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Lab Medicine
Laboratory Diagnosis
108
Medical
Professional
02/12/2007

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Term
CBC
Definition
Purple/lavender tube - simply involves counting the number of RBC’s per unit volume of whole blood, the number of RBC per cubic millimeter gives an indirect estimate of the hemoglobin content of the blood. AKA - erythrocyte count
Term
PT
Definition
Prothrombin Time - PT is a measure of intrinsic coagulation system. It measures factors I,II, V, IX, and X. It is increased by coumadin (warfarin). Because of variability in PT, an international normalized ratio (INR) was established.
Term
PTT
Definition
partial thromboplastin time. PTT measures intrinsic and common pathway activity of factor V and X. Thrombin and fibrinogen. PTT used most often to monitor heparin therapy. It is increase by heparin.
Term
Microcytic hyper chromic anemia
Definition
iron deficiency anemia and thallasemia.
Term
iron deficiency anemia
Definition
RDW(red cell distribution width) is high, most common causes are diet (in children) and GI blood loss (in adults). TIBC (total iron binding count) is increases, serum iron and ferritin is decreased. Most have PICA.
Term
Thallasemia
Definition
most common cause is genetic hemoglobin alteration, RDW is normal.
Term
Normocytic normochromic anemia
Definition
anemia of chronic disease - most common causes are infection, inflammation, and malignancy. RDW and hemoglobin are normal, hemocrit is decreased.
Term
Macrocytic hyperchromic anemia (megaloblastic anemia)
Definition
-vitamin B12 deficiency - due to malabsorption, RDW is high
-folate deficiency - due to inadequate diet; alcoholism. RDW is high.
Term
Hematuria
Definition
presence of intact RBCs in urine. Occurs when there are urinary tract disorders associated with bleeding such as stones, tumors, or lesions present in the urinary tract.
Term
Urine Glucose
Definition
is the Test of Choice for Diabetes Mellitus (Glucosuria)
Term
ESR(Erythrocyte Sedimentation Rate
Definition
test that determines the rate at which erythrocytes separates from plasma and settle to the bottom of the tube. They indicate in general condition such as the presence of acute or chronic inflammation.
Term
RBC Indices
Definition
measures corpuscular constants. Tests include MCV, MCH, AND MCHC.
Term
MCV
Definition
- the mean or average size of the individual erythrocyte
-if below 80 fl - microcytic
-if above 100fl - macrocytic
Term
macrocytosis AND macrocytic anemia
Definition
If the cells are larger than normal, the MCV is increased - if associated with anemia, _______anemia.
Term
microcytosis and microcytic anemia
Definition
If the cells are smaller than normal, the MCV is decreased - if associated with anemia, ______ anemia.
Term
MCH
Definition
mean or average amount of Hb by weight per cell, in pg or uug
-if below 27 pg - hypochromic
-if above 32 pg - hyperchromic
Term
MCHC
Definition
- mean or average Hb in grams per 100 mL of packed erythrocytes
-if below 31% - hypochromic (pale-ish looking cell)
-if btwn 34 +/- 2% - normochromic
-if above 37% - hyperchromic (bright red cell)
Term
RBC indices
Increased in
Definition
megaloblastic anemia, B-12 def/folate def, aplasia, myelofibrosis, hyperglycemia, reticulocytosis, liver disease, drugs, AIDS.
Term
RBC indices decreases in
Definition
iron def anemia, sideroblastic anemia, lead poisoning, hemolytic anemia (Thallasemia), spherocytosis, post - splenectomy
Term
Heparin and coumadin
Definition
used in the treatment of disorders in which there is excessive or undesirable clotting. *The PT (measure of extrinsic coagulation) is increased by heparin and coumadin.
Term
Over heparinize
Definition
to render blood incoagulable with heparin.
Term
Specific gravity
Definition
the ratio of the weight of a given volume of urine to the weight of the same volume of distilled water at the same temperature. It measures the concentration of the solutes (urea and salt) in a urine sample. It provides information regarding the concentrating ability of the kidneys. *A concentrated sample will have a higher spec gravity* Specific gravity is highest in the morning.
