MLSC-382A INSTRUCTOR BETH RAWSON 1 Resu

MLSC-382A INSTRUCTOR: BETH RAWSON
1
Results Interp Wksht Updated: 8/20/2020
RESULTS INTERPRETATION Worksheet STUDENT
NAME: __________________
SECTIONS 1 AND 2:
Given the following results, identify the abnormal or
questionable results, and provide at least one
explanation for them (there may be multiple explanations
possible). The first thing you have to decide is
whether the values presented are valid or spurious (i.e.
inaccurate due to either specimen quality or
handling). The second consideration is what could explain the
abnormalities you are seeing (what kind
of clinical situation OR specimen problem is suspected).
The time listed in the “Previous” column refers to the interval
between the current results and the most
recent previous values. If no values are listed in the “Previous”
column, assume there is no known
history. Generic reference ranges are provided.
NOTE: A key ability for any laboratory professional is to be

able to distinguish spurious results (those
due to improper specimen collection methods) from true clinical
variation due to a pathological
condition.
SECTION 1: CBC Testing
For each example, note which parameter(s) are pertinent to your
explanation. An asterisk next
to a value indicates that it has been flagged by the instrument.
Delta flags are indicated by [%D]
next to the value.
CBC #1: 57-year old Caucasian male, presented to the ED with
chest pain, diagnosed with myocardial
infarction and admitted to the ICU 2 days earlier.
CURRENT PREVIOUS
(8 hours)
REFERENCE
RANGE
UNIT
WBC 4.8 5.4 4.5 – 11.5 103/uL
RBC 2.87 4.65 4.60 – 6.00 (m) 106/uL
HGB 10.1 [%D] 14.2 14.0 – 18.0 (m) g/dL
HCT 29.1 [%D] 42.4 40.0 – 54.0 (m) %
MCV 101 [%D] 91 80 – 98 fL
MCH 35.1 30.5 26 – 32 pg
MCHC 34.7 33.4 32 – 36 g/dL
RDW 12.5 13.3 11.5 – 14.5 %
PLT 224 292 150 – 450 103/uL

MPV 7.9 8.1 6.8 – 10.2 fL
2
CBC #2: 27-year old Greek female, presented for prenatal
evaluation (20 weeks pregnant).
CURRENT PREVIOUS REFERENCE
RANGE
UNIT
WBC 6.6 4.5 – 11.5 103/uL
RBC 5.13 4.00 – 5.40 (f) 106/uL
HGB 10.7 12.0 – 15.0 (f) g/dL
HCT 34.9 35.0 – 49.0 (f) %
MCV 68 80 – 98 fL
MCH 20.9 26 – 32 pg
MCHC 30.7 32 – 36 g/dL
RDW 27.3 11.5 – 14.5 %
PLT 309 150 – 450 103/uL
MPV 7.4 6.8 – 10.2 fL

CBC #3: 19-year old African American male, presented to the
outpatient draw station subsequent to his
yearly physical examination; he did not have any complaints.
CURRENT PREVIOUS REFERENCE
RANGE
UNIT
WBC 5.6 4.5 – 11.5 103/uL
RBC 3.58 4.60 – 6.00 (m) 106/uL
HGB 11.0 14.0 – 18.0 (m) g/dL
HCT 46.4* 40.0 – 54.0 (m) %
MCV 130 80 – 98 fL
MCH 30.7 26 – 32 pg
MCHC 23.7* 32 – 36 g/dL
RDW 22.4 11.5 – 14.5 %
PLT 8* 150 – 450 103/uL
MPV 9.7 6.8 – 10.2 fL
3

CBC #4: 21-year old Filipino female, diagnosed 10 days earlier
with walking pneumonia due to
Mycoplasma pneumoniae.
CURRENT PREVIOUS
(10 days)
REFERENCE
RANGE
UNIT
WBC 3.8 5.6 4.5 – 11.5 103/uL
RBC 2.37 3.91 4.00 – 5.40 (f) 106/uL
HGB 12.0 11.0 12.0 – 15.0 (f) g/dL
HCT 22.3 [%D] 32.5 35.0 – 49.0 (f) %
MCV 94.1 [%D] 83.1 80 – 98 fL
MCH 50.5* 28.0 26 – 32 pg
MCHC 53.6* 33.7 32 – 36 g/dL
RDW 15.3 12.2 11.5 – 14.5 %
PLT 306 284 150 – 450 103/uL
MPV 9.9 9.6 6.8 – 10.2 fL
CBC #5: 41-year old Caucasian female, presented to the ED 12
hours earlier with multiple compound
fractures and major blood loss subsequent to a car accident, and
was admitted to the SICU following

