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1. bone marrow exam and count

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what are the sites used to obtain bone marrow specimens?
1. post/ant iliac crest
2. Sternum
3. vertebral spine
what can you NOT use in bone marrow procedure, why?
Anticoagulant - makes vacuoles in cells.
what types of specimens are taken in a bm procedure?
-aspirate of liquid marrow
-clot
-biopsy
what do you do w/ the aspirate?
1. Perform a differential count
2. Calculate the ME ratio
what is a clot specimen for?
to evaluate the bm cellularity - normal is 50:50 fat to cells,
hypo = 70:30
hyper = 30:70
what is the biopsy used for?
histology processes it, path evaluates it - for bm structure and cellularity
what special needle is used for a biopsy?
Jamshidi
what five stains are used during bm procedures?
1. Romanowsky types
2. Prussian blue - iron evaltn
3. Hematoxylin/Eosin
4. Silver stain
5. Special cytochem. stains
what is Hematoxylin/eosin for?
Romanowsky-type stain, to evaluate bm structure and cellularity seen on the biopsy.
What is the silver stain for?
to assess the reticulin amounts, which are high in myelofibrosis.
what 3 things are evaluated during microscopic eval of a biopsy?
Clot section?
1. Cellularity
2. Myelofibrosis - reticulin
3. Megakaryocyte quantitation
Same things for clots
wbat is done with the aspirate specimen?
a differential - by us!
where on the smear is a bone marrow aspirate diff done?
next to a particle, where there
-aren't many RBCs
-are sufficient intact whites
-is an even distribution
how many cells are counted during the differential?
200 to 1000
what about the megakaryocytes is evaluated?
-quanity on 10x
-maturation stage (MK1, 2, 3)
what is the normal ME ratio?
3:1
what are 2 ME ratio abnormalities?
Myeloid hyperplasia 5:1
Myeloid hypoplasia 1:1 or more
What is perl's reaction?

what 3 things indicate increased iron stores?
Evaluation of bone marrow iron stores.
-Normal, ringed, and pathological sideroblasts.

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