MLS 1114 Exam 1

Flashcards for key vocabulary and concepts in hematology and hemostasis, based on lecture notes.

Hematology

The study of blood and blood-forming organs.

Hemostasis

The process of stopping bleeding.

Hematocrit

The percentage of blood volume occupied by red blood cells.

Manual differential

Manual counting and classification of white blood cells on a stained blood smear.

Buffy coat

The layer of leukocytes and platelets that forms between the plasma and red blood cells when blood is centrifuged.

EDTA

An anticoagulant used in hematology to prevent blood clotting.

Na+ citrate

An anticoagulant used in coagulation studies.

Zeta potential

The electrical potential of particles in a colloidal system, affecting cell repulsion and aggregation.

Acute phase protein

Proteins whose serum concentrations increase or decrease in response to inflammation.

Rouleaux

Arrangement of red blood cells in stacks resembling coins.

Trapped plasma

Plasma that remains within the red blood cell column after centrifugation in a hematocrit test.

ESR

Erythrocyte Sedimentation Rate; the rate at which red blood cells settle in a tube over a specified time.

CBC

Complete Blood Count; a panel of tests that includes WBC count, RBC count, platelet count, hemoglobin, hematocrit, and RBC indices.

VCS

Volume, Conductivity, and Scatter; parameters measured by automated hematology analyzers.

Absolute

The actual number of cells present in a given volume of blood.

Relative

The percentage of each type of white blood cell present in a sample.

Levy-Jennings chart

A graph used to plot and monitor the results of control samples in quality control.

Delta check

A comparison of a patient's current laboratory results with previous results to detect significant changes.

QA

Quality Assurance; a comprehensive set of policies and procedures designed to ensure the reliability of laboratory results.

QC

Quality Control; the procedures used to monitor the accuracy and precision of laboratory tests.

Shift

A sudden change in the control values that continues at about the same level on one side of the mean.

Trend

A gradual change in the control values usually moving in one direction and over at least three days.

Quality assurance

Encompasses all activities aimed at ensuring the quality of laboratory services, including pre-analytical, analytical, and post-analytical phases.

Quality control

A set of processes and procedures implemented to monitor and evaluate the accuracy and reliability of laboratory testing.

How to preform microhematocrit

Fill two tubes ¾ with blood, seal one end with clay, spin with open end towards center, read using card. Both tube must be within 1% of each other

Reasons for falsely increased microhematocrit

Centrifuge to slow, centrifuge spin time too short, poikilocytosis (variation in rbc shape)

Reasons for falsely decreased microhematocrit

Tissue fluid, severe edema, milking the finger stick, hemolysis, too much anticoagulant, improper clay seal, loosing cells during centrifugation

Hematocrit Range

Male 45%, female 35%

3 Phases of an ESR

Aggregation Phase - rbcs come together and form rouleaux

Sedimentation phase - aggregates fall out of solution because RBCs are denser than plasma

Packing phase - RBCs pack together

What is Zeta Potential?

The electrical charge normally found on RBCs that precent aggregation

What proteins decrease zeta potential

Acute phase proteins

What can cause an elevated ESR

Almost anything, infections, autoimmune diseases, pregnancy, waldenstrom’s macroglobulinemia, multiple myeloma

How long should a ESR be left alone?

One hour

Normal sed rate for children

0-10mm/hr

Normal sed rate for men

Younger than 50: 0-15

Older than 50: 0-20

Normal sed rate for Women

Younger than 50; 0-20mm/hr

Older than 50: 0-30mm/hr

What could cause a falsely increased ESR

Too warm room, tilted tube, agitation

What could cause a falsely decreased ESR

old sample or clotted sample

How to do a WBC estimation

on 40x count amount of WBC in 10 fields then multiply by 2000

How to do a plt estimate

in 100x count plts in 10 fields then multiply b 15,000

Neutrophils

Granulocytes, also called polymorphonuclear (PNM) WBC or Seg. Neutral blue or pink cytoplasm, 2-5 lobes connected by thin filaments