surgery.
CURRENT PREVIOUS
(8 hours)
REFERENCE
RANGE
UNIT
WBC 18.4 [%D] 10.6 4.5 – 11.5 103/uL
RBC 2.85 2.00 4.00 – 5.40 (f) 106/uL
HGB 8.62 [%D] 6.58 12.0 – 15.0 (f) g/dL
HCT 26.1 [%D] 19.2 35.0 – 49.0 (f) %
MCV 91.4 [%D] 96.3 80 – 98 fL
MCH 30.2 32.9 26 – 32 pg
MCHC 33.1 34.2 32 – 36 g/dL
RDW 17.6 13.1 11.5 – 14.5 %
PLT 124 [%D] 245 150 – 450 103/uL
MPV 8.4 8.5 6.8 – 10.2 fL
4
SECTION 2: Coagulation Testing
For each scenario the relevant screening test results are given
(PT/INR, PTT, Fibrinogen, D-Dimer

values), and any anticoagulant therapy is noted. Mixing studies
or additional coagulation studies
are noted as appropriate.
Coagulation #1: 22-month old male presented to the pediatrician
for evaluation of history of easy
bruising and right knee swelling after the child ran into an end
table during play.
CURRENT PREVIOUS
(2 hours)
REFERENCE RANGE UNIT
PT 10.6 10.2 12.6 – 14.6 seconds
INR 1.0 0.9 0.9 – 1.2
PTT 48.5 52.1 23.8 – 34.2 seconds
Fibrinogen 422 160 – 455 mg/dL
D-Dimer 0.21 <0.50 mg/L
Anticoagulant None None None None
A mixing study was performed; results are as follows:
Coagulation #2: 42-year old Hispanic male presented to the ED

with lower left leg pain. Patient has a
history of DVT (3 years prior).
CURRENT PREVIOUS REFERENCE RANGE UNIT
PT 15.8 12.6 – 14.6 seconds
INR 1.5 0.9 – 1.2
PTT 23.8 23.8 – 34.2 seconds
Fibrinogen 115 160 – 455 mg/dL
D-Dimer 32.7 <0.50 mg/L
Anticoagulant None None None
PTT MIX Initial, 1:1 mix with
PNP
60 minutes, 37º, 1:1
mix with PNP
UNIT
PATIENT 27.6 26.9 seconds
CONTROL 28.5 29.1 seconds
5

Coagulation #3: 73-year old Asian-American female, presented
to primary care physician for routine
examination and anticoagulant medication management.
CURRENT PREVIOUS
(14 days)
PT 72.2 20.7 12.6 – 14.6 seconds
INR 6.4 2.0 0.9 – 1.2
PTT 35.4 23.8 – 34.2 seconds
Fibrinogen 160 – 455 mg/dL
D-Dimer <0.50 mg/L
Anticoagulant Coumadin Coumadin None None
Coagulation #4: 67-year old Indian male, admitted for removal
of right foot abscess.
CURRENT PREVIOUS
(24 hours)

PT 9.4 13.1 12.6 – 14.6 seconds
INR 0.8 1.0 0.9 – 1.2
PTT 16.4 28.7 23.8 – 34.2 seconds
Fibrinogen 160 – 455 mg/dL
D-Dimer <0.50 <0.50 mg/L
Anticoagulant None None None None
6
SECTION 3: Hemoglobinopathy Testing
For each of 8 patient examples you are given the citrate agar
(acid pH); the cellulose acetate (alkaline
pH); the hemoglobin, hematocrit, and MCV; and patient
demographics.
For each patient example, given the agar/acetate and CBC
results, determine ALL possible hemoglobin
phenotypes. If there are multiple options, which one is most
likely? (HINT: look at ethnicity)
Refer to the “Hgb Electrophoresis Interpretation” lecture on
Canvas for more guidelines and examples.

List the hemoglobin fractions that travel with each of the 4
control fractions. Only consider A, A2, F, S,
C, D, G, E, and O for this exercise.
Acid agar: Alkaline acetate:
F: ________________ A: _______________
A: ________________ F: _______________
S: ________________ S: _______________
C: ________________ C: _______________
Patient #1: 4-month old Caucasian male
Hgb 14.2 g/dL
Hct 45.1 %
MCV 100 fL
Final phenotype: ______________________________ (HINT: Is
this normal for age?)
Patient #2: 24-year old Asian-American female
Hgb 12.5 g/dL
Hct 38.7 %
MCV 89 fL
Final phenotype: ______________________________

