Body Fluid Counts and Differentials Quiz

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Questions and Answers

What should be done if deterioration of the Sysmex XN Check BF control is suspected?

  • Call the Sysmex Technical Assistance Center and inform the department supervisor. (correct)
  • Discard the control vial immediately without further checks.
  • Store the control at room temperature to prevent further damage.
  • Continue using the control until results are received.

Which of the following is NOT a recommended practice for the Sysmex XN Check BF controls?

  • Storing the controls in frozen conditions. (correct)
  • Using controls only within their expected assay ranges.
  • Maintaining the recommended temperature range for storage.
  • Discarding vials confirmed to be damaged.

What action should be taken if a control vial of Quantimetrix Spinalscopics shows signs of microbial contamination?

  • Notify the supervisor but continue using the vial.
  • Use the vial after sterilizing it.
  • Retest the control before deciding on discarding it.
  • Discard the control vial immediately. (correct)

What is indicated by the mean of a control result being outside the expected assay ranges?

<p>Deterioration of the control may be suspected. (B)</p> Signup and view all the answers

Which of the following statements about automated and manual fluid control levels is correct?

<p>Levels 1 and 2 are available for both Sysmex XN and Quantimetrix. (C)</p> Signup and view all the answers

What is the effective date of the current version 8.0 of the Body Fluid Counts and Differentials procedure?

<p>6/12/2024 (C)</p> Signup and view all the answers

Which of the following steps is NOT included in routine body fluid analysis?

<p>Bacterial culture (C)</p> Signup and view all the answers

What must be used if similar results are not produced when running specimens in duplicate?

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

What is the status of version 7.0 of the procedure?

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

For which type of analysis are validated fluid sample types analyzed on Sysmex XN Hematology analyzers?

<p>Total WBC and RBC counts (B)</p> Signup and view all the answers

Which device is utilized for manual counts of lower cell counts?

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

What type of staining is used for manual differential counts?

<p>Wright's staining (A)</p> Signup and view all the answers

Which of the following represents the timeline for version 8.0?

<p>Approved now, Effective later (C)</p> Signup and view all the answers

When performing a 100 cell differential, what should you do if it is not possible?

<p>Set count to a lesser number under ‘Set Count’. (D)</p> Signup and view all the answers

What is the primary function of the MEM in reporting results?

<p>To record body fluid counts. (B)</p> Signup and view all the answers

What is required for slides showing abnormal results?

<p>They must be reviewed by a pathologist. (B)</p> Signup and view all the answers

What is indicated if results are abnormal or concerning during reporting?

<p>Delivery and/or call to the pathologist is required for immediate review. (D)</p> Signup and view all the answers

What fluid types are mentioned that might require a differential count?

<p>CSF and synovial fluid. (A)</p> Signup and view all the answers

What should be done with the Path Review form after completion?

<p>It must be submitted for review. (A)</p> Signup and view all the answers

What action is NOT recommended before completing a fluid differential?

<p>Change the fluid type mid-test. (B)</p> Signup and view all the answers

What is the first step in performing a 100 cell differential?

<p>Select the type of fluid on the GUI keyboard. (B)</p> Signup and view all the answers

What is the depth of the cell counting chamber in a hemacytometer?

<p>0.100 mm (B)</p> Signup and view all the answers

What is the volume of the sample chamber in a hemacytometer?

<p>0.1 Microliter (C)</p> Signup and view all the answers

Which ruling pattern is used in the metallized hemacytometer?

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

How many small squares are in each group within the hemacytometer's central square millimeter?

<p>16 (A)</p> Signup and view all the answers

What is the total area covered by the rulings in a hemacytometer?

<p>9 square millimeters (D)</p> Signup and view all the answers

Which of the following descriptions correctly identifies the groups in the hemacytometer's ruling?

<p>The middle line of the triple lines acts as a boundary. (B)</p> Signup and view all the answers

What is indicated by the ruling lines in a hemacytometer?

<p>The volume for each small square (C)</p> Signup and view all the answers

When does the specified version of the Body Fluid Counts and Differentials procedures become effective?

<p>6/12/2024 (D)</p> Signup and view all the answers

What is the minimum number of white cells required in CSF to prepare a cytosmear slide?

