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Phils Hemo RBCS

Phils Hemo

QuestionAnswer
This procedure involves a diluent-acetic acid (lyces RBCs); and is counted in a Neubauer hemacytometer Manual WBC count
This procedure involved packed red cell volume; values are slightly high than automated due to trapped plasma. Hematocrit
This procedure uses reagent-sodium dithionite. used as a screening test only confirmed via electrophoresis Solubility test for Hgb S
This procedure measures ability of RBCs to take up water without lysing osmotic fragility
This procedure measures the amounts of settling rbcs in a column in anticoag. whole blood. non specific indicator of inflamation ESR (Sed rate)
What are four sources of error for a manual Hct Tourniquet left on too long, excessive anticoag, hemolysis, poikilocytosis
What is the effect of leaving a tourniquet too long on a manual Hct increases value due to hemoconcentration
What is the effect of having excessive anticoag on a manual Hct decreased value due to shrinkage
What is the effect of hemolysis on a manual Hct decreased
What is the effect of poikilocytosis on a manual Hct increased due to trapped plasma
What are two sources of error for a manual retic inclusion bodies, refractive artifacts
What is the effect of inclusion bodies and refractive artifacts in a manual retic count increased
What is the effect on MCV due to changes at room temp Increases due to RBC swelling
What is the effect on Hct due to changes at room temp Increased due to MCV
What is the effect on MCHC due to changes in room temp decreased due to increased Hct
What is the effect on ESR due to changes in room temp Decreased due to swollen RBC
What is the effect on Osmotic fragility due to changes in room temp Increased
What is the effect on WBC count due to changes in room temp Decreased
What is the effect on WBC morphology due to change in room temp necrotic cells and vacuolization
What parameters are affected on a hematology analyzers if there is a WBC over 50000 Increases RBC, may increase hgb, hct, and indices inaccuracy
How can you resolve a WBC over 50000 for a hemo analyzer dilute blood and rerun. Substract WBC from RBC, perform spun Hct and recalculate indices
What parameters are affected on a hemo analyzer if there are cold agglutinins decreases RBC, increases MCV, MCH, MCHC, Hct inaccurate
What parameters are affected on a hemo analyzer if there are nucleated RBCs Increases WBCs
How can you resolve cold agglutinins for a hemo analyzer prewarm blood to 37 C and rerun
How could you resolve nucleated RBCx for a hemo analyzer Corrected WBC=uncorrected WBC X 100 / (100 + NRBCs/100 WBC)
What parameters are affected on a hemo analyzer if there are giant platelets decreased platelets and increased WBC
What can be done to resolve giant platelets for a hemo analyzer Examine blood film
What parameters are affected on a hemo analyzer if there is an old specimen increases mcv, decreases, plt, automated diff may be inaccuarte
How do you calculate Retic % Retics per 1000 RBC/10
How do you calculate Retic % using the miller disc Retics in square A X 100/Retics in square B X9
How do you calculate a corrected retic Count (CRC) Retic X (Hct %/48)
How do you calculate MCV (Hct X 10)/RBC
How do you calculate MCH (Hgb X 10/RBC)
How do you calculate MCHC (Hgb X 100)/Hct
What is the rule of threes RBC X 3= Hgb (+/- 5%) Hgb X 3= Hct (+/- 3%)
How do you calculate the corrected WBC (Uncorrected WBC X 100)/ 100+ nucleated RBC per 100 WBCs
Another name for a pronormoblast Rubriblast
Another name for a basophillic normoblast Prorubricyte
Another name for a polychromatic normoblast rubricyte
Another name for a orthochromatic normoblast Metarubricyte
Another name for a pholychromatophiic erythrocyte Reticulocyte
What are two asynchronous erythropoiesis megaloblastic and iron deficiency
This asynchronous erythropoiesis is characterized by nuclear maturation lags behind cytoplasmic maturation and cell grows larger without dividing Megaloblastic
This asynchronous erythropoiesis is characterized by cytoplasmic maturation that lags behind nuclear maturation due to deficiency of iron needed for hemoglobin synthesis Iron deficiency
What are three hemoglobin derivatives Methemoglobin, sulfhemoglobin, carboxyhemoglobin
This hemoglobin is caused by iron being oxidized to ferric (3+), usually acquired from exposures to oxidants and is rarely inherited methemoglobin
This hemoglobin is caused by sulfur bound to heme it is acquired from exposure to drugs and chemicals sulfhemoglobin
this hemoglobin is caused by carbon monoxide bound to heme carboxyhemoglobin
What is the effect of methemoglobin O2 cannot bind, cyanosis, and death (heinz bodies)
What is the affect of sulfhemoglobin O2 affinity is 1/100th normal, cyanosis, cannot be converted back to normal hemoglobin
What is the affect of carboxyhemoglobin reduced O2 to tissues and can be fatal
These are RBC fragments, helments, and triangular cells schistocytes
