Week 4.2 Laboratory Test Values--Hematology Tests--Cbc, Coagulation

Front 1

CD4

Back 1

Blood test- lymphocyte immunophenotyping
AIDS testing
CD4= T-helper cells
60 - 75%
600 - 1500 /microliter

Front 2

CBC

Back 2

complete blood count

RBC, WBC w/ differential, platelets, Hct, Hgb, MCV, MCH, MCHC, PT, PTT, MPV

Front 3

RBC

Back 3

red blood count, red cell count

4.8--5.6 m/mm3

millions/cubic millimeters

Front 4

WBC

Back 4

white blood count

MALES: 5,000--10,000k/mm3

FEMALES: SAME

CRITICAL: <2500 or >30,000

k/mm3=thousand/cubic millimeter

Front 5

DIFFERENTIAL COUNT

Back 5

neutrophils: 40-70%
bands: 4-8%
eosinophils: 0-5%
basophils: 0-1%
lymphocytes: 25-40%
monocytes: 5-8%

Front 6

neutrophils

Back 6

40 - 70%

increase showing bands or stabs indicates presence of acute bacterial infection

Front 7

eosinophils

Back 7

0-5%

increase shows allergic reaction or infection of parasites

Front 8

lymphocytes

Back 8

25 - 40%

B cells--antibody production
T cells--cellular-type immune reactions
Increase indicates chronic bacterial infection or acute viral infection

Front 9

basophils

Back 9

0.5 - 1%

indicative of parasitic infections or allergic reactions

Front 10

monocytes

Back 10

5-8%

Front 11

red cell indices

Back 11

MCV: 82 - 92
MCH: 27 - 31 pg (picograms)
MCHC: 32 - 36 g/dL
RDW: 11 - 14.5 (less than 15%)

Front 12

MCV

Back 12

mean corpuscular volume--red cell indices
measures SIZE

82-92%

hematocrit% X 10
MCV= --------------------------
RBC million/mm3
useful in categorizing ANEMIAS (normocytic, microcytic, macrocytic

Front 13

MCH

Back 13

mean corpuscular hemoglobin

27 - 31pg (picograms)

hemoglobin g/dL X 10

MCH=RBC m/mm3
measures WEIGHT (average amt of hemoglobin within an RBC
diagnoses of ANEMIAS (normocytic, microcytic, macrocytic)

Front 14

MCHC

Back 14

mean corpuscular hemoglobin concentration (red cell indices)
32 - 36%
measures CONCENTRATION of HEMOGLOBIN within an RBC
diagnosing ANEMIAS (as normochromic or hypochromic) cannot be considered HYPERchromic because the MAX is 37%

Front 15

RDW

Back 15

red cell distribution width (red cell indices)

less than 15%

used in classifying ANEMIAS
measures degree of anisocytosis (blood condition w/ RBCs of variable & abnormal sizes

Front 16

Hct

Back 16

hematocrit
measurement of % of RBCs in a total blood volume

40 - 48%



CRITICAL: <15% OR >60%

evaluation of ANEMIAS
(value should be about 3x the Hgb value)

Front 17

Hb, Hgb

Back 17

hemoglobin

12 - 16 g/dL



CRITICAL: <5.0 g/dL or >20 g/dL

Front 18

PT

Back 18

prothrombin time, Pro-time, INR (internationized normalized ratio)

11 to 13 seconds

85 - 100%

CRITICAL: >20 seconds

measures: COAGULATION TIME
indication of liver disease, vitamin K deficiency, intrinsic clotting factors V, VII, and IX, or fibrinogen
measures coumarin ingestion (Coumadin, Panwarfin)

Front 19

PTT, APTT

Back 19

partial thromboplastin time, activated partial thromboplastin time

PTT = 21 to 35 seconds

aPTT = 30 - 40 seconds

used for heparin monitoring & to check intrinsic clotting factors of clotting formation (but ACT is better for CPB (cardiopulmonary bypass)
LIVER DISEASE

Front 20

INR

Back 20

international normalized ratio
for PTT, aPTT
standardizes the potency of thromboplastin used in testing--different batches have different potencies

therapeutic INR: 2 - 3.5 seconds
target ranges are different for varying diseases:
DVT (deep vein thrombosis) prophylaxis: 1 to 1.5
recurrent DVT: 3 to 4
Atrial fibrillation: 2 to 3

Front 21

ANC

Back 21

absolute neutrophil count

ANC = WBC X (% neutrophils + % bands)

CRITICAL: <1000

Front 22

ACT

Back 22

activated clotting time, activated coagulation time

ACT= 70 - 120 seconds

accepted level for heparin monitoring during CPB (cardiopulmonary bypass) is: 400 to 480 seconds


CRITICAL: depends

Front 23

platelet count (thrombocyte count)

