Esr Hcrit (Lab)

Front 1

ESR definition

Back 1

Erythrocyte Sedimentation Rate

- Non-speci method for detection and monitoring of inflammatory response to tissue injury where changes in levels of Acute Phase Reactants/Proteins occur

Hint 1

Non-speci for ____ to ____ due to changes in APR/APP

Front 2

Unit of Measurement for ESR testing

Back 2

mm/hr

Fall of RBC in mm per 1 hour of standing

Front 3

Factors affecting ESR

Back 3

1. RBC Factor

2. Plasma Composition Factors

3. Mechanical/Technical Factors

Hint 3

RPcM/T

Front 4

RBC Factors in ESR

Back 4

1.RBC repel each other due to net (-) charge. When plasma protein conc. changes, RBCs lose this charge and form rouleaux

2. Larger mass/particle = faster rate of fall/ sedimentation velocity (Macrocyte ゝ Microcyte)

3. Shape alterations causes decrease in formation of rouleaux (Sickle cell and Spuherocytes)

4. Low RBC amount but more sediments (severe anemia)

Hint 4

1. Net Charge

2. Speed

3. Size

4. Plasma Composition

Front 5

RBCs that form clumps or 'stacks of coins

Back 5

Rouleax

Front 6

Conditions with shape alteration

Back 6

Sickle Cell Anemia

Spherocyte RBC

Anisocytosis

Poikilocytosis

Hint 6

PASS

Front 7

Proteins that are responsible for the Plasma Component Factors of ESR testing

Back 7

Acute Phase Reactants / Acute Phase Proteins:

- Fibrinogen

- alpha-1 Globulin

- alpha-2 Globulin

Hint 7

FAG1/2

Front 8

Mechanical/Technical Factors in ESR testing:

Back 8

1. Tilting of 3 degress can cause errors up to 30%.

2. Tube rack should not be subject to any movements of vibrations.

3. Large changes in Temperature can affect sedimentation rate. (High temp. = High ESR)

Hint 8

Tilt

Rack

Temp

Front 9

ESR represents nonspecific response to tissue damage and inflammation, however it does not denote ___ and only presence of disease is shown

Back 9

Severity

Front 10

High/Elevated ESR occurs in: 🐟

Back 10

1. Pregnancy after 3rd month

2. Acute/Chronic Infections

3. Rheumatic Fever and Rheumatoid Arthritis

4. Myocardial Infarction

5. Nephrosis

6. Acute Hepatitis

7. Menstruation

8. TB

9. Macroglobulinemia

10. Cryoglobulinemia

11. Hypo/Hyperthyroidism

Hint 10

P3/M

Ac/Ch Inf

RhF/Art

MyoInr

Ac Hpa

Npr

TB

Mcr/Cro-Gbsm

Ho/HeTh

Front 11

Low/Decreased ESR in:

Back 11

1. Polycythemia

2. Congestive Heart Failure

3. Hypofibrinogenemia

4. RBC abnormalities

Front 12

Method that requires EDTA blood, Long stem pipette, and a special tube that is filled up to the O mark (white)

Back 12

Wintrobe and Landsberg Method of ESR

Front 13

Method that uses Citrated blood for ESR

Back 13

Westergren Method of ESR with Citrated blood usinh 0.109M Trisodium Citrate

Front 14

Westergren ESR Ref Values:

Back 14

Women: 0-15mm/hr

Men/Children: 0-10mm/hr

Hint 14

W

M/C

Front 15

Wintrobe and Landsberg Ref Value ESR

Back 15

Women: 0-20 mm/hr

Men: 0-9 mm/hr

Hint 15

W/M

Front 16

Stages of ESR 🐟

Back 16

1. Lag Phase / Initial Rouleaux Formation (10mins; slight sedimentation)

2. Decantation / Rapid Settling or Packing of Red Blood Cells (40mins; rapid and constant)

3. Final Sedimentation of Red Blood Cells (10mins; slow sedimentation)

Front 17

Magnification for Retic count 🐟

Back 17

1000x magnification OIO

Front 18

Supravital Stains for Retic Count 🐟

Back 18

New Methylene Blue

Brilliant Cresyl Blue

Hint 18

NMB/BCB

Front 19

Unit for HCT, ESR, RETIC C, OFT

+ Formula

Back 19

Hct - %

ESR - mm/hr

Retic Count - %

OFT - %

Retic Count: (# Retics counted / 1000RBC) x 100

Front 20

Retic Count Ref Ranges

Back 20

Adults: 0.5 - 1.5 %

Newborn: 2.0 - 6.0%

Front 21

Blood Smear Specimen 🐟

Back 21

Whole blood with anti-coagulant EDTA

(Ethylene Diamine Tetraacetic Acid)

Front 22

Factors that causes High ESR

Back 22

RBC Factors:

1. High mass and size

2. Anemia (low count)

3. High APR concentration

4. Increased temperature

5. Vibration Movement

Front 23

APR Factors that increase ESR

Back 23

Fibrinogen

Alpha-1-Globulin

Alpha-2-Globulin

Globulin

Front 24

Conditions that cause low ESR 🐟

Back 24

1. Polycythemia vera

2. Hypofibrinogenemia

3. Congestive Heart Failure

4. Diseases that cause shape alteration:

- Sickle Cells

- Spherocytes

- Anisocytosis

- Poikilocytosis

Front 25

What is measure in Hct?

Back 25

Packed cell volume or direct RBC mass

volume of erythrocytes

reading of packed cells

Front 26

Materials of Macrohematocrit Reading

Back 26

Wintrobe Tube, Long Stem Pipette

Front 27

Formula for MacHct (%)

Back 27

(Packed Cell Volume/Total Volume used) x 100

Front 28

Hct Reference Values

Back 28

Male: 40-54 %

Female: 35-49%

Front 29

Errors in MacHct

Back 29

False Increase:

- Undercentrifugation

- Prolonged standing

- Inclusion of buffy coat

False Decrease:

- Overcentrifugation

- Hemolyzed Sample

- High conc. of anti-coagulant

Front 30

Materials in MicHct

Back 30

Capillary Tube (blue if using EDTA vacutainer; red if heparinized is required)

Sealing Clay and Wax

Microhematocrit centrifuge

Microhematocrit Reader

Front 31

Length of the wax in MicHct

Back 31

4mm

Front 32

MicHct Centrifugation Reqs.

Back 32

12,000rpm for 5mins

Front 33

Sources of Error for MicHct

Back 33

Incomplete sealing of tubes (F low)

Inadequate Centrifugation

Overanticoagulated

Inaccurate time and speed of Centrifugation

Front 34

Purpose of Smear Prep

Back 34

When stained, allows for differential counting of WBC and morphological study

Front 35

Types of Blood Smears

Back 35

1. Cover Glass Smear - even distribution of WBC that wedge smear

2. Wedge Smear

3. Spun Smear

4. Buffy Coat Smear - if less than 1 x 10^9/L WBC count

5. Thick Blood Smear - for blood parasites

Front 36

Requirements of blood drop in smear

Back 36

Approx. 1cm from the slide end

use only a small drop

Approx. 30-40 degree angle range

Front 37

PASS of Thin and Thick Smear

Back 37

Thin:

↑Pressure

↓ Angle, Size of Blood Drop, Speed of Spread

Thick:

↓ Pressure ↑ Angle, Size of Blood Drop, Speed of Spread

Front 38

OFT Formula

Back 38

(Tube #) x 0.02mL = % of OF