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HEMA 1 LEC > Unit 3.5 DIFFERENTIAL COUNT > Flashcards

Unit 3.5 DIFFERENTIAL COUNT Flashcards

1
Q

This involves both quantitative and qualitative study of the types of leukocytes.

A

DIFFERENTIAL COUNT

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2
Q

It also includes quantitative and qualitative study of thrombocytes as well as morphologic abnormalities of erythrocytes

A

DIFFERENTIAL COUNT

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3
Q

represents the percentage distribution of the different WBCs

A

DIFFERENTIAL COUNT

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4
Q

METHODS OF BLOOD SMEAR PREPARATION

A
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5
Q

Preferred for bone marrow preparations

A

Coverslip Method

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6
Q

It has the advantage of superior leukocyte distribution

A

Coverslip Method

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7
Q

NOT for routine peripheral blood smear preparation.

A

Coverslip Method

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8
Q

Coverslip Method Procedure:
Place (?) at the center of coverslip held between thumb & forefinger
Invert another coverslip rotated (?)
As soon as the blood spreads, pull apart the 2 coverslips in a (?).

A

1 drop of blood
45O
firm and steady motion

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9
Q

Glass Slide-Coverslip Method

Place 1 drop of blood near (?) of a glass slide. Place coverslip.
As soon as the blood spreads, (?) the coverslip along the surface of the slide

A

one end
push forward

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10
Q

Most convenient and most commonly used.

A

Two-Glass Slide Method (Wedge slide/Push smear)

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11
Q

Two-Glass Slide Method (Wedge slide/Push smear) Disadvantages:
1. Tendency of larger cells to settle at the slide edges & (?)
2. (?) of nucleated cells
3. (?) to cells

A

feathered ends

Poor distribution

Greater trauma

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12
Q

Utilizes the wedge procedure

A

Miniprep/Hemaprep

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13
Q

A precision blood spreader prepares dual smears simultaneously at a constant angle and speed.

A

Miniprep/Hemaprep

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14
Q

Glass slides are placed on a platform inside the instrument

A

Hemaspinner

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15
Q

Instrument spins causing the slide to be covered with a monolayer of cells beam of sensor light to detect blood distribution

A

Hemaspinner

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16
Q

For finding reactive/immature or abnormal cells that are present in small numbers

A

Buffy Coat Smear

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17
Q

For easier location of bacteria & parasites

A

Buffy Coat Smear

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18
Q

Buffy coat smear is considered a concentrate smear for WBCs, thus it recommended when the WBC count is _________.

A

Buffy Coat Smear

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19
Q

For blood parasites examination.

A

Thick Blood Smear

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20
Q

CHARACTERISTICS OF A PROPERLY PREPARED WEDGE SMEAR
1. Length: must occupy at least (?) of the slide
2. Should be free of (?)
3. Should have (?) appearance
4. Should be (?) than the stationary slide
5. Must have (?) from thick to thin
6. (?) to allow proper fixation
7. Should terminate in a (?)
8. Should contain at least (?) in which 50% of the RBCs do no overlap each other; the remainder ma overlap in doublets or triplets and the central pallor should be clear

