SPECIAL HEMATOLOGIC PROCEDURES

ESR

Detect and monitor an inflammatory response to tissue injury (an acute phase response)

Plasma composition

Single most important factor affecting the ESR

Westergren

Most common method used to measure ESR

300 mm long x 2.55 mm bore

Measurement of westergren tube

115mm long x 3mm bore

Measurement of wintrobe tube

ESR (left; 0 at top)

Macrohematocrit (right; 100 at top)

Wintrobe tube can be used for _____ and _____

M: 0-10 mm/hr

F: 0-15 mm/hr

NV for ESR using Westergren tube

M: 0-9 mm/hr

F: 0-20 mm/hr

NV for ESR using Wintrobe tube

Increased

Larger the particles = ___ ESR

Increased

Formation of rouleaux = ____ ESR

Increased

Increase acute phase proteins (fibrinogen, A1 globulin, A2 globulin) = ____ ESR

Decreased due to increased viscosity

Increase albumin = ____ ESR

Increased

Tilt, vibration, high temp = ___ ESR

Decreased

Narrower bore = ___ ESR

Decreased

Abnormal shape of RBC = ____ ESR

Increase

Anemia and Leukemia = ___ ESR

Reticulocyte count

Reflect amount of effective RBC production in BM

Reticulocyte

Last immature stage of RBC

Contains remnant cytoplasmic RNA and organelles

2 blue staining granules

Visible w/out fine adjustment

Located away from cell margin

ICSH definition (formal def.) of reticulocytes

NMB and Brilliant cresyl blue

Supravital stain for reticulocytes

Adults: 0.5 - 1.5 %

Newborn: 2-5%

NV of reticulocytes

RC (%) = # of reticulocytes / 10

RC (%) formula

• in 1000 RBC

Absolute reticulocyte count

Actual number of retics in 1L of WB

25 - 75 × 10^9/L

NV for ARC

ARC = ( RBC ct. x RC) / 100

Formula for ARC

CRC = (hct/45) x RC

Formula for CRC (low hct)

RPI = CRC/maturation time

Formula for RPI (polychromasia present)

Howell Jolly bodies

Heinz bodies

Pappenheimer bodies

Hb H

Other inclusions stained by supravital stain

Osmotic fragility test

Measure the ability of the cell to take up water without being lysed

Shape of rbc

Volume

Surface area

Functional state of rbc membrane

Primary factors affecting the OFT

Decreased: target cells have the largest surface are

Target cell = __ OFT

increased: small surface area —> fragile

Spherocyte

Decreased: stronger membrane

Reticulocytes

Cellulose acetate

Hgb eletrophoresis at pH 8.6 use ___

Citrate agar

Hgb electrophoresis at pH 6.2 use ___