Blood cell labeling, mechanisms of localization, and qc Copy

copy of Blood cell labeling, mechanisms of localization, and qc

what is plasma

liquid part of blood, clear portion with clotting factors, a dilute solution of salts glucose amino acids vitamins urea proteins and fats

what are white blood cells involved in

immune system

what are platelets involved in

blood clotting

what are red blood cells involved in

carrying oxygen

what are the two compartments of blood

plasma and cells

what serum

clear portion without clotting factors

what is the amount of blood in the body

5×10^6/mm3

T/F red blood cells are biconcave discs

true

what is the diameter of red blood cells

7-8um

what is the excess amount of red blood cells called

polycythemia

what are deficient amount of red blood cells called

anemia, macrocytic or megaloblastic, microcytic, hemolytic

how long does it take for red blood cells to synthesis in marrow

2-3 days

what is the order of red blood cell formation

stem cell (hemocytoblast) - committed cell (proerythroblast) - ribosome synthesis (early erythroblast) - hemoglobin accumulation ( lase erythroblast) -normoblast - rejection of nucleus (reticulocyte) - erythrocyte

what are the three main components that red blood cells are composed of

hemoglobin, b-12, iron

what is the job of red blood cells

carry oxygen to the body

what is the size of white blood cells

8 x 10^3/ mm3

what are megakaryocytes

platelets

what is the size of megakaryocytes/platelets

150-300K/ mm3

what are the different kinds of white blood cells

neutrophiles (62%)

eosinophils (2.5%)

basophils (0.5%)

lymphocytes

monocytes

red blood cells, white blood cells and megakaryocytes/platelets are made were

bone marrow (myeloid tissue)

how long do red blood cells circulate in the bloodstream for

100-120 days

T/F can red blood cells twist and change shape

true

what happens when red blood cells become fragile

removed from the spleen

what does hemoglobin molecule provides binding sites for what

O2, Fe, B -12

O2 is attached to what in the hemoglobin molecule

iron

what is the gas exchange in the lungs

O2 in, CO2 out

what to do white blood cells have

nucleus

T/F does white blood cells have hemoglobin

false

how long do white blood cells live for

a few hours or days

what is the formation of lymphocytes

pluripotent stem cells - lymphoid stem cells - lymphoblast - lymphocyte

what is the formation of eosinophils

pluripotent stem cells - myeloid stem cells - eosinophilic myeloblast - eosinophils

what is the formation of basophil

pluripotent stem cells - myeloid stem cells - basophilic myeloblast - basophil

what is the formation of neutrophil

pluripotent stem cells - myeloid stem cells - neutrophilic myeloblast - neutrophil

what is the formation of monocyte

pluripotent stem cells - myeloid stem cells - monoblast - monocyte

what white blood cells are granular

eosinophil, basophil, neutrophil

what white blood cells are agranular

monocyte, lymphocytes

what is the chemotaxis movement of white blood cells

move toward sites of infection or tissue damage in response to chemical signals called chemoattractants.

what is the diapedesis movement of white blood cells

squeeze through the walls of blood vessels to exit the bloodstream and migrate into tissues to fight infection or respond to injury

what can to many white blood cells lead to

leukemia AML (acute myeloid leukemia), CML (chronic myeloid leukemia), ALL (acute lymphoblastic leukemia), CLL (chronic lymphoblastic leukemia)

what can to many white blood cells lead to

agranulocytosis or leukopenia

platelets are used for what

clotting around vascular tear

platelets are created where

marrow inside a megakaryocyte

what can abnormal amounts of platelets lead to

thrombocytopenia

what is thrombocytopenia

low platelet count

what exams use Tc-99m labeled red blood cells or ultratag method

RVG cardia imaging, GI bleed studies,liver hemangiomas

what does this image show

MUGA or RVG

what does this image show

Gi bleed (accumulation outside of normal vasculature = bleed

what does this image show liver hemangioma, hot focus in liver = memangioma

what are the methods for red blood cell labeling

in- vitro, modified in vivo, in vivo

what is used for all red blood cell labeling

Tc-99m and cold pyrophosphate kit contents

what is the basic process of labeling red blood cells

stannous ion diffuses into the red blood cells, Tc-99m diffuses into the red blood cells, stannous ion reduces the Tc-99m O4 and makes it unable to diffuse out of the cell

what is the most common red blood cell labeling method

in-vitro

the in vitro method is done

outside the body

what is the labeling efficiency for in vitro method

97%

the in vitro method contents of what

reaction vial stannous chloride tin chloride sodium citrate and dextrose, syringe 1 sodium hypochlorite (light sensitive) used to adjust pH, syringe 2 sodium citrate used to adjust pH

