The flashcards below were created by user
corbin19
on FreezingBlue Flashcards.
-
what is the purpose of a CBC?
- monitor blood and tissue
- monitor overall general wellbeing
-
what is the purpose of the microhematocrit determination?
measure packed red cell volume
-
In this test EDTA whole blood is centrifuged and total PCV is exprssed as a percentage of whole blood volume.
microhematocrit determination
-
This layer of blood contains H2O, electrolytes, glucose, fats, proteins, gasses and clotting factors.
Plasma layer
-
this is the layer where leukocytes and platelets are present.
buffy coat layer
-
this is the layer used to determine HCT known as the packed cell volume.
red blood cell layer
-
how full should you fill capillary tubes?
three fourths of the way
-
how long should microhematocrit samples be centrifuged for?
5 minutes at 14,500rpm
-
duplicates of microhematocrit should be within ____.
1%
-
how do you report microhematocrit determination results?
- average the duplicate results
- report as a percentage
-
microhematocrit reference values
Adult male:
adult female:
infant child:
newborn:
- adult male: 42-52%
- adult female: 37-47%
- infant child: 30-43%
- newborn: 53-65%
-
What are four conditions increased HCT can be seen in?
- polycythemia
- dehydration
- high altitudes
- COPD
-
what four conditions decreased HCT can be seen in?
- anemia's
- hemorrhage
- vitamin or mineral deficiency
- pregnancy
-
what are six sources of error for microhematocrit determination?
- intersitial fluid
- incomplete sealing
- buffy coat
- force stop
- hemoconcentration
- medication
-
The purpose of this test is to screen for anemia in conjunction with the HCT and RBC count.
hemoglobin
-
what is the main component of RBC's?
hemoglobin
-
this transports oxygen to and CO2 from body tissues.
hemoglobin
-
all forms of circulating hemoglobin (except sulfhemoglobin) readily convert to ________.
cyanmethhemoglobin (HiCN)
-
what is the reagent that oxidizes Hgb to methemoglobin by potassium ferricyanide?
drabkin's reagent
-
methemoglobin converts to ____________ in presence of potassium cyanide.
cyanmethemoglobin
-
what is the machine used to perform a hemoglobin test?
spectrophotometer
-
hemoglobin normal reference values
adult male:
adult female:
newborn:
infant:
- adult male: 14-17 g/dL
- adult female: 12-16 g/dL
- newborn: 17-23 g/dL
- infant: 9-14g/dL
-
decreased Hgb can be seen in what two conditons?
-
increased Hgb can be seen in what two conditons.
-
what are five sources of error in Hbg?
- drabkin's reagent in direct sunlight
- Hgb C and Hgb S
lipemia hemoconcentration tech error
-
Why would Hgb C and Hgb S be sources of error in Hgb testing?
- yield turbid solution
- fail to lyse red cells
-
The purpose of this test is to detect leukopenia or leukocytosis and to monitor progress of diseases.
WBC count
-
what is the methodology of a WBC count?
unopette method
-
what are the three components of the diluent in an unopette?
- buffered ammonium oxalate
- sorensen's buffer
- thimerosal
-
what is the purpose of buffered ammonium oxalate in an unopette?
- dilutes sample
- lyse RBC's
- perserves WBC's, Plt's, retics, and NRBCs
-
what is the purpose of sorensen's buffer in an unopette?
maintain pH of reagent
-
what is the purpose of thimerosal in an unopette?
acts as an antibacterial agent
-
what volume does the unopette capillary pipet hold?
20 microliters
-
What is the device used to perform a WBC and platelet count?
hemocytometer
-
how many primary squares are there in a hemacytometer?
18
-
where do you perform an erythrocyte count in a hemacytometer?
four coner and center secondary squares of center primary squares
-
where do you perform a leukocyte count on a hemacytometer?
four corner primary squares
-
where do you perform a platelet count on a hemacytometer?
25 secondary squares of center primary square
-
what is the normal reference values for WBC count
Adult:
Newborn:
- Adult: 4.8-10.8x103/mm3
- Newborn: 9.0-30.0x103/mm3
-
Leukopenia is seen in what four conditons?
