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reticulocytes
SCC hematology 11-19
| Question | Answer |
|---|---|
| define polychromasia | RBCs (specifically retics) showing more than one Wright stain hue (microscopic). Bluish hue (tinge) to RBCs, indicating a retic cell |
| define supra-vital staining | staining of the formed elements (cells) while they are still living. Shift retics need 1-2 days than this would be seen as an increased polychromasia on blood smear. |
| define shift cells/reticulocytes | retics that are released from the bone marrow early |
| • List the maturation sequence of the RBCs (both nomenclatures) | Rubriblast, prorubricyte, rubricyte, metarubricyte, reticulocyte, mature RBC |
| • What is a reticulocyte? | it is the last immuture erythrocyte stage |
| where is the reticulocyte produced? | bone marrow |
| Where can reticulocytes be found in the body? | Bone marrow and the peripheral blood |
| What is maturation time of a reticulocyte, both in the bone marrow and the peripheral blood? | 2-3 days in bone marrow and 1-2 day(s) in peripheral blood |
| • What does a reticulocyte (retic) look like on a Wright's stained smear? | Polychromatic cell--showing purple hue with the salmon/red hue |
| • What kind of staining technique is used to perform manual reticulocyte counts? | supra vital staining |
| • What is the name of the most common stain used to perform manual reticulocyte counts? | new methylene blue |
| • What does a retic look like when stained with a supra-vital stain? What is it about the RBC that makes it stain this way? | stains blue/green becuz new methylene blue only contains one dye and it's the reticulum in the RBC that makes the cell stain the way it does. |
| • What is the clinical significance of the reticulocyte count? | Important: The reticulocyte count is an indication of how well the bone marrow is functioning. |
| • What is a normal adult reticulocyte % count? | 0.5-2.0 % |
| • What is the equation for calculating a reticulocyte count? | Calculation: % Retics = ( # retics/1000 RBCs)/10 |
| • How do you perform a manual reticulocyte count? | mix equally blood and stain, incubate for 3-10 mins at room temp. mix prep 2 wedge smears, count 1000 RBC's under oil, seperate counter retics too, internal quality check with 2nd tech values should be w/in 20% |
| • What are some clinical conditions in which a decreased retic count are associated? | If the patient is very anemic, or polycythemic. |
| • What are some clinical conditions in which an increased retic count can be associated? | low levels of Hematocrit |
| • What is an absolute reticulocyte count, how is it calculated, and what is the normal adult reference range? | Represents the actual number of retics in 1L of whole blood; calculate retics (%) x RBC/100 adult ref. range: 25-75 x 10▫9/L 0r 25,000-80,000/L retics |
| • What is a corrected reticulocyte count, how is it calculated, and what is the normal adult reference range? | Principle: In patient specimens with a decreased retic count the % of retics may be falsely elevated, b/c the whole blood has fewer RBCs. A correction factor is used, considering the average normal hematocrit to be 45%. hematocrit 35% = 2-3 % 25% = 3-5% |
| • What is the reticulocyte production index, how is it calculated, and what is the normal adult reference range? | when shift retics are released from the bone marrow too early, usually released to compensate for anemia taking 1+ days to mature which falsely elevates retic count |
| Reticulocyte production index compensate for shift retics what is the equation? | RPI= (%)reticulocyte x [Hct(%)/45] / correction factor |
| What is the adult reference range for RPI? | Adult reference range: adequate bone marrow response is indicated by a RPI >3; inadequate <2 (NO UNITS) |
| • What are some RBC inclusions that can be confused with retics on a supra-vitally stained smear? | Heinz bodies, Howell-Jolly bodies and pappenheimer bodies (iron frags in the mitochrondria) |
| • How can quality control be performed on manual reticulocyte counts? | By having one tech count one prepared slide and a 2nd count the other then compare and be within 20 % margin of error. |
| 12. What percentage of RBCs is replaced daily in a normal adult? | 1 % as is with all formed elements of the blood |
Created by:
nizhoni