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