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Hematology > Laboratory Methods > Flashcards

Laboratory Methods Flashcards

1
Q

Causes of Shortened Clotting time

A

Premature Activation
* Contamination of tissue factor
* Use of Glass container
Hemolysis
Overfilling

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2
Q

Causes of Prolonged Clotting time

A

Polycythemia vera (Hct: >50%)
Underfilling
Overanticoagulation
Change in pH

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3
Q

Sodium Citrate
* Ratio:
* Concentration:
* Centrifugation:

A

Sodium Citrate
* Ratio (blood:anticoagulant): 9:1
* Concentration: 3.2% (preffered)
* Centrifugation: 2000 g for 10 minutes

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4
Q

Changes in pH can ________ clotting time

A

prolong

Loss of CO2 changes pH
Note: Should be unopened if testing not done

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5
Q

Prolonged tourniquet application - Statis can elevate ____ and ________ ; falsely decreases finrinolytic parameters and falsely ________ clotting time

A

Prolonged tourniquet application - Statis can elevate vWF and Factor VIII ; falsely decreases finrinolytic parameters and falsely shortened clotting time

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6
Q

Common gauge for hemostatis collection

A

20G

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7
Q

Can be used for platelet retension test

A

Heparin

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8
Q

Factor VII and XI

A

Prematurely activated at 4C

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9
Q

Modification of Lee and White Clotting time

A

Plasma Recalcification Test

Time required for blood to clot after Ca2+ is added

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10
Q

Reference Range - Plasma Recalcification Time
* PRP
* PPP

A

Reference Range - Plasma Recalcification Time
* PRP - 100-150 seconds
* PPP - 130-240 seconds

PRP should be 20 seconds faster than PPP

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11
Q

aPTT
* Sample:
* Reagent:
* NV:

A

aPTT
* Sample: Platelet poor plasma (PPP)
* Reagent: Phospholipid (platelin) + Activator + CaCl2
* NV: 20-45 seconds

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12
Q

Partial thromboplastin

A

Contains phospholipid (platelin) only and is a substitute for platelet factor 3

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13
Q

Activator in aPTT

A

Kaolin
Celite
Ellagic acid
Silica

Negatively charged particles that activate PF XII

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14
Q

Monitor Heparin therapy

A

aPTT

modification of partial thromboplastin time

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15
Q

Tests for Intrinsic Pathway

A

Lee and White
Plasma Recalcification time
aPTT

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16
Q

Activator - Activated Clotting Time

A

Diatomite

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17
Q

Test for Extrinsic Pathway

A

Prothrombin Time

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18
Q

PT
* Specimen:
* Reagent:
* NV:

A

PT
* Specimen: PPP
* Reagent: Thrombolastin (Simplastin) + CaCl2
* NV: 10-12 seconds

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19
Q

Therapy monitored in PT

A

Vitamin K antiagonist - Warfarin & Coumarin

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20
Q

INR

International Normalized Ratio

A

provide a standardized PT result and monitor warfarin/coumarin therapy

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21
Q

INR - Warfarin therapy

A

2.0 - 3.0

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22
Q

Manchester Reagent

Rabbit brain tissue thromboplastin

A

Most sensitive PT reagent

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23
Q

Steypven Test

a.k.a Russel Viper venom test

A

Detect deficiency in common pathway

Particularly deficiency in PF X

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24
Q

Stypven Test
* Reagent:
* Snake:
* NV:

A

Stypven Test
* Reagent: Russel’s viper venom
* Snake: Vipera russeli
* NV: 6-10 seconds