Patient #3: 45-year old Egyptian male
Hgb 13.3 g/dL
Hct 39.3 %
MCV 87 fL
Final phenotype: ______________________________
7
Patient #4: 7-year old African-American male
Hgb 12.0 g/dL
Hct 34.5 %
MCV 68 fL
Final phenotype: ______________________________
Patient #5: 29-year old African-American male
Hgb 11.9 g/dL
Hct 36.5 %

MCV 82 fL
Final phenotype: ______________________________
Patient #6: 36-year old Thai male
Hgb 12.4 g/dL
Hct 37.0 %
MCV 74 fL
Final phenotype: ______________________________
Patient #7: 41-year old Indian female
Hgb 13.1 g/dL
Hct 38.6 %
MCV 84 fL
Final phenotype: ______________________________
Patient #8: 18-year old Israeli female
Hgb 11.3 g/dL
Hct 32.6 %

MCV 82 fL
Final phenotype: ______________________________
8
Citrate Agar – Acid pH
Patient 1
Patient 2
Patient 3
Patient 4
Patient 5
Patient 6
Patient 7
Patient 8

CONTROL
C S A F
Cellulose Acetate – Alkaline pH
Patient 1
Patient 2
Patient 3
Patient 4
Patient 5
Patient 6
Patient 7
Patient 8
CONTROL
C S F A

Part 3: MLA Research
Task: Locate one at least one other scholarly article from a
scholarly article or essay database (other than the ones I have
given (or will give you); and mark up the sections that relate to
some aspect of your intentional paper.
Initially, you will need to research several pdf files for your
article to determine which one would be best. Find one that is
interesting and easy enough to comprehend the central argument
(you do not need to read the entire article, just the summary or a
few pages should be enough to make a judgement about whether
it will support your working thesis). The essay or article should
have something to do with an idea that will fit in the
topic/thesis for your paper or may provide you with ideas to put
into your chosen topic/thesis.
Then, complete the following steps:
1. Print out the pages of the article you will use (or the entire
article if you prefer), making marginal and in-text citations in
to show your comprehension of the article and how it lends
itself to your paper topic. You can print off the article or
page(s) and annotate, then take a picture or scan or annotate on
word or another program and submit.
2. Compose one very good paragraph explaining how this article
relates to your paper.
3. Compose a work cited page (with the proper “Works Cited”
citation at the top) for your article (including the text you are
writing about). Therefore, you should have two works listed on
your work cited page. Remember, your works cited page should
be in alphabetical order. Follow MLA current guidelines for
works cited pages. See
https://owl.purdue.edu/owl/purdue_owl.html if necessary.
4. Hand in your article, paragraph, AND your work cited page.

Make sure you put your name on the assignment!
What you will turn in:
1. Annotated page(s) of a scholarly article (or entire article) for
your paper
2. 3-5 or more sentence paragraph explaining how you will use
the information
3. Works Cited page with scholarly article and text in MLA
format
Practical – Slide 10
1
MLSC-382 Updated: 9/20/2020 SLIDE 10
WBC Differential: Please individually identify all 60 cells
below to the best of your ability, using the
following categories as options. When recording your answers
in the table, please use the indicated
shorthand (see bolded abbreviations and their corresponding
WBC subtype below).
• Seg (segmented neutrophils)
• Band (band neutrophil)
• Lymph (normal lymphocyte)
• Mono (monocyte)
• Eo (eosinophil)
• Baso (basophil)
• Atyp (atypical/reactive lymphocyte)
• Meta (metamyelocyte)
• Myelo (myelocyte)
• Pro (promyelocyte)
• Blast (blast)

• Plasma (plasma cell)
• Abn lymph (abnormal lymphocyte)
OTHER POSSIBLE CELLS TYPES SEEN
• nRBC (nucleated RBC)
• Platelet (large or giant platelet)
ASSUME ALL IMAGES COME FROM THE SAME SLIDE –
Use context to help you decide what each cell is
best identified as. Start with the cells you know, and then
compare back to those.
NOTE: All of the WBC subtypes listed here are NOT
necessarily represented in the images included.
This list represents all of the POSSIBLE options. You may end
up using each cell ID once, more than
once, or not at all.
1 2 3 4 5 6
7 8 9 10 11 12
13 14 15 16 17 18
19 20 21 22 23 24
2

25 26 27 28 29 30
31 32 33 34 35 36
37 38 39 40 41 42
43 44 45 46 47 48
49 50 51 52 53 54
55 56 57 58 59 60
3
RBC Morphology Quantitation and Platelet Estimate:
Assume that each of the following images constitutes a single
field, seen under the equivalent of 100x
magnification. Evaluate them as a whole and report the RBC
morphology based on the instructions
included with the practical.
NOTE: Do NOT report 4 individual answers (one for each

image); report ONE answer for the whole
“slide.”
4
Practical – Slide 9 STUDENT NAME:
_________________________
1
WBC subtype below).

