Practical Physiology: Manual WBC Count

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Questions and Answers

What is a common cause of low cell counts during manual counting?

  • Insufficient mixing of the cell suspension (correct)
  • Inclusion of contaminants in the sample
  • Overfilling the counting chamber
  • Long delay in performing the count after filling the chamber (correct)

What condition is indicated by an increase in white blood cell count?

  • Anemia
  • Thrombocytopenia
  • Leukocytosis (correct)
  • Leukocytopenia

Which factor may contribute to inaccurate high white blood cell counts?

  • Mixing the blood with diluent thoroughly
  • Working swiftly after preparing the sample
  • Using a properly calibrated pipette
  • Drawing excessive blood into the pipette (correct)

Which of the following reference ranges is applicable to adult males for white blood cell count?

<p>4-11 109 /L (B)</p> Signup and view all the answers

What is a likely reason for leukocytopenia in patients?

<p>Long-term use of broad spectrum antibiotics (C)</p> Signup and view all the answers

How many squares are there in the central large square?

<p>25 (A)</p> Signup and view all the answers

What is the depth of the chamber used for counting white blood cells?

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

Which squares should not be counted according to the counting rules?

<p>Cells touching the lower and right limits (C)</p> Signup and view all the answers

What dilution should be used when the white cell count is very high?

<p>1:100 (B)</p> Signup and view all the answers

What should be avoided to ensure accurate counts in the haemocytometer?

<p>Contaminating the diluent fluid (A)</p> Signup and view all the answers

What happens if the chamber is left in direct light before counting?

<p>It leads to evaporation (B)</p> Signup and view all the answers

What is the recommended procedure when the white cell count is very low?

<p>Repeat with a smaller dilution (B)</p> Signup and view all the answers

How many small squares are formed when each of the 25 squares is subdivided into 16 squares?

<p>256 (C)</p> Signup and view all the answers

What is the main purpose of the manual white blood cell counting test?

<p>To count the number of white blood cells in a blood sample. (D)</p> Signup and view all the answers

Which of the following solutions is used to dilute the blood sample for WBC counting?

<p>Buffered ammonium oxalate or glacial acetic acid. (D)</p> Signup and view all the answers

When performing the WBC count using a Neubauer counting chamber, what is the dilution ratio of the blood specimen?

<p>1:20. (B)</p> Signup and view all the answers

What type of microscope is typically used to count the white blood cells in this practical?

<p>Compound microscope. (A)</p> Signup and view all the answers

Identify a common source of error in the manual WBC counting procedure.

<p>Failing to completely lyse the red blood cells. (A)</p> Signup and view all the answers

What is the normal reference range for white blood cells in adult males?

<p>5,000 to 10,000 cells per cubic mm. (D)</p> Signup and view all the answers

Which type of fluid is primarily used for diluting white blood cells in this procedure?

<p>1% Acetic acid. (B)</p> Signup and view all the answers

What is the objective magnification used during the counting of white blood cells?

<p>10x objective. (C), 40x objective. (D)</p> Signup and view all the answers

What is the first step in the procedure for counting white blood cells?

<p>Transfer 380µL of 1% acetic acid into a small Kahn tube (B)</p> Signup and view all the answers

What is the dilution achieved by mixing 20µL of blood with 380µL of acetic acid?

<p>1:20 (B)</p> Signup and view all the answers

How long should the solution be left to ensure complete lysis of the cells?

<p>2-3 minutes (C)</p> Signup and view all the answers

What is the recommended magnification for counting the leukocytes in the haemocytometer?

<p>x10 (A)</p> Signup and view all the answers

What should be done if there is more than a 10% difference in cell counts between the two sides of the chamber?

<p>Repeat the test with a new sample (D)</p> Signup and view all the answers

Which part of the haemocytometer should be cleaned before use?

<p>The central area (A)</p> Signup and view all the answers

What is the size of the Neubauer chamber's counting grid?

<p>3 mm x 3 mm (D)</p> Signup and view all the answers

When filling the haemocytometer, which side should be disregarded when counting overlapping cells?

<p>None of the sides (B)</p> Signup and view all the answers

Flashcards

WBC count purpose

To determine the number of white blood cells (WBCs) in a blood sample.

WBC dilution ratio

Dilution of blood specimen with diluting fluid (1% acetic acid) to 1:20 ratio before counting.

Neubauer's counting chamber

Specialized slide used to count cells, like WBCs, in a controlled area after dilution.

WBC diluting fluid

1% acetic acid solution used to separate and count WBCs while preserving them.

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Haemocytometer

Improved Neubauer Counting chamber ; specialized slide used precisely count blood cells in laboratory settings.

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Normal WBC range (adult)

Refer to tables for expected WBC count for adult males and females from lab manuals.

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WBC count calculation

Calculate the number of WBCs per cubic millimeter (mm³) based on counting in counting chamber and dilution ratio.

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Sources of errors

Potential mistakes during sample preparation, counting (e.g., sample inconsistencies or improper dilution).

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White Blood Cell Count

A laboratory test method used to determine the number of white blood cells (leukocytes) in a blood sample.

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Acetic Acid Dilution

A procedure used to lyse red blood cells in a blood sample, preparing a solution for counting white blood cells.

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Neubauer Chamber

A specialized microscope slide with a precisely etched grid for counting blood cells under a microscope.

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Blood Sample Preparation

The process of collecting a blood sample, preparing it with acetic acid, and transferring it to a Neubauer chamber for counting leukocytes.

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Leukocyte Counting Technique

A precise method for counting white blood cells within designated squares of the hemocytometer, considering overlapping cells.

