A patient sample comes off an automated cell counter with a ...

[Kthamas]

A patient sample comes off an automated cell counter with a failure of the red cell rule of three. The red count is lower than expected given the hemoglobin.
 
  The MCV, MCH, and MCHC are elevated. Which of the following is the most likely reason for this failure?
 
  a. Megaloblastic anemia
  b. Lyse-resistant red cells
  c. Cold agglutinin
  d. Lipemia

Question 2

Which of the following occurs if testing is not performed with 24 hours from specimen collection?
 
  a. White blood count rises
  b. WBCs deteriorate and RBCs swell
  c. Hemoglobin rises
  d. MCV decreases

[dlook33]

Answer to Question 1

ANS: C
The red count is lower than expected for the data; this suggests a cold agglutinin is present. The red cells are thus clumped at room temperature, and the clumps are being counted as one large cell. This lowers the red count and raises the MCV and MCHC. The only red cell parameter that is probably valid is the hemoglobin measurement.

Answer to Question 2

ANS: B
Sample age can have a profound effect on blood cell analysis. Specific problems with older samples include WBC fragility and loss, swelling (which increases the MCV) and possible lysis of RBCs, and the deterioration of platelets.

[Kthamas]

Correct answers!

[dlook33]

Great! Please up vote