A

1/2 to 2/3

waves, holes, and ridges

smooth and even

narrower

gradual transition

Thin enough

feathery tail

10 LPF

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21
Q

Too large drop of blood

A

TOO THICK SMEAR

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22
Q

Too fast spread

A

TOO THICK SMEAR

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23
Q

Too high angle

A

TOO THICK SMEAR

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24
Q

High hematocrit

A

TOO THICK SMEAR

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25
Q

Too small drop of blood

A

EXTREMELY THIN SMEAR

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26
Q

Too slow spread

A

EXTREMELY THIN SMEAR

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27
Q

Too low angle

A

EXTREMELY THIN SMEAR

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28
Q

Low Hematocrit

A

EXTREMELY THIN SMEAR

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29
Q

Accumulation of nucleated cells

A

GRITTY APPEARANCE

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30
Q

large number of leukocytes

A

GRITTY APPEARANCE

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31
Q

Use of heparin as anticoagulant

A

GRITTY APPEARANCE

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32
Q

Too slow spreading/delay in spreading

A

GRITTY APPEARANCE

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33
Q

Using only a part of the drop of blood

A

GRITTY APPEARANCE

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34
Q

Rough edge or dirty spreader slide

A

GRITTY APPEARANCE

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35
Q

METHODS OF MANUAL DIFFERENTIAL COUNT

A
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36
Q

WBCs are counted in consecutive fields as the blood film is moved from side to side

A

Cross-sectional/Crenellation Method

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37
Q

WBCs are counted in consecutive fields from the tail toward the head of the smear

A

Longitudinal Method

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38
Q

Ideal if smear is thin enough since cells can be identified all the way.

A

Longitudinal Method

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39
Q

WBCs are counted in a pattern of consecutive fields near the tail on a horizontal edge. Count 3 consecutive horiontal edge fields, 2 fields towards the center, 2 horiontal and 2 vertical to the edge

A

Battlement Method

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40
Q

Using the Oil Immersion Objective:
Estimate (?); Examine (?)
Perform WBC Differential count - A total of (?) are counted and classified according to type

A

Platelets and WBCs
RBC morphology
100 WBCs

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41
Q

The total number of cells to be counted could be decreased or increased when any of the following criteria are observed:
(?) if the total WBC count is < 1 x 10 9/L (< 1,000/µL)
Count (?) if in the first 100 count, any of the following are observed::

A

50 Cells
additional 100 cells

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42
Q

> (?) Eosinophils
(?) Basophils
(?) Monocytes
(?) are greater than Neutrophils

A

10%
2%
11%

Lymphocytes

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43
Q

METHODS OF CLASSIFYING NEUTROPHILS

A
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44
Q

WBCs are classified based on the number of lobes indication their age

A

ARNETHS CLASSIFICATION

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45
Q
  • WBCs are classified according to granulation
A

SCHILLINGSS CLASSIFICATION

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46
Q

Younger forms are placed on the left; mature and old forms on the right

A

SCHILLINGSS CLASSIFICATION

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47
Q

1 round or indented nucleus

A

I

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48
Q

5% (blast cells)

A

I

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49
Q

2 nuclear divisions

A

II

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50
Q

35 %

A

II

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51
Q

3 nuclear divisions

A

III

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52
Q

41 %

A

III

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53
Q

4 nuclear divisions

A

IV

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54
Q

17 %

A

IV

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55
Q

5 or more

A

V

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56
Q

2% (oldest)

A

V

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57
Q

Schillings Hemogram

A

1 2 3 4 5 Eos Baso Lym Mono

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58
Q

Schillings Hemogram Shift to the LEFT:

A

increase in immature forms

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59
Q

Schillings Hemogram Shift to the RIGHT:

A
  • increase in mature forms
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60
Q

young forms with accompanying WBC count.

A

Regenerative Shift to the Left

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61
Q

Infections, appendicitis & acute sepsis

A

Regenerative Shift to the Left

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62
Q

young forms with N or WBC count

A

Degenerative shift to the Left

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63
Q

Typhoid fever and TB

A

Degenerative shift to the Left

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64
Q

Pernicious anemia or megaloblastic anemia

A

Shift to the RIGHT

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65
Q

: cells that possess segments or lobes connected with a distinct thin chromatin filament

A

Filamentous

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66
Q

: nucleus with thinned-out portion

A

Non-filamentous

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67
Q

REPORTING
1. Relative count - Cells are reported in
2. Absolute count - Cells are reported as

A

% or decimal

number per volume of blood (e.g.: cells /µL or /L )

