| Question |
Answer |
| Red vacutainer |
"no anticoagulant; used for Ab tests |
| Light blue vacutainer |
sodium citrate; coag studies - PT APTT |
| Mottled vacutainer |
serum separater (can be used in conjunction with others); red mottled= for cholesterol |
| Green vacutainer |
heparin; used for osmotic fragility (and a lot of chemistry) |
| Gray vacutainer |
potassium oxalate or sodium fluorate; used for glucose studies |
| LAP stain |
leukocyte alkaline phosphatase; stains LAP, which is found in normal PMNs, but not in PMNs found in Chronic Myelocytic Leukemia |
| Peroxidase stain |
positive in myeloid progenitor cells, but not in erythroid or lymphoid cells; peroxidase is only in myeloid primary granules |
| Prussian blue |
stains iron; used to identify sideroblasts; also called Perl's stain |
| New Methylene Blue |
supravital stain; (another is Brilliant Cresyl blue stain) stains RNA- shows reticulocytes, and also hemoglobin - Heinz bodies |
| MCV |
measure of volume/size; range 80-99 femtaliters; macrocytic= >99; microcytic= <80 |
| MCV calculation |
Hematocrit/RBC count |
| MCHC |
mean corpuscular hemoglobin concentration (concentration of hemoglobin); determines normochromic, hypochromic |
| MCHC range |
32-36 is normal; >36 in spherocytosis (>36 isn't really a problem; you can't have hyperchromic RBCs); <32= hypochromic |
| MCHC calculation |
Hemoglobin/Hematocrit; in grams/liter |
| MCH |
Mean corpuscular hemoglobin; |
| MCH range |
27 to 31 picograms/cell |
| MCH calculation |
Hemoglobin/RBC count |
| What causes an increased MCHC? |
falsely elevated = turbidity of sample or cold agglutinins; truly elevated - spherocytosis |
| Normal range PMNs |
2,000-7,000; 50-70% (20-55% in newborns) |
| Normal range Lymphs |
1,500-4,000; 25-45% adults; 45-75% children |
| Normal range Monos |
200-1,000; 2-10% adults; 0-12% children |
| Normal range Eosinophils |
0-450 (ave. 150); 0-5% adults |
| Normal range Basophils |
0-150; 0-1% adults |
| Normal range WBC count |
4,000-11,000/cubic mm |
| M:E Ratio range |
the ratio of myeloid to erythroid precursors in bone marrow; normally it varies from 2:1 to 4:1; we learned 1.5:1 to 3:1; |
| Decreased M:E |
a decreased ratio may mean a depression of leukopoiesis or normoblastic hyperplasia depending on the overall cellularity of the bone marrow. |
| Increased M:E |
infections, chronic myelogenous leukemia, or erythroid hypoplasia; |
| Acanthocyte |
projections; no central pallor |
| Basophilic stippling |
little clumps of RNA; isn't a granule; with lead poisoning, see with BOTH supravital or Wright-Giemsa |
| Cabot ring |
piece of DNA; surrounds RBC |
| Heinz body |
denatured hemoglobin; can ONLY see with Supravital stain (like Brilliant Cresyl blue) |
| Hemoglobin C |
"""washington monument""" |
| Hemoglobin H |
"""golf ball""; ONLY see with supravital stain; will have lots" |
| Hemoglobin SC |
"abnormal chunk of hemoglobin; called ""bird in flight"" (don't confuse with schistocyte)" |
| Howell-Jolly bodies |
piece of nucleus left from nucleus expulsion; can be seen with BOTH Wrights or Supravital |
| Pappenheimer bodies |
iron; the iron itself won't stain, but the RNA it's stuck to will; can be seen with normal stain or iron (Prussian blue) stain |
| Dyserythropoiesis |
exploded, abnormal nucleus of a red blood cell |
| Hypersegmented PMN |
B12 or folic acid problems |
| Pelger-Huet PMNs |
genetic; no associated problems |
| Toxic granulation |
fusion of primary granules; occurs with infection; often have a shift to the left too |
| Sessile bodies |
little nuclear protrusions; often with toxic granulation; doesn't show anything in itself |
| Dohle bodies |
ribosomes or RER; faint, light blue inclusions; often around edge of PMN; |