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25
Bypass plasma factor VII and directly activate plasma factor X
Stypven Test
26
Stypven Test * Abnormal: * Normal:
Stypven Test * Abnormal: Factor X * Normal: Factor VII | Test also help distinguish between factor X and factor VII deficiencies
27
5M Urea Solubility test | a.k.a **Dickhert's Test**
Detect deficiency in **Factor XIII**
28
5M Urea Solubility Test * Reagent: * Substitute:
5M Urea Solubility Test * Reagent: 5M Urea * Substitute: 1% monochloroacettic acid or 2% aceticacid
29
5M Urea Solubility Test * Normal: * Abnormal:
5M Urea Solubility Test * Normal: Insoluble - F XIII is present * Abnormal: Soluble - Deficiency in F XIII | A stable fibrin clot with FXIII is resistant to 5M urea
30
Thrombin Time | addition of exogenous **thrombin** to activate clot formation
Detect deficiency in **Fibribogen **in patient **not** undergoing *heparin therapy*
31
**Not** indication for Heparin therapy patient
Thrombin time
32
Thrombin Time * Sample: * Reagent: * Heparin * NV:
Thrombin Time * Sample: PPP * Reagent: Thrombin * Heparin: Affected * NV: 10-14 seconds
33
Greatly Prolonged Thrombin Time
Hypofibrinogenemia | **<100 mg/dL**
34
Prolonged in Thrombin Time
Hypofibrinogenemia Dysfibrinogenemia FDP Heparin therapy
35
Reptilase Test
Detect deficiency in **Fibribogen **in patient undergoing *heparin therapy*
36
Reptilase Test * Reagent: * Heparin: * Snake: * NV:
Reptilase Test * Reagent: **Reptilase** in snake venom * Snake: **Bothrops atrox** * NV: **10-15** secopnds
37
Enzyme found in Bothrops atrox venom that has similar activity to thrombin
Reptilase
38
Greatly Prolonged in Reptilase Test
Dysfibrinogenemia
39
Claus Factor I assay
Estimates functional fibrinogen level
40
Claus factor I assay * Specimen: * Reagent: * Dilution: * Buffer:
Claus factor I assay * Specimen: PPP * Reagent: **Bovine thrombin** **(50 NIH units/mL)** * Dilution:** 1:10** * Buffer: **Owren Buffer**
41
Tests for Primary Hemostasis
Bleeding Time Capillary Resistance Test Clot Retraction Test Platelet Count Platelet Adhesiveness Platelet Aggregation
42
Actual time it takes for a wound to stop bleeding
Bleeding Time
43
Methods - Bleeding Time | Mnemonics: BleeDing IVY
* Duke Method (Earlobe) * Ivy Method (Pressure cuff at 40 mmHg)
44
Duke's Method * Site: * NV:
Duke's Method * Site: Earlobe * NV: <8 minutes
45
Ivy Method * Site: * NV:
Ivy Method * Site: Volar surface of the forearm * NV: 3-6 minutes | uses filter paper strips after 2 minutes and again every after 30 sec.
46
Positive Pressure Test | Capillary resistance test
Rumple Leed Test/Tourniquet Test
47
Negative Pressure Test | Capillary resistance test
Hess Test/Suction Test
48
Positive/Tourniquet/Rumple-Leed * Tool: * Application: * Observe for petechiae:
Positive/Tourniquet/Rumple-Leed * Tool: BP cuff * Application: 5 minutes * Observe for petechiae: after 5 minutes
49
Negative/Suction/Hess Test * Tool: * Application: * Observe for petechiae:
Negative/Suction/Hess Test * Tool: Suction Cup (2 cm) * Application: 1 minute * Observe for petechiae: 5 minutes
50
Brecher - Cronkite Method
Reference Method for Manual platelet count
51
No. of RBCs in 1 Platelet * Rodaks: * Steininger:
No. of RBCs in 1 Platelet * Rodaks: 25 RBCs * Steininger: 10-40 RBCs
52
Test for Platelet adhesiveness
Glass Bead Retention Test/Salzmann Method | normal platelet that have vWF will adhere and aggregate to the beads
53
Platelet Aggregation Test
**In vitro test** to determine the **ability of platelets to aggregate** using **aggregating agents** which make **sample becomes clearer** and **transmits more light** as platelet aggregates | Aggregating agents: Epinephrine, Collagen, ADP, **Restocitin**
54
Test - Determination of **Lysis Time**
Euglobulin Lysis Time
55
Principle - Euglobulin Lysis Time
**Euglobulin** is a protein that is *precipitated* after **plasma is diluted with water and acidified** and clot is incubated at 37C | Diluted PPP + Acid = Euglobulin + Thrombin = Clot (incubated at 37C)
56
Gelation
Clot formation indicating increased fibrinolysis | Test for secondary fibrinolysis (DIC)
57
Protamine Sulfate Gelation Test * Reagent: * Principle: * Result:
Protamine Sulfate Gelation Test * Reagent: Protamine sulfate * Principle: Paracoagulation * Result: (+) Clot formation ; (-) No clot | Protamine replaces secondary degradation products
58
Ethanol Gelation Test * Reagent: * Principle: * Result:
Ethanol Gelation Test * Reagent: **50% Ethanol** * Principle: Paracoagulation * Result: (+) Clot formation ; (-) No clot | Ethanol causes soluble fibrin monomer to dissociate and then polymerizes
59
Latex D-dimer assay
Specific test to intravascular fibrin formation and diagnose DIC | measure a specific FDP - D-dimer
60
In D-dimer assay, it is already positive after ____ hours after DIC onset
In D-dimer assay, it is already positive after **4 hours** after DIC onset
61
Intravenous anticoagulant
Heparin
62
Oral anticoagulant
Warfarin
63
Heparin Therapy * Action: * Administration: * Treatment: * Therapy:
Heparin Therapy * Action: Inhibit thrombin by enhancing anti-thrombin III * Administration: Intravenous anticoagulant * Treatment: Protamine sulfate * Therapy: APTT and ACT
64
Warfarin Therapy * Action: * Administration: * Treatment: * Therapy:
Warfarin Therapy * Action: Antagonize Vitamin K and induce PIVKAs * Administration: Oral anticoagulant * Treatment: Vitamin K, FFP * Therapy: PT
65
Used during **coronary artery bypass graft surgery** and during **cardiac catheterization** and in several medical conditions.
Heparin Therapy
66
Differentiate *Leukemoid reaction* vs. *CML*
Leukocyte Alkaline phosphatase (LAP) test | Increase: Leukemoid reaction; Decrease: CML
67
Differentiate** *AML* and *Monocytic leukemia* **from **ALL**
MPO
68
Differentiate ***AML & Myelomonocytic leukemia*** from **ALL**
Sudan Black B | stains Lipids on granulocyte
69
Periodic Acid Schiff Test (PAS)
Diagnose DiGuglielmo's Syndrome (M6)
70
Differentiate **Granulocytic** from **Monocytic** cells
Naphthol AS-D Choroacetate esterase | Stain specific esterase
71
Tartrate-resistant ACP (TRAP)
Diagnose **Hairy cell leukemia**
72
Differentiate **ALL** from *AML*
Terminal deoxyribonucleotidyl transferase
73
Fresh Capillary Blood
Recommended specimen in LAP test
74
Heparinized whole blood
Recommended specimen in NBT

Hematology (6 decks)

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