Anatomy and Physiology II: Lab 04

How many white blood cells do you count in the image? a. 16 b. 1 c. 2 d. Roughly 200

2 "One monocyte and one neutrophil are visible in the image. Notice that platelets are much smaller than white blood cells and red blood cells."

How many red blood cells are present in the tube, considered that the tube contains 10 ml of blood? a. 5.1 x 10^12 cells b. 5.1 x 10^11 cells c. 5.1 x 10^10 cells d. The numbers of red blood cell are not measured in a complete blood count

5.1 x 10^10 cells "To get the total number of red blood cells in the tube you only have to calculate: # of RBCs per liter x blood volume."

The measured hematocrit of the control sample is 42. What's the percentage of the blood plasma? a. 42 b. 100 c. 1 d. 58

58 "Hematocrit and plasma make up almost 100%. The buffy coat, composed of white blood cells and platelets compose less than 1%."

What abnormal blood cell morphology can you observe in the sample from Patient 2? a. There are no abnormalities visible b. Abnormally segmented nuclei of neutrophils c. Abnormally shaped red blood cells d. Abnormal number of platelets

Abnormally shaped red blood cells "The red blood cells in this sample show an abnormal shape and appear very elongated compared to red blood cells from a healthy person."

What could you test for in the case of Patient 3 to confirm your diagnosis of hemophilia? a. Measure the amount of clotting factor VIII and IX in the blood b. Measure the speed of blood clotting c. All options are correct d. Gene sequencing

All options are correct "In the case of a bleeding disorder, blood clotting test would be one of the first test requested, including measurement of partial thromboplastin time and prothrombin time. The presence of absence of clotting factors VIII and IX further helps classify the type of hemophilia. As hemophilia is an inherited disorder, a genetic test provides information about the specific mutation."

What does the complete blood count of Patient 2 suggest? a. Anemia b. Porphyria c. Leukopenia d. Polycythemia

Anemia "The complete blood count of of Patient 2 suggests a slight anemia. However, there could be other causes, such as nutritional deficiencies, bone marrow damage, kidney failure, as well as acute or chronic bleeding."

How does an automatic hematology analyzer determine the total number of cells? a. It's determined manually by the lab technician b. With an in-built PCR machine c. With an in-built microscope d. Based on electrical resistance

Based on electrical resistance "Since the blood is mixed with an electrolyte solution, they can be distinguished as non-conductive in an electric field. This allows detection of single cells and determination of their total count."

Patient 1: a 33 year old female, Returned from her travels to Tanzania with recurring fever chills. There are very typical sign for an infection with Plasmodium falciparum - an intracellular parasite causing malaria in patients.

Diagnosis: Malaria "We detected the characteristic ring stages of parasite inside the patient's blood cells and measured an increased white blood cells, indicative for an infection. Tanzania is in fact an endemic area for Plasmodium falciparum, supporting the diagnosis."

Patient 2: a 10 month old boy, We detected abnormally shaped red blood cells in the blood smear of the patient's blood that is a very clear sign for sickle cell anemia. In fact, the name of the disease is based on the abnormality in red blood cells morphology that we observed.

Diagnosis: Sickle cell anemia "The sickle-shape results from a mutation in the hemoglobin. Red blood cells containing the mutated hemoglobin are very rigid and cannot flow freely in the blood vessels, leading to painful swelling of the joints and anemia."

What can you detect in the blood smear of Patient 1? a. Intracellular parasites b. Extracellular parasites c. Viruses d. Bacteria

Intracellular parasites "There are parasites visible inside the red blood cells, suggesting that it's an intracellular blood parasite. Viruses are too small to be detected by light microscopy and most bacteria are much smaller than the structures seen in the micrograph."

Which component of the blood is responsible for blood clotting? a. Hemoglobin b. White blood cells c. Red blood cells d. Platelets

Platelets "Platelets, also called thrombocytes, are a component of blood whose role is to stop bleeding by blood clotting."

