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it covers the tests associated with hct, hgb, procedures and their normal values
Typology: Lecture notes
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Hematocrit ● test that is performed based on the principle of separating cellular elements of blood from the liquid part → plasma ● “packed cell volume” ● defined as the percentage of PCV to the total amount of blood ● provides useful information about the size and content of rbc when correlated with other information i.e. rbc ct, hgb conc ● the numbers generated by true tests enable to calculate rbc indices
Methods of Hematocrit Determination
● capillary blood/anticoagulated venous blood ● if capillary blood- heparinized ex. 42 % = 42 % or 42 / 100 = 0. 42 nv CU units SI units male 41. 5-50. 4 % 0.415–0. female 35. 9–44. 6% 0.359–0.
plasma : water, proteins, glucose, hormones buffy coat : leukocytes & platelets hematocrit : red blood cells
note: the results are read at the top of packed cell column
Hemoglobinometry ● Hemoglobin
hgb nv: male-14-17.5g/ dL female- 12.3-15. 3 g/dL SI: 140-175 g/L 123-153 g/L
● test for hgb is performed on a free flowing capillary blood or from venous blood in EDTA ● reported as g/100 ml of blood or g/dl ● hgb can also be estimated from its oxygen combining power of the blood: 1gm hgb = 1.34 ml O ● Sahli pipet- used to contain whole blood to be diluted chemicals to lyse rbc to release hgb into the sol’n for determination (20uL)
Hemoglobin derivatives ● Methemoglobin
CO2 and CO
Methods of hgb determination 1.Colorimetric Method a. Direct visual colorimetric ● Tallqvist- lithographed colors correspond the hgb values ranging from 10-100 %
SLS hemichrome molecule- absorbance of this molecule is measured at 555nm to determine haemoglobin
Sources of error in estimation of hgb
Quality control
Conditions with variation in hgb level
Erythrocyte Sedimentation Rate ● measures the degree of settling of erythrocytes in plasma during a specified period of time ● useful diagnostic for hidden diseases like cancer, tb, but not specific for any particular disease ● increased in cases of TB, acute and chronic infections, acute viral hepatitis, CA, multiple myeloma, LE, pregnancy and rheumatic fever
zetacrit percent at the knee of curve (hct reader) → compute for ZSR %
- 65% markedly increased
formula: zsr % = hct / zetacrit % x 100 nv: 40-50% male & female
Erythrocyte Osmotic Fragility Test ● tests the strength of rbc of changes in the content, membrane composition or shape and withstand hemolysis in various hypotonic sol’n of NaCl ● when placed in a hypotonic sol’n , rbc tends to take in water and begin to swell; upon reaching a max. capacity of water absorption, rbc will then burst (hemolysis) ● in hypertonic sol’n , they loose fluid thereby shrink and crenate ● normal rbcs withstand dilutions of about 0.5% NaCl before they hemolyse; more fragile cells hemolyse at 0.75% NaCL ● in isotonic sol’n of 0.85% NaCl, no lysis of rbc will occur ● this test is associated with certain anemias ● increased rbc fragility (IH= tube 24, CH= tube 20) seen in hemolytic jaundice, hereditary spherocytic anemia, hereditary ovalocytic anemia and other hemolytic anemias
● decreased osmotic fragility (IH= tube 19, CH= tube 16) is associated with obstructive jaundice, iron deficiency anemia, sickle cell anemia, thalassemia, esp when many target cells are present
first pink tinge = initial hemolysis no sediment of cells = complete hemolysis
nv: (hemolysis)
tube no. percent sol’n
IH tube 22 0. CH tube 17 0.