Peripheral Blood

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julieaburch
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83128
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Peripheral Blood
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2011-05-06 16:05:58
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Peripheral Blood
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Peripheral Blood
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  1. What are the constituents of blood?
    • Plasma (liquid)
    • Erythrocytes (RBCs)
    • Leukocytes (WBCs)
    • Platelets
  2. What are the layers of an Anticoagulated Blood Sample when allowed to settle?
    • Top 50-60% = Plasma
    • Buffy Coat = WBCs & Platelets
    • Bottom 40-50% = Erythrocytes
  3. What is the formula for Packed Cell Volume ("Hematocrit")?
    • Hematocrit = R/T X 100 [%]
    • R = erythrocytes in anticoagulated sample; T = total
  4. What is the liquid phase of anticoagulated blood?
    Plasma
  5. What is the fluid remaining after blood has clotted called?
    Serum
  6. Identify the picture. What is its function?

    • Erythrocyte
    • Gas Exchange
  7. What is the oxygen carrying molecule in erythrocytes? What is oxygen bound to?
    • Hemoglobin
    • Oxygen is bound to iron in the heme ring
  8. What is the lifespan of erythrocytes? At end of life, most are phagocytized and destroyed where?
    • ~120 days
    • Spleen (small # destroyed in circulation)
  9. What is the iron atom in the porphyrin ring called? What is the protein part called?
    • Heme
    • Globin
  10. What is the most common hemoglobin chain type? What are the other two?
    • Hb A: α2β2 (>95%)
    • Hb A2: α2δ2 (1.7-3.3%)
    • Hb F: α2γ2 (<2%)
  11. When it comes to erythrocytes, what does normocytic mean? Microcytic? Macrocytic? Normochromic? Hypochromic?
    • Normocytic: normal size
    • Microcytic: small (<6.5 microns)
    • Macrocytic: large (>8.5 microns)
    • Normochromic: normal central pallor
    • Hypochromic: widened central pallor (> 1/2 diameter of cell)
  12. What is an immature RBC containing RNA known as? How long do RBCs contain RNA for after leaving the marrow? What is the normal count for these?
    • Reticulocyte
    • 1 day
    • Normal reticulocyte count: 1% of RBCs (~1% of RBCs replaced daily)
  13. Identify the cell below:
    Reticulocyte
  14. What are the normal parameters for RBC Count in males and females?
    • Males: 4.7-6.1
    • Females: 4.2-5.4
  15. What are the normal parameters for Hemoglobin for males and females?
    • Males: 13-18
    • Females: 12-16
  16. What are the normal parameters for Hematocrit for males and females?
    • Males: 39-52
    • Females: 34-47
  17. What are the normal parameters for Mean Corpuscular Volume (MCV) for males and females?
    • Males: 80-100
    • Females: 80-100
  18. What are the three Granulocytes within Leukocytes (contain specific granules)?
    • Neutrophils
    • Eosinophils
    • Basophils
  19. What are the two Agranulocytes within Leukocytes (may contain lysosomes) (nonspecific granules)?
    • Lymphocytes
    • Monocytes
  20. What are the most common type of leukocytes?
    Neutrophils
  21. Identify the cell below. What is its primary function? What is their typical lifespan?
    • Neutrophil
    • Phagocytosis, predominantly bacteria; Main defense against bacterial infection
    • ~10 hours in circulation, 1-4 days in tissue
  22. When is an increase in Neutrophils seen?
    In acute infection, inflammation, or other stress (particularly in an increase in "band" forms)
  23. Identify the cell below. What is its main function? What is their typical lifespan?
    • Eosinophil
    • Phagocytosis of antigen-antibody complexes; kill parasites
    • Lifespan in Blood: ~ 8 hours
  24. When is an increase in Eosinophils seen?
    In allergic reactions and parasitic infections
  25. What are the least common leukocytes?
    Basophils
  26. Identify the cell below:
    Basophil
  27. Identify the cell below:
    Small resting lymphocyte
  28. A significant number of neutrophils roll around along the endothelial surface of blood vessels. What is this space called? What is this population of neutrophils for?
    • Marginating Pool
    • Can be rapidly mobilized with acute stress or infection
  29. The function of basophils is not entirely clear, but it is believed that they may control immune reactions, or are possibly related to tissue mast cells. When is an increase in Basophils seen?
    In chronic infections and some neoplasms
  30. What cell type is able to recirculate between blood and tissue?
    Lymphocytes
  31. When is an increase in Lymphocytes seen?
    Increase in viral infections, Toxoplasmosis, other conditions; infectious mononucleosis, reactive or "atypical" lymphocytes
  32. Identify the cell below:
    Large granular lymphocyte
  33. What do B-cells differentiate into?
    Plasma Cells: antibody synthesizing cells
  34. Identify the cell below:
    Reactive ("Atypical") Lymphocyte
  35. Identify the cell below:
    Reactive ("Atypical") Lymphocyte
  36. How long do Monocytes circulate in blood? What might they differentiate into?
    • ~ 8-14 hours; long survival in tissues
    • May differentiate into tissue macrophages (aka histiocytes)
