Podcast
Questions and Answers
What is the primary reason for performing a blood count using a 3.2% sodium citrate tube instead of using EDTA?
What is the primary reason for performing a blood count using a 3.2% sodium citrate tube instead of using EDTA?
- To ensure accurate measurement of platelet and leukocyte counts (correct)
- To increase the platelet count significantly
- To decrease the volume of blood needed for the test
- To prevent artifacts during slide preparation
Which of the following describes a characteristic of pseudothrombocytopenia?
Which of the following describes a characteristic of pseudothrombocytopenia?
- Low platelet counts that are misreported as elevated white blood cell counts (correct)
- Elevated platelet counts resulting from sample contamination
- High platelet count falsely reported due to inferior laboratory techniques
- Inaccurate leukocyte counts due to overlapping platelet clumps
What is the effect of an incorrect angle when using the two-glass slide method for blood film preparation?
What is the effect of an incorrect angle when using the two-glass slide method for blood film preparation?
- It has no effect on smear quality.
- Both high and low angles result in unusable smears.
- A high angle results in a thin smear, while a low angle results in a thick smear.
- A low angle produces a thin smear, while a high angle results in a thick smear. (correct)
What is a disadvantage of using anticoagulant-free blood from a finger prick?
What is a disadvantage of using anticoagulant-free blood from a finger prick?
What is the ideal length of a blood smear film when using the wedge method?
What is the ideal length of a blood smear film when using the wedge method?
What does an increase in hematocrit require when preparing a blood smear?
What does an increase in hematocrit require when preparing a blood smear?
What is a common issue found with blood smears that have uneven distribution of white blood cells?
What is a common issue found with blood smears that have uneven distribution of white blood cells?
Which of the following best describes the ideal shape of a blood smear?
Which of the following best describes the ideal shape of a blood smear?
What is the effect of spreading the blood smear too slowly?
What is the effect of spreading the blood smear too slowly?
What is one advantage of using the centrifugal (spinner) type preparation method?
What is one advantage of using the centrifugal (spinner) type preparation method?
Which solution is NOT necessary for blood film staining?
Which solution is NOT necessary for blood film staining?
In Romanowsky-type stains, which component is primarily responsible for coloring the nucleus blue/purple?
In Romanowsky-type stains, which component is primarily responsible for coloring the nucleus blue/purple?
What is the main purpose of using fixative in blood film preparation?
What is the main purpose of using fixative in blood film preparation?
Which automated instrument is primarily used for both slide making and staining?
Which automated instrument is primarily used for both slide making and staining?
Why is it important to use non-anticoagulated blood for certain automated methods?
Why is it important to use non-anticoagulated blood for certain automated methods?
When manually preparing a blood smear, what is the ideal time to leave the Wright's stain on the slide?
When manually preparing a blood smear, what is the ideal time to leave the Wright's stain on the slide?
Which of the following statements is true regarding the Sysmex SP-10?
Which of the following statements is true regarding the Sysmex SP-10?
What is a likely cause of eosinophil granules appearing gray in a blood smear?
What is a likely cause of eosinophil granules appearing gray in a blood smear?
Which unusual finding in a blood smear could indicate a patient with increased lipid levels?
Which unusual finding in a blood smear could indicate a patient with increased lipid levels?
What appearance would indicate that the red blood cells in a blood smear might be improperly stained?
What appearance would indicate that the red blood cells in a blood smear might be improperly stained?
When examining a blood smear, what would a grainy appearance typically indicate?
When examining a blood smear, what would a grainy appearance typically indicate?
Which of the following is NOT a common problem encountered in blood smear staining?
Which of the following is NOT a common problem encountered in blood smear staining?
What should be avoided when using the 40x high-dry objective for WBC count estimation?
What should be avoided when using the 40x high-dry objective for WBC count estimation?
Which of the following factors influences the rejection of a blood smear film during microscopic examination?
Which of the following factors influences the rejection of a blood smear film during microscopic examination?
What is the primary use of the 100x oil immersion objective during a blood smear examination?
What is the primary use of the 100x oil immersion objective during a blood smear examination?
When estimating the WBC count using the 40x high-dry objective, how is the final count calculated?
When estimating the WBC count using the 40x high-dry objective, how is the final count calculated?
What indicates a potential problem when observing RBCs in the feathered edge while using the 40x objective?
What indicates a potential problem when observing RBCs in the feathered edge while using the 40x objective?
What is the estimated platelet count per µL if the average observed platelets in ten fields using the 100x objective is 150?
What is the estimated platelet count per µL if the average observed platelets in ten fields using the 100x objective is 150?
During microscopy, which condition would require a separate process for transferring observations from the 10x objective to the 100x objective?
During microscopy, which condition would require a separate process for transferring observations from the 10x objective to the 100x objective?
What characteristic should be noticed when examining the ideal area of a blood smear under the 10x low power objective?
What characteristic should be noticed when examining the ideal area of a blood smear under the 10x low power objective?
Flashcards
EDTA-induced platelet clumping
EDTA-induced platelet clumping
EDTA, an anticoagulant, causes platelets to clump together, making them appear fewer than they actually are.
