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MLPAO Hematology 199 Test Prep
Questions
Hemolytic disease of the newborn: Cells of the ___ enter ___ circulation during delivery - โ โ Fetus, Maternal Hemolytic Disease of the Newborn: Anti-D breaks down RBCs of the fetus in - โ โ Subsequent pregnancies Indirect Antiglobulin Coombs Test (IAT) - โ โ Detect antibodies that are fixed on the surface of RBCs Direct Antiglobulin Coombs Test (DAT) - โ โ Examines for free flowing antibodies against the RBCs Blood Donations: Mixed with - โ โ SAGM (Saline Adenine Glucose Solution) Blood Donations: Lifespan - โ โ 42d Donor requirements: Minimum Age - โ โ 17 Donor requirements: At least __ days since las donation - โ โ 56 Donor requirements: No history of - โ โ malaria Donor requirements: Weight of at least - โ โ 50kg All donated blood is assed for - โ โ ABO and Rh group, Antibodies, West Nile Virus, Hep B and C, (Human T-Cell lymphotrophic Viruses I and II, and Anti Hep-B core Antibody)
All blood donations undergo - โ โ Leukoreduction Leukoreduction definition - โ โ Process of filtering out white blood cells, fibrin, and platelets Blood Components and Storage Temperature: Fresh frozen plasma - โ โ < -18 to -20c Blood Components and Storage Temperature: Frozen cryoprecipitate - โ โ < -40c Blood Components and Storage Temperature: Platelets - โ โ 20-24c Blood Components and Storage Temperature: Thawed Cryoprecipitate - โ โ 20-24c Blood Components and Storage Temperature: Thawed Plasma - โ โ 1-6c Blood Components and Storage Temperature: RBCs - โ โ 1- 6c Blood Components and Storage Temperature: Albumin - โ โ 20-24c Blood Components and Storage Temperature: Coagulation Factors - โ โ 2-8c Handling and Storage of Coagulation samples: ____ plasma if not tested within ___ of arrival - โ โ Freeze, 4h Coagulation samples: Some clotting factors are considered to be - โ โ highly labile (destroyed at room temperature)
Slides are washed with buffer of pH ___ to develop colour on the slide - โ โ 6. Stain is comprised of ____ and ____ dyes - โ โ Basic, acidic What is the basic (cationic) dye? - โ โ Methylene blue Methylene blue stains the ___ of the cell and the granules of _____ (____ in colour) - โ โ Nucleus, basophils, blue-grey What is the acidic (anionic) dye? - โ โ Eosin Eosin stains ___ and the granules of ____ (_____ in colour) - โ โ Hemoglobin, eosinophils, red-orange Neutral cell components utilized ___ dye resulting in the stain to be ____ - โ โ Both, Purple Manual staining procedure: Stain for approximately ___ - โ โ 1-3m Manual staining procedures: Add ___ proportions of buffer - โ โ equal Manual staining procedures: Allow slide to sit for at least ___ - โ โ 3m What to do if slides are too blue? - โ โ Decrease stain time, increase rinsing time, decrease buffer pH What to do if slides are too pink? - โ โ Increase stain time, decrease rinsing time, increase buffer pH What may cause slides to have stain deposits? - โ โ Dirty slide, stain solutions not filtered properly, stain dried up on slide.
