Peripheral Blood Smear
adequate cell distribution or morphology
Advantage of finger or heel puncture
Echinocytic RBCs Spherocytes Vacuolated PMNs
Blood cell artifacts
1. Clumping of platelets 2. Few slides can be made before clotting of site
Disadvantages of finger or heel puncture
Sickle-cell Anemia
Drepanocytes in RBC morphology indicates
Pseudoleukocytosis
EDTA induced platelet satellitosis will cause
1. Multiple slides can be made 2. Does not have to be prepared on site 3. Prevents platelets from clumping
Main advantage of using EDTA tubes
Platelets WBCs RBCs Morphology of the 3 cell lines Infections
Peripheral Blood Smear evaluates:
Complete Blood Test Hemogram
Peripheral Blood Smear is the CAPSTONE of a ________________________ or ______________________
Hereditary Spherocytosis
Spherocytes in RBC morphology indicates
T
T/F More can be learned from Peripheral Blood Smear than any other HEMATOLOGIC test
Hemoglobinopathies
Target cells in RBC morphology indicates
produces excellent leukocyte distribution
advantage of coverslip method
30 seconds
blood film turnaround time
5 hours
blood films made in a duration of more than _______________ are unacceptable
Hemogram
broad screening test to check for such disorders as anemia, infection, and many other diseases
Sodium phosphate - 6.4 aged distilled water - 6.4 to 6.8
buffer solutions used and their pH
1. Finer shaped with slightly curved feather edge 2. 2/3 to 3/4 of slide 3. smooth 4. rainbow edges 5. whole drop is picked up and spread
characteristics of a well-made wedge smear
Wright stain
commonly used to stain peripheral blood thin smears in Hematology
methylene blue eosin methanol Buffer
components of romanowky stain
bone marrow aspirate smears
coverslip method is used for
Thrombocytopenia
decrease in platelet count
2-3 mm
diameter of drop of blood
Manual Wedge Technique
easy, common, most convenient method
humidity breath anemic
factors of drying artifacts
1-3 minutes
for how long should the stain remain
2-3 hours
high quality blood films can be made, as long as it is made within
0.25 inches or 1 cm
how far must the drop be placed from the end of the slide
greenish metallic sheen
if proper pH is achieved due to proper buffer-stain ratio, what indicates
Thrombocytosis
increase in platelet count
pink-purple
macroscopic appearance of a well-stained Peripheral Blood Smear
adheres blood cells to slide
mechanism of action of methanol
Sysmex SP-1000i Beckman Coulter
models of automated slide making and staining
7.2
pH for malarial parasites in thick smear
1. Autoimmune patients 2. Pregnancy 3. EDTA-induced
platelet satellitosis may be due to
Platelet Satellitosis
platelets surround the cell membrane of a neutrophil
very slight
pressure applied in cover slip method
Modified Wrights-Giemsa stain
recommended for thick smears for evaluation of blood parasites such as Plasmodium sp.
glass slide with frosted edge spreader or pusher slide
requirements of manual wedge technique
dry ASAP (fan) keep tube stoppered fixative before staining
solution to drying artifacts
anemic
they have high plasma:rbc ratio
thin smear
thick or thin smear? Heavy pressure
thick smear
thick or thin smear? High angle (>45 deg)
thick smear
thick or thin smear? Light pressure
thin smear
thick or thin smear? Low angle (<30 deg)
thick smear
thick or thin smear? fast speed
thick smear
thick or thin smear? large drop of blood
thin smear
thick or thin smear? slow speed
thin smear
thick or thin smear? small drop of blood
1. Manual Wedge Technique 2. Coverslip Method 3. Automated Slide making and staining
types of thin film techniques
moth eaten look heavily demarcated central pallor crenated appearance
water or drying artefacts may give RBCs what look
bright orange granules
well-stained Peripheral blood smear: Eosinophil's cytoplasm appearance
pink with lilac granules
well-stained Peripheral blood smear: Neutrophil's cytoplasm appearance
orange
well-stained Peripheral blood smear: RBC appearance
blue
well-stained Peripheral blood smear: WBC's nuclei appearance
blue-black granules
well-stained Peripheral blood smear: Basophil's cytoplasm appearance
prevents spreading to monolayer thin film
what happens when too little pressure is applied in the coverslip method
cells rupture, morphologic evaluation is impossible
what happens when too much pressure is applied in the coverslip method
larger cells near the edge of the film
what is the effect if you pushed the spreader too slow?
distilled water (neutral pH)
what is used to rinse the slide
lower angle (<30) Polycythemia Newborns
what should you do if the hematocrit is higher than normal? in what cases is it high?
higher angle (>45)
what should you do if the hematocrit is lower than normal
Purists
who believes that anticoagulant-free blood is still the specimen of choice for blood cell morphology evaluation
They will count platelet clumps as WBCs
why does EDTA induced platelet satellitosis cause pseudoleukocytosis (in automated cell counters)
avoid drying artifact
why must all blood smears and bone marrow smears be dried as quickly as possible before staining