Leslie's PAVLOV NOTES pt. 3

Cast formed at the junction of the ascending loop of Henle and the distal convoluted tubule, may produce structures with a tapered end.

Hyaline casts

Cylindroids have same significance

Hyaline casts

Most commonly seen broad casts

granular and waxy

Reagent strip for glucose turns out negative but the doctor orders a Clinitest

Doctor suspects IEM

Gradual change in the control sample results

Trend

Anti-neutrophilic cytoplasmic antibody

Wegener's granulomatosis

Hematuria, Heavy proteinuria, RBC cast

Henoch-Shonlein Purpura

Genetic disorder showing lamellated and thinning glomerular basement membrane

Alport syndrome

Principle of Micral test

EIA

RBCs in hypotonic urine

Ghost cells

WBCs in hypotonic solution

Glitter cells

Renal calculi may form in

Calyces, renal pelvis, ureters and bladder

Inserted through the nose

Levine tube

Inserted through the mouth

Rehfuss tube

Tubeless test for gastric acidity

Diagnex tubeless test

Principle of Gualac-based test for FOB

pseudoperoxidase activity of hemoglobin

Sperm count equation

Sperm conc. x Specimen volume (mL) = sperm/ejaculate

Odorless urine

Acute tubular necrosis

Glitter cells

Pale blue

PMN granules

violet

Sternheimer-malbin stain

Crystal violet and safranin O; Supravital stain differentiates RTE cells from WBCs and transitional EC

RTE cell

ECCENTRIC NUCLEUS

Transitional epith. Cells

CENTRAL NUCLEUS; May for syncytia or clumps

↑ Specific gravity

Falsely low Nitrite, Proteins and Glucose

Basic tool in evaluating anemia

Stained blood smear

Detectable only by examination of a peripheral blood film

Poikilocytosis

Poikilocytosis

Variation in shape

Abnormal variation in the size of erythrocyte is known as

Anisocytosis

Blood pressure cuff DURING collection is set at

40 mmHg (Harmening)

Not an end cell

Lymphocyte

Kidney or bean shaped nucleus

Metamyelocyte

Sausage shaped nucleus

Band cell

First stage seen with a DMS

Promegakaryocyte

Numerous cytoplasmic granules

Two or more nuclei, No visible thrombocytes

Megakaryocyte

Platelet alpha and dense granules

Organelle zone

Outer surface of platelets

Glycocalyx

Three-part differential

granulocytes, lymphocytes, monocytes

Poikilocyte most commonly seen in hemolytic anemias

Target cell

Hemoglobin at periphery with concentrated central Hb surrounded by area of pallor

Leptocyte

elongated or slit-like area of central pallor disease, hereditary stomatocytosis, or as artifact osmotic changes due to cation imbalance (Na+/K+)

Mouth cell — Stomatocyte

Interior portion of cell is hollow, resembling a horn or helmet; Seen in microangiopathic hemolytic anemias

Helmet cells/horn cells — keratocytes

thin, elongated, pointed ends, crescent shaped; Contain polymers of abnormal hemoglobin S; Seen in hemoglobinopathies SS, SC, SD, and S/B-thalassemia

Sickle cells — drepanocytes

Pear-shaped cell with one blunt projection. Seen in megaloblastic anemias, thalassemia, and extramedullary hematopoiesis (myelofibrosis, myelophthisic, anemia)

Teardrop cell — dacryocytes/dacrocyte

Have evenly spaced round projections; Seen in liver disease, uremia, heparin therapy, pyruvate kinase

Burr cells — echinocytes

unevenly spaced pointed projections; Associated with alcoholic liver disease, post-splenectomy, and abetalipoproteinemia

Acanthocytes - spur cells

Platelet shedding

Mature megakaryocyte

Metamegakaryocyte

Test/s for PNH

Sugar water test

Sucrose hemolysis

Acid-serum test (Ham's test)

higher degree of hemolysis

(+) PNH

Sugar water test

Citrated whole blood

Performed within 2hrs

In the Ham's method for PNH, when the patient has recelved blood transfusions, ______ lysis occurs because of the presence of normal transfused red blood cells

