Week 2 Lec: BHE, QAP, BC Flashcards
1
Q
Basic screening test and is one of the most frequently ordered laboratory procedure.
A
Complete Blood Count
2
Q
Gives valuable diagnostic information about the hematologic and other body system, prognosis response to treatment and recovery.
A
Complete Blood Count
3
Q
Consist of a series of test that determines number, variety, percentage concentration and quality of blood cells.
A
Complete Blood Count
4
Q
Main inclusions of CBC?
A
Hgb, Hct, RBC and WBC count, Differential Count
5
Q
What are the RBC parameters?
A
RBC count
HGB
HCT
MCV
MCH
MCHC
RDW (red blood cell distribution width)
RETIC (reticulocyte count)
6
Q
What are the platelet parameters?
A
PLT count
MPV
7
Q
What are WBC parameters?
A
WBC count
NEUT count: % and absolute
LYMPH count: % and absolute
MONO count: % and absolute
EO and BASO count: % and absolute
8
Q
the main component of erythrocytes; serves as the vehicle for the transportation of oxygen and carbon dioxide
A
Hemoglobin
9
Q
serves as an important buffer in the extracellular fluid
A
Hemoglobin
10
Q
Measurement of the concentration of Hgb in the blood.
A
Hemoglobin Determination
11
Q
Used to screen for disease associated with anemia and to evaluate polycythemia.
A
Hemoglobin Determination
12
Q
Reagent for hemoglobin determination?
A
drabkin’s reagent
13
Q
is the ratio of the volume of packed RBCs to the volume of whole blood
A
Hematocrit
14
Q
Hematocrit is also called?
A
Packed Cell Volume (PCV)
15
Q
Hct test is part of the?
A
CBC
16
Q
This test indirectly measures the RBC mass.
A
Hematocrit Determination
17
Q
Hematocrit Determination indirectly measures?
A
RBC mass
18
Q
Results of Hct Test are expressed as the ____________ of packed RBCs in the whole blood.
A
percentage by volume
19
Q
Aside rom Hb determination, it is also an important measurement in the determination of anemia or polycythemia.
A
Hematocrit Determination
20
Q
blood test used to find out how many RBCs
A
RBC Count
21
Q
RBC count is also known as?
A
Erythrocyte count
22
Q
Why is RBC count imporant?
A
because RBCs contain Hgb which carries oxygen to your body tissues
23
Q
How is RBC count reported?
A
cells per microliter (μL, mcL, also called cubic millimeter, mm3), milliliter (mL, also called cubic centimeter, or cc), or liter (L)
24
Q
Increase RBC
A
Polycythemia Vera
25
Decrease RBC
Anemia
26
WBCs may be counted visually using a microscope and?
Hemacytometer
27
The White Blood Cell count technique is the same as RBC counting, but the typical dilution is?
1:20
28
The diluent in White Blood Cell count is a ______________.
dilute acid solution
29
White Blood Cell count is also known as?
Leukocyte count
30
Serves as a useful guide to the severity of the disease process.
White Blood Cell count
31
A WBC count detects?
hidden infections
32
Differential Count is also known as?
WBC differential count
33
Differential count shows the?
Percentage of each type of WBC
34
can detect immature WBC and abnormalities, both of which are signs of potential issues; RBC and platelets can be seen as well
Differential Count
35
The total count of circulating WBC is differentiated according to?
the five types of leukocytes
36
Neutrophils in differential count give information about?
pyogenic infection
37
Eosinophils in differential count give information about?
allergic disorder, parasitic infestation
38
Basophils in differential count give information about?
parasitic infection
39
Lymphocytes in differential count give information about?
viral infection
40
Monocytes in differential count give information about?
severe infection by phagocytosis
41
Use to assess the erythropoietic activity of the bone marrow.
Reticulocyte count
42
Reticulocyte count uses ____________.
whole blood anticoagulated with EDTA
43
stain used for reticulocyte count
new methylene blue, brilliant cresyl blue, and pure azure blue
44
an immature anucleated cell that can be found in peripheral blood
reticulocyte
45
young forms of erythrocytes
reticulocytes
46
duration of reticulocyte in peripheral blood
1 day
47
duration of reticulocyte in bone marrow
1-2 days
48
Ratio of whole blood and stain for blood smear preparation?
1:1
49
Reference range of reticulocytes for adults?
0.5-2%
50
Reference range of reticulocytes for children?
2-6%
51
Rate at which red blood cells sediment in a period of one hour.
Erythrocyte Sedimentation Rate (ESR)
52
Common hematology test and nonspecific measure of inflammation.
