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Hematology 1 [LEC] > PBS AND DIFFERENTIAL COUNT > Flashcards

PBS AND DIFFERENTIAL COUNT Flashcards

1
Q

Materials used:-
Glass slide
-Spreader
-Blood sample (whole blood)

A

WEDGE BLOOD SMEARS

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2
Q

-Place a drop of blood 1cm away from labelled end

A
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3
Q

-When using blood from finger or heel, prevent touching the skin with the slide

A
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4
Q

-Hold the slide with blood in one hand and the spreader on the other hand

A
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5
Q

-Place the spreader slightly in front of the blood drop (30-40 degree angle)

A
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6
Q

-Draw the spreader slide back

A
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7
Q

-As soon as blood comes in contact with spreader, it begins to spread to the edges, if not, wiggle it a little

A
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8
Q

-Push the spreader rapidly over the entire length of the slide

A
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9
Q

Let dry, stain.

A
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10
Q

a) Glass slides must be clean

A

WEDGE BLOOD SMEARS

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11
Q

b) As soon as blood is placed on the slide, immediately make the smear

A

WEDGE BLOOD SMEARS

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12
Q

WEDGE BLOOD SMEARS delay

A

abnormal distribution of wbc (many large cells accumulate at the thin edge) rouleaux of red cells and plt clumping.

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13
Q

WEDGE BLOOD SMEARS
Causes of poor blood smear:

A

-drop of blood too large or too small-Spreader slide pushed in a jerky manner
-Failure to put the entire edge of the spreader slide against the slide while making the smear
-Failure to put the spreader in a proper angle against the slide.
-Failure to push the spreader slide completely across the slide

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14
Q

results in thicker smear for very low hct

A

Increase angle

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15
Q

gives a thin smear for patients with very high hematocrit

A

Decrease angle

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16
Q

Too much Drop of blood

A
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17
Q

Too little Drop of blood

A
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18
Q

Angle Too high

A
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19
Q

Angle Too low

A
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20
Q

Pressure Decreased

A
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21
Q

Pressure Increased

A
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22
Q

Speed Too slow

A
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23
Q

Speed Too fast

A
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24
Q

A. Materials used:
-2 cover slips (22mm thick, 0.13-0.17 mm thick)
-Blood sample

A

COVER GLASS SMEARS

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25
Q

COVER GLASS SMEARS
B. Procedure:
-Hold 1 cover glass by its [?], place a drop of blood

A

2 adjacent corners

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26
Q

COVER GLASS SMEARS
B. Procedure:
-With the second hand, hold the [?] as the first

A

second cover slip

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27
Q

COVER GLASS SMEARS
B. Procedure:
-Gently place the [?] on top of the one containing blood

A

second cover glass

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28
Q

COVER GLASS SMEARS
B. Procedure:
drop of blood in the middle of the 2 glass slides forming

A

16 sides

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29
Q

COVER GLASS SMEARS
B. Procedure:
-Just before spreading of blood is complete, separate the 2 cover glasses by a [?] (avoid squeezing the 2 glass slides together)

A

rapid, even, horizontal, lateral pull

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30
Q

COVER GLASS SMEARS
B. Procedure:
-Allow the smears to [?]
-Stain

A

air dry completely

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31
Q

Cover glasses must be clean

A
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32
Q

When obtaining blood from finger tip puncture, do not touch the skin

A
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33
Q

The cover glasses should be put together without delay upon dropping of blood

A
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34
Q

COVER GLASS SMEARS delay

A

clumping of plts and wbcs, rouleaux formation

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35
Q

-Too large drop of blood causes too thick smear

A

COVER GLASS SMEARS

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36
Q

-This type of smear prep gives a more even distribution of wbcs than the wedge

A

COVER GLASS SMEARS

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37
Q

More time consuming, tedious, harder to master

A

COVER GLASS SMEARS

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38
Q

Harder to label

A

COVER GLASS SMEARS

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39
Q

Coverslips are easily broken

A

COVER GLASS SMEARS

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40
Q

A. Materials used
-Blood sample
-Instrument: Hemaspinner

A

AUTOMATED SPUN SMEAR

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41
Q

AUTOMATED SPUN SMEAR
B. Procedure
-A clean glass slide is placed on a plate, [?] are placed at the center of the slide.