Pseudothrombocytopenia
Pseudothrombocytopenia
A condition where a low platelet count is falsely reported due to platelet clumping by EDTA, not a true decrease.
3.2% Sodium Citrate
3.2% Sodium Citrate
An anticoagulant that does not cause platelet clumping, used when platelet clumps are suspected.
Platelet clumps
Platelet clumps
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Anticoagulant-free blood
Anticoagulant-free blood
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Two-glass slide method
Two-glass slide method
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Pusher slide (spreader)
Pusher slide (spreader)
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Film slide
Film slide
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30°–45° angle
30°–45° angle
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Thick smear
Thick smear
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Thin smear
Thin smear
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Blood smear size
Blood smear size
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Optimal spreader speed
Optimal spreader speed
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Hematocrit effect on smear angle
Hematocrit effect on smear angle
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Large smear
Large smear
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Small smear
Small smear
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Fast smear speed
Fast smear speed
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Slow smear speed
Slow smear speed
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Longitudinal scanning
Longitudinal scanning
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Battlement (Rodak) scanning
Battlement (Rodak) scanning
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Ideal blood smear (wedge method)
Ideal blood smear (wedge method)
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Uneven WBC distribution
Uneven WBC distribution
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Feather edge issues
Feather edge issues
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Center of film issues
Center of film issues
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CellaVision HemaPrep
CellaVision HemaPrep
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Centrifugal blood smear
Centrifugal blood smear
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Coulter LH
Coulter LH
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Sysmex SP-10
Sysmex SP-10
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Blood film staining purpose
Blood film staining purpose
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Methanol (fixative)
Methanol (fixative)
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Wright stain
Wright stain
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Romanowsky-type stain
Romanowsky-type stain
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Methylene blue
Methylene blue
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Eosin
Eosin
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RBC color (stained)
RBC color (stained)
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WBC nuclei color
WBC nuclei color
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Neutrophil cytoplasm color
Neutrophil cytoplasm color
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Eosinophil granules color
Eosinophil granules color
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Blue/purple RBC
Blue/purple RBC
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Gray RBCs
Gray RBCs
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Dark WBCs
Dark WBCs
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Gray Eosinophil granules
Gray Eosinophil granules
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Too pale/red RBCs
Too pale/red RBCs
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Barely visible WBCs
Barely visible WBCs
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Bluer-than-normal blood film
Bluer-than-normal blood film
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Grainy blood film
Grainy blood film
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Holes in film
Holes in film
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Blue specks on film edges
Blue specks on film edges
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10x Objective
10x Objective
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Snowplow Effect
Snowplow Effect
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40x High-Dry Objective
40x High-Dry Objective
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WBC Count Calculation
WBC Count Calculation
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50x Oil Immersion Objective
50x Oil Immersion Objective
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Feathered Edge
Feathered Edge
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Thick Part of Smear
Thick Part of Smear
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Rouleaux
Rouleaux
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100x Oil Immersion Objective
100x Oil Immersion Objective
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Platelet Count (OIO)
Platelet Count (OIO)
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RBCs Per Oil Immersion Field
RBCs Per Oil Immersion Field
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Study Notes
EDTA-Induced Platelet Clumping
- EDTA (ethylenediaminetetraacetic acid) can cause platelets to clump together, appearing as large clumps, similar in size to white blood cells (WBCs).
- This can cause a falsely low platelet count.
Pseudothrombocytopenia
- A falsely low platelet count due to the effects of EDTA.
- The incorrect counts occur because the anticoagulant EDTA causes clumping of platelets, making them appear fewer in numbers.
Pseudoleukocytosis
- A falsely elevated white blood cell (WBC) count.
- Large platelets might be misidentified as WBCs, leading to a higher WBC count as determined by a manual count.
Case Study
- Initial platelet count was 90,000/mm³.
- Initial leukocyte count was 15,000/mm³.
- Platelet clumps were observed on blood smear.
- Blood recollected using sodium citrate.
- Second platelet count was 115,000/mm³.
- Second WBC count was 11,000/mm³.
- Correct final platelet count: 126,500/mm³.
- Correct final WBC count: 12,100/mm³.
Anticoagulant-Free Blood (Finger Prick)
- Advantages:
- Performed at the patient's side, minimizing delays and complications.
- Can sometimes prevent artifacts.
- Disadvantages:
- Platelets can clump, leading to inaccuracies.
- Few well-prepared blood films can be made, when finger pricks have healed.
Blood Film Preparation Methods
- Two-glass slide method (Manual Wedge Technique): Most frequently used
- Materials: Pusher slide (aka: spreader), film slide
- Procedure: The angle between the two slides should be between 30° and 45°, to create thiner or thicker smears.
- Quality Control: The angle of the spreader determines smear thickness(too high leads to thicker smears, too low leads to thinner smear).
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Description
Explore the phenomena of EDTA-induced platelet clumping and its implications for blood count accuracy. This quiz covers pseudothrombocytopenia and pseudoleukocytosis through a detailed case study, illustrating the importance of proper anticoagulant use. Test your knowledge on interpreting laboratory results affected by these issues.