Band Neutrophil

immature form of seg, neutral blue or pink cytoplasm, C or S shaped lobe

Eosinophil

Pink cytoplasm, lots of red/orange granules, segmented nucleus

Basophils

Dark blue/purple granules, segmented nucleus, light purple cytoplasm

Lymphocytes

Round or oval nucleus, nucleus is roughly the size of an RBC, high n:c,

Monocyte

Nucleus is larger than RBC, variable nucleus size, often have vacuoles

Hemocytometer calculation

(# Cells counted) (Diltuion factor) / (Number of squares counted) (Sq. Volume)

If counting WBC on hemocytometer, what is sq volume?

0.1

If Counting RBCs on hemocytometer, what is sq volume?

0.004

If you counted 5 RBC squares and counted 500 RBCs, with a dilution factor of 1:100 what is the rbc count?

2,500,00

Rule of 3

RBC x 3 = HBG +- 3

HBGx 3 = HCT +- 3

MCV meaning and normal range

Mean corpuscular volume, directly measured

Measurement of the average RBC size, Normal range 80-100f

MCV Calculation

(HCT/RBC) X 10

Gold standard method for HBG measurement

Cyanmethemoglobin

MCH meaning and normal range

Mean corpuscular hemoglobin

average amount of hbg in each rbc, Normal range 28-34

MCH Calculation

HGB/RBC X 10

MCHC meaning and normal range

Mean corpuscular hemoglobin concentration

Concentration of hgb in each RBC, normal range 32-36%

MCHC Calculation

HGB/HCT X 100

What can cause a high MCHC

RBC agglutination (Cold, clots), hemolysis, lipema

RDW Meaning and normal range

RBC Distribution width

measures anisocytosis 12-14.6%/ 80-100fL

What indices are measured?

Mean corpuscular volume (MCV), Red cell distribution width (RDW)

What indices are calculated?

Mean corpuscular hemoglobin (MCH), Mean corpuscular hemoglobin concentration (MCHC)

Coulter principal

Cells are diluted in and pulled through small aperture by a vacuum, cells are poor conductors so they will impede the direct current and be able to be measured. The resistance is able to be measured

Relative calculation

(Absolute)(100)/ total WBC = relative %

If the total leukocytes were 30 and the absolute monocytes was 4.2, what is the relative monocytes?

14%

If the total WBC was 10 and the relative neutrophils were 76%, what is the absolute neutrophil count?

7.6

(Relative/100) x WBC = absolute

Too much

-phillia

-cytosis

neutrophillia, monocytosis, leukocytosis,

Too little

-penia

lymphopenia, leukopenia

R flag

Analyzer might have counted partials as WBC when they might have been something else

+++++++

Results exceed instrument linearity

Way too high

- - - - - - - - - - - -

Total Vote out

Runs don’t match by 2 SD

……….

Incomplete calculation

Values that are calculated and not measured can’t be reported, if theres not Hgb then hct can’t be reported

Calculation to correct for nRBCs

(Analyser generated WBC count) (100)/ (# nRBCs+ 100)

If the sysmex says there a WBC count of 37, and you count 126 nRBC in the diff, what is the corrected WBC count?

16.4

What chemical is added during the Cyanmethemoglobin method to oxidize Fe2+ and Fe3+

Potassium ferricyanide

What does MCV tell you about the RBC

The average RBC size

Are lymphocytes considered granulocytes?

No

What does VCS Technology stand for?

Volume, Conductivity, Light

Using rule of 3s, if a patient hgb is 13 what should their hct be?

36-42

Using the rule of 3s If a patients RBC is 5, what should their hgb be?

12-18

What is oxidized hemoglobin called?

Methemoglobin or oxyhemoglobin

What state is oxyhemoglobin in?

In a ferrous state

Which one of the indices reflects the amount or weight of HGB per RBC?

MCHC