Hematology 1 - Module 1 [MidTerm]

Who described “worms” in the blood?

Athanasius Kircher

Who gave an account of erythrocytes?

Anton Van Leeuwenhoek

Who is the father of Hematology?

William Hewson

How did Giulio Bizzozero describe platelets?

Petite plaques

Who developed the wright stain?

James Homer Wright

Who made the first automated cell counter known as Coulter counters?

Joseph and Wallace Coulter

Red liquid circulating in the heart, veins, arteries and capillaries

Blood

This is the main fluid for transporting nutrients, waste products, gases and hormones through the circulatory system

Blood

This is transported by the blood from the tissues for elimination by the lungs

Carbon dioxide

This refers to the regulation of certain balances in the body

Homeostasis/Buffering action

Increased plasma osmolality promotes _________________ in the kidneys

water reabsorption

Decreased plasma osmolality promotes what?

Water excretion

This type of leukocyte protects against most bacterial agents by engulfing these bacteria, and releasing its granular contents, which have antibacterial action

Neutrophils

This type of leukocyte protects against a wide range of infectious agents by performing phagocytosis

Monocytes

This type of leukocyte protects against helminthic infections

Eosinophil

This type of leukocyte are active against most viruses and its subpopulation of B-lymphocytes differentiate into plasma cells to produce antibodies

Lymphocytes

This refers to the mechanism by which blood flow to an injured blood vessel is arrested in order to prevent excessive blood loss

Hemostasis

This is the liquid part of anticoagulated and unclotted blood

Plasma

This is the liquid part of clotted blood

Serum

These are microorganisms in the blood that can cause diseases

Blood-borne pathogens

According to the studies done in recent year in what part of the specimen collection has the most errors to occur during testing?

Pre-analytic phase

To avoid hemoconcentration/hemodilution, how many minutes should a patient sit in a supine position prior to drawing blood?

15-20 minutes

This may be observed shortly after a high-fat meal or due to high-fat diet

Lipemia

This may be observed in patients with high concentrations of bilirubin

Icterus

Which part of our body can be used for peripheral puncture?

Finger, earlobe, heel, big toe

When pricking the finger which finger is commonly/should be used?

Ring or middle finger

Which part of our body is no longer recommended for skin puncture due to less capillary access?

Earlobe

This is where puncture is done for newborns and infants

Heel

This is where puncture is done for infants

Big toe

What should be the depth of puncture for peripheral puncture?

2-3mm

Characteristics of Blood

Fluid, red, slightly alkaline, specific gravity of 1.055, thick and viscous, 75-85mL blood per kg body weight, 20g of solids/100mL of blood

FUNCTION OF THE BLOOD. Refers to the delivery of gasses to and from the tissues

Respiratory

FUNCTION OF THE BLOOD. Refers to the delivery of nutrients to the tissues. These nutrients are dissolved in the _______

Nutritive; plasma

FUNCTION OF THE BLOOD. Refers to the delivery of waste products from the tissues to the excretory organs for elimination from the body

Excretory

Hormones are secreted by the?

Endocrine glands

A physiological factors that is most commonly encountered when testing for hormones, ACP, and urinary excretion of electrolytes

Diurnal variation

Tobacco smokers generally have high blood concentrations of?

Carboxyhemoglobin, plasma, catecholamines, and cortisol

Hormonal changes in tobacco smokers also result in ____ eosinophil counts and ____ neutrophils and monocyte counts

Lower; higher

Chronic smoking leads to increase of?

HGB, RBC count, MCV, and WBC count

Skin puncture for adults is only applicable if?

Extreme obese, history of thromboembolism, stroke or DIC, and Extensive burns, examination requested necessitates skin puncture

Sources of venous blood are?

Median cubital vein, cephalic vein, basilic vein

When doing venipuncture, the angle should be at?

15-30 degrees

Distance of the tourniquet from the puncture site should be?

3-4 inches

What is the most preferred form of EDTA due to its solubility?

K2EDTA

What is not recommended form of EDTA due to its high pH?

Na3EDTA

Recommended ratio for EDTA:blood

1\.5-2.2 mg EDTA per mL of blood

What is the blood-anticoagulant ratio?

