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HEMATOLOGY 1 > PBS > Flashcards

PBS Flashcards

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1
Q

When should blood smears be made from EDTA blood?

A

Within 3 hours after collection

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2
Q

Advantages of EDTA blood smear

A

Multiple smears, delayed preparation, prevents platelet clumping

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3
Q

Disadvantages of EDTA blood smear

A

Platelet satellitism, EDTA-induced platelet clumping

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4
Q

What conditions can EDTA cause in PBS?

A

Pseudothrombocytopenia, pseudoleukocytosis

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5
Q

Correction for EDTA effects in PLT

A

Recollect using 3.2% Na Citrate, multiply platelet count by 1.1

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6
Q

Best specimen for evaluating cell morphology?

A

Anticoagulant-free blood

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7
Q

Advantages of anticoagulant-free blood

A

Prepared at patient’s side, prevents some artifacts

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8
Q

Disadvantages of anticoagulant-free blood

A

Platelet clumping (caused by glass), limited films can be made

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9
Q

Most frequently used blood film preparation method?

A

Two-glass slide method (Manual Wedge Technique)

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10
Q

What angle should be between the pusher and film slide?

A

30 - 45 degrees

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11
Q

Effect of too high angle of spreader?

A

Thicker smear

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12
Q

Effect of too low angle of spreader?

A

Thinner smear

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13
Q

Ideal size of blood drop for smear?

A

2-3mm

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14
Q

Effect of too large blood drop?

A

Thicker smear

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15
Q

Effect of too small blood drop?

A

Thinner smear

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16
Q

Distance from label when preparing smear?

A

1 cm away

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17
Q

Effect of too fast spreader speed?

A

Thicker smear

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18
Q

Effect of too slow spreader speed?

A

Thinner smear, poor WBC distribution

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19
Q

Effect of high hematocrit (Hct) correction in PBS?

A

Lower the angle (as low as 25 degrees)

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20
Q

Effect of low hematocrit (Hct) correction in PBS?

A

Raise the angle

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21
Q

How should the scanning method be done under microscope?

A

Longitudinal (tail to head) or battlement (back and forth serpentine)

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22
Q

What is the ideal transition of a blood smear from thick to thin area?

A

Gradual transition

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23
Q

How much of the film slide should the smear cover?

A

2/3 to 3/4 of the length of the film slide

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24
Q

What shape should the smear be?

A

Finger-shaped

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25
What should be visible on the smear?
Lateral edges
26
What should the smear not have?
Irregularities, holes, or streaks
27
What appearance should the feather edge have?
Rainbow appearance
28
What problem occurs with Wedge method?
WBCs are unevenly distributed across the slide
29
Where are segmented neutrophils, monocytes, and eosinophils more visible?
In the feather edge and side edges
30
Where are small lymphocytes more visible?
At the center of the film
31
What is the purpose of blood smear staining?
Evaluation of cellular morphology
32
What is the fixative used in blood smear staining?
Methanol
33
What buffer solution is used for blood smear staining?
0.05 M NaPO4 at pH 6.4
34
What is the pH range for blood smear staining?
6.4 to 6.8
35
What is the commonly used stain for blood smears?
Wright/Wright Giemsa stain
36
What is a Romanowsky-type stain?
A stain containing methylene blue and eosin B or eosin Y
37
What is the function of methylene blue in staining?
It is a basic stain that colors the nucleus and some cytoplasmic structures blue or purple
38
What structures are described as basophilic?
DNA or RNA
39
What is the function of eosin in staining?
It is an acidic stain that colors cytoplasmic structures orange-red
40
What structures are described as acidophilic?
Proteins with amino groups
41
What are some examples of Romanowsky-based stains?
Wright stain, Giemsa stain, May-Grunwald stain
42
What automated method for PBS does not require a power source?
CellaVision HemaPrep®
43
What type of blood is used in centrifugal (spinner) type preparation?
0.2 mL of well-mixed anticoagulated blood
44
What is a key advantage of the centrifugal (spinner) type method?
Even distribution of blood cells; consistent; fewer smudge cells
45
Other types of automated methods for PBS preparation
Coulter LH, Sysmex SP-10
46
Macroscopic characteristic of a well-stained blood smear
Pink to Purple
47
RBC color in a well-stained blood smear
Orange to Salmon-pink
48
WBC nuclei color in a well-stained blood smear
Purple-blue
49
Neutrophil cytoplasm color in a well-stained blood smear
Pink to Tan (granules violet to lilac)
50
Eosinophil granules color in a well-stained blood smear
Bright orange
51
RBCs appearing gray or blue in smear
Staining buffer too basic, inadequate rinsing, heparinized blood used
52
WBCs appearing too dark in smear
Staining buffer too basic, inadequate rinsing, heparinized blood used
53
Eosinophil granules appearing gray in smear
Staining buffer too basic, inadequate rinsing, heparinized blood used
54
RBCs appearing too pale or red in smear
Stain buffer too acidic, under buffering, over rinsing
55
WBCs barely visible in smear
Stain buffer too acidic, under buffering, over rinsing
56
Blood film appearing bluer than normal
Increased blood proteins (e.g., plasma cell myeloma)
57
Grainy appearance on blood film
RBC agglutination (e.g., cold hemagglutinin disease)
58
Holes in blood film
Increased lipid levels
59
Blue specks at feather edge of blood film
Markedly increased WBC and platelet counts
60
10x Objective Use in microscopic examination of PBS
Assess overall film quality, color, and cell distribution; locate rare abnormal WBCs; detect "snowplow" effect, fibrin strands, rouleaux formation, RBC agglutination, parasites; assess examination area
61
Snowplow effect indication
More than four times the number of WBCs per field at the lateral edges or feather edge compared with the monolayer area
62
Fibrin strands detection
Film should be rejected if present
63
40x High-Dry or 50x Oil Immersion Objective Use
Examine areas where red cells have central pallor, are near each other but not overlapping; cells are appropriately stained; avoid feathered edge and thick part
64
Feathered edge appearance under higher magnification
Red cells appear macrocytic, flattened, and lack central pallor; WBCs distorted
65
Thick part appearance under higher magnification
Red cells appear microcytic and may form rouleaux
66
Method for estimating total WBC count using 40x high-dry objective
Count leukocytes in 10 fields, find the average number of WBCs per field, then multiply by 2,000 to get estimated WBC count per μL
67
Method for estimating total WBC count using 50x oil immersion objective
Count leukocytes in 10 fields, find the average number of WBCs per field, then multiply by 3,000 to get estimated WBC count per μL
68
100x Oil Immersion Objective Use
Examine nuclear details of white blood cells; tabulate WBC differential; estimate platelet count
69
RBC count per 100x OIF
200 to 250 RBCs per 100x OIF in normal smear
70
Method for estimating platelet count using 100x oil immersion objective
Scan ten oil immersion fields, average platelets per field, multiply by 20,000 for estimated plt. ct. per μL
71
Platelet estimate formula in significant anemia or erythrocytosis
Average number of platelets per field x total RBC count / 200
72
Storage duration for blood smear slides
At least 7 days before proper disposal

HEMATOLOGY 1 (29 decks)

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