Erythrocyte Sedimentation Rate (ESR)
53
One of the oldest hematology tests; detects inflammation and roughly estimates its intensity
Erythrocyte Sedimentation Rate (ESR)
54
uses graduated concentrations of saline solutions to detect spherocytes
Osmotic Fragility Test
55
RBCs with proportionally reduced surface membrane area are called?
spherocytes
56
Osmotic Fragility Test uses graduated concentrations of saline solutions to detect spherocytes in what disorder?
hereditary spherocytosis or warm autoimmune hemolytic anemia
57
phenotypically detects an inherited RBC enzyme deficiency causing severe episodic hemolytic anemia
Glucose-6-Phosphate Dehydrogenase (G6PD) Assay
58
are used to detect and diagnose sickle cell anemia and other inherited qualitative hemoglobin abnormalities and thalassemia's
Sickle Cell Solubility Screening Assay and its follow-up tests, Hemoglobin Electrophoresis And High Performance Liquid Chromatography
59
is the sum of all those activities in which the laboratory is engaged to ensure that information generated by the laboratory is correct
Quality Assurance
60
Includes all aspects of laboratory activities that affect the results produced from the choice of method, to the handling of specimen and reporting results.
Quality Assurance
61
The real purpose of Quality Assurance is?
to determine how correct/incorrect the result is
62
3 Major Activities of Quality Assurance?
Preventive, Assessment, Corrective
63
activities done in prior to the examination of the specimen or sample that is intended to establish system conducive to accuracy testing
Preventive
64
activities done during testing to determine whether the test systems are performing correctly
Assessment
65
done when error is detected to correct the system; recalibration of the instrument/machine
Corrective
66
intended to ensure the reliability of the laboratory test
QA in Hematology Laboratory
67
The objective of QA in Hematology Laboratory is?
to achieve precision and accuracy
68
is the closeness of the estimated value to the true mean
Accuracy
69
is the reproducibility of a result, whether accurate or inaccurate
Precision
70
Method of blood collection wherein the blood sample collected is called peripheral blood instead of capillary blood.
Skin puncture
71
In skin puncture, the blood sample collected is called?
peripheral blood
72
Sample via skin puncture is a mixture of?
capillary, venous, and arterial blood with interstitial (tissue) fluid and intracellular fluid
73
Sites of skin puncture?
- finger (middle or ring)
- earlobe (less free nerve endings, less pain and less tissue juice)
- <1yr old: lateral portion of the plantar surface of the heel/toe
74
Methods of Skin Puncture?
* Heel Stick Procedure
* Finger Puncture – 3rd or 4th finger of nondominant hand
* Earlobe Puncture – abnormalities in WBC and histiocytes
75
Sites to avoid for skin puncture?
* inflamed and pallor areas
* cold and cyanotic areas
* congested and edematous areas
* scarred and heavily calloused areas
76
Order of Draw – Skin Puncture?
1. Tube for blood glass analysis
2. Slides, unless made from specimen in the EDTA microcollection
3. EDTA microcollection tube
4. Other microcollection tubes with anticoagulant
5. Serum microcollection tubes
77
manner of inserting a needle attached to a syringe to a palpable vein to collect blood for laboratory testing
Venipuncture
78
Blood sample collected in venipuncture is called?
venous blood
79
most widely used blood sample in all laboratory tests is via what blood collection method?
Venipuncture
80
3 factors involved in a good venipuncture?
* Phlebotomist
* Patient and his/her vein
* The equipment needed
81
Angle of needle insertion for routine venipuncture and donor bleeding venipuncture?
30 degrees and 45 degrees respectively
82
In venipuncture, bevel should be?
bevel up
83
Length of needle for venipuncture?
1 to 1.5 inches
84
How long could you leave the tourniquet on?
1 min
85
Blood pressure cuff range for venipuncture?
40 to 60 mmHg
86
Number of attempts for venipuncture?
maximum of 2
87
Order of Draw for Venipuncture?
* Blood culture (yellow stopper)
* Coagulation tube (blue)
* Serum tubes with or without activator
* Heparin (green)
* EDTA (lavender)
* Sodium fluoride tube with or without EDTA or oxalate (gray stopper)
88
Sites of venipuncture in newborn infants up to 18 months old?
- External jugular vein
- Temporal vein (scalp vein)
- Superior longitudinal sinus
89
Sites of venipuncture in older children (18 months to 3 y/o)?
- Femoral vein
- Long saphenous vein
- Popliteal vein
- Ankle vein
90
Sites of venipuncture in 3 y/o to adult life?
