Automated Blood Cell Analysis Overview
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Questions and Answers

What effect does protein buildup have on the orifice diameter in earlier systems?

  • It increases the orifice diameter.
  • It decreases the orifice diameter. (correct)
  • It has no effect on the orifice diameter.
  • It intermittently alters the orifice diameter.

What is a negative consequence of protein buildup in cell counting systems?

  • It enhances cell counts.
  • It improves electrical resistance.
  • It stabilizes the flow of cells.
  • It leads to falsely elevated cell volumes. (correct)

What was a requirement for older impedance instruments that is now mitigated in current designs?

  • Regular software updates.
  • Manual cleaning of apertures. (correct)
  • Connection to external power sources.
  • Calibration before each use.

What does coincident passage of multiple cells through the orifice cause?

<p>Artificially large pulses. (B)</p> Signup and view all the answers

What is one way that modern impedance instruments minimize carryover of cells from one sample to another?

<p>Incorporating burn circuits. (D)</p> Signup and view all the answers

How does increased electrical resistance affect cell flow in older systems?

<p>It slows down the flow of cells. (A)</p> Signup and view all the answers

What can falsely decreased cell counts result from?

<p>Coincident passage loss. (A)</p> Signup and view all the answers

What internal feature do current impedance instruments utilize to combat protein buildup?

<p>Burn circuits. (B)</p> Signup and view all the answers

What does side scatter primarily correlate with in terms of cellular analysis?

<p>The degree of internal complexity (C)</p> Signup and view all the answers

Which angle range is associated with forward high-angle scatter?

<p>5 to 15 degrees (C)</p> Signup and view all the answers

Which of the following is NOT a capability of larger flow cytometers?

<p>Basic sample analysis (D)</p> Signup and view all the answers

What does differential scatter primarily combine?

<p>Low-angle scatter and high-angle forward light scatter (D)</p> Signup and view all the answers

How are scatter properties typically visualized in flow cytometry analysis?

<p>Via two-dimensional cytograms or scatterplots (D)</p> Signup and view all the answers

What is a key role of computer software in flow cytometers?

<p>Providing automatic start-up and shutdown functions (D)</p> Signup and view all the answers

Which factor varies the most regarding specimen handling in flow cytometers?

<p>The type of cytometer used (A)</p> Signup and view all the answers

What type of data can be extracted from the cytograms generated by flow cytometers?

<p>Quantitative and qualitative information (D)</p> Signup and view all the answers

What is the primary function of Beckman Coulter's rotated light scatter detection algorithms?

<p>To separate cells with similar volume but different scatter characteristics. (D)</p> Signup and view all the answers

Which measurement is primarily used to initially separate nucleated RBCs from WBCs in the UniCel DxH 800?

<p>Axial light loss (AL2) (C)</p> Signup and view all the answers

How does the UniCel DxH 800 identify and count nucleated RBCs?

<p>Through algorithms applied to data collected from multiple light scatter measurements. (C)</p> Signup and view all the answers

What is the role of the watershed concept in the UniCel DxH 800's operation?

<p>To search for established populations and aid in determining counts. (A)</p> Signup and view all the answers

What does the combination of technologies in the UniCel DxH 800 primarily aim to achieve?

<p>To provide a three-dimensional cytograph of WBC populations. (C)</p> Signup and view all the answers

Which parameter is NOT one of the scatter measurements used by the UniCel DxH 800?

<p>Capillary light absorption (CLA) (D)</p> Signup and view all the answers

Which company manufactures the comprehensive line of hematology analyzers including the UniCel DxH 800?

<p>Beckman Coulter (C)</p> Signup and view all the answers

What does the term 'data transformation' refer to in the context of the UniCel DxH 800?

<p>Applying algorithms to separate and count cell populations. (D)</p> Signup and view all the answers

What is the percentage of lymphocytes (LY) in the suspected lymphocytosis case?

<p>51.3% (B)</p> Signup and view all the answers

Which blood component shows an abnormal distribution in the suspected case?

