MODULE 1: COMPLETE BLOOD COUNT Flashcards
(209 cards)
1
Q
Complete Blood Count is previously known as
A
Full Blood Count
2
Q
Hemoglobin concentration (WHO)
A
Hemoglobin
3
Q
Erythrocyte Volume Fraction (WHO)
A
Hematocrit
4
Q
Erythrocyte Number Concentration (WHO)
A
RBC count
5
Q
Leukocyte number concentration (WHO)
A
WBC count
6
Q
Leukocyte type number fraction (WHO)
A
Differential count
7
Q
Thrombocyte Number concentration (WHO)
A
Platelet count
8
Q
Hemoglobin reference range in male (Conventional)
A
14-17.5 g/dL
9
Q
Hemoglobin reference range in female (Conventional)
A
12.3-15.3 g/dL
10
Q
Hemoglobin reference range in male (SI)
A
140-175 g/L
11
Q
Hemoglobin reference range in female (SI)
A
123-153 g/L
12
Q
The conversion factor for hemoglobin
A
10
13
Q
Used to diagnose and follow the treatment of anemia
A
Hemoglobin
14
Q
Hemoglobin is increased in:
A
Polycythemia Vera, Morning, Smokers, Strenuous exercise, high altitude
15
Q
Hemoglobin is decreased in:
A
Anemia, patients lying down
16
Q
Cyanmethemoglobin method aka:
A
Hemiglobincyanide method
17
Q
reference method approved by the CLSI
A
cyanmethemoglobin method
18
Q
The cyanmethemoglobin method measure all forms of hemoglobin except:
A
Sulfhemoglobin
19
Q
Converts hemoglobin into methemoglobin
A
Potassium ferricyanide
20
Q
Converts methemoglobin to cyanmethemoglobin
A
Potassium cyanide
21
Q
shortens conversion time from 10-15minutes to 3 minutes
A
Dihyrogen Potassium phosphate
22
Q
enhances lysis of RBCs
A
Nonionic detergent
23
Q
Specimen for hemoglobin determination
A
EDTA whole blood
24
Q
Sources of error: can be corrected using a patient blank
A
Lipemia
25
Sources of error: can be corrected by centrifuging test mixture and testing hemoglobin on the supernatant fluid
Increased WBCs and platelets
26
Sources of error: dilute hemoglobin with distilled water
HbS and HsC
27
Sources of error: use of dihydrogen potassium phosphate
Increased globulins
28
Sources of error: causes no effect on hemoglobin determinations
Overanticoagulation
29
Hb is converted to oxyHb by shaking with aqueous NH4OH; imprecise
Oxyhemoglobin procedure
30
Uses HCl to convert Hb into acid hematin, followed by dilution with distilled water drop by drop until the color matches that of the standard (comparator block)
Acid Hematin test
31
Used by some automated instruments to convert Hb to SLS-methemoglobin. Does not generate toxic waste
Sodium lauryl sulfate
32
Volume of RBC expressed over the percentage of the total whole blood volume
Hematocrit
33
term recommended by the national committee for CLS
Packed cell vallume
34
Relationship of Hb to Hct (ratio); may vary with the cause of anemia and the effect on the RBC indices especially the MCV
1:3
35
Hematocrit reference range for male (Conventional)
41.5-50.4%
36
Hematocrit reference range for female (Conventional)
35.9-44.6%
37
Conversion factor for Hematocrit
0.01
38
Hematocrit reference range for male (SI)
0.415-0.504 volume fraction
39
Hematocrit reference range for female (SI)
0.359-0.446 volume fraction
40
reference manual method for microhematocrit method
Spun microhematocrit
41
Heparinized and used for non-anticoagulated whole blood
Red capillary tube
42
Plain and used when processing anticoagulated blood
Blue capillary tube
43
Microhematocrit tube forms a ____ with the tray of clay
90 angle
44
Clay plug should be _____ long
4-6mm
45
Should not be included for the microhematocrit reading
Buffy coat
46
Hematocrit results must agree within:
+/- 0.02 L/L
47
Layers of blood after centrifugation: Top of the tube
Fatty Layer
48
Layers of blood after centrifugation: Second layer
Plasma
49
Layers of blood after centrifugation: Third layer
Buffy Coat
50
Layers of blood after centrifugation: Bottom
Packed red cells
51
Falsely Low results (Hematocrit)