Term
A high specific gravity indicates
Definition
Decreased fluid intake, dextran administration, urine preservatives, x-ray contrast media, adrenal insufficiency, hepatic disease, CHF, excessive water loss - sweat, fever, vomiting, diarrhea.
-If the kidneys do not excrete enough water the urine will be more concentrated, and the specific gravity will be_____(high/low).
Term
A low specific gravity indicates:
Definition
acute renal failure, alkalosis, diabetes insipidus, glomerulonephritis, hypercalacemia, hypothermia, fluid intake, renal parechymal disease, Vit K def.
- If the kidneys excrete too much water the urine will be dilute, therefore, specific gravity will be_____(high/low).
Term
Proteins in Urine
Definition
Albumin - strenuous (violent) exercise, emotional stress, pregnancy, infections, glomerulonephritis, new borns (1st week).
Globulins - glomerulonephritis, tubular dysfunction.
Hemoglobin - Hematuria, hemoglobinuria.
Fibrinogen - sever renal disease.
Nucleoproteins - WBCs in urine, epithelial cells in urine.***Bence Jones Multiple Myeloma, Leukemia.
Term
urine orders in ammonia
Definition
urine oder of UTI, stale urine
Term
Sweet or fruity oder
Definition
Odor of fat metabolism from starvation, or Diabetes Mellitus
Term
Putrid or Foul urine smell
Definition
urine odor of Leukocytes associated with UTI
Term
Maple syrup urine smell
Definition
Metabolic disorder of infants
Term
Mousey urine smell
Definition
PKU - congenital metabolic disorder
Term
glucose
Definition
the sugar most commonly found in urine
Term
glycosuria or glucosuria
Definition
Excessive glucose in urine, occurs when the blood glucose level exceeds the reabsorption capacity of the renal tubules, that is when the glomerular filtrate contains more glucose than the tubules are able to absorb.
Term
hemoglobinuria
Definition
The presence of hemoglobin in urine, occurs when there is excessive destruction of red blood cells within the vascular system or when hematuria is present and urine specific gravity is low. Seen when renal clearance of excessive Hgb, excessive red cell destruction in blood, clostridium and plasmodium infections, autoimmune hemolytic anemia, drugs, burn injuries, ingestion of poisons, transfusion reactions, and venoms.
Term
Hematuria
Definition
Bleeding occurs when stones, tumors or lesions are present in the urinary tract. Also when there is trauma, hemorrhage, stones, infarction, and infection at any level of the urinary system.
Term
RBC casts
Definition
Poikilocytosis, Spherocytosis, Burr cells , Acanthocytes, Basophilic stippling, Cabot rings, Pappenheimer bodies, Rouleaux formation,
Term
Rouleaux formation
Definition
- RBC become aligned and aggregates resembling stacks of coins: hyperproteinemia disorders such as multiple Myeloma. - Heinz bodies: hemolytic anemia and G6PD deficiency
Term
Pappenheimer bodies
Definition
RBC cytoplasmic inclusions up to 2 um in diameter. They stain dark violet with Wrights stain - seen in severe hemolytic anemia, asplenia, and post-splenectomy state, and sideroblastic anemia, Thallasemia, and megaloblastic anemia.
Term
Cabot rings
Definition
thready, blue, ring shaped, twisted or figure-eight RBC cytoplasm inclusions - severe anemia
Term
Basophilic stippling
Definition
describes cytoplasmic inclusions. RBCs have cytoplasm that is stippled with a number of fine granules, which are ribosomal RNA remnants. Seen in lead poisoning.
Term
Basophilic stippling
Definition
symmetrical sharp projections, usually graded as slight, moderate, or marked - chronic liver disease.
Term
Acanthocytes
Definition
symmetrical sharp projections, usually graded as slight, moderate, or marked - chronic liver disease.
Term
Burr cells
Definition
symmetrical shaped RBC - sepsis, drugs am G6PD deficiency, burns, hemolytic anemia and renal failure
Term
Spherocytosis
Definition
spherical shaped RBC. Autoimmunic hemolytic anemia, transfusion reactions, hereditary G6PD deficiency, and hereditary spherocytosis, and water dilution.