A

3-4 drops of blood

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42
Q

AUTOMATED SPUN SMEAR
B. Procedure
-When the top of the instrument is closed, the plate spins at a high speed for a period of time (excess blood is thrown from the slide to a basin)

A
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43
Q

AUTOMATED SPUN SMEAR
B. Procedure
-Resultant slide is completely covered with a [?]
-Stain

A

monolayer of cells

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44
Q

A. Materials used:
-Wintrobe tube
-Capillary pipette, steel needle
-Glass slides-Coverslip

A

BUFFY COAT SMEAR

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45
Q

BUFFY COAT SMEAR
B. Procedure:
-Using the capillary pipette, fill a [?] with well mixed whole blood

A

wintrobe tube

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46
Q

BUFFY COAT SMEAR
B. Procedure:
-Centri:

A

15 minutes, 1500g

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47
Q

BUFFY COAT SMEAR
B. Procedure:
Locate the buffy coat, separate [?] except a small amount near the buffy coat

A

plasma

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48
Q

BUFFY COAT SMEAR
B. Procedure:
-Using capillary pipette, remove the

A

small amount of remaining plasma, the entire buffy coat, small amount of red cells

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49
Q

BUFFY COAT SMEAR
B. Procedure:
-Place on a glass slide, [?] (do not spread out too much on the slide)

A

mix

50
Q

BUFFY COAT SMEAR
B. Procedure:
-Transfer a small amount of blood to each of two slides, immediately prepare

A

wedge or cover and a glass smear

51
Q

BUFFY COAT SMEAR

The amount of [?] should be approximately equal to the volume of the cellular portion of the mixture

A

plasma mixed with the buffy coat and red cells

52
Q

Microhematocrit tubes may also be used to centrifuge the specimen

A

BUFFY COAT SMEAR

53
Q

cut the tube [?], transfer blood onto slide

A

near the buffy coat layer

54
Q

[?] on a buffy coat smear does not always make an accurate differential count

A

Distribution of WBCs

55
Q

tend to settle according to their cell type during the centrifugation process

A

nucleated cells

56
Q

the differentials from a well made buffy coat smear correlate relatively well with the standard blood smear

A

leukopenia

57
Q

A. Materials used:
-Blood sample
-Glasss slide

A

THICK BLOOD SMEAR

58
Q

THICK BLOOD SMEAR
B. Procedure
Place [?] in the center of a glass slide

A

one large drop of blood

59
Q

THICK BLOOD SMEAR
B. Procedure
Using the [?], carefully spread the drop of blood over an area the size of a dime

A

corner of the second slide

60
Q

THICK BLOOD SMEAR
B. Procedure
[?]: place newspaper behind the slide.
Spread the drop od blood until the newspaper print is just visible through the blood.

A

Thickness

61
Q

THICK BLOOD SMEAR
B. Procedure
Allow the film to completely dry before staining (?)

A

4-2 hrs at room temp, preferably overnight

62
Q

THICK BLOOD SMEAR
B. Procedure
-If not completely dry, will [?] during staining. (This type of stain is not fixed prior to staining)

A

wash off

63
Q

Stains used:

A

Romanowsky Stains
-Wright’s (oxidized methylene blue, eosin azures)
-Wright’s
– Giemsa/ Modified (more delicate staining char)
-Leishman
-Jenner
-May-Gruwald

64
Q

(oxidized methylene blue, eosin azures)

A

-Wright’s

65
Q

(more delicate staining char)

A

-Wright’s– Giemsa/ Modified

66
Q

oxidized methylene blue

A

Eosin B or Eosin Y

67
Q

oxidized methylene blue products

A

Azure B

68
Q

Are considered polychromatic (Impart different colors to cells and cellular elements)

A

Romanowsky Stains

69
Q

promotes ionization during which time staining takes place

A

Buffer

70
Q

neg charged, azure B: pos charged

A

eosin ions

71
Q

STAINING
Procedure:
-Place the dried smear level on a [?]
-Fix by flooding with methanol-Flood slides with [?], time for 4 minutes
-Without removing the stain, add equal volume of [?]
-Mix 2 solutions on the slide by gently blowing back and forth over the solutions (a [?] should form, time for 7 minutes)-rinse thoroughly with tap water
-Wipe the [?], air dry

A

staining rack
Wright-Giemsa stains
phosphate buffer
metallic green sheen
back of the slides

72
Q

a) Pink to orange

A

red blood cells

73
Q

b) Pinkish-grey

A

reticulocytes

74
Q

c) Dark purple nuclei

A

lymphocytes and neutrophils

75
Q

d) Lighter nucleus

A

monocytes

76
Q

e) Bright orange granules

A

eosinophils

77
Q

f) Dark blue black granules

A

basophils

78
Q

g) Violet to purple granules

A

platelet

79
Q

h) gray blue with fine reddish granules

A

Cytoplasm of the monocyte

80
Q

has a light pink cytoplasm with lilac granules

A

Neutrophil

81
Q

shows varying shades of blue cytoplasm

A

Lymphocyte

82
Q

cell parts taking acidic dyes appear more pink, parts taking basic dye show pale staining

A

too acidic

83
Q

rbcs appear greyish-blue, white cell uclei stain deeply purple

A

too alkaline

84
Q

equal staining of the film

A

Staining rack should be level

85
Q

causes stain to precipitate on the dried smear

A

Insufficient washing

86
Q

fades the stain

A

Excessive rinsing

87
Q

If restain: flood smear with [?] and rinse to remove the stain BUT, new smear and stain is always advisable.