Incomplete sealing, Short sample, Over-anticoagulated blood, Hemolysis
52
Falsely elevated results (hematocrit)
Inadequate centrifugation, Allowing the tubes to stand after centrifugation before reading, Including buffy coat in the reading, Hemoconcentration, Abnormal RBC morphology leading to trapped plasma
53
small amount of plasma that remains in the RBC portion of spun HCT
Trapped plasma
54
Trapped plasma is increased in:
Sickle cell anemia, Hypochromic anemia, Spherocytosis, Macrocytosis, Thalassemia
55
Falsely elevated/low results (Hematocrit)
Insufficient mixing of blood, improper use of HCT reader
56
Uses the Wintrobe tube; no longer used; centrifuge WB @ 2000-2300g for 30 mins
Macrohematocrit method
57
Anticoagulants for macrohematocrit method
Oxalate, Heparin, EDTA
58
Does not directly measure HCT; Not affected by trapped plasma
Automated techniques
59
Directly measured by automated methods
MCV and RBC
60
Neubauer Counting Chamber total area
9 mm2
61
Neubauer counting chamber depth
0.1 mm
62
Neubauer Counting squares (WBC square area):
1 mm2
63
Neubauer Counting Square (Volume of Large square)
0.1 mm3
64
Neubauer Counting Square (RBC Square area)
0.04 mm2
65
Neubauer Counting square (Volume of small central square)
0.004 mm3
66
Speirs-Levy Counting chamber total area
10 mm2
67
Speirs Levy Counting chamber depth
0.02 mm
68
Speirs-Levy counting chamber total volume
2.0 mm3
69
used for eosinophil count because of its large volume
Speirs-Levy counting chamber
70
Fuchs-Rosenthal Counting Chamber Total area
16 mm2
71
Fuchs-Rosenthal Counting chamber depth
0.2 mm
72
Fuchs-Rosenthal Counting chamber total volume
3.2 mm3
73
used for eosinophil count because of its large volume (2nd chamber)
Fuchs-rosenthal counting chamber
74
Thoma RBC pipette bead color
Red
75
Thoma RBC pipette outstanding marks
0.5, 1, 101
76
Thoma RBC pipette bulb volume
100
77
Thoma RBC pipette dilution range
1:100, 1:1,000
78
Thoma WBC pipette bead color
White
79
Thoma WBC pipette outstanding marks
0.5, 1, 11
80
Thoma WBC pipette bulb volume
10
81
Thoma WBC pipette dilution range
1:10, 1:100
82
RBC Normal range in men (conventional)
4.5-5.9x 10^6/uL
83
RBC normal range in women (conventional)
4.5-5.1 x10^6/uL
84
RBC conversion factor
10^6
85
RBC normal range for men (SI)
4.5-5.9x10^12/L
86
RBC normal range for women
4.5-5.1x10^12/L
87
RBC is higher in
newborns
88
RBC is slightly decreased in
Childhood/adolescence and after 50 years of age
89
RBC is highest in the ____ and lowest in the ____
Morning, evening
90
RBC is increased in
Polycythemia, dehydration, and high alatitudes
91
RBC is decreased in
anemia and other disorders
92
not recommended due to poor precision
RBC count by manual method
93
Dilution in polycythemia (Manual RBC count)
1:300
94
Dilution in severe anemia (Manual RBC count)
1:100
95
RBC diluting fluid should be isotonic to:
prevent lysis of RBCs
96
RBC diluting fluids
Hayem's NSS, Dacie's, Toisson's, Gower's, Bethel,3-8% Na citrate
97
If rule of 3 doesn't fit consider:
Cloted sample, cold agglutinin, Lipemic and icteric sample
98
WBC normal range (Conventional)
4.4-11 x10^3/uL
99
WBC normal range (SI)
4.4-11.3 x 10^9/L
100
WBC conversion factor
10^6
101
WBC in newborns
higher, 10-30x10^9/L
102
WBC in 1 year old
6-17x10^9/L
103
WBC in adult
4-11x10^9/L
104
highest in the afternoon, lowest in the morning
diurnal variation
105
smoking, exercise, emotional stress, anxiety, release of epinephrine, pregnancy
Physiologic leukocytosis (without tissue damage)
106
Bacterial infection, Appendicitis, Leukemia, HDN
pathologic leukocytosis
107
Viral diseases, Typhoid fever, measles, brucellosis, RA, LE, liver cirrhosis, infectious hepatitis, radiation, drug therapy
Leukopenia
108
Specimen used for manual WBC count
EDTA
109
