Haematology

Terms in this set (157)

The study of form and structure of cells and tissue.

A blood film produced by dragging a drop of blood across a glass slide.

A chemical that prevents cells from deterioration.

An alcohol fixative used for blood films.

The degree of moisture in the air.

romanowsky stain

A group of stains that contain eosin and methylene blue.

A dye that produces a red colour in cells.

A dye that produces a blue colour in cells.

supra vital stain

A stain that colours living cells or tissue.

ESR (Erythrocyte Sedimentation Rate)

- The rate at which RBC's settle out from whole blood

A thick-walled tube marked 0-100 used for Wintrobe ESRs.

sickle cell disease

An inherited haemolytic anemia caused by HbS.

A haemolytic disease caused by a parasitic infection. (Plasmodium sp.)

Increase in spherical red blood cells.

A larger than normal cell, usually refers to RBC.

Decrease in cell colour, usually refers to RBC.

Immature RBC which still retains its nucleus.

haematocrit (Hct)

Volume of packed RBC's, as a percentage of whole blood

variation in shape of RBC's

Variation in size of RBC's

WBC differential

Soft organic material that fills the cavities of the bone. Site of blood cell formation.

A smaller than normal cell, usually refers to RBC.

Blood cells in "stacks of coins" formation.

An increase in the packed cell volume (Hct).

CBC (complete blood count)

This incorporates all RBC, WBC and platelet measurements. Twenty tests in all.

measures the oxygen-carrying capacity of the blood. Test may be ordered when anaemia or bleeding is suspected and is usually done in conjunction with the Hct.

Measures the packed red blood cell volume. The ____________ is routinely done to check for anaemia or bleeding.

white cell count (WBC)

The number of white blood cells per ml of blood. It relates the state of the patient's white blood cell production and if there is an increased number of leucocytes in response to infection or leukaemia.

red cell count (RBC)

The number of red blood cells per ml of whole blood. It relates if the patient may be bleeding or not properly producing red cells.

red cell indices

mean cell volume related the size of the average red cell. Mean cell haemoglobin relates the average haemoglobin content per cell. Mean cell haemoglobin concentration relates the ratio of size to haemoglobin concentration for the average red cell. Red cell distribution width relates the spread of size of the red cell population. These indices aid in diagnosing the type of red cell pathogenesis.

differential white cell count

a "diff" is the percentage and absolute values of each of the different types of white cells.

The number of platelets per ml of whole blood which affect the patient's ability to produce clots.

reticulocyte count

very young red blood cells and the count is a measure of bone marrow response to anaemia.

ESR (erythrocyte sedimentation rate)

This is the rate of settling red cells and is indicative of certain disease processes.

sickle cell preparation

A test for the presence of an abnormal haemoglobin (Hb S) which causes sickle cell anaemia

laboratory department:
tests such as:
-glucose
-electrolytes
-cholesterol
-blood gases
-urinalysis (may be subsection)
-serology (may be subsection)

laboratory department:
tests such as:
-whole anti-coagulated blood
-number and type of cells and special staining procedures for blood and bone marrow
-coagulation (may be subsection) testing blood for clotting related to anticoagulant therapy or bleeding disorders

laboratory department:
tests such as:
identification and antibiotic sensitivity of microorganisms
-bacteria
-viruses
-parasites
-fungi

laboratory department:
also know as immunohaematology or transfusion science.
-performs blood grouping and crossmatches for transfusion

laboratory department:
includes:
histology: the processing and staining of tissue samples
cytology: the processing and staining of fluid samples and slides for examination for abnormal and malignant cells

cbc (complete blood count)

haematology testing:
-most commonly ordered haematology test

haematology testing:
complete blood count - includes up to _______________ done on an automated instrument.
-WBC, RBC, platelet counts, HgB, Hct. differential and RBC and platelet indices (MCV, MCH, MCHC, RDW, MPV)
-does NOT include ESR, Retics, Sickle cell prep, malaria

-found in red blood cells, also gives RBC's their red colour

oxygen transport

Hemoglobin - responsible for ________________ to cells and carbon dioxide transport from tissue.

