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histogram charts, electrophoresis, more junk for machines
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normal RBC

RBC agglutination

Dimorphic RBC, RBC fragments, elevated RDW

macrocytic RBC, elevated RDW, shift to the right

microcytic RBC, elevated RDW, shift to the left

normal WBC

WBC shift to the left BLASTS
increase in immature granulocytes, abnormal cell populations, eosinophilia (R3 flag)

immature granulocytes

lymphocytosis

variant lymph

cellular interference

eosinophilia

blasts

normal PLT

small PLT

giant PLT

rbc and PLT overlap

scatter plot
how to fix cold agglutinins
warm specimen at 37 C for 15 min the re-run
how to fix lipemic sample
perform Hgb determination on plasma supernatant, then subtract plasma Hgb value from original blood specimen hemoglobin
saline replacement - replace patients plasma with isotonic saline, remember to put same amount of saline as the amount of plasma taken out
how to fix sample with leukocytosis
dilute specimen and multiply cell counts by DF

what does patient 1 have?
Hgb S electrophoresis

what does patient 2 have?
S trait (AS)

what does patient 3 have?
Hgb C

what does patient 4 have?
Hgb SC

what does patient b have
thalassemia barts, hydrops fetalis, a thalassemia major
errors that happen when cold agglutinins are present
↓ RBC
↑ MCV, MCHC, HGB, MCH, grainy appearance
will show as dual population on rbc map or right shift on histogram
what happens with a lipemic sample
↑ HGB, MCH, MCHC
turbidity affects spectrophotometer in reading hgb
what happens with a sample when it is hemolyzed
↓ RBC
↑ HCT
what happens with a lysis resistant RBC (abnormal hgb) sample
↑ WBC, HGB
HGB S, C, OR F may fail to lyse and will be counted as wbc
what happens when a sample has microcytes or schistocytes
↓ RBC
↑ PLT
what happens with a sample when there is NRBC
↑ wbc
what happens when there is platelet clumps
↑ WBC
↓ PLT
redraw with sodium citrate and multiply by 1.1
what happens when WBC is increased (>100,000)
↑ HGB, RBC, HCT, MCH, MCHC