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68
Q

Absolute count =

A

Relative count (%) x total WBC count

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69
Q

47 77%

A

PM Neutrophil

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70
Q

1.8 7.8 x 109/L

A

PM Neutrophil

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71
Q

0 7%

A

Band cells

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72
Q

0 0.7 x 109/L

A

Band cells

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73
Q

20 40%

A

Lymphocytes

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74
Q

1.0 4.8 x 109/L

A

Lymphocytes

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75
Q

2 10%

A

Monocytes

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76
Q

0.01 0.8 x 109/L

A

Monocytes

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77
Q

0 6%

A

Eosinophils

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78
Q

0 0.6 x 109/L

A

Eosinophils

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79
Q

0 1%

A

Basophils

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80
Q

0 0.2 x 109/L

A

Basophils

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81
Q

are volatile

A

Circulating cells

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82
Q

cause lymphocytes & eosinophils to disappear from circulation within 4 8 hrs

A

Corticosteroid hormones

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83
Q

causes granulocytosis within minutes

A

Epinephrine

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84
Q

CLINICAL SIGNIFICANCE of variation in counts:

A
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85
Q

Acute Infections -

A

Neutrophilia Pathologic causes

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86
Q

bacterial, some viral, fungal, parasitic

A

Neutrophilia Pathologic causes

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87
Q

Acute Inflammatory conditions

A

Neutrophilia Pathologic causes

88
Q

vasculitis

A

Neutrophilia Pathologic causes

89
Q

response to tissue injury

A

Neutrophilia Pathologic causes

90
Q

Malignancy (neoplastic growth)

A

Neutrophilia Pathologic causes

91
Q

carcinomas

A

Neutrophilia Pathologic causes

92
Q

sarcomas

A

Neutrophilia Pathologic causes

93
Q

myeloproliferative disorders

A

Neutrophilia Pathologic causes

94
Q

Tissue necrosis

A

Neutrophilia Pathologic causes

95
Q

burns

A

Neutrophilia Pathologic causes

96
Q

trauma

A

Neutrophilia Pathologic causes

97
Q

MI

A

Neutrophilia Pathologic causes

98
Q

RBC hemolysis

A

Neutrophilia Pathologic causes

99
Q

Metabolic disorders

A

Neutrophilia Pathologic causes

100
Q

Drugs, chemicals, venoms

A

Neutrophilia Pathologic causes

101
Q

corticosteroids

A

Neutrophilia Pathologic causes

102
Q

growth factors

A

Neutrophilia Pathologic causes

103
Q

Response to therapy

A

Neutrophilia Physiologic causes

104
Q

In response to physical or emotional stimuli

A

Neutrophilia Physiologic causes

105
Q

stress, exercise, smoking, pregnancy

A

Neutrophilia Physiologic causes

106
Q

Stem cell disorders

A

Neutropenia Inherited causes

107
Q

Genetic disorder of the immune system

A

Neutropenia Inherited causes

108
Q

Disorders of cellular development

A

Neutropenia Inherited causes

109
Q

Intrinsic defects

A

Neutropenia Inherited causes

110
Q

Fanconis

A

Neutropenia Inherited causes

111
Q

Kostmanns

A

Neutropenia Inherited causes

112
Q

Cyclic neutropenia

A

Neutropenia Inherited causes

113
Q

Chediak-Higashi

A

Neutropenia Inherited causes

114
Q

BM/stem cell destruction

A

Neutropenia Acquired causes

115
Q

megaloblastic anemia

A

Neutropenia Acquired causes

116
Q

(severe folic & Vit. B 12 deficiency)