Methods of Determining Hemoglobin:
Specific gravity method:
-gives an estimate of Hb - good for screening blood donors
-1 drop of blood + prepared copper sulfate solution
-blood falls rapidly = __________________

Methods of Determining Hemoglobin:
Specific gravity method:
-gives an estimate of Hb - good for screening blood donors
-1 drop of blood + prepared copper sulfate solution
-blood falls slowly or rises = __________________

Colorimetric Methods:
Principle:
________ is converted to a coloured compound and compared with standards of known concentration

dare hemoglobin meter

Colorimetric Methods:
-expensive and not very accurate

acid haematin methods

Colorimetric Methods:
-acid reagent pH < 7.0 (less)
The cells are lysed and the colour is measured and compared to known concentrations

alkaline haematin methods

Colorimetric Methods:
-basic reagent pH > 7.0 (greater)
The cells are lysed and the colour is measured and compared to known concentrations

cyanmethemoglobin method

Colorimetric Methods:
-this is the most common method
-Drabkin's reagent lyses the RBC and reacts with the Hb to form ___________________ which is a stable pigment
-this pigment is measured using a photometer and the concentration of Hb is calculated with a standard curve.

heavy glass slide

Cell counts (WBC, RBC, platelet) Manual method:
Hemacytometer:
A __________________ manufactured specifically to count RBC's. WBC's, platelets and other body fluid cells

2 counting chambers

Cell counts (WBC, RBC, platelet) Manual method:
Hemacytometer:
It has ______________________ which are raised and contain microscopic etchings on the glass to make precise counting

Cell counts (WBC, RBC, platelet) Manual method:
Hemacytometer:
a special cover slip is used to cover the chambers
__________ sample depth

Cell counts (WBC, RBC, platelet) Manual method:
Hemacytometer:
"V" shaped troughs on each counting chamber used to _______________ the hemocytometer

Cell counts (WBC, RBC, platelet) Manual method:
Hemacytometer:
cells should be left to settle for ___________ after the hemocytometer has been charged

damp paper towel

Cell counts (WBC, RBC, platelet) Manual method:
Hemacytometer:
Use petri dish set up with ______________ to keep moisture and prevent the sample from drying out.

microhematocrit

capillary tubes containing blood are sealed at 1 end and then centrifuged at 11,500 rpm for 3-5 mins.
-the volume of packed red blood cells is then compared to the total volume of the whole blood sample

Microhematocrit:
capillary tubes containing blood are sealed at 1 end and then centrifuged at ______ rpm for _______ mins.
-the volume of packed red blood cells is then compared to the total volume of the whole blood sample

sources of error

Making a blood smear:
________________________
-dirty slides
-excessive pressure
-delay in spreading the blood
-too large/too small a drop of blood
-spreader at wrong angle
-speed of the push

staining of blood films

purpose - to allow the routine microscopic examination of both peripheral blood and bone marrow smears.

capillary blood

staining of blood films:
best sample is ______________ but EDTA blood is usually used.

evaluation of cellular elements:
_____________ - estimate # of

evaluation of cellular elements:
___________- examination of morphology (colour, size, shape)

evaluation of cellular elements:
estimate of # and a differential count (identification of type and maturity of 100)

Romanowsky Family of stains:
These stains are ______________ and contain combinations of methylene blue, eosin and methanol

methylene blue, eosin, methanol

Romanowsky Family of stains:
These stains are polychromatic and contain combinations of _____________, ____________ and ____________

wright's, giemsa, leishmann's, jenner's

types of Romanowsky stains are:

Romanowsky Family of stains:
All stains MUST be filtered before use and staining times should be determined with each new ___________________.