Term
Poikilocytosis
Definition
variation in shape of RBC - iron deficiency anemia
Term
Anisocytosis
Definition
variation in size of red cells
Term
Poikilocytosis
Definition
variation in shape of red cells
Term
Distorted lymphocytes
Definition
squashed or distorted cells, caused by excessive pressure on the cells during the process of making the smear. Recorded as normal.
Term
Accumulated white cells
Definition
bunch of white cells on the edge of a blood smear, caused by improper spreading during the process of making the smear - should not be counted or recorded.
Term
Smudge cells
Definition
bare nucleus of a ruptured white cell. Found normally or are caused by heavy pressure during the making of the smear. A large number of smudge cells can also be seen in leukemia and indicate an increase in the fragility of the cells or abnormal destruction of the cells. Not recorded or counted.
Term
Disintegrated cell
Definition
ruptured cells, could be from improper preparation that causes the cells to rupture. Can be found in blood smears made from old anticoagulated blood which is over 2 hours old. May also be indicative of patients with various toxic conditions.
Term
Poorly stained eosinophils
Definition
may be caused by incorrect pH of buffer solution, improper mixing of stain and buffer solution, or too short a staining time. Should be recorded as normal eosinophils.
Term
Precipitated Stain
Definition
caused by failure to properly flush the excess stain off the slide during the staining process. Should not be counted.
Term
Neutrophil with Toxic Granules
Definition
large, coarse granules. Caused by overstaining the smear or using a buffer solution, they are seen in severe infections, chemical poisoning, and malignant neutropenia. Recorded as misc. white cells.
Term
Hypersegmented Neutrophil
Definition
aka the P.A. poly cell - seen in pernicious anemia, its nucleus is broken up into 5 to 10 segments and is usually larger than a normal neutrophil.
Term
Vacuolated cell
Definition
has holes or vacuoles in cytoplasm which are signs of degeneration. They are seen in severe infections, chemical poisoning, and leukemia. Reported under misc white cells.
Term
Tissue cells
Definition
be squeezed out of a finger puncture, it resembles a monocyte. In a tissue cell, the outer edges are raveled or fragmentary. Often a tail is present. However, in a monocyte the edges are clear cut and definite. Tissues are rarely seen. They should be recorded and reported.
Term
Basket cells
Definition
net like nucleus from a ruptured white cell. A few basket cells may be found in a normal blood smear, they are probably older forms of the smudge cell. Should not be recorded or reported.
Term
Crescent Bodies
Definition
aka semi-lunar bodies, selenoid bodies, or achromocytes. They are believed to be remains of erythrocytes. Seen in normal blood smears, they are also seen in malaria and hemolytic anemia. Should not be reported or recorded.
Term
Hemocytoblast
Definition
- premature blood cell
- stem cell
-made in bone marrow
Term
Reticulocyte
Definition
immature RBC
Term
Band cell
Definition
aka stab cell, immature WBC
Term
Melamegokaryote
Definition
immature thrombocyte
Term
Leukocyte
Definition
white blood cell, protects body from invasion of harmful substances
Term
Granulocytes
Definition
group of leukocytes containing granules in their cytoplasm
Term
Agranulocytes
Definition
group of leukocytes without granules
Term
neutrophil
Definition
fights infection by swallowing bacteria (phagocytosis). *Indicate bacterial infection.
Term
polymorphonuclear leukocyte
Definition
another term for a neutrophil, named for many segments present in the nucleus
Term
Eosinophils
Definition
increase with allergy and some infections
Term
Basophil
Definition
brings anticoagulant substances to inflamed tissues
Term
Lymphocyte
Definition
an agranulocyte leukocyte that is active in the active process of immunity (t-cells, b-cells, and Natural killers). In an adult if there are more lymphocytes than neutrophils - think leukemia.
Term
Monocyte
Definition
an agranulocyte leukocyte that performs phagocytosis to fight infection
Term
Cell types
Definition
Hemocytoblasts, band cells, melamegokaryotes, leukocytes, granulocytes, agranulocytes, neutrophils, basophils, polymorphonuclear leukocytes, moncytes, eosinophils.
Term
Epithelial cells in urine (three types)
Definition
squamous cells. Transitional cells, and Renal cells.