9:1

This accelerates antithrombin action to inhibit thrombin formation

Heparin

WHat type of oxalate causes shrinkage of RBCs

Potassium oxalate (K2C2O4)

WHat type of oxalate causes swelling of RBCs

Ammonium oxalate ((NH4) 2C2O4)

This is the most critical step in blood collection

Patient identification

It is important to note the time of extraction, which composition in the blood is increased in the morning?

WBC count

It is important to note the time of extraction, which composition in the blood is decreased in the morning?

RBC count, hemoglobin, hematocrit

A solid swelling or mass of blood in the tissues caused by the leakage of blood from the vessels during venipuncture

Hematoma

A decrease in the fluid content or plasma volume which is usually

Hemoconcentration

Refers to the rupture of the red blood cells. Hemoglobin is released into the surrounding fluid

Hemolysis

A temporary loss of consciousness caused by the insufficient flow of blood to the brain.

Syncope

Whole blood is used in what test?

CBC, OFT, ESR

This plasma is used for coagulation tests

Platelet-Poor Plasma

This plasma is used for Platelet function tests

Platelet-Rich Plasma

This is used for prothrombin consumption test

Serum

This is used for PBS Examination, WBC differential count, reticulocyte count

Blood smear

This is used for WBC differential count, abnormal cell morphology studies, blood-borne parasitic infection studies

Buffy Coat Smear

Used for hematological tests blood is collected in a flask with glass beads or paper clips.

Defibrinated Blood

This is used for bleeding time and micro method of clotting time

Fresh Blood From Skin Puncture

Order of Draw for Venipuncture

Blood Culture (Yellow), Citrate (Blue), Non-additive (Red), Heparin (Green), EDTA (Lavender), Fluoride (Gray)

This is a restriction that should be done for patients with contagious disease

Isolation

This is a restriction that should be done for patients who are immunocompromised

Reverse isolation

What is the recommended ratio for K2C2O4 and (NH4)2C2O4 mixture?

2:3

K2C2O4 and (NH4)2C2O4 mixture is also known as?

Double oxalate, balanced oxalate, Paul-Heller’s fluid, or wintrobe fluid

Double oxalate can be used for?

RBC count, RBC parameter, ESR determination

What oxalate is used to prevent clotting of blood body fluids

Lithium oxalate

Heparin can be used for?

RBC count, RBC parameters, Osmotic fragility

What anticoagulant is used when tests such as:

Standard Westergren method of ESR: blood to anticoagulant ratio 4:1

Coagulation testing (using platelet poor plasma)

Modified Westergren method of ESR for blood collected with EDTA

Platelet aggregometry test (using rich plasm++)

Platelet counts when platelet satellatism or clumping is encountered

Citrate

What anticoagulant is used when tests such as:

Cell counts (RBC, WBC, Platelets)

RBC parameters

RBC indices

ESR determination

Peripheral Blood Smear

Differential count

EDTA/Versene/Sequestrene

Order of Draw for Skin Puncture

Blood gas analysis, Slide, EDTA microcollection tube, Other microcollection tube, Serum microcollection tube

This may be due to hemolytic transfusion reactions among other.

In vivo hemolysis

This can occur due to positional changes

Hemoconcentration/hemodilution

In what position causes a decrease plasma volume, thus causes an increase in plasma concentrations of proteins

Upright position

What increases along with stress?

Cholesterol

What decreases when you are stress?

HDL-cholesterol

Hyperventilation increases what?

WBC count

Life span of platelets

9-10 days

This maintains blood vessel integrity by instigating vessel wall repair and it also controls homeostasis

Platelets

Five types of Leukocyte

Neutrophils, eosinophils, basophils, lymphocytes, monocytes

This provides immune reaction to pathogens by phagocytosis or antibody production

White Blood Cells

What are the diseases in WBCs?

Leukocytosis, leukopenia, leukemia

What are the diseases in RBCs?

Anemia, Polycythemia

This functions as hemoglobin synthesis as well as carrying oxygen to the peripheral tissues and also carrying carbon dioxide

Red Blood Cells

What is the average life span of erythrocytes

120 days

What are the shape of RBC

Biconcave disk with central pallor area

PLASMA or SERUM. All coagulation factors are present

Plasma

PLASMA or SERUM. Clotting factors that are consumed in coagulation

Serum

PLASMA or SERUM. Hazy

Plasma

PLASMA or SERUM. Clearer

Serum