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Hematology Tests 1-2

Hematology

QuestionAnswer
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 "<p>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
Created by: redavis2