HCT stands for? - โ โ Hematocrit Hematocrit is the volume of RBCs after centrifugation for ____ at ____ rpm - โ โ 5m, 1200 HCT: Cells are typically ___% of blood volume - โ โ 40- HCT: Must be centrifuged within ___ of collection - โ โ 4h HCT Normal Values: Critical - โ โ <0.20 and >0. HCT Normal Values: Infant - โ โ 0.50-0. HCT Normal Values: Toddler - โ โ 0.35-0. HCT Normal Values: Male - โ โ 0.40-0. HCT Normal Values: Female - โ โ 0.35-0. Optical light scatter is used in - โ โ Blood cell differentials (counting) Optical light scatter: Forward angle light scatter measures - โ โ Cell size and volume Optical light scatter: Side light scatter measures - โ โ granularity and nuclear size Units: RBC count - โ โ x10^12/L Units: WBC count - โ โ x10^9/L Units: Platelet count - โ โ x10^9/L Units: Reticulocytes - โ โ Whole number Units: Hemoglobin - โ โ g/L
HCT Errors: Improper collection of specimen will cause falsely increased or decreased HCT? - โ โ Either HCT Errors: Hemolysis will cause falsely increased or decreased HCT? - โ โ Decreased (breakdown of RBCs) HCT Errors: Delays in reading results will cause falsely increased or decreased HCT? - โ โ Increased (unpacking of RBCs) HCT Errors: Buffy coat added will cause falsely increased or decreased HCT? - โ โ Increased HCT Clinical Factors: Dehydration will cause HCT to be [Increased/Decreased] - โ โ Increased (due to decreased plasma volume) HCT Clinical Factors: Bleeding will cause HCT to be [Increased/Decreased] - โ โ Decreased HCT Clinical Factors: Erythropoietin stimulation will cause HCT to be [Increased/Decreased] - โ โ Increased HCT Clinical Factors: Living at high altitudes will cause HCT to be [Increased/Decreased] - โ โ Increased HCT Clinical Factors: Improper RBC production (eg. Sickle cell, anemia, thalassemia) will cause HCT to be [Increased/Decreased] - โ โ Decreased HCT Clinical Factors: Macrocytic anemias and Spherocytosis will cause HCT to be [Increased/Decreased] - โ โ Increased (due to trapped plasma) WBC: size in um - โ โ 10-
WBC: countable under _magnification - โ โ 40x WBC: Detail can be seen under ___ magnification - โ โ 100x Manual Count: WBC dilution ratio for normal counts - โ โ 1/ Manual Count: WBC dilution ratio for low counts - โ โ 1/ Manual Count: RBC dilution ratio - โ โ 1/ Manual Count: Platelet dilution ratio - โ โ 1/ Manual Count: Formula - โ โ Cells Counted x Dilution Factor / Area (number of squares counted) x Depth (0.1) Manual Count: T/F count both sides of the chamber and find the average - โ โ T Manual Count: Which part(s) of the Hemocytometer is used to count WBC under normal circumstances? - โ โ Four corners Manual Count: Which part(s) of the Hemocytometer is used to count WBC when count is low? - โ โ All 9 squares Manual Count: Which part(s) of the Hemocytometer is used to count RBCs? - โ โ Middle square Manual Count: Formula reports results in WBC/ - โ โ uL (or WBC x10^3 must be converted to WBC/L or WBCx10^9) WBC reference ranges: Critical values - โ โ <1 and > WBC reference ranges: Adult - โ โ 4.5-11. WBC reference ranges: Infant - โ โ 9.0-30.