Less

Test using sodium dithionite

Screens for HbS; (+) Turbidity

Solubility test

Metabisulflte is a reducing substance that enhances deoxygenation and sickling (+)

This test cannot differentiate homozygous Hb SS and heterozygous sickle cell trait (Hb AS)

Sodium metabisulfite

Definitive diagnosis of group Hb SS

Hb electrophoresis

Vitamin K dependent group

II, VII, IX, X

Hemophilia A is deficiency of

Factor VIII

Hemophilia B is deficiency of

Factor IX

Hemophilia C is deficiency of

Factor XI

Coagulation factors are assigned a roman numeral

in order of discovery

low platelet count

prolonged PT

prolonged PTT

prolonged TT

What follow up test should be performed?

Presence of FDP/FSP

Sex-linked recessive mode of inheritance

Hemophilia A

Hemophilia B

Autosomal recessive

Hemophilia C

A patient on thrombolytic therapy shows bleeding and the ff lab tests (before heparin)

PTT very long

Fibrinogen very low

DIC

A patient on thrombolytic therapy shows bleeding and the ff lab tests (during heparin infusion)

PTT very long

Fibrinogen low

DIC

has been used in: patients of advanced age; those with leg fractures, cancer or obesity; undergoing hip surgery, varicose vein surgery, or estrogen therapy; those having DIC or CHF, and those with history of venous thrombosis.

Minidose heparin

Monitors patient on oral anticoagulants (Coumadin, Coumarin, Warfarin)

PT (INR)

Monitors patient on heparin

aPTT

Test for extrinsic pathway

Specimen tested within 24 hours

PT

Test for intrinsic pathway

Specimen tested within 4 hours

aPTT

D-dimer is positive in DIC as soon as

4 hours 30

Positive for Philadelphia chromosome

CML

Presence of Ph' chromosome

BETTER prognosis

M1

AML without maturation

M3 — Acute Promyelocytic leukemia

AML with DIC, t(15:17) P' chrom. Auer rods and fag got cells

FAB Classification

>30% Blast cells

WHO Classification

>20% Blast cells

Darkly staining mass of of sex chromosome attached to the end of the nucleus of somatic cells

Barr bodies

macrophages, adipocytes, fibroblasts, endothelial cells

Stromal cells

Predominant cell in the Bone marrow

Metamyelocyte (Juvenile)

Appearance of Primary/ nonspecific granules

Promyelocyte

Appearance of secondary/specific granules

Myelocyte

Leukocytosis

WBC > 11x10^9/L

Number of lymphocytes is greater than the number of PMN present in the sample

200 differential count

Correction of WBC count

Adult ≥ 5 NRBCs/100

Neonate ≥ 10 NRBCs/100 WBC

Poor man's platelet aggregation study

Examination of blood film of fresh capillary blood

Best way to make smear

Smooth and rapid

Thin blood smear

Smaller drop of blood

Slower spread

Lower angle

Thick blood smear

Larger blood drop

Fast spread

Higher angle

The needle used in the evacuated tube system (ETS) is _______ ended.

Double

Third layer on spun hematocrit

Buffy coat layer

Overcentrifugation

No effect on Hb (HICN method)

Decreased ESR and Hct

Coagulation specimen

Centrifuged within 1 hour

PPP (Coagulation studies)

Centri 1,500g for 15 mins

PRP (Aggregometry studies)

Centri 50g for 30 mins

Higher in the afternoon

Eosinophils

If the stain cannot be performed immediately, the unfixed smears may be stored in the dark at room temperature for up to two weeks without significant loss in activity

Chloroacetate esterase

Differentiate acute myelogenous and myelomonocytic leukemias from acute lymphocytic leukemia

Sudan Black B

Macrocytosis of 25%-50% is graded as

2+ to 3+

Hemolyzed sample for coagulation testing

REJECT

Manual detection of fibrin clot formation

Tilt tube method

Wire loop

Electromechanical

Fibrometer