• Mono (monocyte)
• Eo (eosinophil)
• Baso (basophil)
• Blast (blast)
1 2 3 4 5 6
7 8 9 10 11 12
13 14 15 16 17 18

19 20 21 22 23 24
_________________________
2
25 26 27 28 29 30
31 32 33 34 35 36
37 38 39 40 41 42
43 44 45 46 47 48
49 50 51 52 53 54
55 56 57 58 59 60

_________________________
3
“slide.”
_________________________
4

1
WBC subtype below).
• Mono (monocyte)
• Eo (eosinophil)
• Baso (basophil)
• Blast (blast)

1 2 3 4 5 6
7 8 9 10 11 12
13 14 15 16 17 18
19 20 21 22 23 24
2
25 26 27 28 29 30
31 32 33 34 35 36
37 38 39 40 41 42

43 44 45 46 47 48
49 50 51 52 53 54
55 56 57 58 59 60
3
“slide.”

4
1
WBC subtype below).
• Mono (monocyte)
• Eo (eosinophil)
• Baso (basophil)
• Blast (blast)

1 2 3 4 5 6
7 8 9 10 11 12
13 14 15 16 17 18
19 20 21 22 23 24
2

25 26 27 28 29 30
31 32 33 34 35 36
37 38 39 40 41 42
43 44 45 46 47 48
49 50 51 52 53 54
55 56 57 58 59 60
3
“slide.”

4
`
1
WBC subtype below).
• Mono (monocyte)

• Eo (eosinophil)
• Baso (basophil)
• Blast (blast)
1 2 3 4 5 6
7 8 9 10 11 12
13 14 15 16 17 18
19 20 21 22 23 24

2
25 26 27 28 29 30
31 32 33 34 35 36
37 38 39 40 41 42
43 44 45 46 47 48
49 50 51 52 53 54
55 56 57 58 59 60
3

“slide.”
4
1

WBC subtype below).
• Mono (monocyte)
• Eo (eosinophil)
• Baso (basophil)
• Blast (blast)

1 2 3 4 5 6
7 8 9 10 11 12
13 14 15 16 17 18
19 20 21 22 23 24
2
25 26 27 28 29 30
31 32 33 34 35 36
37 38 39 40 41 42
43 44 45 46 47 48

49 50 51 52 53 54
55 56 57 58 59 60
3
RBC Morphology Quantitation:
“slide.”
4

1
WBC subtype below).
• Mono (monocyte)
• Eo (eosinophil)
• Baso (basophil)
• Blast (blast)

1 2 3 4 5 6
7 8 9 10 11 12
13 14 15 16 17 18
19
20
21
22
23

24
2
25 26 27 28 29 30
31 32 33 34 35 36
37 38 39 40 41 42
43 44 45 46 47 48
49 50 51 52 53 54
55 56 57 58 59 60

3
“slide.”
4

1
WBC subtype below).
• Mono (monocyte)
• Eo (eosinophil)
• Baso (basophil)
• Blast (blast)

1 2 3 4 5 6
7 8 9 10 11 12
13 14 15 16 17 18
19 20 21 22 23 24
2
25 26 27 28 29 30
31 32 33 34 35 36
37 38 39 40 41 42

43 44 45 46 47 48
49 50 51 52 53 54
55 56 57 58 59 60
3
“slide.”

4
1
WBC subtype below).
• Mono (monocyte)
• Eo (eosinophil)
• Baso (basophil)

• Blast (blast)
1 2 3 4 5 6
7 8 9 10 11 12
13 14 15 16 17 18
19 20 21 22 23 24

2
25 26 27 28 29 30
31 32 33 34 35 36
37 38 39 40 41 42
43 44 45 46 47 48
49 50 51 52 53 54
55 56 57 58 59 60
3

“slide.”
4
1
WBC subtype below).

• Mono (monocyte)
• Eo (eosinophil)
• Baso (basophil)
• Blast (blast)
1 2 3 4 5 6
7 8 9 10 11 12

13 14 15 16 17 18
19 20 21 22 23 24
2
25 26 27 28 29 30
31 32 33 34 35 36
37 38 39 40 41 42
43 44 45 46 47 48
49 50 51 52 53 54
55 56 57 58 59 60

3
“slide.”
4

MLSC-382A INSTRUCTOR BETH RAWSON 1 Resu

MLSC-382A INSTRUCTOR BETH RAWSON 1 Resu

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