Fragmentation of RBCs, seen with DIC, hemolysis, artificial heart valves, burns, and hemolytic anemias all indicate what RBC abnormality schistocytes
These are crescent, S or C shaped or boat shaped Sickle cells
another name for drepanocytes is sickle cells
the presences of these may indicate sickle cell anemia sickle cells
these are blunt, rectangle, dark staining projections Hemoglobin C crystals
When hemoglobin C crystals are seen they may indicate hemoglobin C disease
These are tear drop shapped teardrop cells
Dacrocytes is another name for this cell teardrop cells
The presence of teardrop cells may indicate myelofibrosis and or anemias
This is characterized by central pallor greater than one third cell's diameter hypochromia
When is hypochromia seen IDA and thalassemia
This is characterized by a mixture of normochromic and hypochromic RBC anisochromia
When Is anisochromia seen dimorphic anemias and post transfusion
This is characterized by a variation in size Anisocytosis
When is anisocytosis seen anemias
This is characterized by RBC greater than 9 um macrocytes
These are most frequently seen in Vit B12 deficiency, folic acid deficiency, hemolytic anemia, cirrhosis, alcoholism and newborns Macrocytes
This is characterized by RBC less than 6 um Microcytes
Microcytes are normally seen in iron deficiency anemia and thalassemia
This is characterized by a variation in shape of rbc poikilocytosis
when is poikilocytosis seen many anemias
These rbcs are characterized with an oval or pencil shape elliptocytes/ovalocytes
When are elliptocytes and ovalocytes seen hereditary ovalcytosis and anemias
These RBC are characterized by a round cell with knobby uniform projections crenated RBCs
when are crenated RBCs seen in osmotic imbalance, in thin part of smear, due to anticoagulant or slow drying
These RBC are characterized by round cell with spiny unevenly spaced projections variable number in different fields Burr cells
Echniocytes are also known as Burr cells
these are often seen when there has been damage to the RBC membrane, uremia, carcinoma of stomach, bleeding peptic/gastric ulcers burr cells
These are characterized by shrunken cells with irregular spiny projections Acanthocytes
These are normally seen when there has been damage to the RBC membrane, alcoholic cirrhosis, post splenectomy, and abetalipoproteinemia ancanthocytes
this is characterized by a bluish gray color polychromasia
These are young RBC, reticulocytes with supravital stain, sign of active erythropoiesis, increased with acute blood loss, hemolytic anemia, following treatment for iron deficiency or pernicious anemia polychromasia
These rbc are characterized by a bull's eye or mexican hat cell target cells
another name for a targe cell is codocytes
these are seen a lot in hemoglobinopathies, thalassemia, alcoholism, post splenectomy target cells
These rbcs are characterized by a slitlike central pallor stomatocytes
These can be seen in hereditary spherocytosis, thalassemia, alcoholic cirrhosis, Rh null stomatocytes
These RBC are small dark staining with out central pallor spherocytes
These are often seen when the rbc membrane is damaged, autoantibodies, burns, hemoglobinopathies, hemolysis, ABO hemolytic disease of the newborn, incompatible transfusion spherocytes
These rbcs resemble stacks of coins rouleaux
this is seen when there is a serum protein abnormality, often in multiple myeloma and macroglobulinemia rouleaux
How does rouleaux impact the hemo analyzer it doesn't
These are RBCs in irregular clumps agglutination
these are often seen with autoantibodies or cold autoagglutinin agglutination
how does agglutination affect the hemo analyzer a lot
These inclusions are an aggregation of RNA (ribosomes) Basophilic stippling
These often appear as multiple irregular puple inclusions evenly distributed through the cell basophilic stippling
Basophilic stippling is usually associated with what conditions Toxic reactions, accelerated or abnormal hemoglobin synthesis, thalassemia
These inclusions are nuclear remnants (DNA) Howell Jolly Bodies
These often appear round, purple bodies, usually one per cell howell jolly bodies
Howell Jolly bodies are normally associated with what conditions Postsplenectomy, thalassemia, hemolytic and megaloblastic anemias, and sickle cell
These are due to faulty iron utilization Pappenheimer bodies (seen on wright stain)
These are small purplish-bluew granules, vary in size shape, and number, ually at periphery in clusters Pappenheimer body
Pappenheimer bodies are associated with what conditions sideroblastic anemias, postsplenectomy, thalassemia, sickle cell, hemochromatosis
These inclusions are normal during aging but pitted by the spleen Heinz Bodies
These are described as round blue inclusions, varying sizes, may be more than one heinz bodies
Heinz bodies are associated with what conditions G6PD deficiencies, unstable hemoglobin, chemical injury to RBC, drug induced hemolytic anemia
These are due to faulty iron utilization in hemoglobin synthesis siderotic granules seen in iron stain