<p>5 white cells (A)</p> Signup and view all the answers

What type of stain is used for staining the slide after smear preparation?

<p>Wright's stain (C)</p> Signup and view all the answers

Which fluid appearance requires using 1-3 drops for slide preparation?

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

When preparing a cytosmear slide, what is added to the sample chamber to potentially reduce cell distortion?

<p>22% bovine serum albumin (C)</p> Signup and view all the answers

At what relative centrifugal force (RCF) should the cytocentrifuge be set for processing the fluid?

<p>1500 RCF (B)</p> Signup and view all the answers

What should be labeled on the cytosmear slide?

<p>Patient name, accession number, date, and tech code (A)</p> Signup and view all the answers

If the fluid is bloody, how should it be diluted for slide preparation?

<p>1:5 saline dilution (B)</p> Signup and view all the answers

What action must be taken with the sample chamber after it is filled?

<p>Cap the chamber and place in cytopsin (B)</p> Signup and view all the answers

Which of the following fluid types is classified under the LIS code 'PTDFL'?

<p>Peritoneal Dialysis (C)</p> Signup and view all the answers

What is the LIS code for colorless fluids?

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

Which site is responsible for all fluid types according to the provided content?

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

Which fluid type corresponds to the LIS code 'SYN'?

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

What color does the LIS code 'AMBER' represent?

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

Which of the following is NOT a type of body fluid mentioned?

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

What fluid type is represented by the LIS code 'JP'?

<p>Jackson Pratt (C)</p> Signup and view all the answers

The LIS code 'GRN' corresponds to which color of fluid?

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

Which site is primarily used for spinal fluids?

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

What type of fluid is associated with the LIS code 'PFLD'?

<p>Cerebral Spinal (C)</p> Signup and view all the answers

Which LIS code should be used if a code isn't available for a fluid type?

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

What is the LIS code for pleural fluids?

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

Which color of fluid is represented by the LIS code 'PINK'?

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

For which type of fluid is the LIS code 'BROWN' used?

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

Flashcards

Sysmex XN Check BF

A specialized type of control material used for validating the accuracy and precision of automated body fluid analysis systems.

Levels 1 and 2

Levels 1 and 2 refer to the different concentrations of analytes within the control material, allowing for assessment of both high and low ranges of measurement.

Storage Temperature

Storing controls outside the recommended temperature range can lead to degradation, affecting the reliability of test results.

Control Deterioration

When the control results consistently fall outside the expected ranges after troubleshooting, it suggests possible deterioration of the control material, requiring replacement.

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Quantimetrix Spinalscopics

A type of control material used specifically for manual cell count analysis of body fluids.

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Major revision

A major revision of a document or procedure, typically involving significant changes or updates.

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Approved and Current

A formal process of approving a document or procedure, ensuring it meets established standards.

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Retired

A document version that has been replaced by a newer version.

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Date Added

The date the document was added to the system.

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Date Effective

The date the document's content officially takes effect.

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Date Retired

The date when the document's content officially stops being applicable.

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Body Fluid Analysis

A manual or automated process used to analyze body fluids, such as blood or urine.

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Sysmex XN Hematology Analyzer

An automated hematology analyzer used for counting and differentiating cells in body fluids.

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Fluid Differential

A specialized type of blood test that analyzes the different types of cells present in a fluid sample.

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Fluid Type

The type of fluid being analyzed determines the specific cell types being counted. Different fluids have different normal cell populations.

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100 Cell Differential

A fluid differential involves counting 100 cells under a microscope to determine the percentage of each cell type present.

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Adjusted Differential Count

If a 100 cell differential is not possible, the count can be adjusted to a lower number or terminated using the 'Term' key.

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Pathologist Review

Results considered abnormal, unusual, or suspicious require review by a pathologist.

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Reference Ranges

The reference ranges for body fluid counts and differentials can be found in the Hematology Global Test Parameters.

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LIS Reporting

Fluid counts are reported in the Laboratory Information System (LIS) using the 'MEM' function and a specific worksheet.

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Hemacytometer

A type of counting chamber used for cell counting in laboratories.

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Hausser Bright-Line Hemacytometer

A specific type of hemacytometer with a bright-line grid pattern.