- Radiation
- Medication
- Chemotherapy
- idiopathic
-
Leukocytosis is seen in what five conditions?
- infections
- leukemia
- smoking
- pregnancy
- appendicitis
-
to detect thrombocytosis and thrombocytopenia is the purpose of what test?
platelet count
-
normal reference value for platelet count
150-450x103/mm3
-
thrombocytosis can be seen in what four condtions?
- splenectomy
- myeloprliferative disorders
- acute blood loss
- surgery
-
thrombocytopenia can be seen in what three condtions?
- decreased platelet production
- increased platelet destruction
- increased platelet sequestration
-
what does ESR stand for?
errythrocyte sedimentation rate
-
to detect a nonspecific response to acute and chronic infection, inflammation, and tissue necrosis or infarction is the purpose of what test?
ESR
-
what is the methodology for ESR?
westergren method
-
what test measures the rate RBC's fall in diluted human plasma?
ESR
-
how long must the tube be allowed to stand in a vertical position undistuirbed in an ESR?
one hour
-
how do you report ESR results?
- read the distance from the top of the tube to the plasma-red cell interface
- report results using mm/hr as unit of measure
-
normal reference values for ESR
Men:
women:
- Men: 0-15 mm/hr
- Women: 0-20 mm/hr
-
what type of ESR result would be seen in patients able to form rouleaux?
increased ESR
-
reading after ___ hours will falsely decrease ESR results.
three hours
-
what is the quality control for ESR.
currently none required
-
to determine the relative amount of effective erythopoiesis taking place in bone marrow is the purpose of what test?
reticulocyte count
-
what is the methodology for a reticulocyte count?
new methyline blue method
-
immature RBC's that still contain RNA and ribosomes are called what?
reticulocytes
-
______ amounts of whole blood is incubated with new methylene blue for ___ minutes
-
how may RBC's will you count when performing a reticulocyte count?
1000
-
how many discrete blue granules must be counted to call a RBC a reticulocyte?
two
-
normal reference values for reticulocyte count
Adults:
Newborns:
- Adults: 0.5-2.0%
- Newborns: 2.5-6.0%
-
what are two conditions that increased retic counts may be seen?
-
what are two conditions that decreased retic counts may be seen in?
- aplastic anemia
- ineffective erythropoiesis
-
The purpose of __________ is to serve as a quality control mechanism to check RBC count, Hgb and Hct measurements
RBC Indices
-
Average volume of RBC's in femtoliter (fL)
Mean Corpuscular Volume (MCV)
-
Average weight of Hgb in RBC's in picograms (pg)
mean corpuscular hemoglobin (MCH)
-
Average concentration of hemoglobin in each individual RBC in percent or grams/dL.
Mean Corpuscular Hemoglobin Concentration MCHC
-
A degree of cell size variation expressed in percent.
Red Cell Distribution Width (RDW)
-
formula for MCV
MCV=(Hct)10/RBC Count
-
Formula for MCH
MCH=(Hgb)10/RBC Count
-
Formula for MCHC
MCHC=(Hgb)100/Hct%
-
formula for RDW
RDW=SD of MCV/mean MCV
-
normal reference value for MCV
80-99fl
-
normal reference value for MCH
27-31pg
-
normal reference value for MCHC
32-36%
-
normal reference value for RDW
11.5 - 14.5%
-
How do you interpret results of MCV?
indicates size of RBC
- normocytic
- microcytic
- macrocytic
-
What does MCH indicate?
Hgb content in RBC
-
what can a decreased MCH be seen in?
microcytic anemia
-
what can an increased MCH be seen in?
macrocytic anemia
-
increased MCH can be seen in what?
macrocytic anemia
-
what does MCHC indicate?
- concentration of Hgb in average RBC
- central pallor
-
what is the normal central pallor of a RBC?
2-3 microns in diameter
-
to provide additional information for the diagnosis of hematologic disorders in conjunction with the WBC, RBC and platelet counts is the purpose of what test?
WBC Differential
-
What is the definition f a WBC differential?
the percentage of each type of WBC present in the blood
-
what are the components of a WBC differential?
- 100 WBC Diff
- WBC Morphology
- WBC estimate
- Platelet estimate
- RBC morphology
-
When scanning a blood smear under 10x what do you check?
