Clin Dx Lab overview
Terms
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- Role of phlebotomist?
- trained to draw blood
- Role of CLS, Med Tech
- BS and Certified to do lab work
- Role of CLT or Med. Lab technician?
- Associate degree and certified to do lab work
- Role of lab tests?
- Discover,Confirm,Determine,Monitor,Detect recurrence
- Test used to detect disease early when interventions can be effective?
-
Screening
(PAP,PSA,PPD)
(Sensitivity) - Test used on pts with sns/sxs of disease or abnormal screen?
-
Diagnostic
(Blood cultures)
(specificity) -
True positive
inc'd = dec'd false negative - Sensitivity
-
True negative
dec'd = inc'd false positive - Specificity
- Factors that interfere with test results
- diet,meds,fluids,handling,collection,organ failure,posture,timing
-
Red Tube -->
Blue Tube --> -
centrifuged,no anticoag=serum
NA citrate,preserve clotting factors to measure PTT, PT time -
Purple tube -->
Tiger tube --> -
EDTA, prevent clots, study WBC
Gel to seperate serum and cells -
Gray -->
Yellow --> -
study glucose
blood cultures - Green tube -->
- study ammonia, carboxyhemoglobin
- Liquid portion, collected without use of anticoagulant
- Serum
- Collect using anticoagulant, contains fibrinogen and clotting factors
- Plasma
-
Blood composition
45% -->
55%--> with 90%? -
RBCs
Plasma/Water - Study of formed elements in blood
- Hematology
- Hematology studies what transport functions?
- oxygen,nutrients,immunity,waste products
- Process of blood development and production?
- hematopoiesis
- Blood cells develop in bone marrow and differentiate into (2) types of lines?
- myeloid and lymphoid
- Myelocytes become leukocytes and are differentiated into (2) catergories?
-
agranular
granulocytes - Granulocytes
- eosinophils,basophils,neutrophils
- Agranular
- lymphocytes
- production of neutrophils,basophils,eosinophils,monocytes
- myelopoiesis
- 3 components of CBC
- WBC,RBC,Hg
- Protein consisting of globin,protoporphyrin, and FE
- hemoglobin
- NL hemoglobin levels:
-
male - 14-18
female - 12-16
newborn - 17-23
Panic - <8 or >20 - Packed cell volume
- Hematocrit
- NL Hct levels:
-
male- 40-54%
females - 37-47%
newborns- 50-62%
Panic <24% - Causes of inc'd Hct
-
smokers,high altitude,dehydration
(inc'd RBCs) - Causes of dec'd Hct
-
megaloblastic anemia,blood loss,Fe def. anemia,pregnancy
(dec'd RBC) -
Avg volume of red cells
= Hct/RBC - MCV
-
Weight of Hg of RBC
= HgB/RBC - MCH
-
Avg. concentration of Hg in a volume of red cells
=HgB/Hct - MCHC
- Measure of the degree of anisocytosis, used to determine thalessemia,Fe def. anemia
- RDW
- Formed in bone marrow,role in hemostasis
-
Platelets
(NL 140-400000)
(critical <50000,>1mil) - Red blood cell production in the bone marrow
- erythropoesis
- Variation in RBC size
-
Anisocytosis
(normocytic,microcytic - fe def.anemia,macrocytic - B12 folate def.anemia) - Variation in shape
- Poikilocytosis
-
Spherocyte
Target cell -
-no central pallor,osmotic fragility
-Abn Hg, clump in center,liver disease -
Shistocytes
Burr Cells
ovalocyte -
-fragments,heart valves
-projections, anorexia,burns,liver disease
-oval,sickle cell -
Tear drop
Stomatocytes
Helmet cells -
-cry for bone marrow
-smily cells,liver disease,lupus
-pac man, G6PD - Basophilic stippling is caused by
- metal,lead poisoning
- Howell-jolly bodies are found in
- post splenectomy,DNA remenent new periphery
- Bluish-purple dots in grps, represent FE in RBC
- siderocytes
- Denatured protein in G6PD
- Heinz bodies
- Stack of coins, due to multiple myeloma
- Rouleaux formation
- Contain retics, reflect responsiveness of erythropoetic activity-esp. for anemics
- reticulocytes
- Rate at which RBC settle out of anticoagulated blood in 1 hr
- ESR
- ESR is most usefull in
- polymalgia rheumatica,temporal arteritis
- Inc'd ESR
- infection,inflammation,pregnancy
- Dec'd ESR
- microcytic
- NL ESR
- allergies,viral infxns,cirrhosis,malaria