  37. Identify the cell below. What are its two main functions?
    • Monocyte
    • Phagocytosis: organisms (fungi, mycobacteria), debris, foreign material
    • Antigen processing and presentation to lymphocytes
  38. Identify the small purple cell below. What is its function?
    • Platelet
    • Adhere to injured blood vessel wall: immediate hemostatic plug; form surface for coagulation cascade
  39. What does a platelet count of 20,000 microliters or more indicate?
    Adequate hemostasis for normal conditions
  40. What does a platelet count of 50,000-100,000 microliters indicate?
    Adequate for most surgery
  41. What does a platelet count of less than 10,000 microliters indicate?
    Risk of spontaneous hemorrhage
  42. What are the most important values involved in a Complete Blood Count (CBC)?
    • Red Cells: MCV
    • White Cells: absolute number
    • Platelets: platelet count
  43. What is the preferred index for evaluating anemia?
    Mean Corpuscular Volume (MCV)
  44. What is a normal Mean Corpuscular Volume (MCV)? What is classified as Microcytic? Macrocytic?
    • Normocytic: 80-100 femtoliters (Normal)
    • Microcytic: less than 80
    • Macrocytic: more than 100
    • Femtoliters = 10-15 L
  45. What does the Red Cell Distribution Width (RDW) measure? What is a normal distribution? What is an increased count known as?
    • Measure of variation in red cell size
    • Normal = 12.5-14.5
    • Increased = anisocytosis
  46. What is the Red Cell Distribution Width (RDW) useful for?
    • Iron Deficiency: increased RDW
    • Thalassemia: normal RDW
  47. Most CBC instruments classify cells by size. If a cell is 2-20 femtoliters, what is it, by definition? What two cell types are classified as these?
    • Platelet
    • RBCs and WBCs
  48. What are the Adult Reference Ranges for WBC Count for males and females?
    • Males: 4-11
    • Females: 4-11
  49. What are the Adult Reference Ranges for Platelets for males and females?
    • Males: 140-440
    • Females: 140-440
  50. What is the best gauge of resistance to bacterial infection? How is this calculated? What value is often associated with significant risk of serious bacterial infection?
    • Absolute Neutrophil Count (ANC)
    • ANC = WBC X [% Segs & bands] X 0.01
    • ANC < 500/ microL
  51. For Pediatric Blood Counts, are Hemoglobin and MCV higher or lower? When are adult levels achieved? Are lymphocyte and granulocyte counts higher or lower? When are adult levels achieved?
    • Hemoglobin & MCV lower: achieve adult levels after puberty
    • Lymphocyte Count higher: until ~ age 7 years
    • Granulocyte Count lower: no age given
  52. What is the ethnic variation on CBCs for African Americans?
    Lower WBC, Granulocyte, mean Hemoglobin & MCV counts
  53. Identify the phenomenon seen below. Where does this happen?
    • Platelet Clumping
    • Does not happen in blood vessels; strictly a test tube phenomenon
  54. There are certain conditions that may interfere with Hematology Analyzers. What 5 factors may cause a spurious increase in WBC count?
    • Cryoglobulins
    • Heparin
    • Nucleated Erythrocytes
    • Unlysed Erythrocytes
    • Platelet Clumping
  55. There are certain conditions that may interfere with Hematology Analyzers. What 4 factors might cause a spurious decrease in WBC count?
    • Clotted Specimen
    • Leukemia
    • Uremia
    • Some Immunosuppressive Agents
  56. There are certain conditions that may interfere with Hematology Analyzers. What 5 factors might cause a spurious increase in Hemoglobin?
    • Cryoglobulins
    • Heparin
    • Hyperbilirubinemia
    • Lipedemia
    • High WBC Count
  57. There are certain conditions that may interfere with Hematology Analyzers. What 2 factors might cause a spurious decrease in Hemoglobin?
    • Clotted Specimen
    • Sulfhemoglobin
  58. There are certain conditions that may interfere with Hematology Analyzers. What 3 factors might cause a spurious increase in RBC count?
    • Cryoglobulins
    • Giant Platelets
    • High WBC Count
  59. There are certain conditions that may interfere with Hematology Analyzers. What 4 factors might cause a spurious decrease in RBC count?
    • Autoagglutinins
    • Clotted Specimen
    • Hemolysis (in vitro)
    • Microcytic RBCs
  60. There are certain conditions that may interfere with Hematology Analyzers. What 4 factors might cause a spurious increase in Platelet count?
    • Cryoglobulins
    • Hemolysis (in vitro)
    • Microcytic RBCs
    • WBC Fragments (acute leukemia)
  61. There are certain conditions that may interfere with Hematology Analyzers. What 4 factors might cause a spurious decrease in Platelet count?
    • Clotted Specimen
    • Giant Platelets
    • Heparin
    • Platelet Clumping
  62. There are certain conditions that may interfere with Hematology Analyzers. What 4 factors might cause a spurious increase in MCV?
    • Autoagglutination or Rouleaux
    • High WBC Count
    • Hyperglycemia
    • Reduced RBC Deformability
  63. There are certain conditions that may interfere with Hematology Analyzers. What 3 factors might cause a spurious decrease in MCV?
    • Cryoglobulins
    • Giant Platelets
    • Hemolysis (in vitro)

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