CAP Pro Course - Hematology - White Blood Cells

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Margaret A. Reinhart, MS, MT(ASCP)
Reviewer: Laurie Bjerklie, MA, MLS(ASCP)CM

Continuing Education Credits

Objectives

  • Identify preanalytic variables that may adversely affect the accuracy of automated white blood cell counts or manual differentials.
  • Identify non-white blood cell particles that may interfere with automated white blood cell counts and interpret general instrument flagging messages.
  • Differentiate mature, immature, and abnormal myeloid cells on peripheral smears and correlate findings with basic clinical conditions.
  • Differentiate mature, immature, and abnormal lymphoid cells on peripheral smears and correlate findings with basic clinical conditions.

Course Outline

  • Identify preanalytic variables that may adversely affect the accuracy of automated white blood cell counts or manual differentials.
      • Sample Collection Requirements for Automated White Blood Cell Analysis
      • Time and Temperature Impacts on WBC Stability
      • Alternative Anticoagulant Use in Specimen Collection
      • Degenerative WBC Changes Observed on Manual Differential Smear
      • The recommended maximum time and temperature for storing a blood sample before making a smear or performing an automated white blood cell differential...
      • What, if any, alternative anticoagulant can be used if the anticoagulant in a lavender top tube is causing platelet clumping?
      • A medical laboratory scientist sees several of these structures, indicated by the arrows, on a manual blood smear. Please identify them.
      • The medical laboratory technician observes platelet clumping in a blood sample, and in vitro sensitivity to EDTA is suspected. The blood is redrawn in...
  • Identify non-white blood cell particles that may interfere with automated white blood cell counts and interpret general instrument flagging messages.
      • Platelet-associated Interference: Platelet Clumps
      • Platelet-associated Interference: Megakaryocytes
      • Platelet-associated Interference: Giant Platelets
      • Particle Interference: Lyse-Resistant Red Blood Cells
      • Particle Interference: Nucleated Red Blood Cells (nRBCs)
      • Particle Interference: Cryoglobulins
      • Instrument Flagging: Manufacturer-defined Flags
      • Instrument Flagging: User-defined Flags/ User-adjustable Manufacturer-defined Flags
      • A medical laboratory scientist is reading a blood smear and sees the structures indicated by the arrows.What is the identification of these structures...
      • The following flag is usually determined and set by the lab and not by the manufacturer of the instrument:
      • A medical laboratory scientist is reading a blood smear and sees the structures indicated by the arrows. What is the identification of these structure...
      • Nucleated red blood cells and lyse-resistant red blood cells can be misidentified by some hematology analyzers. Which of the following is most likely ...
  • Differentiate mature, immature, and abnormal myeloid cells on peripheral smears and correlate findings with basic clinical conditions.
      • Introduction
      • Mature Myeloid Cells
      • Immature Myeloid Cells: Granulocytes
      • Immature Myeloid Cells: Monocytes
      • Abnormal Myeloid Cells in the Peripheral Blood: Immature Cells
      • Abnormal Myeloid Morphology: Benign Changes
      • What is the correct order of granulocyte maturation in the bone marrow?
      • A medical laboratory science student was practicing manual differentials and their cell identification. They were reviewing a smear from a 24-year-old...
      • A medical laboratory science student was practicing manual differentials and their cell identification. They were reviewing a smear from a 62-year-old...
      • A medical laboratory scientist sees 51% of the cells indicated by the arrows in the image in a WBC differential. What is a likely diagnosis of this pa...
      • A medical laboratory science student was practicing manual differentials and their cell identification. How would they correctly identify this cell?
  • Differentiate mature, immature, and abnormal lymphoid cells on peripheral smears and correlate findings with basic clinical conditions.
      • Mature Lymphoid Cells
      • Variations in Mature Lymphocyte Morphologies
      • Immature Lymphoid Cells
      • Abnormal (Malignant) Lymphocyte Morphologies
      • Abnormal (Malignant) Lymphocyte Morphologies, continued
      • A medical laboratory science student was practicing manual differentials and their cell identification. What would they call these cells?
      • A technologist found several cells identified by the arrow in the image in a blood smear. Name the cell and a possible cause.
      • A medical laboratory science student was practicing manual differentials and their cell identification. On this smear review, would they classify eith...
      • A CBC has an abnormal cell count flag and cell morphology flag. The smear is reviewed by the medical laboratory scientist and numerous cells similar t...
      • A medical laboratory scientist is reading a smear of a patient with multiple myeloma. She finds a few cells that have unusual morphology, such as the ...
  • References
      • References

Additional Information

Level of Instruction: Intermediate
Intended Audience: This program is designed as an educational and training tool for MLS, MT, and MLT personnel, medical laboratory science students and interns, pathology residents, and practicing pathologists.
Author: Margaret Reinhart, MS, MT(ASCP) is a Senior lecturer in Biological Sciences at the University of the Sciences in Philadelphia PA where she teaches hematology, clinical immunology, parasitology, and other related courses. She was the MLS Program Director there for 30 years. She is also adjunct instructor in Hematology at Pennsylvania Hospital, Philadelphia PA. She holds a Masters Degree in Biology and in Health Care Administration.
Reviewer Information: Laurie Bjerklie, M.A., MLS(ASCP)CM is currently a Content Developer for MediaLab and LabCE. She earned a B.S. in Medical Laboratory Science from the University of North Dakota and an M.A. in Curriculum and Instruction from Saint Xavier University. She has over 14 years of experience in higher education and has held faculty positions in both MLT and MLS programs. She most recently served as the Program Manager of Medical Laboratory Science at Saint Louis University.

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