<p>Red Blood Cells (RBC) (D)</p> Signup and view all the answers

What is the White Blood Cell (WBC) count in the normal distribution sample?

<p>4.3 (A)</p> Signup and view all the answers

Which parameter indicates a possible anemia condition based on HGB values?

<p>HGB 10.6 (A)</p> Signup and view all the answers

What is the MCV value in the suspected abnormal distribution case?

<p>80.6 (D)</p> Signup and view all the answers

Which white blood cell type has the lowest percentage in the normal case?

<p>Eosinophils (B)</p> Signup and view all the answers

What does an RDW of 19.9 suggest in the suspected case?

<p>High variability in red cell size (D)</p> Signup and view all the answers

How does the platelet count (PLT) in the suspected case compare to the normal range?

<p>Normal (A)</p> Signup and view all the answers

What does the WBC data correlate with in the Sapphire printout?

<p>Differential count data (B)</p> Signup and view all the answers

What technique does the Sapphire use to measure different cell populations?

<p>Computerized cluster analysis (B)</p> Signup and view all the answers

Which additional information is displayed under CBC data according to the Sapphire printout?

<p>Nucleated RBC and reticulocyte data (D)</p> Signup and view all the answers

What is the primary purpose of the tungsten-halogen darkfield optics system in the Sapphire?

<p>To measure absorbance (C)</p> Signup and view all the answers

What happens if significant interference occurs in the WBC-BASO count?

<p>The instrument substitutes the WBC-PEROX value (B)</p> Signup and view all the answers

Which types of cell populations are classified by the computerized cluster analysis in the Sapphire?

<p>Both normal and abnormal clusters (A)</p> Signup and view all the answers

In the Sapphire system, which scatter measurements are plotted for WBCs?

<p>7-degree versus 90-degree and 0-degree versus 90-degree depolarized scatter (C)</p> Signup and view all the answers

What is the significance of the dark precipitate noted in the Sapphire report?

<p>It signifies the presence of peroxidase-containing cells (C)</p> Signup and view all the answers

What cellular components are indicated to fall below the basophils in a blood analysis?

<p>Reactive lymphocytes (B)</p> Signup and view all the answers

Which of the following indicators reflects a lack of distinct separation in WBC clusters?

<p>WBC immaturity (B)</p> Signup and view all the answers

In the provided blood analysis, what is the MCV value reported?

<p>84.7 fL (C)</p> Signup and view all the answers

Which type of cells uniquely cluster below the mononuclear cells in a blood smear analysis?

<p>Blast cells (B)</p> Signup and view all the answers

What is indicated by the presence of NRBC in the provided blood test?

<p>Presence of nucleated red blood cells (B)</p> Signup and view all the answers

What does an increased RDW value suggest about red blood cell populations?

<p>Anisocytosis or variation in RBC size (D)</p> Signup and view all the answers

Which of the following parameters shows a high value in the blood analysis provided?

<p>WBC at 8.62 X103 cells/!L (B)</p> Signup and view all the answers

What does the high value of Retic at 2.13 % suggest about the bone marrow activity?

<p>Increased rate of reticulocyte production (C)</p> Signup and view all the answers

What does the value of MCH indicate in the blood analysis?

<p>Mean corpuscular hemoglobin content per cell (B)</p> Signup and view all the answers

What aspect of the blood analysis is indicated by the high value of MPV at 9.4 fL?

<p>Increased number of large platelets (C)</p> Signup and view all the answers

Flashcards

Protein buildup effect

Protein accumulation decreases orifice diameter, slows cell flow, and increases electrical resistance, leading to lower cell counts and falsely elevated cell volumes.

Coulter principle

A method of cell counting based on the detection of changes in electrical resistance as cells pass through a small aperture.

Cell counting instruments

Devices that measure changes in electrical impedance to count cells.

Aperture cleaning

Process of removing protein buildup to maintain accurate cell counting.

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Coincident passage loss

More than one cell passing through the aperture at the same time, leading to inaccurate cell counts.

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Falsely increased cell volumes

Inaccurate reading when cells pass through the aperture too fast.

