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What parameters need to be re-run/recalculated when a sample is lipemic or icteric?
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SMH does plasma blank to obtain a corrected Hg. Corrected Hg = initial Hg - [plasma blank Hg x (1 - initial Hct)]. MCH & MCHC are recalculated using the new Hg.
Can also do plasma replacement and use new values for Hg, MCH, MCHC, but can not lose more than 3% of RBCs during manipulation. |
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Name some other conditions that would falsely affect the Hg (and MCH, MCHC). How do you correct for these?
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Cryoglobulins: put in water bath
Paraproteins: do plasma replacement |
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If NRBCs are present on a slide, what parameter must be corrected?
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WBC count needs correcting b/c the analyzer will have counted the NRBCs as whites.
Corrected WBC = (original WBC x 100) / (# NRBCs per 100 whites + 100) |
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What is one solution to preveting platelet clumping or platelet satelliting?
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Re-collect in a citrate tube; Remember to multiply results by 1.1 dilution factor*
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What parameters must be corrected when the WBC count is very high? (Answer is per SMH's method. There are other ways to do this!)
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Must re-do red cell indices because Hg would've been falsely high; Corrected RBC = original RBC - (original WBC/1000); Make a buffy coat poor sample (WBCs need to be < 15); use MCV, MCHC from new run.
Recalculate new Hct & Hg. |
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A specimen from a diabetic has an extremely high MCV. What should you check for? How can you determine if the MCV is true or falsely high?
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Check chemistry for glucose levels. If high, causes RBC swelling. Make a 1:1 dilution with blood + saline/diluent/isoton, and re-run sample to see if MCV changes.
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What is the normal M:E ratio in bone marrow?
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3:1
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What are some clinical signs of leukemia?
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Frequent infections, weight loss, swollen lymph nodes, splenogegaly, hepatomegaly, bruising/bleeding, bone/joint pain
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What is the difference between chemotherapy & radiation?
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Chemotherapy targets cells in specific cell cycles while radiation targets DNA (by damaging it).
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What is the purpose of administering a drug like neupogen/GM-CSF to a cancer patient?
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Combat the neutropenia caused by chemotherapy.
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What % of blasts are required to diagnose an ACUTE leukemia according to FAB classification? Is this in the peripheral blood or in the bone marrow?
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Must have > 30% blasts in the bone marrow
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What % of blasts are required to diagnose an ACUTE leukemia according to WHO classification?
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Must have > 20% blasts in peripheral blood or bone marrow
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What additional method of testing is used by WHO classification to diagnose leukemias that is NOT used by FAB.
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Molecular methods
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What causes CML? What are the 3 phases of CML?
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Philidelphia chromosome (translocation between 9, 22).
Chronic/initial, accerlerated, blast crisis phases (blast crisis is when it changes to an acute form!) |
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What is the ~ M:E ratio seen with CML?
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25:1
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