These are blue granules of varying sizes and shapes siderotic granules
Siderotic granules are associated with what conditions sideroblastic anemia, post splenectomy, thalassemia, sickle cell, and hemochromatosis
MCV means Mean Corpuscular volume
What is the reference range for MCV 80-100
MCV is helpful in the classification of what Anemias
MCV <80 means Microcytic
MCV >100 means Macrocytic
MCV (80-100) means normocytic
Hct % X 10 / RBC is the calculation for MCV
This is the least useful of the indicies MCH
What does MCH stand for Mean corpuscular Hemoglobin
What is the reference range for MCH 27-31 pg
Hgb X 10 / RBC is the calculation for what MCH
MCHC means Mean corpuscular hemoglobin concentration
Hgb X 100/ Hct % is the calculation for MCHC
What is the normal range for MCHC 32-36 g/dL
MCHC of 32-36 means Normochromic
MCHC of <32 means Hypochromic
Higher levels of MCHC indicate what kind of problem Hyperlipidemia, cold agglutinin or instrument error
If Hgb is low what should be the next thing you look at MCV
MCV is high when? Macro/normo anemias, vit B 12 deficiency, folic acid deficiency, alcoholism, malignant growth, reticulocytosis
MCV is low when Iron deficiency anemia, chronic anemia, thalassemia
In bone marrow failure, metastatic malignancy, chronic renal disease and leukemia what will you see with the MCV MCV=normal but Retic=normal or decreased
In hemolytic anemia (r) MCV is MCV= normal Retic=increased
RDW means Red cell distribution width
This reflects the homogeneity or heterogeneity of the red cell size in a population RDW
RDW is associated with anisocytosis
What is the norm value for RDW 11-15%
increased RDW is acquired
Decreased RDW is hereditary
This measures the bone marrow's response to anemia Retic count
When is a Retic count helpful normocytic (normal MCV) anemias
What is the normal range for Retic count .5-2.0 %
this is a qualitative abnormality. Abnormality in amino acid sequence of globin chain but not in amount of globin produced hemoglobinopathy
This is a quantitative abnormality, amino acid sequence of globin chains is normal but there is underproduction of one or more globin chains thalassemia
Examples of hemoglobinopathy sickle cell anemia and trait, hemoglobin C disease
Exampls of thalassemia Beta thalassemia major and minor
This anemia is caused due to inadequate iron for Hgb synthesis Iron deficiency
This anemia is caused due to an enzymatic defect in heme synthesis sideroblastic
this anemia is due to defective iron utilization anemia of chronic diseases
this anemia is due to decreased production of beta chains (hetero) beta thalassemia minor
This anemia is classified as microcytic, hypochromic, with a normal Hb electro, increased RBC, increased RDW, Decreased serium iron, Increased TIBC, decreased ferritin Iron deficiency
This anemia is characterized as microcytic hypochromic, with a normal Hb electro, pappenheimer bodies, baso stippling, siderocytes, increased serum iron, decreased TIBC, increase serum ferritin, decreased retics Sideroblastic anemia
This anemia is usually normocytic normochromic witha normal Hb Electro, low serum iron, normal tIBC increased serum ferritin, decreased retics Anemia of chronic disease
This anemia is classified as microcytic hypochromic, with >90% HbA on hb Electro, normal serum iron TIBC, and RDW increased RBC beta thalassemia minor
This anemia is caused by decrease production of beta chains (homo) beta thalassemia major
This anemia is caused by a reduced intrinsic factor secondary to Gastric atrophy def. of vit B impairs DNA synthesis Pernious anemia
This anemia is caused due to the inheritance of S from both parents. Substitution of valine for glutamate in sixth position Sickle Cell anemia
This anemia is classified as microcytic, hypochromic, with up to 98% hb F in electro, MCV 50-60, retic 2-8% Beta thalassemia major
This anemia is classified as macrocytic, with a decrease of serum B12 and intrinsic factor pernious anemia
This anemia is classified as normocytic normochromic with >80% HbS on electro, a positive solubility test, retics 5-20% may have shift to left and throbocytosis sickle cell anemia
This anemia is caused by defects of the cell membrane hereditary spherocytosis
This anemia is caused by autoantibodies autoimmune hemolytic anemia
this anemia is normocytic, normochromic, increased MCHC, retics, indirect bili and osmotic fragility with a decrease in haptoglobin hereditary spherocytosis
This animal is normocytic, normochromic, with an increased retics, and indirect bilirubin, a decreased haptoglobin and positive DAT autoimmune hemolytic anemia
anemia due to blood loss with RBC-normo/normo WBCs-increased (left shift) Retics-increased within 3-5 days peaks at 10 H/H-steady within first few hours, full extent visible within 48 hrs Other-platelets increase within 1 hour and nRBCs may be relea Acute blood loss
Anemia due to blood loss with RBC-micro/hypo WBC-normal retics-normal H/H-decreased other-decreased serum iron and ferritin chronic blood loss
Created by: jnwells03