| Auer rod |
malformed azurophilic granules; can occur in myeloblast |
| Alder-Reilly bodies |
mucopolysaccharides in PMNs; dark blue, obscures nucleus; looks like basophil, but will see too many of them; genetic disorder |
| Chediak-Higashi granules |
large azurophilic granules; caused by defective microtubules; found in albinism and infection |
| Faggot cell |
multiple auer rods (azurophilic granules) |
| May-Hegglin anomaly |
has 1) dohle-like bodies 2) enlarged platelets and 3) thrombocytopenia |
| Giant myelocyte |
"huge, ""lagging"" nucleus; in B12 deficiency" |
| Eosinophil increase happens in . . . |
parasites; allergies; some cases of Hodgkkins lymphoma |
| ESR |
erythrocyte sedimentation rate; shows inflammation or tissue destruction |
| Increased ESR |
" inflammation; Rheumatoid arthritis; infections; myocardial infarct; sickle cell anemia; lupus; false elvated - anemia |
| IL-3 |
interleukin 3; most important blood growth factor; stimulates blast forming units for erythrocytes |
| Erythropoietin |
glycoprotein that acts like a hormone; made in the kidney; the principle RBC regulator; is made in response to hypoxia |
| Corrected WBC count |
(uncorrected WBC#)/(100 + number of nucleated RBCs per 100 WBCs) X 100 |
| The Rule of 3 |
The RBC count (per cub. mm)X3 = hemoglobin (gm/dl)x3 = hematocrit (%) |
| Normal RBC range (women) |
4.0-5.5 million/cub mm |
| Normal RBC range (men) |
4.5-6.0 million/cub mm |
| Normal Hemoglobin range (women) |
12-16 gm/dl |
| Normal Hemoglobin range (men) |
16-20 gm/dl |
| Normal Hematocrit range (women) |
42(+/- 5)% |
| Normal Hematocrit range (men) |
47(+/- 5)% |
| Bone marrow sites (adults) |
upper sternum; posterior illiac crest; lumbar vertebrae (NOT long bones) |
| Bone marrow sites (children) |
tibia (there is still hematopoetic action in long bones in children) |
| MMM signs |
a chronic myeloproliferative; MMM has dacryocytes, and large platlets; MMM shows a leukoerythroblastic response (all cell lines are increased); BM biopsy usually has a dry tap |
| CML signs |
chronic mylogenous leukemia; BM is hypercellular; the only chronic myeloproliferative with the Philadelphia Chromosome; can have blast crisis stage (bruising, bleeding, weakness) |
| Heparin mode of action |
activates antithrombin - keeps thrombin from coagulating |
| EDTA mode of action |
chelates Calcium (used in the coag pathways) |
| Sodium citrate mode of action |
removes Calcium (used in coag pathway) |
| Poikilocytosis |
abnormal shape of RBCs |
| Anisocytosis |
abnormal size of RBCs |
| Aplasia |
low or no cellular development |
| Agranulocytosis |
failure bone marrow to make enough granulocytes (e.g. PMNs) |
| Polychromasia |
blue appearance of RBCs; indicates reticulocytes; generally larger |
| Neutrophilia can be caused by . . . |
infection, malignancy (like CML) |
| Signs of neutrophilia |
shift to the left; increased LAP score |
| What can be used for controls on a Coulter? |
patient samples that have been tested on another machine; these are only good for 24 hours |
| What should you do when your slide does not match the Coulter print out? |
check patient history; re run the sample on the Coulter; check for clots; verify it's the right slide; check for smudge cells (could be lymphs); call for a redraw; |
| Normal range for Platelets |
150-450 x10^9/L |
| Lymphocytosis caused by |
normal in children; viral infection (mononucleuosis, Epstein Barr); Pertussis infection; Acute Lymphoblastic Leukemia (ALL) |
| Reticulocytes contain what? How do they appear? |
contain meshwork of rRNA (this only stains with new Methylene blue); appear blueish and larger than normal RBCs |
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