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Internal cleaning systems

Automated features in cell counters that prevent protein buildup, thus improving accuracy and preventing carryover.

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Falsely decreased cell counts

Inaccurate counting due to coincident passage of multiple cells simultaneously through the counting aperture.

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Light scatter in flow cytometry

Light scattering from cells, providing information about cell size, internal complexity, and refractive index.

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Orthogonal light scatter

Light scatter at 90 degrees, reflecting light from larger cell structures, correlating with cell complexity.

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Forward low-angle scatter

Light scatter at 2-3 degrees, which relates to cell volume and refractive index.

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Forward high-angle scatter

Light scatter at 5-15 degrees, also related to cell volume and refractive index.

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Differential scatter

Combining low- and high-angle forward light scatter, primarily used in some flow cytometers.

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Cytograms/Scatterplots

Visual representations generated by plotting scatter properties at different angles, useful in interpreting flow cytometry results.

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Flow cytometer variability

Flow cytometers vary in design, automation level, and computer functionalities.

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Specimen handling in flow cytometry

Specimen preparation procedures for flow cytometry are instrument dependent, ranging from manual to fully automated systems.

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Lymphocytosis

An increase in the number of lymphocytes (a type of white blood cell) in the blood.

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WBC 9.0

A total white blood cell count of 9.0.

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LY% 51.3

Lymphocytes represent 51.3% of the total white blood cells, a key diagnostic marker.

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RBC 3.98

Red blood cell count of 3.98.

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Hgb 12.9

Hemoglobin concentration of 12.9.

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Hct 37

Hematocrit value of 37%.

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RDW 19.9

Red blood cell distribution width of 19.9%.

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Platelet count 418

Platelet count of 418.

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Rotated Light Scatter Detection

A technique used in hematology analyzers to separate cells based on their light scattering characteristics at different angles. This helps identify cells with similar volumes but different internal structures.

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Axial Light Loss (AL2)

A measure of light absorption as it passes through a cell in a flow cytometer. It helps differentiate cells based on their size and internal complexity.

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Low-Angle Light Scatter (LALS)

A measurement of light scattering at a small angle, reflecting the cell's overall size and granularity.

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Median-Angle Light Scatter (MALS)

A measurement of light scattering at a medium angle, primarily related to cell granularity or internal complexity.

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Upper-Median Angle Light Scatter (UMALS)

A measurement of light scattering at a higher angle, reflecting the cell's surface characteristics and potential irregularities.

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Nucleated RBCs

Red blood cells with a nucleus, identified and counted separately in a complete blood count (CBC) analysis.

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Watershed Concept

A method used in cell analysis to identify and separate different populations of cells based on their unique scattering characteristics.

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Cytograph

A three-dimensional representation of cell populations generated by a flow cytometer, displaying different cell types based on their scattering characteristics.

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WBC-BASO

A channel in the CELL-DYN Sapphire that measures the number of white blood cells based on their basophilic properties (e.g., staining characteristics).

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WBC-PEROX

A channel in the CELL-DYN Sapphire that measures the number of white blood cells based on their peroxidase activity (e.g., enzyme activity).

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Internal Check

The WBC-PEROX channel provides a measure of the white blood cell count that is independent of the WBC-BASO channel. This allows for a comparison and validation of the results.

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Interference

When the WBC-BASO channel is significantly affected by factors that interfere with the detection of white blood cells (e.g., protein buildup), the instrument uses the WBC-PEROX channel as a substitute to provide a more accurate count.

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Cluster Analysis

A computerized method used in the CELL-DYN Sapphire to identify and classify different populations of cells, including abnormal cells.

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Platelet Clumps

Groups of platelets that stick together, potentially affecting the accuracy of platelet counts. Cluster analysis helps differentiate these clumps from individual platelets.

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Scattergrams

Visual representations of cell populations based on their size, granularity, and other properties. They are used to differentiate between different types of cells, including normal and abnormal cells.

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What is the relationship between WBC immaturity and cell cluster separation?

