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Phils Hemo RBCS
Phils Hemo
| Question | Answer |
|---|---|
| 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
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