A

Neutropenia Acquired causes

117
Q

myelodysplasia

A

Neutropenia Acquired causes

118
Q

marrow failure

A

Neutropenia Acquired causes

119
Q

marrow replacement

A

Neutropenia Acquired causes

120
Q

Infectious - any overwhelming infection

A

Neutropenia Acquired causes

121
Q

Infectious diseases

A

Neutropenia Acquired causes

122
Q

tularemia

A

Neutropenia Acquired causes

123
Q

typhoid

A

Neutropenia Acquired causes

124
Q

brucellosis

A

Neutropenia Acquired causes

125
Q

hepatitis

A

Neutropenia Acquired causes

126
Q

influenza, measles, mumps, rubella

A

Neutropenia Acquired causes

127
Q

IM

A

Neutropenia Acquired causes

128
Q

malaria

A

Neutropenia Acquired causes

129
Q

Drugs - cancer chemotherapy, chloramphenicol, sulfas/other antibiotics, phenothiazines,benzodiazepine, antithyroids, anticonvulsants, quinine, quinidine, indomethacin, procainamide, thiazides

A

Neutropenia Acquired causes

130
Q

Liver disease

A

Increase Neutrophil destruction

131
Q

storage diseases

A

Increase Neutrophil destruction

132
Q

LE Radiation

A

Increase Neutrophil destruction

133
Q

cytotoxic drugs

A

Increase Neutrophil destruction

134
Q

benzene

A

Increase Neutrophil destruction

135
Q

Toxins - alcohol, benzene compounds

A

Increase Neutrophil destruction

136
Q

Immune-mediated

A

Increase Neutrophil destruction

137
Q

collagen vascular disorders

A

Increase Neutrophil destruction

138
Q

RA

A

Increase Neutrophil destruction

139
Q

AIDS

A

Increase Neutrophil destruction

140
Q

thers - starvation, hypersplenism

A

Increase Neutrophil destruction

141
Q

Inherited, malignant or reactive

A

Eosinophilia

142
Q

Hypoadrenalism

A

Eosinophilia

143
Q

Inflammatory - eosinophilic fasciitis

A

Eosinophilia

144
Q

Allergic reaction

A

Eosinophilia

145
Q

asthma

A

Eosinophilia

146
Q

hay fever

A

Eosinophilia

147
Q

drug reaction

A

Eosinophilia

148
Q

allergic vasculitis,

A

Eosinophilia

149
Q

serum sickness

A

Eosinophilia

150
Q

Neoplastic diseases

A

Eosinophilia

151
Q

Hodgkin lymphoma

A

Eosinophilia

152
Q

CML

A

Eosinophilia

153
Q

collagen vascular disease

A

Eosinophilia

154
Q

ulcerative colitis

A

Eosinophilia

155
Q

L-tryptophan eosinophilic myalgia

A

Eosinophilia

156
Q

T cell lymphomas

A

Eosinophilia

157
Q

Parasitism - Nematodes, Trematodes, Cestodes (trichinosis, filariasis, schistosomiasis)

A

Eosinophilia

158
Q

Nonparasitic infections

A

Eosinophilia

159
Q

systemic fungal

A

Eosinophilia

160
Q

Scarlet fever

A

Eosinophilia

161
Q

chlamydial pneumoniaof infancy

A

Eosinophilia

162
Q

gonnorrhea

A

Eosinophilia

163
Q

hansens disease

A

Eosinophilia

164
Q

Associated with recovery phase of most infections during drug specific parasite manifestation

A

Eosinophilia

165
Q

Skin disorder

A

Eosinophilia

166
Q

psoriasis

A

Eosinophilia

167
Q

eczema

A

Eosinophilia

168
Q

pemphigus

A

Eosinophilia

169
Q

dermatitis

A

Eosinophilia

170
Q

herpetiformis

A

Eosinophilia

171
Q

erythema multiforme

A

Eosinophilia

172
Q

exfoliative dermatitis

A

Eosinophilia

173
Q

Respiratory

A

Eosinophilia

174
Q

pulmonary eosinophilic syndromes

A

Eosinophilia

175
Q

Lofflers

A

Eosinophilia

176
Q

tropical pulmonary eosinophilia

A

Eosinophilia

177
Q

Churg-Strauss syndrome

A

Eosinophilia

178
Q

Idiopathic hypereosinophilic syndromes - affecting heart, liver, spleen,CNS, other organs

