Hematology Laboratory Terms Flashcards

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Questions and Answers

What is a hemogram?

A type of blood film

A complete blood count (correct)

A test for hemoglobin levels

A process for blood donation

What is the purpose of a purple top tube?

For urine analysis

For venous blood collection

For peripheral blood smear (correct)

For coagulation studies

Why is liquid tripotassium EDTA more preferred over powder form?

Liquid mixes more easily with blood.

What can result from using more than five hours of EDTA for peripheral blood smear?

Echynocytic RBC, spherocytes, necrobiotic leukocytes, vacuolated neutrophils. Signup and view all the answers

What is the action of EDTA on platelets?

Prevent platelets from clumping on the glass slide. Signup and view all the answers

What phenomenon may occur with some patients' platelets when placed in EDTA?

Platelet satellitosis. Signup and view all the answers

What phrase describes platelets that surround or adhere to neutrophils?

Platelet satellitosis. Signup and view all the answers

What errors can result from using EDTA?

Pseudo thrombocytopenia and pseudo leukocytosis. Signup and view all the answers

How can EDTA problems be prevented?

By collecting blood using sodium citrate tubes. Signup and view all the answers

What is the multiplier for WBC and platelet count in sodium citrate?

1.1 Signup and view all the answers

What should be expected when films are made from a drop of fingerstick blood or collected from heparinized tubes?

Platelet clumping. Signup and view all the answers

How can the problems of heparinized microhematocrit tubes be eliminated?

By using EDTA microcollection tubes. Signup and view all the answers

What technique is the easiest to master for making peripheral blood smears?

Manual wedge technique. Signup and view all the answers

What are the dimensions of glass slides used in blood smears?

3 inch by 1 inch. Signup and view all the answers

What device is attached to EDTA tubes for peripheral blood smear?

Diff safe dispenser. Signup and view all the answers

What does a slow push create in blood smear preparation?

Poor leukocyte distribution. Signup and view all the answers

How is a push type wedge preparation performed?

The slide is pushed. Signup and view all the answers

What fraction of the slide length should be covered with peripheral blood?

2/3 or 3/4 of the slide. Signup and view all the answers

What is the ideal shape of a blood film?

Finger-shaped slightly rounded at the feather edge, not bullet-shaped. Signup and view all the answers

What is the Sysmex SP-10 used for?

Automated slide making and staining system. Signup and view all the answers

How many blood films can the Sysmex SP-10 make every second?

30 Signup and view all the answers

What artifact can occur from blowing on a slide to dry it?

Crenated RBC or develop water artifact aka drying artifact. Signup and view all the answers

What are the stains used for peripheral blood smear?

Pure Wright stain or Wright Giemsa stain. Signup and view all the answers

What does the Giemsa stain contain?

Methylene blue azure. Signup and view all the answers

What stains neutral components?

Oxidized methylene blue and eosin. Signup and view all the answers

What is the buffer for oxidized methylene blue and eosin?

0.05 M sodium phosphate. Signup and view all the answers

What is free methylene blue?

A basic stain that stains acidic cellular components such as RNA. Signup and view all the answers

What does free eosin stain?

Basic components such as hemoglobin and eosinophil granules. Signup and view all the answers

How long does staining take for each stage?

1-3 minutes. Signup and view all the answers

What are the types of automated slide stainers?

Hema-tek stainer Signup and view all the answers

What do quick stains entail?

Staining that takes up to 1 minute. Signup and view all the answers

What stain is used in quick stains?

Modified Wright or Wright Giemsa stain. Signup and view all the answers

What buffer is used in quick stains?

Aged distilled water. Signup and view all the answers

What should be used to wipe the back of quick stains?

Alcohol. Signup and view all the answers

What color indicates RBC in an alkaline stain?

Gray. Signup and view all the answers

What color indicates WBC in an alkaline stain?

Dark. Signup and view all the answers

What do gray granules in an alkalinic stain represent?

Eosinophil granules. Signup and view all the answers

What condition does a blue blood film indicate?

High proteins, plasma cell myeloma, rouleaux formation. Signup and view all the answers

What do holes in the film signify?

High lipid levels. Signup and view all the answers

At what objective do blood films begin?

10x or LPO. Signup and view all the answers

What indicates an unacceptable film?

More than four times the number of cells per field at the edges or feather. Signup and view all the answers

What signifies unacceptable films in LTO?

Presence of fibrin strands. Signup and view all the answers

At what power can WBC estimate be performed?

Ohio or high dry. Signup and view all the answers

How do you calculate WBC?

Average number of WBC x 2000 if HPO, multiply by 3000 if OIO. Signup and view all the answers

What does OIO stand for?