Back 23

ADULT: 150,000 - 400,000/mm3

CRITICAL: <50,000 or >1 million/mm3

Front 24

MPV

Back 24

mean platelet volume

MPV: 7.4 - 10.4 fL

MPV is to platelets what MCV is to RBCs.

useful in differential diagnosis of thrombocytopenia--the manufacturing of platelet size
low MPV= low size of platelets
high MPV=large size immature platelet formation

Front 25

D-dimer

Back 25

coagulation study that measures the product of clot lysis (breakdown). Values are elevated in DIC, MI, venous thrombosis

less than 250 mcg/L

Front 26

fibrinogen

Back 26

200 to 400 mg/dL

fibrinogen is converted to fibrin by clot initiation factors. Levels decrease with active clot formation. Fibrinogen is also an acute phase protein and is elevated in infection and inflammation.

Front 27

FSP

Back 27

fibrin split product or fibrin degradation product

<250 mcg/L

breakdown product of fibrin clot. Elevated levels are indicative of DIC (dessiminated intravascular coagulation)

Front 28

blasts

Back 28

0%
very immature white cells; diagnostic for leukemia when seen in the peripheral blood.

Front 29

blood chemistry test that indirectly measures the amount of iron stored in the body by measuring the small amount of iron that is always present in the blood. Used to diagnose iron deficiency anemia:

Back 29

ferritin test

Front 30

blood chemistry test that measures the level of a protein that carries iron in the blood--used to diagnose iron deficiency anemia:

Back 30

total iron binding capacity
(TIBC)

Front 31

blood test to monitor the effectiveness of the anticoagulant drug heparin when it is given in high dosages:

Back 31

ACT--activated clotting time

Front 32

What would be the expected result of the ACT test on a patient on heparin?

Back 32

prolonged, rather than normal, activated clotting time would be expected.

Front 33

Blood test to monitor the effectiveness of heparin when it is given in normal doses:

Back 33

PTT-partial thromboplastin time

Front 34

Blood test to evaluate the effectiveness of the anticoagulant drug Coumadin

Back 34

PT--prothrombin time

Front 35

Test used to determine the amounts of immunoglobulins in the blood:

Back 35

electrophoresis

Front 36

Name the immunoglobulins in the blood:

Back 36

IgA, IgD, IgE, IgG, & IgM

Front 37

What does ELISA stand for?

Back 37

enzyme-linked immunosorbent assay

Front 38

What kind of test is ELISA?

Back 38

HIV test--serology test that detects antibodies against HIV in serum;
can also be positive in SLE, Lyme disease or syphilis.

Front 39

Serum test for antibodies against HIV;
used to confirm the findings of a positive ELISA & make a diagnosis of HIV infection:

Back 39

Western Blot

(remember the dictated phrase, "And confirmed by Western Blot."

Front 40

Test that measures tiny amounts of HIV RNA that are present in the serum during the 6 weeks before the HIV antibodies can be detected:

Back 40

viral load test

Front 41

What is the term for:
the quantity of a substance required to produce a reaction with a given volume of another substance, or the amount of one substance required to correspond with a given amount of another substance.

Back 41

titer

Front 42

Test used to screen donated blood for the presence of HIV:

Back 42

p24 antigen test

Front 43

Test that monitors the number of helper T cells, used to monitor the progression of disease and response to antiretroviral drugs:

Back 43

CD4 count;
CD4: CD8 ratio is also monitored

Front 44

Rapid test that uses the patient's serum mixed with horse erythrocytes. If positive, heterophile antibodies in the patient's serum will cause the horse's erythrocytes to clump:

Back 44

MonoSpot test;
heterophil antibody test

Front 45

Urine test used to monitor the course of multiple myeloma. The cancerous plasma cells produce this abnormal immunoglobulin tha can be detected in urine:

Back 45

Bence Jones test

Front 46

Urine test that uses radioactive tracers to diagnose pernicious anemia:

Back 46

Schilling test

Front 47

Radiologic procedure that combines a 2-dimensional ultrasound image with Doppler ultrasonography that color codes images of the blood according to their velocity and direction, showing turbulence and variation in velocity by variations in brightness:

Back 47

color flow duplex ultrasonography

Front 48

The "gold standard" test for evaluating tortuous varicose veins and diagnosing deep vein thrombosis:

Back 48

color flow duplex ultrasonography

Front 49

Normal RBC count

Back 49

4.8 to 5.6 million mcL (microliters)

Front 50

Normal WBC count

Back 50

5,000 to 10,000 per millimeters cubed

Front 51

Normal range for:
segmented neutrophils
aka: segs, polys, polymorphoneucler leukocytes

Back 51

40% to 70%
increased in bacterial infections, pregnancy, some leukemias
decreased in some cases of poisoning, some viral infections, some leukemias, & post chemo & radiation.

