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