- cell distribution
- platelet clumps
- abnormal looking cells
- rouleaux formation
-
When performing a WBC diff what do you check under 40x?
WBC estimate
-
how do you perform a WBC estimate?
under 40x count the number of WBC's in ten fields and devide by 10
-
average WBC/HPF equates to how many estimated total WBC/mm3
2-4
4-6
6-10
10-20
- average WBC/HPF =Total WBC/mm3
- 2-4 = 4000-7000
- 4-6 = 7000-10000
- 6-10= 10000-13000
- 10-20 = 13000-18000
-
when performing RBC morphology what do you check?
- anisocytosis
- poikilocytosis
- hypochromasia
- polychromasia
- RBC inclusion
-
if there are more than 10 NRBC's in your peripheral blood smear what is the formula to correct the WBC count?
(WBC x 100)/(100+NRBC)
-
how would you report Megakaryocytic cells, smudge cells, or epithelial cells?
list and report as #/100 WBC
-
how is a platelet estimation performed on a WBC differential?
under oil immersion count all platelets in 10 fields and devide by 10.
-
how is a platelet estimation reported?
report as adequate, increased, decreased, or clumped
-
if platelet estimated differs from the automated count what should be checked?
- check feathered edge for platelet clumps
- check for platelet satelitism
-
WBC Diff normal reference values
Segs:
Band:
Lymphs:
Mono:
Eosinophils:
Basophils:
- Segs: 40-80%
- Band: 0-10%
- Lymphs: 25-45%
- Mono: 0-10%
- Eosinophils: 0-7%
- Basophils: 0-2%
-
How are results reported for a WBC diff?
- report out each type of WBC in %
- annotate WBC morphology
- annotate RBC morphology
- annotate platelet estimation
-
Neutrophilia is seen in:
- Bacterial Infections
- Chronic myelogenous leukemia (CML)
-
Eosinophilia is seen in:
- Allergic reactions
- Parasitic infections
- CML
-
Basophilia is seen in:
- Immediate hypersensitivity reactions
- CML
-
Lymphocytosis is seen in:
- Viral infections
- Chronic Lymphocytic Leukemia
- infectious mononucleosis
-
monocytosis is seen in:
- tuberculosis
- syphilis
- monocytic leukemia
-
what three things does CSF provide the CNS?
- nutrients
- removal of metabolic waste
- cushion against trauma
-
total volume of CSF
Adults:
Neonates:
- Adults: 140-170 ml
- Neonates: 10-60 ml
-
what five items is CSF examined for?
- Color
- Appearance
- WBC count
- RBC count
- WBC Differential
-
In CSF ________ in conjunction with a differential is useful in diagnosis of disease.
Cell count
-
What type of stain is used for a CSF differential
wright stain
-
how soon must a CSF differential be done
within one hour
-
CSF is collected in 3 plain sterile tubes. What is each tube used for?
- Tube 1 for chemistry & serology
- Tube 2 for microbiology
- Tube 3 hematology
-
between what vertebrae is a lumbar puncture performed?
- 3rd and 4th lumbar vertebrae
- 4th and 5th lumbar vertebrae
-
what type of stain is used to perform a cell count on CSF?
unna stain
-
When performing a WBC count on CSF how where do you count the WBC's?
in all 9 primary squares on both sides of the hemacytometer
-
what is the formula to calculate the total WBC count in CSF?
- WBC Count= average # of cells counted x 1.1
- use mm3 as the unit of measurement
-
true or false
the same procedure is used in both the WBC count and RBC count in CSF
true
-
what is the formula to detect added WBC due to traumatic tap in CSF?
WBC added=(WBCblood x RBCcsf)/RBCblood
WBC added - CSF WBC count= true CSF WBC count
-
how do you report a CSF diff if <100 cells are counted?
report the number of each cell
-
normal reference values for CSF
Color:
Appearance:
WBC count:
RBC count:
- color: colorless
- appearance: clear
- WBC: 0-5mm3
- RBC: none seen
-
normal reference values for CSF Diff
- Lymphs: 70%
- Monos: 30%
- Segs: none to occasional
-
how can you tell if xanthochromia is the result of intracranial hemorrhage?