Front 52

Normal range for:
bands (stabs)

Back 52

4% to 8%
increase known as 'left shift', may indicate severe or acute infection

Front 53

Normal range for:
basophils

Back 53

0 to 1%
increased in chronic myelogenous leukemia (CML) and polycythemia.
Decreased in hyperthyroidism & bone marrow suppression.

Front 54

Normal range for:
eosinophils

Back 54

0 to 5%
increased in allergic reactions, parasitic infections, and chronic myelogenous leukemia (CML)

Front 55

Hct

Back 55

hematocrit
percentage of red blood cells in a volume of blood
40% to 48%
Hct is roughly 3x Hgb value

Front 56

Hgb

Back 56

hemoglobin
amount of iron-binding heme in blood
reduction: malnutrition, iron deficiency anemia, leukemia, thalassemia, hemorrhage, anemia of chronic disease
elevation: polycythemia vera, dehydration, compensation for reduced oxygen concentration

Front 57

ESR

Back 57

erythrocyte sedimentation rate
speed at which erythrocytes settle out of plasma

normal: 15-20 mm/hr

Front 58

What can be determined from:
ESR

Back 58

non-specific for any particular disease, but erythrocytes may settle faster in infections, inflammations (collagen-vascular diseases), neoplasms, and tissue necrosis or infarction. Test used to determine presence of autoimmune diseases.

Front 59

What is meant by:

a shift to the left

Back 59

increased numbers of immature neutrophils in blood (indicating infection)

Front 60

Name the test:
a test for the presence of nonagglutinating antibodies against red blood cells, using antihuman globulin antibody to agglutinate cells coated with the nonagglutinating antibody.

Back 60

antiglobulin test;
The direct antiglobulin test detects antibodies bound to circulating red cells in vivo. It is used in the evaluation of autoimmune and drug-induced immune hemolytic anemia and erythroblastosis fetalis. The indirect antiglobulin test detects serum antibodies that bind to red cells in an in vitro incubation step. It is used in typing of erythrocyte antigens and in compatibility testing (cross-match).

Front 61

Name the test:

(for presence of antibody) cells containing antigens to a given antibody are mixed into the solution being tested

Back 61

agglutination test;
(agglutination indicates presence of the antibody)

Front 62

Name the test:
1. a test of the compatibility of donor and recipient blood performed before transfusion: red cells of the donor are placed in serum of the recipient (major crossmatch) and red cells of the recipient in serum of the donor (minor crossmatch) and antiglobulin is added to increase reactivity; the presence of hemolysis or agglutination indicates incompatibility. 2. a test for the presence in the serum of a prospective transplant recipient of cytotoxic antibodies against donor tissue antigens: donor lymphocytes are placed in serum of the recipient; the presence of cytolysis indicates incompatibility and the likelihood of hyperacute graft rejection.

Back 62

crossmatch;
Called also pretransplant crossmatch and HLA crossmatch. Written also cross match and cross-match.

Front 63

NAME THE TEST:
test used to detect antibodies bound to circulating red cells in vivo. It is used in the evaluation of autoimmune and drug-induced immune hemolytic anemia and erythroblastosis fetalis.

Back 63

direct antiglobulin test

Front 64

NAME THE TEST:
test used to detect serum antibodies that bind to red cells in an in vitro incubation step. It is used in typing of erythrocyte antigens and in compatibility testing (cross-match).

Back 64

indirect antiglobulin test

Front 65

NAME THE TEST:
red cells of the recipient are placed in serum of the recipient

Back 65

minor crossmatch

Front 66

NAME THE TEST:
red cells of the donor are placed in the serum of the recipient:

Back 66

major crossmatch

Front 67

NAME THE TEST USED IN TOXICOLOGY
a type of agglutination test in which antigen to a given antibody is adsorbed to latex particles and mixed with a solution to observe for agglutination of the latex.

Back 67

latex agglutination test

Front 68

NAME THE TEST USED IN TOXICOLOGY:
a highly sensitive and specific assay method that uses the competition between radiolabeled and unlabeled substances in an antigen-antibody reaction to determine the concentration of the unlabeled substance; it can be used to determine antibody concentrations or to determine the concentration of any substance against which specific antibody can be produced.

Back 68

radioimmunoassay

used on blood & other body fluids as well as forensic toxicology

Front 69

NAME THE TEST USED TO DETERMINE ANTIGEN-ANTIBODY REACTIONS:
any of several methods for the quantitative determination of chemical substances that utilize the highly specific binding between an antigen or hapten and homologous antibodies, including radioimmunoassay, enzyme immunoassay, and fluoroimmunoassay.

Back 69

immunoassay

Front 70

NAME THE TEST:
fluorescent-tagged antibody reacts with antigen-antibody complex in the presence of ultraviolet light:

Back 70

immunofluorescence;
indirect fluorescent antibody (IFA);
tests for antinuclear antibodies (ANAs);antimitochondrial antibodies (AMAs)

Front 71

NAME THE TEST:
widely used in drug testing of urine specimens:

Back 71

EMITV