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Cell Depth

The depth of the chamber where the cells are counted. Usually 0.1 mm.

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Volume

The volume of the liquid contained over a specific area of the counting chamber. In this case, it's 0.1 microliter.

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Ruling Pattern

The pattern of lines on a hemacytometer, often using a specific grid like the Neubauer ruling.

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Neubauer Ruling

A specific ruling pattern used in hemacytometers. It divides the grid into smaller squares.

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Boundary Lines

The main grid lines of the Neubauer ruling, defining the boundaries of different areas.

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Triple Lines

The group of three lines on the Neubauer ruling, with the central line being the boundary.

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Cytosmear slide preparation

When a fluid sample contains a high number of white blood cells (WBCs), a cytosmear slide is prepared to further examine the cells. This slide helps visualize the cells and allows for a more detailed analysis.

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Cytocentrifugation

The procedure used to prepare a cytosmear slide involves spinning the fluid sample in a centrifuge called a 'cytocentrifuge'. This concentrates the cells onto the slide for clearer examination.

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Wright's stain

A special type of stain used to visualize white blood cells and their components on a cytosmear slide. It helps differentiate different types of white blood cells.

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Fluid volume for cytosmear preparation

The amount of fluid used to prepare a cytosmear slide depends on its clarity. Clear fluids require a larger volume compared to cloudy or bloody fluids. This ensures optimal cell distribution on the slide.

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Bovine Serum Albumin (BSA)

A protein solution added to the fluid sample during cytosmear preparation. It helps minimize cell distortion and improve the yield of cells on the slide.

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Centrifugation speed adjustment

The speed at which the cytocentrifuge spins the fluid sample can be adjusted. If white blood cells are fragile, the spinning speed should be lowered to prevent damage.

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Slide preservation

The process of placing the prepared cytosmear slide in a special container or cytopsin. This ensures proper preservation and storage of the slide for further analysis.

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Slide labeling

Important information, such as patient name, sample identification number, date, and technician code, is written on the slide. This helps ensure proper tracking and identification of the sample throughout the analysis process.

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Pericardial Fluid

A type of body fluid found in the space between the heart and the pericardium.

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Peritoneal Fluid

A type of body fluid found in the abdominal cavity.

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Pleural Fluid

A type of body fluid found in the space between the lungs and rib cage.

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Bronchial Washing Fluid

A type of body fluid obtained by washing the bronchi.

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Jackson Pratt Fluid

A type of body fluid collected from a Jackson Pratt drain.

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Amniotic Fluid

A type of body fluid found in the amniotic sac surrounding the fetus.

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Cerebral Spinal Fluid

A type of body fluid found in the spinal canal.

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Paracentesis Fluid

A type of body fluid collected from the peritoneal cavity.

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Peritoneal Dialysis Fluid

A type of body fluid collected from the peritoneal dialysis system.

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Synovial Fluid

A type of body fluid found in the joints.

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Fluid Sample

A fluid sample collected from a patient with a body fluid specimen.

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Body Fluid Counts and Differentials

An automated and manual procedure to count and differentiate cells in body fluids.

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Fluid Color

The color of the fluid sample.

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Colorless Fluid

Colorless

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Red Fluid

Red

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Study Notes

Document Title and Number

  • Title: Body Fluid Counts and Differentials – Automated and Manual
  • Number: HEME-0001

Revision and Approval

  • Revision: 8.0
  • Approval Date: 6/12/2024
  • Approved By: Clifton Bridges Laboratory Director SMH RGH (CLBRIDGE)
  • Reviewed By: Clifton Bridges Laboratory Director SMH RGH (CLBRIDGE)

Review and Completion Dates

  • Last Approval or Periodic Review Completed: 6/12/2024
  • Next Periodic Review Needed On or Before: 6/12/2025
  • Review Date: 6/12/2024
  • Effective Date: 6/12/2024

Performed By

  • Performed By: Clifton Bridges Laboratory Director SMH RGH (CLBRIDGE), Mark Williams Laboratory Director (WILL1050), Jack Wilson Laboratory Director SPEC RCH (JJWILSON), Angie Duong Laboratory Director (ADUONG), Jeffery Green MD (JTGREEN), Lindsey Matthews Laboratory Director (MATT0083), Cora G Uram-Tuculescu Laboratory Director (URAM0000), Thuy Sandy Pham Education Coordinator (101706)