WBC differential count is generally performed. Signup and view all the answers

What is the normal count of RBC in a normal patient?

200 to 250 RBC per 100 x oil immersion field. Signup and view all the answers

What is CellaVision?

A popular digital cell morphology system. Signup and view all the answers

What does anisocytosis refer to?

The size of the RBC. Signup and view all the answers

What does hypochromia refer to?

The color of RBC. Signup and view all the answers

What does poikilocytosis refer to?

The shape of the RBC. Signup and view all the answers

Under what field is platelet estimation done?

100x oil immersion objective lens. Signup and view all the answers

What does leukocytosis mean?

Elevated WBC count. Signup and view all the answers

What does leukopenia mean?

Low WBC count. Signup and view all the answers

What is indicated by a left shift?

Increase in neutrophils bands. Signup and view all the answers

What does the rule of three state?

Three times the hemoglobin is the hematocrit. Signup and view all the answers

What does mean cell volume provide?

Average RBC volume. Signup and view all the answers

What is the normal range for MCV?

80-100 fL. Signup and view all the answers

What does normocytic mean?

Within reference interval mean cell volume. Signup and view all the answers

What does microcytic mean?

Lower than 80 fL. Signup and view all the answers

What does macrocytic mean?

Greater than 100 fL. Signup and view all the answers

What does mean cell hemoglobin concentration measure?

Concentration of hemoglobin in red blood cells. Signup and view all the answers

What does normochromic refer to?

Normal MCHC. Signup and view all the answers

What does hypochromic refer to?

Less than MCHC. Signup and view all the answers

Study Notes

Hemogram and Blood Collection

A hemogram is a complete blood count essential for diagnosing various conditions.
Purple top tubes are used for preparing peripheral blood smears, crucial for blood analysis.

Importance of EDTA in Blood Sample Handling

Liquid tripotassium EDTA is preferred over powder as it mixes more effectively with blood.
Prolonged exposure (more than five hours) to EDTA can lead to anomalies in blood smears such as echynocytic RBCs, spherocytes, and necrobiotic leukocytes.

Effects of EDTA on Platelets

EDTA prevents platelet clumping on slides, which is critical for accurate analysis.
Platelet satellitosis occurs in some patients, causing their platelets to aggregate around neutrophils, leading to false low platelet counts (pseudothrombocytopenia).
To avoid complications from EDTA, it is advisable to collect blood using sodium citrate tubes.

Slide Preparation Techniques

Manual wedge technique is the most widely used and easiest method to prepare peripheral blood smears.
Blood films should cover 2/3 or 3/4 of the slide and have a specific shape, slightly rounded at the feather edge, to ensure optimal analysis.
The standard slide size is 3 inches by 1 inch.

Automated Systems and Staining

Sysmex SP-10 is an automated slide maker that can produce 30 blood films per second.
Staining techniques include pure Wright stain or Wright-Giemsa stain, for highlighting different cellular components.
Quick stains can be completed in under 1 minute; modified Wright or Wright-Giemsa stains are used in rapid tests.

Interpretation of Stains

Alkaline stains yield gray RBCs, while WBCs appear dark.
Stains can reveal conditions like high proteins resulting in rouleaux formation or high lipid levels that create holes in the film.

Microscopy Techniques

Initial observations of blood films occur at 10x or low power objectives, whereas WBC estimates are more accurately conducted at higher magnifications.
For differential counts, Oil Immersion Objective (OIO) at 100x is utilized, with an acceptable RBC count being 200 to 250 RBCs per 100x field.

Cellular Characteristics

Anisocytosis refers to varied RBC sizes; hypochromia indicates pale-colored RBCs, while poikilocytosis describes abnormal shapes.
Leukocytosis denotes elevated WBC counts, while leukopenia indicates a decrease in WBCs.

Red Blood Cell Indices

Mean cell volume (MCV) represents average RBC size, normal range is 80-100 fL.
Classification by MCV:
- Normocytic: within normal range
- Microcytic: less than 80 fL
- Macrocytic: greater than 100 fL
Mean cell hemoglobin concentration (MCHC) indicates the average concentration of hemoglobin within RBCs, with normochromic indicating normal MCHC levels and hypochromic less than the standard.

General Notes

The rule of three states that hemoglobin should be approximately three times the hematocrit value.
It’s crucial to observe for signs of deterioration in smear quality, such as fibrin strands or excessive cell accumulation at slide edges, which are red flags for inaccurate results.

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Test your knowledge of essential hematology laboratory terms with these flashcards. This quiz covers crucial concepts such as hemogram, blood tubes, and cell types that are vital for lab work in hematology. Perfect for students and professionals in the medical field!