MLT 2.1 HematologyTerms and definitions 07010
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| Hematology | The study of blood
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| Universal Precautions (Standard) | Method for controlling infection in which all blood and certain body fluids are treated as if infectious.
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| Blood-borne Pathogen | pathogenic microorganisms that are present in human blood and can cause disease in humans. These pathogens include, but are not limited to, hepatitis B virus (HBV) and human immunodeficiency virus (HIV).
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| Venipuncture | process of obtaining a sample of venous blood
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| Erythrocytes | A cell that contains hemoglobin and can carry oxygen to the body. Also called a red blood cell (RBC)
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| Leukocytes | A cell that lacks hemoglobin, has a nucleus, is capable of motility, and defends the body against infection and disease by ingesting foreign materials and cellular debris, by destroying infectious agents or by producing antibodies
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| Thrombocytes | A platelet. Crucial to normal blood clotting
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| Plasma | liquid component of blood that still contains fibrinogen
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| Serum | Liquid component of blood when fibrinogen is allowed to clot into fibrin
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| Fibrinogen | Protein converted into fibrin to form blood clots; produced in liver & circulates in teh plasma
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| Anti-coagulant | Prevents clots from forming in blood
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| Hemolysis | Alteration or destruction of RBC's
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| Hemoconcentration | high amount of RBC's in realtion to plasma
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| Hematoma | Local mass of blood within organ or tissue
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| Immunocompromised | Person can't fight off infection; Having an immune system that has been impaired by disease or treatment.
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| Peripheral Blood Smear | a blood test that gives information about the number and shape of blood cells.
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| Polychromatic Stain | Stain that produces many colors when seen under a microscope
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| Phagocytosis | Ingestion and digestion of solid substances
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| Colony Stimulating Factor | Hormorne that stimulates cell development and deiiferentation
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| Antibody | "imunoglobin"; Substance that binds with antigen
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| Antigen | Foreign matter that enters body
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| Hematopoiesis | Process of maturation and development of blood cells
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| Lysosomes | contain hydrolytic enzymes necessary for intracellular digestion
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| Ribosomes | Cell organelle responsible for protein systhesis
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| Granulocytes | ype of white blood cell filled with microscopic granules
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| Precursor Cells | Cells that give rise to other cells
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| Blood and body fluids are considered potentially infectious for: | 1. HIV; 2. HBV; 3. Other blood borne pathogens
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| The single most important source of infection | BLOOD
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| Universal presautions protects: | 1. Non-intact skin; 2. Mucus Membranes
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| The single most important step to prevent the spread of disease | HANDWASHING
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| The study of blood | Hematology
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| total adult volume of blood | 5-6 liters; 7-8% of body weight
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| blood composed of: | 1. Formed elements; 2. Fluid protein
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| Formed elements of blood | 1. Erythrocytes- contain Hgb; 2. Leukocyte- Defend agains tviral and bacterial infections; 3. Thrombocyte- function in blood clot formation
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| Fluid portion of blood | 1. Plasma- contains fibrinogen; 2. Serum- contains no fibrinogen (used to form clot)
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| Anticoagulants | Prevent blood from clotting; Binds or inactivates coagulation factors
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| Lavender/Purple Top | Contains EDTA (liquid or powder form); Chelates the calcium in blood ( forms an insoluble)
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| Lavender/Purple Top | Preserves blood morphology; Choice fro routine hematology; Amount of EDTA is important
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| Excess EDTA | Shrinkage of RBC's; Decreased hematocrit; Decreased ESR; Degenerated WBC; Increase MCHC; Platelet swell and break up causing an increased count
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| In lavender/Purple top test must be performed within how mant hours of collection | 2 Hours; After 6 hours RBC's swell and WBC's show vacuolization and pyknotic nucleus (dark RBC nucleus)
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| Blue Top | Containd Sodium CItrate 9:1; Choice for caogulation studies; Maintains stability of the coagulation factors ( Factor V- Proaccelerin, Factor VIII- Antihemophilic A)