-a basic stain
-cell components that stain with this dye are called basophilic

methylene blue:
-a basic stain
-blue stain
-cell components that stain with this dye are called ______________

-an acid stain
-cell components are called acidophilic

Eosin:
-an acid stain
-a red-orange stain
-cell components are called _____________

A fixative to minimize distortion and protect cells during staining. Dyes can be dissolved in ___________ so fixing and staining occur at the same time.
*Handle carefully as it is poisonous and can be absorbed directly through the skin.

sorenson's phosphate buffer

The diluent for Giemsa stain and also used in the final rinse.
-pH should be 6.8 but 6.4 can also be used
-should be prepared fresh daily from concentrate or reconstituted with distilled water from a capsule.
*Improper pH is a common cause of staining problems.

sorenson's phosphate buffer:
The diluent for _______________ and also used in the final rinse.

sorenson's phosphate buffer:
pH should be ____ but _____ can also be used.
*improper pH is a common cause of staining problems

Microscopic Characteristics:
(colour) Mature RBC

lilac or light purple

Microscopic Characteristics:
(colour) neutrophil granules

Microscopic Characteristics:
(colour) eosinophil granules

dark blue-purple

Microscopic Characteristics:
(colour) basophil granules

Microscopic Characteristics:
(colour) platelets

Microscopic Characteristics:
(colour) lymphocyte cytoplasm

Auto slide stainers:
-uses a "conveyor belt" style of moving slides along a flat surface

Auto slide stainers:
-slides placed into holder suspended from a moveable arm.
-arm moves the slides from stain to stain for appropriate periods of time.

the coulter principle

an electronic method for counting and sizing particles (cells)

volume, conductivity and scatter (VSC)

The coulter principle is turned into an automated call counter sorting cells by _____________________

The computer from Coulter Counter uses info from VSC technology for each cell type to generate a ______________.

Automated methods for CBC:
The coulter principle:
Sample is measured _______ within the instrument

principle by volume

used for CBC:
Generate a flow of electricity from one (external) electrode to another (internal) electrode which is encased in a housing with a small opening.

conductivity and scatter

used for CBC:
principle by volume:
Analysis was improved be addition of 2 more technologies:
_____________________________

principle of conductivity

used for CBC:
uses radio waves (RF= redio frequency) to differentiate cells based on internal constituents.
ie. WBC differential
-conductivity of RF in lymph's is different than basophil

principle by scatter

used for CBC:
-uses laser beam - measures amount of laser light "scattered" by cells.
-affected by surface and internal call characteristics
ie. granulocytes scatter more light than agranulocytes

a parasite transmitted by mosquitoes. Is also a plasmodium species.

whole capillary blood

Malaria:
specific requirements:
-___________________, NO anticoagulant (*preferred)
-venous EDTA blood also acceptable
-thick and thin blood smear requiresd
-after blood collection, patient history is also required - travel out of country, fevers, when did they start, first onset

test NOT part of a CBC:
Malaria:
specific requirements:
-whole capillary blood, NO anticoagulant (*preferred)
-___________ blood also acceptable
-thick and thin blood smear requiresd
-after blood collection, patient history is also required - travel out of country, fevers, when did they start, first onset

erythrocyte sedimentation rate (ESR)

test NOT part of a CBC:
-The rate at which RBC's fall (sediment)
-units are mm/hr
-affected by size, shape and # of RBC's
-increased protein causes rouleaux (stacks of coins formation)
-a non-specific test which can be elevated in many conditions

test NOT part of a CBC:
erythrocyte sedimentation rate (ESR)
-The rate at which RBC's fall (sediment)
-units are ___________
-affected by size, shape and # of RBC's
-increased protein causes rouleaux (stacks of coins formation)
-a non-specific test which can be elevated in many conditions

-results from abnormality in the number of chains
-an inherited disorder usually of Mediterranean heritage
-alpha thalassemia = decreased alpha chains
-beta thalassemia = decreased beta chains

alpha thalassemia

Thalassemia
-results from abnormality in the number of chains
-an inherited disorder usually of Mediterranean heritage
-_______________ = decreased alpha chains

beta thalassemia

Thalassemia
-results from abnormality in the number of chains
-an inherited disorder usually of Mediterranean heritage
-_______________ = decreased beta chains

hemoglobinopathies

-results from an abnormality in the amino acid chain sequence
-some abnormal Hb are Hb C, Hb D, Hb E and Hb S
-Hb S causes sickle cell anemia, an inherited disorder found in the black population where RBC's become sickel shaped when oxygen supply is reduced

Hemoglobinopathies:
_______ causes sickle cell anemia, and inherited disorder found in black population where RBC's become sickle cell shaped when oxygen supply is reduced.