The purple tubes contain EDTA as an additive, which is a strong anticoagulant. What's the role of an anticoagulant in hematology? a. Preserve the sample b. Induce blood clotting c. Prevent blood clotting d. Degrade the sample

Prevent blood clotting "EDTA is added to blood samples as an anti-coagulant to prevent blood clotting, also called blood coagulation. Other commonly used anti-coagulants in hematology are citrate, oxalate or heparin."

What are neutrophils, eosinophils, basophils, lymphocytes, and monocytes? a. They are all white blood cells b. They are all different variants of hemoglobin c. They are part of the blood plasma d. They are all minerals

They are all white blood cells "neutrophils, eosinophils, basophils, lymphocytes, and monocytes are all white blood cells, also called leukocytes. They can be distinguished by their distinct morphologies."

What's the advantage of a blood smear compared to a complete blood count? a. To obtain a clear image of the blood cell morphology b. Blood smears are obtained more quickly than complete blood count c. It serves as an additional quality control d. It helps identify viral infections

To obtain a clear image of the blood cell morphology "Blood smears focus on red blood cells, white blood cells, platelets, and in some cases, they help identify blood parasites. Viruses cannot be identified with this technique due to their small size.

The dry blood smear is stained. Why is staining essential in analyzing the blood sample? a. To visualize the different blood cells b. To preserve the sample c. To test the pH of the sample d. To visualize the hemoglobin content

To visualize the different blood cells "In order to distinguish the different blood cells from each other, blood smears must be stained, Typically used stains are Romanowsky, Wright's or Giemsa. They all enable the detection of white blood cell, red blood cell and platelet abnormalities."

What's the role of red blood cells? a. Transport of O2 from the lungs b. Transport of albumin to muscle cells c. Immune defense against bacterial infections d. Immune defense against viral infections

Transport of O2 from the lungs "Red blood cells, also called erythrocytes, take up oxygen in the lungs and deliver it to all kinds of tissues in the body."

It looks like there are no abnormalities in the complete blood count of Patient 3. However, Patient 2 shows some abnormal values. Which blood cell disorder can we rule out for Patient 2? a. Anemia b. All of the options are correct c. White blood cell (WBC) disorder d. Red blood cell (RBC) disorder

White blood cell (WBC) disorder "It looks like we can rule out any white blood cell disorder, such as leukemia, as the complete blood count only shows abnormal mean corpuscular volume (MCV), mean corpuscular hemoglobin (MCH), hematocrit (HTC) and hemoglobin (hb)."

In Patient 1. Which parameters show an abnormal value? a. All b. White blood cells count (WBC) and platelets (PLT) c. None d. Red blood cells count (RBC) and hematocrit (HCT)

White blood cells count (WBC) and platelets (PLT) "White blood cells are slightly elevated and platelets decreased in Patient 1. An increased number of white blood cells could be a sign of infection."

What do hematologists work with? a. Heart b. Bones c. Blood d. Brain Cells

Blood "A hematologist is concerned with the study, diagnosis, treatment, and prevention of diseases related to blood."

Patient 3: a 2 year old boy, We couldn't find any abnormalities in the complete blood count (CBC) and also the peripheral blood smears appeared normal. However, the patient showed very typical signs of a bleeding disorder, such as easy bruising and bleeding without any obvious cause.

Diagnosis: Hemophilia

What structures does Giemsa stain? a. Endosomes b. Extracellular matrix c. Phosphate groups in the DNA d. The cell membrane

Phosphate groups in the DNA "Giemsa specifically binds to phosphate groups of DNA, in particular to regions of DNA that are rich in bonding between adenine-thymine."

What is visible on the microscopic image of the stained blood sample? a. Red blood cells and platelets b. Red blood cells and white blood cells c. White blood cells and platelets d. Red blood cells, white blood cells and platelets

Red blood cells, white blood cells and platelets "Giemsa stains red blood cells red/pink and platelets in light pink. The leukocyte nuclear chromatin appears in magenta."

What is your observation for the blood smear of Patient 3? a. White blood cells appear abnormally shaped b. There are no abnormalities visible c. Red blood cells have a fuzzy cell membrane d. Platelets appear abnormally shaped

There are no abnormalities visible "This looks indeed like a blood film of a control sample without abnormalities."