Unsatisfactory anticoagulant for manual WBC count
Heparin
110
Performed as a check on the validity of electronic methods for calibration; back up method
manual WBC count
111
Lyses the erythrocytes so that they will not obscure the leukocytes; must be refrigerated and filtered frequently
WBC diluting fluid
112
Components of WBC diluting fluid
1% Ammonium Oxalate
2-3% Glacial Acetic Acid
1% Hydrochloric Acid
Turk's solution
113
dilution for WBC >30x10^9/L
1:100
114
Dilution for WBC 100-300x 10^9/L
1:200
115
Dilution for WBC <3.0 x10^9/L
1:10
116
Failure to mix specimen before sucking
Failure to mix pipette with specimen
Bubbles in pipette
WBC False decrease
117
Diluting fluid contaminated with blood
Bubbles in pipette (while sucking diluting fluid)
Drawing blood far past the appropriate mark
WBC False Increase
118
Are not lyzed by WBC diluting fluid and will be counted as WBC
Nucleated RBCs
119
Also don't lyse in diluting fluid
Target cells and sickle cells
120
Correct WBC count if >=
5 nRBC/1000 WBC
121
Has better cell detail (Blood smear)
Faster film drying (thin)
122
Will show contraction of cells
Slow film drying (thick)
123
Blood smear should be made within ____ hours of collection from blood anticoagulated with EDTA
5
124
Aka spreader-slide, push smear, 2 slide method
Wedge Blood Smear
125
Smearer or spreader slide with ______________ is recommended
Chamfered or beveled corners
126
Size of blood drop for wedge blood smear
2-3 mm in diameter, 0.25 inch
127
Position of spreader slide (angle)
30-45
128
Smear should terminate how many inches near the end of the slide
0.5
129
Increasing the angle leads to (Blood smear)
thick smear
130
Decreasing the angle leads to (Blood smear)
thin smear
131
Decreased pressure
Increased angle of spreader slide
increased size of droplet of blood
increased speed of spreader
extremely thick smears
132
Increased pressure
Decreased angle of spreader slide
decreased size of droplet of blood
decreased speed of spreader
extremely thin smears
133
Area the smear should cover in the glass slide
2/3 to 3/4
134
2 cover glass are used in this blood smear
Cover glass smear
135
blood smear utilized extensively for BM exams
Cover glass smear
136
Stimulates the manual spreader-type technique
Wedge (push) type
137
drops of blood placed on center of slide and spun for a period of time
Centrifugal (spinner) type/Spun smear
138
Used for finding reactive, immature or abnormal cells that are present in small numbers; In finding megaloblastic nucleated cells, hypersegmented neutrophils, plasma cells and tumor cells;Easier to locate bacteria or parasites
Buffy Coat smear
139
Used when looking for blood parasites such as malaria
Thick and Thin blood film
140
Thick smear
Detection
141
Thin smear
Identification
142
For best results of blood staining, blood should be stained for how many hours after collection
2-3
143
stains present produce multiple colors when applied to cellular elements
Nonvital polychrome stain
144
stains specific celuular components
nonvital monochrome stain
145
used to stain specific cellular components in the living state; no fixatives are used in the staining process
supravital monochrome stain
146
Routinely used to stain peripheral blood and BM smears
Romanowsky stain
147
a basic dye, (+) charged, stains the acidic components of the cell (nucleus) blue/purple
Methylene blue
148
an acidic dye, (-) charged, stains the basic components of the cells (cytoplasm) orange/pink
Eosin
149
monobasic K phosphate, dibasic Na phosphate;
Buffer
150
ph ideal for blood and BM staining
6.8
151
pH used when looking for malarial parasites
7.2
152
most commonly used routine peripheral blood smear which is oxidizes methylene blue and eosin
Wright's stain
153
combines eosin and methylene blue in methanol with glycerin;
Wright-Giemsa