Printed By

  • Printed By: Leetta Bateman Lead MLS (12/12/2024)

Organization

  • Organization: Richmond Market

Specimen Collection

  • CSF: Submitted in 3 sterile tubes (labeled sequentially) - Tube 1: Chemical & Immunologic studies, Tube 2: Microbiologic examination, Tube 3: Cell Count and Cytological examination
  • Other fluids (pleural, peritoneal, pericardial): Collected in EDTA tube or non-additive container (3-7mL volume ideal)
  • Crystal analysis: Red top tube or non-additive container; avoid EDTA
  • If EDTA is the only option for analysis, note.
  • Include body fluids from other sites (e.g., bronchial washings, amniotic fluid) in analysis.

Handling Conditions

  • Check for sterility in sample transfer.
  • Use correct containers for testing.
  • Label samples correctly.
  • Follow sample transfer protocols.
  • Track samples accurately to designated labs.
  • If inadequate volume, communicate with caregiver.

Specimen Storage and Stability

  • Prompt examination prioritised for all fluids.
  • CSF samples are handled as STATs.
  • Perform examination within 2 hours of arrival; if >8 hours, add comment (SPEDL).
  • Fluid specimens stored for 7 days at 2-8°C.
  • Fluid cytosmear slides stored at least 1 week at room temperature.
  • Improper specimens noted in documentation.

QC Material

  • Sysmex XN Check BF - Automated Body Fluid Controls (Levels 1 & 2)
  • Do not freeze controls.
  • Store controls within recommended temperatures.
  • Discard vials if deteriorated.
  • Contact supervisor with deterioration suspicion.
  • Quantimetrix Spinalscopics – Manual Fluid Cell Count Controls (Levels 1 & 2)
  • Check for microbial contamination.
  • Use appropriate Cellpack dilutions for samples.

Performing QC - Sysmex XN Check BF

  • Remove XN Check BF control and equilibrate to 15-30°C for 15 minutes.
  • Analyze control in instrument QC Analysis mode.
  • Switch to Manual mode and select Body Fluid.
  • Wait for background check, print results, and file.
  • Mix vial, load Level 1 and Level 2 onto holder.
  • Process XN Check BF Level 2 after Level 1 status is green.

Performing QC - Quantimetrix Spinalscopics

  • Remove controls and let come to room temperature.
  • Mix controls thoroughly.
  • Fill hemacytometer chambers with controls
  • Count RBCs/WBCs.
  • Document control results.
  • If acceptability is not met, document troubleshooting and corrective action in Unity.

Performing QC - Background Checks

  • Review and find acceptable before use.
  • Document any corrective action needed in Unity.

Macroscopic Findings

  • Appearance: Color, clarity, and other attributes (whole specimen and supernatant)
  • Turbidity: (0–4+) for clarity
  • Consistency: Describing consistency of fluid

Procedure: Body Fluid Counts and Differentials, Automated and Manual

  • Include steps for preparation, specimen collection, and handling fluids.
  • Describe testing procedures and QC requirements.
  • Discuss microscopic findings and interpreting test results.
  • Ensure accuracy and consistency in performing tests and interpreting results.

Procedural Notes

  • Document abnormal CSF.
  • Explain causes for different body fluids.

Equipment and Materials

  • Sysmex XN Hematology Analyzer
  • Neubauer Hemacytometer/Disposable Hemacytometer
  • Microscope
  • Cyto-Tek Centrifuge
  • Cyto-Tek Specimen Chamber Assembly
  • Manual Cell Counter

Reagents

  • Cellpack - Diluting Fluid
  • Wright-Giemsa Stain Pack
  • New Methylene Blue
  • Hyaluronidase

Notes (regarding reagents)

  • Background checks performed on reagents.
  • Reagent stability periods documented.
  • Detailed information of reagent storage and use provided.

Reporting Automated Counts (from instrument)

  • Report results, including TNC-BF/WBC and RBC-BF, as whole numbers on worksheets.
  • Move decimal points for WBC/RBC reports (TNC-BF/WBC: 3 places to the right, RBC-BF=6 decimal places).
  • Document count in worksheets.

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