Term
Squamous cells
Definition
flat and abundant, irregular cytoplasm. These are the least significant of the epithelial cells. Found in the urethral lining of the male and female and the lining of the vagina in the female.
Term
Transitional cells
Definition
caudal or tail cells , smaller than squamous. They are pear shaped with a central nucleus. Pathological conditions, especially nephritis and CHF, result in urine containing transitional cells. Found in the lining of the renal pelvis, bladder, and upper urethra.
Term
Renal cells
Definition
found in the renal tubule. There shouldn’t be renal epithelial cells in urine.
Term
Crystals in urine
Definition
The presence of Cystine, Leucine, Tyrosine are all indicative of pathology.
Term
Leucine, tyrosine
Definition
often appear together in the urine of pts with severe liver disease.
Term
Cystine
Definition
appear in urine as a result in genetic defect. They appear in the urine of pts with cystinuria, and homocysternia.
Term
Uric acid crystals
Definition
increased in pts with gout, malignant lymphoma, or leukemia.
Term
Calcium oxalate
Definition
appear in urine after the ingestion of certain foods, (cabbage, asparagus) may reflect severe chronic renal disease or increased absorption of oxalates from food following small bowel disease and resection, notably Crohn’s disease.
Term
Hippuric acid
Definition
appear in urine after ingestion of certain vegetables and fruits with benzoic acid content. They have little clinical significance.
Term
Triple phosphate
Definition
the ingestion of fruit may cause triple phosphate to appear in urine.
Term
Hematopoiesis or hemopoiesis
Definition
the formation and maturation of blood cells. All cell blood cell types originate from a single primitive blood cell called a stem cell (Hemocytoblast).
Term
Band or stab cells
Definition
slightly immature neutrophils. They can be identified by c-shaped nuclei that have not yet formed lobes. Five percent of neutrophils in circulation are band cells. This percentage increases during some infections.
Term
Turbidity
Definition
aka transparency, refers to the clarity of a specimen. Excessively cloudy urine is turbid. As urine cools, dissolved substances crystallize. In alkaline, these substances include phosphate and carbonate crystals. In acid urine, they include uric acid, calcium oxalates, and urates. As urates precipitate, a pinkish cloud forms - called Brick Dust. These crystals are not associated with pathology.
Other substances that cause urine cloudiness are mucous threads, bacteria, cells, and casts.
Term
Hemacytometer
Definition
is a specially designed counting chamber of uniform dimensions used in counting blood cells. The red blood cell count uses the center square of the hemacytometer for counting. The white blood cell count is in the outer corners. *****A shift to the left tells you neutrophils are greater than 90% and there is a bacterial infection*****.
Increase in lymphocytes in a CBC is indicative of leukemia, pertussis, infectious mononucleosis, cytomegalovirus virus, toxoplasmosis, syphilis, smallpox, and infectious lymphocytes cause by viruses (Coxsackie’s virus, echo virus, and adenovirus).
** If an adult there are more lymphocytes than neutrophils, think leukemia**
Term
PT
Definition
- measure of extrinsic coagulation system and measures factors I, II, V, IX, and X.
-increased by warfarin/coumadin, used to monitor coumadin, and used to screen for hemostatic dysfunction as a result of liver disease, vit K deficiency, factor deficiency, and DIC.
Term
PTT
Definition
- measures intrinsic and common pathway of factor V, X thrombin and fibrinogen, -PTT is used most often to measure heparin therapy.
-It is increased by heparin.
Term
Hemolytic anemia
Definition
result from impaired RBC production, blood loss, or accelerated RBC destruction (hemolysis). Physiological causes include: stem cell disorders, DNA disorders, heme and globin disorders, and RBC survival disorders (I.e. hemolytic disorders). It is a type of absolute anemia.
Term
Thallasemia
Definition
most common cause is a genetic hemoglobin alteration. The RDW is normal in Thallasemia. - These are microcytic hypochromic anemia.
Term
Iron deficiency anemia
Definition
most common causes are: chronic GI blood loss in adults, and dietary deficiencies in children, The RDW is high in IDA. Total iron binding count (TIBC) is increased, serum iron decreased, and ferritin is decreased.
