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PRACTICAL 1 MLT126
MLT 126: HEMATOLOGY AND COAGULATION
| Question | Answer |
|---|---|
| For an adult female, what is the reference range for a RBC count? | 4.0-5.4x10^6/microlitre |
| For an adult female, what is the reference range for Hct? | 37-47% |
| For an adult female under 50, what is the reference range for ESR? | less than or equal to 13mm |
| True or false: An adult male over 50 would have an ESR reference range of 20 or less mm | False; females over 50 have 20 or less mm |
| In adult males, (blank) would be the reference range for a Hgb test. | 13-18g/dL |
| In males under 50, what is the reference range for an ESR | 10 or less mm |
| Why would a reticulocyte count exceed 2% in a newborn? | they are engaged in more erythropoiesis |
| Less than 2% is the average reference range for what kind of test? | Reticulocyte count |
| What is the reference range for an adult male Hct? | 42-52% |
| 11-16g/dL is the reference range for an adult female's | Hgb |
| What would the MCV range be to classify a microcytic cell? | less than 80 fl |
| What range would classify Normochromic cells? | 32-36% |
| Microcytic hyperchromic cells would have MCV and MCHC ranges of... | less than 80fl and more than 36% |
| What causes normocytic, normochromic anemias to occur | Improper (hypo) proliferation of erythrocytes in the bone marrow, likely due to chronic illness, bone marrow disorder, or early on iron deficiency anemia |
| Discocyte= | RBC (normal) |
| When would polychromatophilia be seen in a peripheral blood smear? | When a patient's blood is attempting to regenerate quickly |
| The presence of blister cells would indicate towards what kind of anemia? | Heinz-bodies mediated (microangiopathic) hemolysis (mechanical RBC trauma) |
| True or False; You can preserve an unstained peripheral blood smear that cannot be stained immediately | True; you can allow it to dry and store at room temperature |
| What is the purpose of the polychromatic Wright stain? | The methylene blue, azure blue, and eosin pink are combined to isolate blood cell components based on their pH requirements |
| What is the sequence of a proper Wright stain? | 1) Wright stain = 2min 2) Buffer = 4mins, followed by a 30 sec water rinse 3) Alcohol on back 4) Let it dry at room temperature |
| What is the main method of hemoglobin analysis, and what is the principle? | photometry via microcuvette; the RBCs membrane is disintegrated by sodium deoxycholate, allowing the Hgb to be released |
| How does RBC size affect ESR results? | the formation of a rouleaux increase RBC mass, increasing the ESR |
| How can RBC shape affect an ESR result? | lack of rouleaux formation will decrease the ESR |
| What is the principle of the ESR analysis? | Utilizing the Westgard method, ESR measures the settling of RBCs in diluted human plasma over a 60min period of time |
| True or false: ESR is inversely proportional to plasma viscosity | True |
| If whole blood in a lavender tube is refrigerated, when should the test be performed | within 6 hours |
| Blood in an EDTA should be no more than (blank) old for an ESR test | 2 hours old |
| What is an ESR test used for? | Diagnostic screening, particularly to view inflammatory conditions in the body |
| How can plasma affect an ESR result? | increased fibrinogen and immunoglobulin levels will result in rouleaux, causing an increase |
| Why would aplastic anemia cause a high reticulocyte count? | ineffective erythropoiesis |
| Why is timing of specimen usage important for reticulocyte counts? | The blood cells need to be living still for an accurate assessment of their erythropoietic capabilities/ current RBC morphology. The retics can also mature to RBCs in the tube (8hrs<), which can lead to falsely lowered results |
| Why must a corrected reticulocyte count be done? | anemia causes inaccurate reading of RBC population; it is done to not overestimate bone marrow production |
| What is the average Hct of an adult male? | 45% |
| What is the average Hct of an adult female? | 42% |
| How is the regular % or reticulocytes calculated? | # retics x 100/1000 RBCs |
| How is a corrected reticulocyte count calculated? | retic % times patient's Hct/average normal Hct |
| What is the principle of a reticulocyte count? | Analyze the erythropoietic activity of a patient's bone marrow based on the amount of immature RBCs in the peripheral blood; uses a suprvital stain to view cells still possessing RNA (reticulocytes) |
| What is the principle of the sickle cell solubity test? What follow-up testing must be done if the test is positive? | Qualitative test that determines the presence of Hgb S, which is present in high qualities for Sickle Cell Anemia; positive result means there needs to be a Hgb electrophoresis follow-up to confirm |
| Describe how iron deficiency affects oxygen capacity | Whether its due to dietary insufficiency or blood loss, a lack of iron means not enough of heme is formed when the iron binds to protoporphyrin. this causes microcytic, hypochromic cells |
| Why might a high retic count be indicative of Hemolytic anemia? | The bone marrow is attempting to overcompensate for blood loss or lack of RBCs |
| Why would you see schistocytes and bite cells in a hemolytic anemia peripheral blood smear? | Both are results of RBCs undergoing phagocytic activity |
| Typically, someone with a lowered reticulocyte count could have Normocytic anemia. Why is that? | The bone marrow is experiencing erythropoietic production issues |
| Why would Howell-Jolly bodies be present in a peripheral blood smear | The spleen is unable to properly filter out RBCs that still contain nuclear fragments/DNA |
| Pappenheimer bodies are aggregates of mitochondria, ribosomes, and ferritin iron that can be seen in which kind of anemia? | Hemolytic anemia |
| Heinz bodies are precipitated, denatured Hgb often found in congenital (blank) anemia | Hemolytic |
| What RBC inclusions can be seen in pernicious anemia? | cabot rings, howell-jolly bodies, basophillic stippling |
| When centrifuging an EDTA sample for hematocrit testing, you must place which end of the capillary tube towards the outside of the centrifuge? | sealed clay side |
| For adults under 50, male or female, what is the reference ESR range | 13 or less |
| Adult male reference range for RBC count | 4.5-6.1x10^6microlitres |
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innazukaa
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