what are the steps for the in vitro method

Draw heparin into syringe (If patient has heparin allergy, use ACD), Draw 1-3 mL of blood into syringe (Use 18-gauge needle/IV/butterfly), Add 1 mL of blood to UltraTag reaction vial, Allow blood to incubate at room temperature for 5 minutes, Add syringe I, invert the vial a few times for mixing , Add syringe II, invert the vial a few times for mixing, Add 10-100 (20-25) mCi of Tc-99m sodium pertechnetate, Incubate for 20 minutes with occasional mixing

what identification method used for in vitro method

patient must be reinjected with their own blood, second person to identify the patient, special identifier sticker on the patients wristband

what is the dose, and injection time for the in vitro method

20-25mCi re injected within 30 minutes or sooner

how is the in vivo method done

in side the body

what are the steps for the vivo method

Stannous ion (as Sn-PYP) is injected into the patient – not through plastic iv, Wait 20-30 minutes. Inject Tc-99mO4-, The RBCs are tagged immediately

what are the advantages of the in vivo method

less chance of needle stick injury, no blood handling, no chance of injecting the wrong blood into a patient

what are the disadvantages of the in vivo method

labeling efficiency is lower 80-90%, unlabeled Tc-99m will accumulate in the thyroid, stomach, and kidneys increasing background activity

what is the labeling efficiency for the in vivo method

80-90%

how is modified in vivo method done

in and out side the body

what are the steps for the modified in vivo method

1.Inject patient with the stannous ion 2.Wait 20 minutes 3.Draw blood into syringe containing 20-30 mCi of Tc-99m 4.Wait 10 minutes 5.Re-inject tagged blood

what are the advantage of in vitro

best tagging efficiency

what are the disadvantages for in vitro

must handle blood

must take special precaution to inject the correct blood into the patient

what are the advantages for modified in vivo

good tagging efficiency without having to make an actual kit

what are the disadvantages of the modified in vivo

requires leaving the butterfly in the patient for 20 plus minutes

what radiopharmaceutical are used for infection imaging

In-111 oxine labeled white blood cells, Tc-99m HMPAO labeled white blood cells

what radiopharmaceutical are used for thrombus detection

In-111 oxine and chloride labeled to platelets

neutrophils act as what

acute infection responders

what are neutrophils help use do in NM

support infection imaging

what is the abundance of neutrophils

62%

what radiopharmaceutical was used for this image

In-111 WBC

what radiopharmaceutical was used for this image

Tc-99m HMPAO WBC

what does infection imaging help identify

osteomyelitis

if there is increased activity when using Tc-99m MDP and In-111 WBCs it indicates what

osteomyelitis

what is the critical organ when using Tc-99m HMPHA WBCs

spleen

what is the dose for Tc-99m HMPAO

7-25mCi

when is imaging performed for Tc-99m HMPAH

2-4 hours and 24 hours

what can be seen on 24 hour images using Tc-99m HMPAO

free pertechnetate

what radiopharmaceutical used for this image

Tc-99m HMPAO

What radiopharmaceutical used for this image

In-111 oxine WBC

what is the maximum time for wbc to accumulate when using In-111 oxine WBC

18-24 hours

T/F there is generally no gut activity when using In-111 oxine WBC

true

what are common areas of uptake when using In-111 oxine WBC

liver, spleen, and bone marrow

using In-111 oxine WBC can lead to what

lower count study

how is white blood cell labeling performed

using patients own WBC, can use donors WBC for rare cases of leukopenia

centrifuge separate, get WBCs separate, inject 500uCi of attatched In111WBCs

what can be used for WBC labeling

In-111, Tc-99m

using In-111 for WBC labeling allows for what

longer delayed imaging (2.8 days T1/2) of sever days

what could lead to low tagging for WBC labeling

Leukopenia (WBCs), Drugs in patient, RBCs in plasma during labeling (pink injection – heme), Low volume of blood drawn

what is the tagging percent for WBC labeling

75-90%

when should WBC be injected

Within 5 hours of the initial blood draw, Within 3 hours of labeling

what are the steps for WBC labeling using Tc-99m

Leukocytes are separated and suspended in plasma/ACD

Fresh Tc-99m HMPAO is added (methylene blue is not used)

Incubated for 15 minutes

• Labeling efficiency is 50-60%

Increase counts for imaging

what is biodistribution

biological characteristics of radiopharmaceutical when it is incorporated in a body space circulatory supply or organ system