Automated Testing
In this instrument, the sample is mixed with a lysing agent AND a fluorescent dye is added to the mixture to aid with flow cytometry analysis
Sysmex
Heinz bodies contain this and can be visualized using this type of stain
Precipitated Hb; New Methylene Blue (supravital stain)
Which factors does UFH inhibit?
IIa, IXa, Xa, XIa, XIIa
What is a non-conforming event?
any occurrence, product, or process that fails to meet established standards, specifications, or procedures. These deviations require immediate identification, documentation, investigation, and corrective action to prevent recurrence.
What does a code brown indicate in a hospital setting in Alberta?
chemical spill or hazardous substance release
Beckman Coulter instruments use VCS technology in its flow cell. What does this mean?
V = volume analysis, C = conductivity analysis, S = light scatter analysis
Differentials and RBC morphologies should not be performed on this type of smear
Buffy coat smears, trephine biopsy, thick smear
What is reptilase used for and why is it helpful?
Used in conjunction with TT to diagnose fibrinogen deficiencies (quality and quantity) and detect heparin contamination; snake venom similar to thrombin but this is helpful because it’s resistant to inhibition by antithrombin III, so samples contaminated with heparin or pts with direct thrombin inhibitors do not have a prolonged TT.
You drop your mom off to her doctor's appointment before you go to work an off shift at RAH Core department. When you get to work, you get an unexpected call from your mom. She forgot her healthcare card and wants you to look her up so you can provide her with the information. What should you do?
Kindly refuse.
Health information management in AHS dictates who is allowed to disclose what information. Although you are a healthcare worker, you are not directly responsible for your mom's care. Accessing records are strictly on a need-to-know basis.
How do we ensure/improve ergonomic safety in a cramped laboratory with repetitive pipetting tasks?
- remove barriers to doorways/work are
- place objects not pertinent to tasks away
- taking breaks between pipetting (do something different)
- use an automatic pipette
- take stretch breaks between tasks
- place signage to indicate where things are located/if a person is working in a tight space
Describe the term ‘carryover’ as it relates to Hematology analyzers
If rinse and cleaning between samples is not adequate, or a previous sample had a really high count, cell carry over can occur. This will affect cell counts and can be minimized by additional rinsing between samples
CSF is collected into 3-4 tubes that are numbered. Which tube do technologists perform a cell count and why may physicians want Heme techs to count cells in two tubes
3rd/4th tube (last) and physicians may want to investigate for a traumatic collection so the first and last tube are investigated
What conditions may falsely shorten PT/PTT? Give three scenarios.
hemolysis (started clotting)
traumatic collection (tissue factor released)
prolonged tourniquet application (factors concentrated)
cold storage can activate plts and factors
bacterial contamination
clotted samples
Name the stain used in Hematology to visualize peripheral blood smears
Wright-Giemsa stain OR May-Grunwald Giemsa stain
What is a Class C fire?
Any fire that involves electrical equipment, electrical appliances, or electrical wiring. They are caused by energized electrical elements, such as damaged power cords or overloaded electrical outlets
What can falsely increase red cell counts? Name 3.
giant plts
fibrin strands
very high WBC counts
Name the three types of bone marrow preps and briefly describe what they are used for
Push/Direct/Aspirate smear: for differential cell counts of hematopoietic cells.
Squash/Particle: assessing cellularity, megakaryocyte numbers (2-7 in each particle), and the presence of abnormal cells.
Trephine biopsy/imprint: NOT processed in heme; provides structural information, preserving cell relationships and bone marrow architecture, making it superior for diagnosing diseases that involve the bone itself, like lymphomas, myelofibrosis, and evaluating overall marrow cellularity.
Which factors does thrombin activate?
Factors I, V, VIII, XI, XIII
Literature also states FVII, but not primary activator; TAFI is not technically a factor
Name some of the services provided by the CSMLS?
- continuous learning opportunities
- liability insurance for techs
- prior learning assessments for internationally trained techs
- national certification body/provides exam/competency profiles
You are in the lab preparing buffy coat smears. You are spinning your Wintrobe tubes when suddenly you hear glass breaking inside the centrifuge. What are your next steps?
Stop the centrifuge
Wait thirty minutes for aerosols to settle before opening the centrifuge
Don N95/bring centrifuge to BSC
Disinfect intact tubes/discard broken tubes
This is used to measure Hb in Hematology instrumentation. Please give the wavelengths associated with each instrumentation.
Spectrophotometry
Beckman: 2 methods = 525 (cyanide-Hb pigment), 540 nm (cyanmethemoglobin)
Sysmex: SLS-Hb at 555 nm
What is the % parasitemia using a Miller Ocular lens if a technologist counted 16 parasitized cells in the larger square and 110 RBCs in the smaller square.
1.6%
Choose two coagulation test principles and describe them.
Mechanical Endpoint: measures oscillation of steel ball; ball will stop oscillating once clot forms (ex: PT/PTT)
Photo-optical (Turbidimetric): light passes through sample and as clot forms, absorbance increases (ex: PT/PTT)
Chromogenic Endpoint: uses enzymatic properties of coag factors; uses chromogens bound to peptides that are similar in composition to natural target of coag factor; when present, it will cleave the peptide and colour change is measured (ex: factor-specific assays)
Light-Absorbance (Immunologic): latex microparticles with antibodies used to detect factors (ex: D-dimer testing)
Name three causes of an elevated ESR
high levels of fibrinogen
increased rouleaux formation
decreased number of RBCs
macrocytosis
increased Igs
tilted tube
high temperature
vibration
What are HIACs?
Hazard identification, assessment, and control constitute a proactive safety process to identify workplace dangers (physical, chemical, biological), evaluate their risk levels, and implement controls to eliminate or minimize harm.
Steps: Hazard ID, risk assessment, hazard controls, review/evaluation