 below 10% indicates results are near the mean and are precise
34
Mean
Average of the values
35
Standard deviation
a measure of the dispersion or spread of values in a dataset. It quantifies how much the individual data points deviate from the mean A higher standard deviation indicates a greater spread or variability of values in the dataset
36
What four tests are carried out for iron deficiency anaemia
Serum iron Transferrin (TIBC) % transferrin saturation Serum ferritin
37
How is %transferrin determined
Serum iron/TIBC x1000
38
How is %transferrin determined
Serum iron/TIBC x100
39
What are the clinical findings of iron deficiency anaemia?
Decreased: - Haemoglobin - MCV - MCH - Reticulocytes - Ferritin - serum iron - 15%> transferrin % Hypochromic, microcytic rbcs
40
Clinical findings of Thalassaemia
Reduced - Haemoglobin - MCV - MCH - haptoglobin Increased - Reticulocytes - Lactate dehydrogenase - Bilirubin Hypochromic Microcytic Target cells Anisopoikilocytosis Pappenheimer bodies Basophilic stipppling Inclusion bodies (HbH only)
41
What tests should be carried out for B thalassaemia
HPLC -> low HbA, high HbF and HbA2 Gel electrophoresis Family studies DNA analysis
42
What tests should be carried out for a Thalassaemia
H prep HPLC -> HbH peak and Hb Barts Gel electrophoresis Family studies DNA analysis
43
How is a H prep carried out
Incubation with brilliant Cresyl blue HbH will precipitate Results in appearance of multiple discrete inclusions - golf ball apoearance
44
Clinical findings of megaloblastic anaemia
Increased: - MCV - MCH - Lactate dehydrogenase and bilirubin MCHC (normal or low) Reduced: - WCC - platelets - haptoglobin - reticulocytes Oval macrocytes Hypersegmented neutrophils
45
Stages of granulocyte
Haematopoietic stem cell follows the myeloid pathway -> develops into a CFU-GEMM CFU-GEMM into CF-GM Depending on stimulus GF-GM will develop into a different granulocyte: - G-CSF = neutrophil - IL-5 = eosinophil - SCF = basophil (can become mast cells in tissues) Neut CFU -> myeloblast, promyeloblast, myeloblast, myelocyte, metamyelocyte, mature neutrophil Grow factor inhibits apoptosis and promotes differentiation
46
Clinical findings of ALL
High lymphoblasts greater than 20% Low red cell count Low haemoglobin Low platelet count Hypercellularity in bone marrow Philadelphia chromosome - BCR-ABL1
47
Clinical findings of AML
Varying degrees of myeloblast increase Auer rods
48
Clinical findings of CLL
Hair cells Smudge cells Increased reticulocytes Haemoglobin decreased Neutropenia B Cells expressing CD19, CD5, CD23, CD20
49
Clinical findings of CML
Red blood cell count down Little to no platelets White blood cell count up Blast cells
50
Clinical findings of HS
Spherocytes Anaemia + splenomegaly + jaundice depending on severity Increased: - MCHC - reticulocytes (not always)(recovery phase) - bilirubin Normal or reduced MCV
51
What do we need to rule out for HS
EMA Autoantibodies Autoimmune haemolytic anaemia Irregular maternal IgG antibodies
52
What tests are carried out for HS
EMA flow cytometry SDS-page osmotic fragility test
53
Clinical findings for G6PD
Decreased: - haemoglobin - MCV - haptoglobin Increased - NRBCs - reticulocytes - LDH - bilirubin MCH normal Bite cells Heinz bodies
54
What tests are carried out for G6PD
Heinz body stains MetHb reduction Fluorescence spot screening DNA analysis
55
Explain oxygen dissociation curve
The oxygen dissociation curve is a curve that plots the proportion of Hb in its oxygen saturated form on the vertical axis against the prevailing oxygen tension on the horizontal axis. It’s important for understanding how our blood carries and releases oxygen. It relates oxygen saturation (SO2) and partial pressure of oxygen in the blood (PO2). It is determined by haemoglobin affinity for oxygen i.e. how readily haemoglobin acquires and releases oxygen molecules into the fluid that surrounds it

2.2 Haematology (38 decks)

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