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Hemocytometer

A specialized counting chamber for evaluating cell counts of blood samples.

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Dilution Ratio (1:20)

The ratio of blood volume to acetic acid volume, vital for isolating and counting white blood cells accurately.

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Counting Errors (10%)

A variation of more than 10 percent in counted white blood cell count from the different squares of the counting chamber implies error and demands performing the test again.

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Hemocytometer

A specialized microscope slide used to count cells, like white blood cells, in a precise volume of fluid.

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White blood cell count (WBC)

A diagnostic measurement of the number of white blood cells in a blood sample.

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Dilution Factor

The ratio of diluent to blood. Adjusting this factor changes the count calculation.

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Large squares (corners)

Specific squares on the hemocytometer grid used to count white blood cells.

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Counting rule (edge)

Cells touching the upper and left edge are counted, but cells touching the lower and right edges are NOT.

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High WBCs

Very high white blood cell count, often requiring a larger dilution for accurate counting.

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Low WBCs

Very low white blood cell count, requiring a smaller dilution to avoid undercounting.

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Cleanliness

Crucial for accurate white blood cell counts. The solution, hemocytometer and coverslip must be clean and dust-free.

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Low WBC count causes

Insufficient blood volume, poor mixing, incomplete chamber filling, delayed counting, uneven cell distribution, inaccurate pipettes, or flawed techniques/calculations can all result in a low white blood cell count.

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High WBC count causes

Excessive blood volume, poor mixing, overfilling the counting chamber, uneven cell distribution, inclusion of contaminants (yeast, etc.), incorrect pipettes, or flawed counting/calculation can lead to a high white blood cell count.

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Leukocytosis

A condition characterized by an elevated white blood cell count, usually associated with infections, stress, inflammation, or leukemia.

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Leukocytopenia

A condition characterized by a decreased white blood cell count, often occurring from treatments like chemotherapy or radiation, or long-term antibiotic use.

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Adult Male/Female WBC Range

The normal white blood cell count range for adult males and females is typically 4-11 x 10^9/L.

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Study Notes

Practical Physiology: Manual White Blood Cell Count

  • Lab: Practical physiology lab (3), 2nd year, 2023-2024
  • Lecturer: Karrar Abduljabar Alqershi, M.Lab.Med
  • Topic: Manual White blood cells count

Learning Objectives

  • Understand the purpose, idea and principle of manual WBC counting
  • Count and interpret results
  • Understand calculation procedures
  • Know sources of errors
  • Know normal reference ranges (adult males and females)
  • Recognize when WBCs increase or decrease and why

Purpose of the Test

  • The student will perform and count white blood cells using Neubauer's counting chamber (hemocytometer)

Idea of the Test

  • Blood is diluted in buffered ammonium oxalate or glacial acetic acid to lyse red blood cells (RBCs).
  • This preserves platelets, leukocytes, and reticulocytes.
  • After complete lysis, the solution is clear, allowing for accurate counting.

Principle of the Test

  • Blood is diluted 1:20 with WBC diluting fluid (1% acetic acid).
  • Cells are counted using a counting chamber (low power 10x or high power 40x objective).
  • Undiluted blood cell counts are calculated and reported as white blood cells per cubic millimeter of whole blood

Materials and Equipment

  • 1% Acetic acid (WBC diluting fluid)
  • Pipettes and tips
  • 20µL Sahli pipette
  • Kahn tubes
  • EDTA anticoagulated or capillary blood
  • Microscope
  • Improved Neubauer haemocytometer
  • Ethanol 70%
  • Lancets

Method

  • Transfer 380µL of 1% acetic acid to a tube.
  • Wipe finger with alcohol, prick, and collect 20µL blood into the pipette and tube.
  • Mix the blood and acetic acid.
  • Clean and dry the haemocytometer and coverslip.
  • Place the coverslip on the haemocytometer.
  • Fill the chamber with the diluted blood sample.
  • Allow cells to settle.
  • Count WBCs in the four corner squares of the haemocytometer's grid.
  • Exclude cells touching the edge.
  • Count WBCs in all 4 corner squares, maintain consistency for each count.
  • The test may be rerun if there's a significant difference between opposing corner squares.

Counting Area

  • Neubauer chamber grid: 3mm x 3mm; has 9 squares.
  • Each square has 1mm x 1mm, which is further subdivided into 16 squares.
  • Each small square has an area of 0.0025 mm².
  • The depth of the chamber = 0.1 mm
  • Each grid has depth 0.1 mm.

Calculation

  • Count WBCs from the 4 corner squares.
  • Add the WBC counts (from all squares) from each side.
  • Calculate the average WBCs per chamber.
  • Calculate the number of WBCs per cubic mm; use WBCs per chamber multiplied by the dilution (20) and divide by depth of chamber(0.4)

Clinical Significance

  • Increased (Leukocytosis): Infection, stress, inflammatory disorders, leukemia.
  • Decreased (Leukocytopenia): Chemotherapy, radiation, long-term broad-spectrum antibiotic use.

Notes

  • Perform repeated count at higher dilution (1:100 or 1:200) when WBC count is extremely high.
  • Use lower dilutions (1:10 or 1:5) for exceptionally low counts.
  • Do not contaminate the diluent with dust or cells.
  • Perform counts promptly after filling the chamber. Avoid direct light.
  • Possible error sources: insufficient blood, poor mixing, improper filling, incorrect counts, etc.

References

  • Hematology practical manual, RMIT University, 2014.
  • https://emedicine.medscape.com/article/956278-overview.
  • Hoffbrand's essential hematology, 7th edition, 2016

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