Term
Reticulocyte
Definition
test count - not part of routine CBC. It is used in the initial work up of anemia and on the monitoring the effect of hemantinic or erythropoietin therapy and recovery from myelosupression or monitoring engraftment following bone marrow transplant. Reticulocytes are juvenile RBCs.
Term
Casts in urine
Definition
solidified pertinacious material formed in the tubules of the kidneys. All of the casts listed below are attached to or are Tamm Horsfall proteins except Waxy:
-Hyaline: glomerulonephritis, pyelonephritis, chronic renal disease, CHF, heart failure, stress/exercise, fever.
-Red Blood Cell: acute glomernephritis, strenuous exercise, collagen disease.
-White blood cell: Pyelonephritis, acute glomernephritis, nephritic syndrome
-**Waxy: hyaline casts, stasis of urine, chronic renal disease
Term
Urochrome
Definition
the yellow or amber color of normal urine is due to the presence of a yellow pigment called urochrome. **Urochrome is one of the products formed when hemoglobin breaks down in to simpler compounds.
Term
G6PD Deficiency
Definition
cells are referred to Burr cells. Burr cells are irregularly shaped RBC’s with symmetric, knobby projections. (in heredity G6PD deficiency, the cells are referred as Spherocytosis.
Term
Anemias of Chronic Disease
Definition
Normocytic normochromic anemias,
most common causes are infection, inflammation and malignancy. The RDW is normal. Hemoglobin will be normal but hemocrit will be decreased.
Term
RDW-Red Cell Distribution Width
Definition
provides an estimate of RBC anisocytosis (size variations). RDW is the earliest manifestation of iron deficiency. May be useful in distinguishing iron deficiency anemia from B-thalassemia and anemia of chronic disease. RDW is high in IDA. RDW is normal in thalassemia. RDW is normal in Anemia of chronic disease. RDW is high in Vitamin B-12 deficiency. RDW is high in Folate Deficiency.
Term
Eosinophils
Definition
are most often associated with parasitic infections such as roundworms and fluke infestation.
Term
Eosinophils
Definition
are most often associated with parasitic infections such as roundworms and fluke infestation.
Term
Neutrophil Increase
Definition
Inflammation is the most frequent condition associated with neutrophilic leukocytosis (neurtophilia). Besides an increase in total neutrophil count, there is often some degree of immaturity (“shift to the left”). Usually a shift to the left involves an increase in the early segmented and the band neutrophil stages.
Term
Intrinsic Pathway
Definition
vessel wall injury activates this pathway.
Term
Extrinsic Pathway
Definition
tissue thromboplastin released from injured cells activates this pathway
Term
Iron Deficiency Anemia (IDA)
Definition
most common causes are: chronic GI blood loss in adults, and dietary deficiencies in children. The RDW is high an IDA. TIBC is increased, serum iron decreased and ferritin is decreased. Most will have PICA (these people eat ice chips, clay, dirt, starch or salt).
Term
Uric Acid
Definition
color: Yellow-Brown; shape: polymorphous, rhombohedral prisms, hexagonal plate; Clinical Significance: Gout (chronic alcoholism will lead to a build up of uric acid in the joints that results in Gout), malignant lymphoma or leukemia, fever, some renal tubular diseases.
Term
Sickle Cell Tests
Definition
there are three tests for sickle cell disease: 1) hemoglobin electrophoresis done to find out if the abnormality of Hb S is present in both genes (SS) or some combination of another hemoglobin with the S genes. 2) sickle cell prep, which is doing a finger puncture and placing a drop of blood on a slide and look under the microscope for the characteristic sickle forms. 3) enzyme immunoassay (Hemocard Hb S) using an antibody that is specific for Hb S; sensitive enough for newborn screening and not affected by Hb F or the hematocrit level.
Term
24 Hour Urine Specimen
Definition
The 24 hour urine specimen is a pooling of all urine excreted by patient over a 24 hour period. This test is for quantitative estimations of urinary solute.
Term
Proteinuria
Definition
large amounts of protein present in urine. When you see protein in urine, think kidney disease. This is tested for with a 24 hour urine specimen.
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