Manual Count Platelets: Charge both sides of the chamber and allow to sit for ___ - โ โ 10m Manual Count Platelets: Perform count within ___ of collection - โ โ 3h Manual Count Platelets: Count in ____ squares - โ โ 25 Platelet Reference Range: Critical value >__ x10^9/L - โ โ 1000 Platelet Reference Range: Normal Value - โ โ 150- (x10^9/L) ESR stands for - โ โ Erythrocyte Sedimentation Rate ESR tests the - โ โ Rate ate which RBCs descend within a particular time Increased ESR is typically caused by - โ โ Rouleaux, fibrinogen, and globulin Decreased ESR is typically caused by - โ โ High RBC levels and particular shapes of RBCs ESR: Tubes must be set up within ___ of blood collection - โ โ 2h ESR: Name the two manual methods - โ โ Westergren method, wintrobe method ESR: Manual westergren method specimen(s) used - โ โ EDTA diluted 4:1 with citrate and black top tube (2.4 mL draw into 0.6 mL citrate)
ESR Reference Range: Males - โ โ 0-15mm ESR Reference Range: Females - โ โ 0-20mm ESR Sources of error: Tube not placed vertical in rack will falsely ____ ESR - โ โ Increase ESR Sources of error: Inadequate timing (> 1 h) will falsely ____ ESR - โ โ Increase ESR Sources of error: Temperature of specimen greater than > 25C will falsely ___ ESR - โ โ Increase ESR Sources of error: Improper mixing of specimen will falsely ___ ESR - โ โ Increase ESR Sources of error: Tubes vibrating during test (caused by centrifuge) will falsely ___ ESR - โ โ Increase ESR Sources of error: Air bubbles present in tube will falsely ___ ESR - โ โ Decrease ESR Sources of error: Inadequate timing (< 1 h) will falsely ___ ESR - โ โ Decrease ESR Sources of error: Fibrin clots present within specimen will falsely ___ ESR - โ โ Decrease ESR Sources of error: Hemolyzed specimens will falsely ___ ESR
- โ โ Decrease Reticulocytes are ___ RBCs - โ โ Immature Reticulocytes have a(n) ____ nucleus - โ โ Absent
Reticulocyte Count Clinical Factors: Response to replacement therapy will cause _____ Reticulocyte Count - โ โ Increased Reticulocyte Count Clinical Factors: Aplastic Anemia will cause _____ Reticulocyte Count - โ โ Decreased Reticulocyte Count Clinical Factors: Marrow suppression by drug, toxin, or viral infection will cause _____ Reticulocyte Count - โ โ Decreased Reticulocyte Count Clinical Factors: Pure red cell aplasia will cause _____ Reticulocyte Count - โ โ Decreased Reticulocyte Count Clinical Factors: Bone marrow replacement will cause _____ Reticulocyte Count - โ โ Decreased Thick and thin smears are used primarily to diagnose ____ - โ โ Malaria What is the organism associated with malaria? - โ โ protozoan parasite Plasmodium (P. falciparum, P. malariae, P. ovale and P. vivax) Thick smears: Prepared by spreading a drop of blood in a _____ motion - โ โ Circular motion Thick smears: Stained with ____ stain and ___ ____ - โ โ Giemsa, not fixed Thick smears: RBCs are ____ to examine for parasites - โ โ Destroyed Thick smears: Use ____ blood - โ โ EDTA or Capillary
Plasmodium stains ____ with ____ chromatin dot - โ โ Blue, red Thin smears: Use ___ blood - โ โ Capillary Thin smears: Stained with ____ - โ โ Wright-Giemsa or Giemsa Thin Smears: Malaria parasite is observed within ___ and can be used to identify ___ - โ โ RBCs, species Thin Smears: Samples go to the ____ for confirmation of species
- โ โ PHL (Public Health Lab) ABO: Forward grouping - โ โ Blood group antigens in donor's red cells ABO: Reverse grouping - โ โ Blood group antibodies in donor's serum or plasma ABO: Antigens are found on the - โ โ Surface of RBCs ABO: Antigens are present in/on - โ โ Plasma, saliva, secretions, and tissues (transplants) ABO: Antibodies are ____ occurring in large quantities - โ โ Naturally ABO: Antibodies are Ig_ specific - โ โ M Rh: Antigens are found on the - โ โ Surface of RBCs Rh: Antibodies are Ig_ specific - โ โ G Rh: Antibodies occur when - โ โ Exposed to antigens
What happens if CBC is tested after 24h? - โ โ Platelets clump, WBC nuclei disintegrate, WBC cytoplasm contain dark granules and Vacuoles, and RBCs swell and break down Coagulation: Specimen of choice? - โ โ Plasma Coagulation: What colour tube? What is the additive? - โ โ light blue, sodium citrate Sodium Citrate binds to ___ preventing ____ - โ โ calcium, coagulation Sodium Citrate tube must be - โ โ filled to the maximum draw capacity Coagulation: Document if patient on - โ โ anticoagulant therapy or aspirin Handling and Storage of Coagulation samples: Preparation requirements - โ โ Centrifuge and separate