A lack of distinct separation between the segmented and mononuclear cell clusters on a hematology analyzer indicates WBC immaturity. This means there are immature white blood cells present in the blood sample.

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What are blasts?

Blasts are immature white blood cells that are typically found in the bone marrow. Their presence in the blood can indicate a serious condition, such as leukemia.

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How are blasts represented on a hematology analyzer?

Blasts uniquely cluster below the mononuclear cell cluster on a hematology analyzer. This distinct location helps identify their presence.

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What are reactive lymphocytes?

Reactive lymphocytes are mature lymphocytes that have been activated in response to an infection or other stimulus. They are larger than normal lymphocytes and have a more prominent nucleus.

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What is a left shift?

A left shift refers to an increase in the number of immature neutrophils (bands) in the blood. It suggests an active infection or inflammation.

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What is a segmented cell?

A segmented cell is a mature neutrophil, characterized by a nucleus with multiple lobes or segments.

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What are mononuclear cells?

Mononuclear cells are a type of white blood cell with a single nucleus. This includes monocytes and lymphocytes.

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What are nucleated red blood cells (NRBCs)?

Nucleated red blood cells (NRBCs) are immature red blood cells that still contain a nucleus. Their presence in the blood can indicate a problem with bone marrow function.

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What are large platelets or platelet clumps?

Large platelets or platelet clumps suggest platelet activation or abnormal platelet production. They can contribute to bleeding or clotting problems.

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What are morphology flags?

Morphology flags are indicators on a hematology analyzer that highlight abnormal or unusual features in blood cells, suggesting potential problems.

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Study Notes

Automated Blood Cell Analysis

  • Automated blood cell analysis has replaced manual methods for accuracy and precision, except in phase platelet counting.
  • Analyzers are marketed by various manufacturers, providing eight standard hematology parameters (complete blood count [CBC]) plus differential counts in less than a minute.
  • Automation provides efficient workload management and aids timely diagnosis.
  • Automated cell analysis primarily relies on two principles: electronic impedance and optical scatter.

General Principles

  • Electronic Impedance: Low-voltage direct current (DC) resistance is measured as cells pass through a small aperture, generating voltage pulses proportional to the cell volume.
  • Optical Scatter: Uses laser or non-laser light to analyze cell volume, internal complexity (refractive index or hemoglobin concentration), and other characteristics. Forward scatter relates to volume, while side scatter relates to internal complexity.

Principal Instruments

  • Beckman Coulter: Uses impedance and multiple light-scatter angles (volume, conductivity).
  • Sysmex: Employs impedance and radiofrequency (RF) resistance, including multiple angle light scatter analysis for differential counting.
  • Abbott: Relies on optical scatter (primary measurement) and impedance (secondary measurement) for counting cells.
  • Siemens: Employs a combination of techniques like light scatter and absorption for measuring cell properties.

Automated Reticulocyte Counting

  • Manual reticulocyte counting is inaccurate and imprecise.
  • Automation uses flow cytometry (fluorescent/light scatter).
  • Automated methods improve precision, allowing for improved anemia diagnosis and monitoring.
  • Multiple parameters, such as reticulocyte hemoglobin content (CHr) and immature reticulocyte fraction (IRF), quantify different reticulocyte stages.

Limitations and Interferences

  • Specimen Limitations: Cold agglutinins, icterus, and lipemia can interfere with certain measurements.
  • Instrument Limitations: Methodology limitations may cause errors, like miscounting cell fragments as platelets. Errors in lysis and shrinkage of cellular components due to specimen age are common problems.
  • Analyzers may flag errors due to interferences and specimen limitations.
  • Calibration is critical in automated blood cell analysis. Calibration standards and procedures are crucial to ensure accuracy.

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Automated Blood Cell Analysis PDF

Description

This quiz covers the principles and procedures of automated blood cell analysis, highlighting its advantages over manual methods. Participants will learn about the mechanisms such as electronic impedance and optical scatter that are crucial for accurate hematology parameters. Gain insight into how automation enhances workload management and supports timely diagnosis.

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