45 Questions
What is the primary function of hemoglobin in the body?
To transport oxygen and carbon dioxide
What is the purpose of ESR (Erythrocyte Sedimentation Rate) testing?
To detect inflammation
What is the main difference between a reticulocyte and a mature red blood cell?
Maturity level
What is the purpose of a hemacytometer?
To count blood cells manually
What is the primary function of platelets in the blood?
To clot blood
What is the primary component of the hematology department in a laboratory?
Blood cell analysis and testing
What is the purpose of a Wright's stain in hematology?
To perform a differential count
What is the term for the stoppage of bleeding?
Hemostasis
What is the term for the percentage of red blood cells in whole blood?
Hematocrit
What is the primary function of hemoglobin in the body?
To carry O2 to the cells and CO2 away
What is the normal range of hemoglobin for an adult male?
140-180 g/L
What is the calculation for mean corpuscular volume (MCV)?
(Hct%/RBC) x 10
What type of anemia is caused by a lack of intrinsic factor in the digestive tract?
Pernicious Anemia
What is the normal range of platelet count in the blood?
250,000-450,000 per cubic ml
What is the purpose of a thick blood smear?
To detect malaria
What is the angle at which the spreader is held to prepare a thin blood smear?
30-40°
What is the term for the concentration of hemoglobin in red blood cells relative to their size?
Mean Corpuscular Hemoglobin Concentration (MCHC)
What is the treatment for hemolytic anemia?
Splenectomy
What is the relationship between hemoglobin and the angle of the spreader?
If the hemoglobin is high, then the angle of the spreader is small
What is the consequence of prolonged storage of the EDTA tube?
Cellular distortion
What is the purpose of the buffer in the Wright staining process?
To mix with the stain until shiny
What is the reason for a too blue stain in the Wright staining process?
Stain and/or buffer too alkaline
What is the purpose of the One Step Wright stain?
To simplify the staining process by having the buffer already dissolved in the stain
What is the consequence of insufficient rinsing in the Wright staining process?
RBCs appear grey
What is the role of Giemsa stain in cytogenetics and histopathological diagnosis?
It plays a huge role in cytogenetics and histopathological diagnosis of malaria
What is the composition of Giemsa stain?
Giemsa powder, methanol, glycerol, and water
What is the purpose of fixing the air-dried film in absolute methanol in the Giemsa staining process?
To fix the film and prepare it for staining
What should be avoided when drying thick blood smears for Giemsa staining?
Drying in an incubator or by heat
What is the advantage of using an Automatic Linear Stainer in the laboratory?
It frees the technologist to concentrate on more technically demanding procedures
What is the term for a variation in RBC sizes?
Anisocytosis
What is the term for a RBC with too much hemoglobin?
Hyperchromic
What is the purpose of the WBC differential count?
To count the number of neut, lymphs, monos, eos, and basos in 100 WBCs
What is the term for a RBC with a abnormal shape?
Poikilocytosis
What is the advantage of using Giemsa stain over Leishman stain?
Giemsa stain gives better results in parasitic studies
What does an increased eosinophil count in a blood smear suggest?
Allergy or parasite infection
What is the term for the estimation of platelet count and platelet morphology?
Platelet estimation
Which type of anemia is characterized by the presence of spherocytes?
Hemolytic anemia
What is the normal value of reticulocytes in the blood?
About 1%
What is the purpose of the Wintrobe method for ESR?
To measure the sedimentation rate of red blood cells
What is the difference between the Wintrobe and Westergren methods for ESR?
The Wintrobe tube is 100 mm long, while the Westergren tube is 200 mm long
What is the purpose of a nasal smear?
To detect eosinophils
What is the normal value of white blood cells in the blood?
5000-9000 x10^9/L
What is the purpose of collecting blood samples for cold agglutinins?
To detect autoimmune hemolytic anemia
What is the purpose of collecting blood samples for cryofibrinogen and cryoglobulin?
To detect proteins that precipitate when cold
What is the role of the medical laboratory assistant in hematology?