A

methanol

88
Q

For [?], after staining is done, mount the cover slip blood side down onto a glass slide with mounting medium.

A

coverglass smears

89
Q

Stock solutions of individual stains must be freshly prepared how often?

A

each week

90
Q

Staining buffer solution may only be used for

A

1 hour

91
Q

controls pH

A

Phosphate buffer

92
Q

Performed to determine the relative number of each type of white blood cell present in the blood.

A

DIFFERENTIAL COUNT

93
Q

-Study of red cell, white blood cell and platelet morphology is performed

A

DIFFERENTIAL COUNT

94
Q

Approximation of the number of platelets are made

A

DIFFERENTIAL COUNT

95
Q

-Performed after the cell counts have been completed

A

DIFFERENTIAL COUNT

96
Q

-May be used to double check the wbc count

A

DIFFERENTIAL COUNT

97
Q

tend to show increased concentrations of PMNs, monocytes and large abnormal cells at the edges and tail od the smear

A

Too thin smears

98
Q

causes increased lymphocytes at the center of the smear

A

Too thin smears

99
Q

a. Appendicitis

A

Neutrophilia

100
Q

b. Myelogenous leukemia

A

Neutrophilia

101
Q

c. Bacterial infections

A

Neutrophilia

102
Q

Eosinophilia

A

a. Allergies, allergic reactions
b. Scarlet fever
c. Parasitic infections
d. Eosinophilic leukemia

103
Q

absolute increase in neutrophil count

A

Neutrophilia

104
Q

Lymphocytosis

A

a. Viral infections
b. Whooping cough
c. Infectious mononucleosis
d. Lymphocytic leukemia

105
Q

Monocytosis

A

a. Brucellosis
b. Tuberculosis
c. Monocytic leukemia
d. SBE
e. Typhoid
f. Rickettsial inf.

106
Q

DIFFERENTIAL COUNT PROCEDURE:
a) Place the prepared smear prep on the stage of the microscope
b) Examine under [?]
c) Take note of anything [?]
d) Examine under [?]

A

LPO
unusual or irregular
HPO

107
Q

DIFFERENTIAL COUNT PROCEDURE:
Examine under LPO
a) Check for [?] of white blood cells
b) Examine the [?]
c) If there is an [?] in this area, the diff count may be inaccurate
d) If there are [?], the body of the smear may show decreased plt count
e) Discard smear and make a new one

A

even distribution
thin peripheral edge
increased number of white cells
plt clumps

108
Q

Take note of anything unusual or irregular

A

a) Large abnormal looking cells, rouleaux formation

109
Q

Examine under HPO
WBC estimate

A

(average WBC in 10 fields)

110
Q

DIFFERENTIAL COUNT PROCEDURES

A

a) Cross sectional, crenellation
b) Lonhitudinal
c) Battlement

111
Q

[?] each white blood cell seen and [?] in a differential counter until 100 cells have been counted.

A

Identify; record

112
Q

a) If any [?] are seen, record on a separate sheet of pad paper
h) Examine red cell morphology in a [?] where small amount of red cells only slightly overlap
a) Note variations from normal, classify irregularities as [?]

A

nucleated red cells
thin area
slight, moderate, marked

113
Q

Examine plts for number and morphology
a) Determine approximate number of plts per field [?]
b) plt estimate = [?]

A

(8-20 plts per field)
average number of plts in 10 OIO fields x 20,000

114
Q

Results are reported as

A

percentage of the diff wbc cell types

115
Q

The most preferred method of reporting = absolute wbc count

A

Absolute # of cells/L = % of cell type in diff x WBC/L

116
Q

c) Do not progress too far into the [?] bec morphology is difficult to observe here.

A

thick area

117
Q

d) Do not use the [?] as the red cells appear to have no central pallor area

A

very thin area

118
Q

When WBC count is below 1.0x10^9/L, it may be difficult to find WBCs on the stained smear

A

May perform a 50 differential (NOTE it), buffy coat smear may be prepared

119
Q

If abnormal distribution of cell types:

A

200 cell differential may be done, results divided by 2 (NOTE it)

120
Q

If the diff count shows immature granulocytic cells
shift to the left = [?]
shift to the right = [?]

A

leukemia
increased numbers of hypersegmented neutrophils

121
Q

Smear shows (?).
The white blood cell count is (?).
The differential count is as follows: [?].
No [?] seen.
Platelets are (?).
Smear is (?), (?).

A

red cell morphology
Decreased/WTNR/Increased
Neutrophils: %, Lymphocytes: %, Monocytes: %, Eosinophils: %, Basophils: %
atypical cells
decreased, adequate, increased
positive/negative for malarial parasites
Genus, species, stage of development

Hematology 1 [LEC] (25 decks)

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