A

Eosinophilia

179
Q

certain drugs

A

Eosinophilia

180
Q

hematologic and visceral malignancies

A

Eosinophilia

181
Q

GI inflammatory diseases

A

Eosinophilia

182
Q

sarcoidosis

A

Eosinophilia

183
Q

Wiskott-Aldrich syndrome

A

Eosinophilia

184
Q

Allergy - food, drugs, foreign proteins

A

Basophilia

185
Q

Chronic hemolytic anemia - especially post splenectomy

A

Basophilia

186
Q

Hypothyroidism

A

Basophilia

187
Q

Infections - variola, varicella

A

Basophilia

188
Q

Ulcerative colitis

A

Basophilia

189
Q

Inflammatory diseases - collagen vascular disease, ulcerative colitis

A

Basophilia

190
Q

Long-term foreign antigen stimulation

A

Basophilia

191
Q

Myeloproliferative disorders

A

Basophilia

192
Q

Systemic mast cell disease, chronic hypersensitivity states in the absence of the specific allergen

A

Basophilia

193
Q

Estrogen therapy

A

Basophilia

194
Q

During acute infections

A

Basopenia

195
Q

Stress; Hyperthyroidism

A

Basopenia

196
Q

Increased levels of glucocorticoids

A

Basopenia

197
Q

Reactive (Immune hypersensitivity reaction)

A

Basopenia

198
Q

Infections - many viral, pertussis, tuberculosis, toxoplasmosis, rickettsial, Whooping cough, brucellosis, sometime tuberculosis, secondary syphilis, Viral hepatitis, IM, mumps cytomegalovirus,

A

Lymphocytosis

199
Q

Chronic inflammations - ulcerative colitis, Crohns

A

Lymphocytosis

200
Q

Immune mediated - drug sensitivit, vasculitis, graft rejection, Graves, Sjgrens

A

Lymphocytosis

201
Q

Hematologic - ALL, CLL, lymphoma

A

Lymphocytosis

202
Q

Stress - acute, transient

A

Lymphocytosis

203
Q

Destructive - radiation, chemotherapy, corticosteroids

A

Lymphocytopenia

204
Q

Debilitative - starvation, aplastic anemia, terminal cancer, collagen vascular disease, renal failure

A

Lymphocytopenia

205
Q

Infections - viral hepatitis, influenza, typhoid fever, TB

A

Lymphocytopenia

206
Q

AIDS associated - HIV cytopathic effect, nutritional imbalance, drug effect

A

Lymphocytopenia

207
Q

Congenital immunodeficiency - Wiskott-Aldrich syndrome

A

Lymphocytopenia

208
Q

Abnormal lymphatic circulation - intestinal lymphangiectasia, obstruction, thoracic duct drainage/rupture, CHF

A

Lymphocytopenia

209
Q

Infections - tuberculosis, subacute bacterial endocarditis, syphilis, protozoan, rickettsial

A

Monocytosis

210
Q

Recovery from neutropenia

A

Monocytosis

211
Q

Hematologic - leukemias, myeloproliferative disorders, lymphomas, multiple myeloma

A

Monocytosis

212
Q

Inflammatory diseases - collagen vascular disease, chronic ulcerative colitis, sprue, myositis, polyarteritis, temporal arteritis

A

Monocytosis

213
Q

Monocytopenia is uncommon as an isolated finding.

A

Monocytopenia

214
Q

Following administration of glucocorticoids (During therapy with prednisone, monocytes fall during the first few hours after the first dose but return to above original levels by 12 hours)

A

Monocytopenia

215
Q

Hairy cell leukemia (HCL)

A

Monocytopenia

216
Q

During overwhelming infections that also cause neutropenia

A

Monocytopenia

HEMA 1 LEC (15 decks)

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