To draw specimens for hematology and perform manual tests
Study Notes
Hematology
Definitions
- Anemia: deficiency of hemoglobin or RBC
- Coagulation department: section of the lab concerned with the clotting mechanism of the blood
- CBC: complete blood count, tests for WBC, RBC, Hgb, Hct, indices, and differential
- EDTA: ethylenediaminetetraacetic acid, an anticoagulant used in hematology tubes
- ESR: erythrocyte sedimentation rate, used to determine if inflammation is present
- Hemacytometer: counting chamber for manual WBCs, RBCs, platelets, and sperm counts
- Hematology department: section of the lab that studies blood cells
- Hemoglobin: substance in RBCs that carries oxygen and CO2
- Hemostasis: stoppage of bleeding
- Platelets (thrombocytes): cells involved in the clotting of blood
- Red blood cell indices: calculations to determine the size and contents of red blood cells
- Red blood cells (erythrocytes): cells containing hemoglobin that transport O2 to the body and CO2 away to the lungs
- Reticulocyte (Retic): immature RBC
- White blood cells (leukocytes): cells involved in infection control and immunity
- Wrights Stain: a stain used in hematology for doing differentials
CBC
- WBC count: determines if a patient has an infection (↑WBC) or whether the immune system is compromised (↓ WBC)
- RBC count: may indicate anemia (↓) or polycythemia (↑)
- Hemoglobin: carries O2 to cells and CO2 away
- Hematocrit: reflects the relationship between the amount of RBCs and the amount of plasma in a blood sample
- Normal range for Hgb: 120-160 g/L for females, 140-180 g/L for males
- Normal range for Hct: 0.35-0.47 L/L for females, 0.4-0.52 L/L for males
Red Blood Cell Indices
- MCV: mean corpuscular volume, expresses the average volume of RBCs
- MCH: mean corpuscular hemoglobin, estimates the weight of hgb in RBC
- MCHC: mean corpuscular hemoglobin concentration, expresses the concentration of hgb in RBCs relative to their size
- Normal values: MCV 80-100 fl, MCH 27-32 pg/cell, MCHC 32-37 g/dl
Anemia
- Four types:
- Iron deficiency anemia: caused by a decrease in iron, treatment is iron supplements
- Pernicious anemia: caused by a lack of intrinsic factor, treatment is Vitamin B12 injections
- Aplastic anemia: failure of bone marrow to produce enough RBCs, treatment is bone marrow transplant
- Hemolytic anemia: caused by excessive destruction of RBCs, treatment is splenectomy
Platelet Count
- May be done on an automatic cell counter or manually on a hemacytometer
- Normal value: 250,000-450,000 per cubic ml
Blood Smears
- Two types: thick and thin blood smears
- Thick blood smear: often used to detect malaria
- Thin blood smear: used to perform a manual differential
- Qualities of a good smear: gradual transition from thick to thin, smooth appearance, no ridges or holes, feathered edge
Wrights Stain
- Used to stain blood smears
- Procedure: make slides, stain with Wrights stain, add buffer, wash, and let air dry
Differential
- Consists of three parts:
- WBC differential count: counts the number of neutrophils, lymphocytes, monocytes, eosinophils, and basophils in 100 WBCs
- RBC morphology: examines the size, shape, and amount of hemoglobin in RBCs
- Platelet estimation: estimates the platelet count and platelet morphology
Other Tests
- Retic count: measures the number of reticulocytes in the blood
- ESR: measures the rate of sedimentation of RBCs
- Nasal smear: examines the nasal mucosa for eosinophils
- Cold agglutinins: autoantibodies produced in response to infection or autoimmune hemolytic anemia
- Cryofibrinogen and cryoglobulin: proteins that precipitate when cold
Role of the Med Lab Assistant
- Draws specimens for hematology
- Makes and stains blood smears
- Sets up blood to be run by the automated cell counter
- Performs quality control tasks
- Helps with inventory maintenance
- Performs manual tests under the supervision of a technologist
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