- blood is evenly distributed in all 3 tubes
- no blood clots
- CSF remains xanthochromic after centrifugation
-
How can you tell if xanthochromia is the result of a traumatic tap?
- Blood decreases from tube 1 thru 3
- blood clots are present
- RBC's form sediment when centrifuged
-
if CSF is clotted but no blood is present what does that indicate?
meningitis
-
what are three causes of an increased WBC count in CSF?
- Bacterial infection
- viral infection
- fungal infection
-
What are three causes of increased neutrophils in CSF?
- bacterial meningitis
- early fungal and viral meningitis
- cerebral hemorrhage
-
what are two causes of increased lymphocytes in CSF?
- multible sclerosis
- all forms of meningitis
-
what are two causes of increased moncytes in CSF?
- TB
- all forms of meningitis
-
What are two causes of increased eosinophils in CSF?
- parasitic infection
- allergy
-
what is a cause of a blast in CSF?
Acute leukemia
-
what are three results in CSF that require review?
- NRBC
- metastatic cancer cells
- microorganisms
-
what type of body fluid contains hyaluronate?
synovial fluid
-
what type of body fluid supplies nutrients to cartilage and acts as a lubricant for joints?
synovial fluid
-
what type of anticoagulant should be used on synovial fluid for a cell count or differential?
EDTA or heparin
-
why do you use a plain sterile tube for the viscosity and crystal exam on synovial fluid?
because anticoagulants may crystalize and interfere with crystal ID
-
what type of mycroscopy should be used for synovial fluid crystal exam?
polarized
-
crystal exams must be run ASAP because of what two factors that affect crystal solubility in synovial fluid?
temperature and pH
-
what are the most common crystals seen in synovial fluid?
- monosodium urate (MSU)
- Calcium pyrophosphate dihydrate (CPPD)
-
what is the appearance of MSU crystals?
- needle shaped
- negative birefringence
-
how do CPPD crystals appear in polorized microscopy?
- rod or rhombod shaped
- positive birefringence
-
normal reference value for synovial fluid
color:
appearance:
WBC count:
RBC count:
- Color: pale yellow
- Appearance: clear
- WBC Count: 200-600/mm3
- RBC count: none
-
normal reference values for synovial fluid diff
mononuclears:
neutrophils:
- Monos: =/> 75%
- neutrophils: <25%
-
what are two causes of an increased cell count in synovial fluid?
-
what could cause an increased neutrophil in a synovial fluid diff
septic condition
-
what could cause an increase in lymphocytes in synovial fluid?
non-septic inflammation
-
why would inflammation cause a low viscosity in synovial fluid?
inflammatory cells release enzymes that degrade hyaluronate
-
what could cause the presence of MSU's in synovial fluid?
gout
-
what could cause the presence of CPPD in synovial fluid?
Pseudo-gout
-
what type of serous membrane lines cavity walls?
parietal
-
what type of serous membranes covers organs within a cavity?
visceral
-
The fluid between two serous membranes that is an ultrafiltrate of plasma is called what?
serous fluid
-
this type of serous fluid forms due to systemic disorders that result in a disruption of the balance in the regulation of fluid filtration and reabsorption.
transudates
-
this type of serous fluid forms due to conditions directly involving the membranes themselves and results from inflammatory process
exudates
-
what is the function of serous fluids?
lubricates the surfaces of the serous membranes
-
normal reference values for serous fluids
color:
appearance:
WBC count:
RBC count:
- color: pale yellow
- appearance: clear
- WBC count: <1000/mm3
- RBC count: none
-
what are the predominant cells in serous fluid?
mononuclears (monocytes, lymphocytes, mesothelial cells, macrophages)
-
on a serous fluid diff what percent of your cells should be neutrophils?
<25%
-
what could cause the following colors in serous fluid?
yellow white:
red brown:
yellow brown:
milky green:
- Yellow white: inflammation
- red brown: hemorrhage
- yellow brown: bilirubin
- milky green: chylous fluid
-
what could cause an increased cell count in serous fluid?
-
what could cause an increase in neutrophils in serous fluid?
- sepsis
- endocarditis
- peritonitis
|
|