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Automated Hematology, Manual Cell Counts, and Slide Preparation

When preparing slides, ______________ inside EDTA or Microcontainers should be used

whole blood

_________ whole blood should be made into a slide within 2-3 hours of collection

EDTA

_________ whole blood should be made into a slide within 1 hour of collection

Microcontainer

The ________________ method is the most common spreading method for creating slides

Push-Wedge

A microhematocrit tube (preferably _______________ device) is used to place the blood drop onto the slide

DIFF-SAFE

The spreader slide is held at a ______ degree angle

30-45

A _____ objective is used for the initial scan

10x

During the initial scan you should look for proper ___________ and slide preperation/ quality

staining

During a manual cell count you check RBC and WBC morphology, as well as perform a 100 WBC count differential, and a ___________ and WBC estimate

Platelet

When performing a differential count, you start with an initial scan and locate the thin area, you then switch to 100x and count __________ and __________

cells and platelets

For a RBC ____________ check, scan 10 fields of 200-250 RBCs

morphology

RBC morphology is reported as either ______, ______, or ______

N/N, Micro/Hypo, or Macro/N

With a _____________________, 100 WBCs are counted and each type is recorded

WBC differential

If ⪰6 nRBCs are present every 100 WBCs, a correction is required using the formula _____________________

#WBC x 100/ 100 + #nRBCs

Count the platelets in 10 fields and divide the sum by 10 to get the average, which can be multiplied by ___________ to get the wedge preparations

20,000

__________ estimates are done under 100x with ~ 200 RBCs in the same field

Platelet

__ or less platelets are considered decreased

7

_____ platelets is considered adequate

8-20

___+ platelets is considered increased

21

_________________ are preformed during the differential and is done using a 40x objective

WBC estimates

Formula for the average of 10 fields is total #WBCs/ 10, further multiply average by ________ to determine the WBC estimate

2,000

A Three-Part instrument measures ___________, lymphoocytes, and monocytes

granulocytes

A Five-Part instrument measures __________,____________.____________, lymphocytes, and monocytes

Neutrophils, Basophils, and Eosinophils

________________________ have improved accuracy and precision because many more cells are counted

Hematology analyzers

The principals of operation of hematology analyzers is __________________________________(6)

Electrical Impendence, Radio Frequency, Optical Scatter, VCS Technology, Hydrodynamic focusing, and flow cytometry

______________________ is where cells are pulled through an aperture in a glass tube (creating a vacuum), cells pass through this aperture causing a voltage change which generates a measurable pulse

Electrical impendance

The number of pulses with electrical impendance is the number of cells and the pulse size is the __________ of the cell

volume

Radio Frequency resistance detects cell size based on ________________

cellular density

In Radio Frequency, ____________________ is directly proportional to pulse size or a change in RF resistance

nuclear volume

With ________________, cells pass through a flow cell with a laser focused on it. The scattered light is converted to electrical pulses using photodetectors

optical scatter

A _____________ graphically measures size vs frequency of blood cells

Histogram

Types of Histograms are _______, _______, and _______, Histograms

RBC, WBC, and Platelet

Samples for automated cell counting is limited due to ________, _________, and _________

Cold Agglutinins, Lipemia, and icterus

QM Reference values are determined by ___________

population

At least __ samples establish average values and ranges

20

____________ are materials or devices with known quantitative/qualitative characteristics

Calibrators

___________ verify that the instrument is running properly

Controls

A ________ is a sudden change

shift

A _______ is a continuous change

Trend

__________________________ is a precision measurement of distance to mean

Standard Deviation

_____________ ensures accuracy and should be done every 6 months or of doubt of accurate results

Calibration

____________ verifies accuracy and precision

Quality control

Daily controls should be run every 8 hours and must be ∓__SD

2

Pre-analytical factors include _________________________ (4)

Labeling, sample quality, collection time, and mixing

Post-Analytical factors include ______________________________ (5)

Flags, reflex testing, delta checks, critical values, and multivariate checks (rule of three)

Hct, MCV, MCH, MCHC, RDW, and MPV are all ____________ by hematolgy analyzers

calculated

Diluted Samples are stable for __ hours before WBCs begin to lyse

3

The _______________ consists of a reservoir, capillary pipette, and a pipette shield

Leukochek

The Leukochek and Unopette are common ______________________

dilution systems

The Reservoir contains 1.98ml of ________________, which causes RBCs to lyse; dilution factor is 1:100

Ammonium oxalate

After adding dilutent to sample, it has to settle for __ minutes

10

Charged Neubauer Hemacytometers have to sit in a humidity chamber for __ minutes after creation

15

With a NH, WBCs are counted on the 9 large squares on the __ objective

10x

Platelets are counted with a __ objective on the center square of a NH

40x

WBC QC counts must be within __ of each other

20%

The Depth factor of both WBC and Plt QC is __ (due to 0.1mm depth)

10

The Dilution Factor of both WBC and Plt QC is __ (due to 1:100 DR)

100

Plt QC counts must be within __ of each other

10%

The WBC count formula is:

cells/mm³ = (Avg# cells x 10 x 100)/9

The Plt count formula is:

Plts/mm³ = (Avg# Plts x 10 x 100)/1

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