154
Manual staining method
Rack method, Dip (incubation) method
155
Automated staining method
Platen type, Carousel type, Dip-type instruments
156
RBC microscopic characteristic (good stain)
salmon-pink
157
WBC nuclei microscopic characteristic (good stain)
purple-blue
158
Platelets microscopic characteristic (good stain)
purple-blue to lilac with red-purple granules
159
Eosinophils characteristics (good stain)
orange granules
160
neutrophils (good stain)
pinkish tan cytoplasm
161
monocytes (good stain)
gray ground glass cytoplasm with many tiny red-purple granules
162
bacteria (good stain)
blue
163
malarial parasites (good stain)
sky blue cytoplasm and red purple chromatin
164
3-part differential
granulocytes, lymphocytes, monocytes
165
5-part differential
neutrophils, eosinophils, basophils, lymphocytes, monocytes
166
relative value of neutrophil, segmented
50-70%
167
absolute value of neutrophil, segmented
1.8-7.8 x10^9/L
168
relative value of neutrophil, band
0-5%
169
absolute value of neutrophil, band
0-0.70 x10^9/L
170
relative value of eosinophil
1-3%
171
absolute value of eosinophil
0-0.45 x10^9/L
172
relative value of basophil
0-2%
173
absolute value of basophil
0-0.20 x10^9/L
174
relative value of lymphocyte
18-42%
175
absolute value of lymphocyte
1.0-4.8 x10^9/L
176
relative value of monocyte
2-11%
177
absolute value of monocyte
0-0.80 x10^9/L
178
Percentage of cells counted; Conventional reporting (Differential count)
Relative count
179
Actual number of cells/L of blood; Preferred and more accurate method of reporting
Absolute count
180
WBC count for 2-5 cells/HPF
4-7 x10^9/L
181
WBC count for 4-6 cells/HPF
7-10 x10^9/L
182
WBC count for 6-10 cells/HPF
10-13 x10^9/L
183
WBC count for 10-20 cells/HPF
13-18 x10^9/L
184
Increased immature WBC, blast to stab
Shift to the left
185
Increased mature neutrophils (segmenters)
Shift to the right
186
WBCs are counted in consectuve fields as the blood film is moved from side to side
Ceoss sectional or crenllation
187
Ideal method if the smear is thin enough; WBCs are counted in consecutive fields from tail toward the head of the smear
Longitudinal
188
Uses a pattern of consecutive fields beginning near the tail on a horizontal edge; count 3 consecutive horizontal edge fields, count 2 fields toward the center of the smear, count 2 fields horizontally, count 2 fields vertically to the edge
Battlement
189
useful in the morphologic characterization of anemia
RBC indices
190
MCV convetional units
80-96 um3
191
MCV SI units
80-96 fL
192
MCH Conventional
27.5-33.2 pg
193
MCH SI unit
27.5-33.2 pg
194
MCHC conventional
33.4-35.5%
195
MCHC SI
0.334-0.355
196
Indicates average volume of RBC
mean corpuscular volume
197
seen in megaloblastic anemia, hemolytic anemia with reticulocytosis, liver disease and normal newborn
Macrocytic RBC (>96 fL)
198
seen in IDA, Thalassemia, sideroblastic anemia and lead poisoning
Microcytic RBC (<80 fL)
199
average content (weight) of Hb in the RBC; less valuable than the MCV and MCHC
Mean corpuscular Hemoglobin
200
MCH is increased in
macrocytic anemia
201
MCH is decreased in
microcytic anemia and hypochromic anemia
202
Average concentration of Hb in each individual RBC in g/dL
Mean corpuscular hemoglobin concentration
203
Hyperchromia (>35.5%) is seen in
presence of spherocytes
204
Hypochromia (<33.4%) is seen in
IDA and thalassemia
205
percentage of MCHC that should not occur
>38%
206
percentage of MCHC should not occur; lipemic plasma or abnormal Hb (S or C0
<22%
207
Indicates degree of anisocytosis; determined from the RBC histogram
Red blood cell distribution width
208
normal value of RDW
12-17%
209
seen in IDA, post-transfusion, post-treatment, idiopathic sideroblastic anemia, in the presence of two concurrent deficiencies
Increased RDW
