CLSC 133 Quiz 1 Study Guide

Lavender EDTA Tube

Identify the anticoagulant and the tube top color best suited fro specimen collection when a differential is preformed

2-3 Hours

What is the time limit for making smears after blood collection if the blood is stored at room temperature?

1. White Blood Cell Count (WBC)

2. Red Blood Cell Count (RBC)

3. Hemoglobin (Hgb)

4. Hematocrit (Hct)

5. Mean Corpuscular Volume (MCV)

6. Mean Corpuscular Hemoglobin (MCH)

7. Mean Corpuscular Hemoglobin Content (MCHC)

8. Platelet Count

9. Red Blood Cell Distribution Width (RDW)

Identify the nine parameters for routine CBC

WBC

RBC

Hgb

MCV

Platelet

Identify the CBC parameters that are measured

Hct ("Rule of Three")

MCH

MCHC

RDW

Identify the CBC parameters that are calculated

If nucleated RBC's are present, they need to be reported. They indicate increased erythropoietic activity and usually a pathological condition. The presence of nRBCs per 100 WBCs is falsely elevates, the WBC and is clinically significant.

WBC x 100

———————-

nRBC + 100

(only if nRBC >5)

How many nucleated red blood cells affect the CBC if present in high numbers

Increase

-philia

Decrease

-cytosis

Infections/inflammatory response

Stress response

Malignancies

Surgery

Physical conditions (heat, cold, shock)

Drugs

Pregnancy

What pathological conditions are associated with Neutrophilia

Skin disease

Parasitic disease

Transplant rejection

Myeloproliferative disorders (bone marrow disorder)

Asthma

Allergies

What pathological conditions are associated with Eosinophilia

Myeloproliferative disorders-(bone marrow disorder)

Hypersensitivity reaction reactions

Ulcerative colitis

Chronic inflammatory conditions

Renal disease

What pathological conditions are associated with Basophilia

EBV- Epstein-Barr virus

CMV

Hepatitis virus

HIV

Chronic bacterial infection infections

Autoimmune disorder

Drugs

What pathological conditions are associated with Lymphocytosis

Chronic infections (tuberculosis)

Malignancies

Bone marrow failure

Leukemia with a strong monocytic component

What pathological conditions are associated with Monocytosis

The blood in the EDTA develops IgG antibody at targets platelet glycoproteins

The platelets forms a ring around the neutrophils

Describe the phenomenon of platelet Satellitosis and identify the cause

This produces a falsely low platelet count

How does it affect the platelet count?

So the patient sample is collected in a sodium citrate tube for an accurate platelet count. The blood is recycled and the new platelet count is multiplied by 1.11 because Sodium citrate-blue top-has a dilution factor

How is it resolved

There is a left shift meaning the bone marrow is responding to a need for more WBCs by sending out younger cells (think infection)

You perform a differential on 35% banded neutrophils

What is your interpretation of the finding?

High/elevated

What would you expect the white blood cell count to be?

Left shift/ Leukemoid Reaction

What term is used to describe this picture?

1. Classify 100 WBC

2. Platelet estimate

3. RBC morphology

Briefly identify the steps in performing a differential, including platelet estimate and red blood cell morphology

Normocytic

Normochromic

What are the terms used to describe normal blood cell morphology

Clear

Colorless

Briefly describe the appearance of normal CSF looks like

If ≥ 10 WBC/mm^3 are found in the White Cell Count

When should a differential be preformed in a body fluid

Because cell lyse on prolonged standing (within 30 minutes) and accurate counts become impossible

Why must a CSF be processed STAT

When the CSF appears red, pink, yellow, or orange

Depends on how old the blood is , if there was a traumatic tap, or subarachnoid hemorrhage

Indicates Red Blood Cell hemolysis

What is Xanthochromia

Do you use a special centrifuge called a cycle spin at a low speed

How do you obtain enough cells to preform a differential

Get the average # of Cells from both chambers then apply to the formula below

# of Cells counted x Dilution x Depth

————————————————————————-

Number of Large Squares Counted

How do you calculate the total cell count (What formula do you use)

3mm by 3mm for a total of 9mm^2

What are the dimensions of the hemacytometer in mm's

WBC: 50+45=95/2=47.5 (round up to 48)

48x20x10

——————— = 1066.6 (Round up)

9

1067 WBC/mm^3

You count 50 WBC on side 1 of the chamber. You count 45 WBCs on side 2. You have made a 1:20 dilution and used all nine " W" squares for your count. What is the reported WBC count? Show all work

Dilution: Sample Volume 1

———————————— = ———

Total Volume X

0.5 1

———— = ————-

1.5 X

(Rearrange and solve for x)

0.5 x

————- = 1

1.5

0.5 x = 1.5

x=1.5/0.5=3

RBC: 300+292=592/2=296

296x3x10

——————— =1776

5

1776 RBC/mm^3

You add 1 mL of saline to a glass tube. You use 0.5 mLs a body fluid and add it to the glass tube. You use the diluted body fluid for the hemocytometer. You count 300 RBCs on side 1 and 292 RBC's on side 2. You count 5 "W" squares. What is the reported RBC count?

0-5 / microliter

What is the normal WBC range for CSF

Erythrocyte sedimentation rate (ESR) is a nonspecific test that indicates information

And measures the distance that RBC fall in a vertical tube over a given time (usually 1 hr)

It is directly proportional to RBC mass and inversely proportional to its surface

Reported in mm/hr

What is the principle of the ESR?

Inflammation

Rheumatoid arthritis

Ectopic pregnancy

Tilting the ESR tube (not vertical)

ESR rack that sits under a heating duct

ESR rack that sits on the same counter as a centrifuge

These conditions elevate/increase the ESR

Specimen sitting over 2 hours

Sickle cell anemia

ESR rack that sits under an air conditioning vent

Bubbles in the ESR column (repeat)

Specimen tube is only 1/3 of the way full (repeat)

These conditions decrease the ESR

RBC's have a net negative charge so they repel when proteins are produced during inflammation so the negative charge is overcome, allowing RBCs to form Rouleaux and fall out of the solution

Zeta potential as it pertains to ESR