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| Blue Top | Maintains functional abilities of platelets: ( Used for CBC if platelet clumps in EDTA tube; Adjust the count by 10 percent to account for the dilution); Spin ad separate plasme within 30 minutes of collection
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| Blue top | Test plasma within 2 hours of collection otherwise freeze or refrigerate; 9:1 Ratio is critical (no short draws)
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| Adjusting anti-coagulant in blue top | Adjust amount of anticaogulant on patients with HCT above 55% ( high HCT means less plasma, less plasma needs less anticoagulant); citrate= (100 -HCT/595 -HCT) x amt of blood
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| Green Top | Contains heparin; Prevents coagulation by: 1. Interacting with anti-thrombin, 2. Inhibiting thrombin; Causes WBC and platelet clumping; Used in special hematology and chemistry
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| Gray Top | Contains( 1.Sodium Fluorde- preserves glucose and alcohol, 2. Potassium Oxalate- anticoagulant, binds calcium); For glucose and alcohol testing
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| Red Top | Contains no anticaogulant; Used for most chemistry tests
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| Tiger Top | aka " Marble top"; COntains no anticoagulant; Has silica gel at the bottom for serum and clot separation
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| Order of filling tubes | 1. Sterile specimens, 2. Non- anticoagulated tubes ( red, Tiger), 3. Blue top, 4. Green top, 5. Purplr top, 6. Gray top
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| 2 methods of venipuncture | 1. Vacutainer, 2. Syringe
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| Three main venipuncture sites | 1. Median Cubital- generally anchored, doesn't roll, most prefered site; 2. Basilic Vein- Lacated at inner portion of arm, tends to roll; 3. Cephalic Vein- located on outer portion of arm, skin tends to be a little tougher
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| Alternative venipuncture sites | 1..Veins of the forearm, 2. Hands, 3. Outside the wrist
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| Vacutainer method- sites and veins to avoid | Inside of wrist, Feet or legs of non ambulatory patients (poor blood circulation, may lead to clots), Patients with IV or hep-lock (use opposite arm), Patients with mastectomy (draw from opposite side), NEVER stick a patient more than twice
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| Syringe Method- used for | Small fragile veins, Veins that collasp easily, Veins than can not withstand pressure of vacutainer tubes, Collection of blood culture and blood specimens
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| Needles to use | Vacutainer Method- use multi sample needle (normal size vein, veins with good integrity); Syringe method- use 21-23 gauge needle and 10-20 cc syringe (large syringe creates more vacuum
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| Capillary collection- aka "micro sampling" | Used in infants < 6 months old, young kids and adults (Only microsample is needed, patients with IV's, severely burned, extremely poor veins
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| Capillary puncture sites | neonates/infants- Heel (never puncture curvature of heel, puncture depth no more than 1.6mm); Kids and adults- 3rd or 4th finger (off center of finger tip)
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| Types of Isolation | Strict, Enteric, Wound, Respiratory, Protective
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| Strict Isolation | Protect phlebotamist, Used in contagious diseases transmitted via (direct contact, Air); ex. Meningococcal meningitis, Active TB, Rabies, Diphtheria, Viral encephalitis, Polio, Measles and mumps, Smallpox
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| Enteric Isolation | COntact with dysentery patients; ex. Slamonella E. Colli, Parasitic infection, Fungal infection
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| Respiratory Isolation | Infections transmitted vua airborne droplets; Ex. Tularemia, Legionella, TB, Whooping Cough
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| Protective Isolation | To protect the Immuno-compromised patient from infection; ex. Burn Patients, Leukemia and AIDS, Radiation, Plastic Surgery, Organ Transplant
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| Wound Isolation | Used in open lesions and skin infections
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| Peripheral Smear (purpose) | Examine cells under microscope; Test is called "WBC Differential" (different types of WBC's, RBC morphology, platelet estimate)
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| Qualities of a good smear | Feathered edge with rainbow appearance, Free of holes, ridges, and waves
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| Staining blood smear | Use Wright Stain- Polychromatic, imparts multiple colors; composed of 1. Methylene Blue, 2. eosin Y, 3. Dissolved in Methanol
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| Methylene Blue | Stains acid components of cell shades of purple or blue; Called "Basic Dye"
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| Eosin Dye | Stains the basic components of the cell orange or red; Called "Acidic Dye"
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| Principle of Wright Stain | Neutral components of the cell take up both dyes and will stain a pink color; Phosphate buffer wirh pH 6.4-6.7 is added to stain for ionization ( actual staining occurs in ionization)
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| Qualities of properly stained slide | RBC's-pink; Reticulocytes- Pinkish gray; Nucleus in lymphocytes and neutrophils- Dark purple; Eosinophils- bright orange granules; Basophils- dark blue-black granules; Monocyte cytoplasm- blue-gray; Neutrophil cytoplasm- light pink
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