- wrist vein
- dorsal vein of the hand
- dorsal vein of the ankle
91
Two patterns of veins of the antecubital fossa?
H and M pattern
92
Veins of the Antecubital Fossa?
Median capital vein
Cephalic vein
Basilica vein
93
Most commonly used anticoagulant?
EDTA (Ethylenediaminetetraacetic acid) /Versene/Sequestrene
94
MOA of EDTA?
bind to non-ionized form of Calcium then chelates Calcium
95
3 forms of EDTA?
* Dipotassium EDTA: preferred, more soluble
* Disodium EDTA
* Tripotassium EDTA
96
Recommended amount of blood for Tripotassium EDTA?
1.2 mg/dl of blood
97
Tripotassium EDTA is used for?
CBC, ESR, Platelet count and PBS
98
Tripotassium EDTA can also be used for?
modified Westergren (ESR)
99
Modified Westergren (ESR) consists of?
* 2 ml EDTA blood + 0.5 ml of 3.8% or 0.129 M Na Citrate
* 2 ml of EDTA blood + 0.5 ml NSS
100
Advantages of EDTA (Ethylene Diamine Tetra Acetic Acid) / Sequestrene / Versene
1. Preserve cellular morphology when smears are prepared within 2 hours
2. Prevent platelet aggregation
3. Prevents artefact formation even on long standing
4. Cell count, HbF, Blood grouping and electrophoresis
5. Has a few toxic effects
101
Disadvantages of EDTA (Ethylene Diamine Tetra Acetic Acid) / Sequestrene / Versene?
1. After 6 hours Inc MCV, Inc OFT (osmotic fragility test), Decreased ESR
2. Causes dec PCV (packed cell volume)
3. Not suitable for coagulation studies
102
Most common and preferred anticoagulant for coagulation studies?
Citrate
103
MOA of citrate?
binds calcium
104
Citrate is contained in?
light blue top evacuated tube
105
Anticoagulant buffer of citrate?
3.8%/0.109 M Na Citrate
106
Concentration of citrate used for Westergen method of ESR (black)?
1 part of 3.8% disodium or trisodium citrate and 4 parts blood
107
Concentration of citrate used for Coagulation Testing (PTT/Partial Thromboplastin Time, APTT/Activated PTT Test)?
1 part of 3.8% (.109 M) of 3.2% (.109 M) aqueous solution disodium citrate or trisodium citrate and 9 parts of blood
108
Advantages of citrate?
1. For blood transfusion because citrate is less toxic.
2. Trisodium citrate is used for blood coagulation and platelet function test.
3. Buffered citrate is now commonly used because it helps stabilize plasma pH. Buffered citrate is prepared by adding citric acid to Na citrate. Buffered citrate will increase stability of Factor V and VIII.
4. For investigation of clotting disorders.
(No known disadvantage because it has specific use)
109
Most commonly used anticoagulant for Osmotic Fragility Testing and immunotyping?
Heparin
110
MOA of Heparin?
binds thrombin
111
2 forms of heparin?
* Lithium heparin
* Sodium heparin
112
________ anticoaulant is used for RBC count, haemoglobin, hematocrit, ESR and OFT, electrolytes
Sodium heparin
113
Disadvantages of sodium heparin?
* Not recommended for coagulation studies because it affects all stages of blood coagulation
* Not for WBC
* Not recommended for blood smear preparation
* Most expensive
114
MOA of oxalates?
binds Calcium
115
Recommended concentration of oxalate?
1-2 mg/ml of blood
116
3 forms of oxalate?
* Double Oxalate
* Lithium Oxalate
* Sodium Oxalate
117
Type of anticoagulant with salts of Ammonium and Potassium?
Double Oxalate or Paul Heller
118
When double oxalate is used separately: ammonium oxalate makes RBCs?
swell
119
When double oxalate is used separately: potassium oxalate makes RBCs?
shrink
120
Double Oxalate or Paul Heller is also known as?
Balance Oxalate
121
Uses of double oxalate?
all RBC evaluation tests, since there is no effect on RBC
122
Disadvantages of double oxalate?
* Not recommended for blood transfusions
* Causes agglutination or clumping of WBCs and platelets
* Not recommended for peripheral blood smear preparation
123
Types of complications?
local immediate complication and local delayed complication
124
Type of complication that results in hematoma?
local immediate complication
125
Type of complication that results in hematoma/thrombosis?
local delayed complication
126
platelet to platelet
platelet aggregation
127
platelet to non-platelet
platelet adhesion
128
minimize the error
quality control
129
ensure that results are accurate, precise, and reliable
quality assurance
130
When reporting results, always write the ____________.
unit of measurement