Normally occurring Hb:
-95% of the total Hb in adults is _________
- Hb A = 2 alpha chains + 2 beta chains
- Hb A2 = 2 alpha chains + 2 delta chains
-Hb F (5% or less in adults) = 2 alpha chains + 2 gamma chains
*sometimes called fetal Hb

Mechanical and Technical Errors (ESR)

Erythrocyte sedimentation rate:
-tubes must be vertical
-temp should be constant
-no tilting of ESR tubes, vibrations or bubbles
-timing is critical
-blood must be well-mixed before setting up sedimentation rate

westergren & winterobe ESR
-EDTA blood
- westergren - ________
- winterobe - ________ (smaller diameter)

-black topped Na citrate tubes

reticulocyte count

-a method to estimate the number of immature (teenage) erythrocytes in the peripheral blood
-a suprvitally staining method - cells are stained while still living
-increased in blood loss and may be temporarily increased during treatment for anemia

volume conductivity scatter

size of the average red cell

average Hb content per cell

ratio of size to Hb concentration

spread of size of red cell population

red cell distribution width

Carry deoxygenated blood from capillaries to the heart

Platelet function

4.5 - 6.0 x 10 9/ml

RBC normal ranges:
male- ___________________

4.2 - 5.5 x 10 9/ml

RBC normal ranges:
female- _________________

Hb normal ranges:
adult male- ___________________

Hb normal ranges:
adult female- _________________

Hb normal ranges:
critical values- _______________

Hct normal ranges:
males- ______________

Hct normal ranges:
females-______________

RDW normal ranges

MCV normal ranges

MCH normal ranges

MCHC normal ranges

WBC adult normal ranges

WBC DIFF normal range for Neutrophil

WBC DIFF normal range for Eosinophil

WBC DIFF normal range for Basophil

WBC DIFF normal range for Monocyte

WBC DIFF normal range for Lymphocyte

150-350 x 10 6/ml

Platelets normal range for adults

reticulocytes normal ranges

sed rate (ESR) normal ranges for males

sed rate (ESR) normal ranges for females

sickle cell prep normal range

malaria normal range

dermal puncture from ring finger for this test.

Tests to be run for CBC

MCV, MCH, MCHC, RDW

Red cell indices

reticulocyte count:
method: Mix equal parts EDTA blood and stain, incubate at ___ degree water batch for ______ minutes, mix, make slides

reticulocyte count

Stains used for _________________:
-brilliant cresyl blue
-new methylene blue
-nile blue sulfate

Normally occurring Hb:
______ = 2 alpha chains + 2 beta chains

Normally occurring Hb:
______ = 2 alpha chains + 2 delta chains

Normally occurring Hb:
______ = 2 alpha chains + 2 gamma chains (5% or less in adults)

normochromic (normal colour)/ normocytic (normal size)

Different categories of Anemia:
-RBC's are normal size, normal colour
-deficiency in number due to either defective formation in the bone marrow or increased destruction of RBC's

macrocytic (larger size) - normochromic (normal colour)

Different categories of Anemia:
-RBC's are larger but have normal colour
-these classier seen in vitamin B12 deficiency, folic acid deficiency and in liver disease

microcytic (larger size) - hypochromic (normal colour)

Different categories of Anemia:
-small cells with decreased colour or a "hollow" appearance with a large area of central pallor - seen in Fe deficiency and in thalassemia

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