Page 1Page 2Page 3Page 4Page 5Page 6Page 7Page 8MLAB 1311Body Fluids BF Cell Counts - preTest Instructor:MLAB 1311Body Fluidspre-TestRevised Fall 2010 /10 Name _______________________________Date ___________________________Instructions: Neatly write your answer in the space provided. Unless otherwise noted, each question isworth one point.1. Which tube number is used for body fluid cell counts?2. Complete the following table. (2 pts.)Normal Color Normal ClarityA. serous fluidB. CSF3. Define xanthochromia. (Be specific.)4. W hat three body fluids are referred to as serous fluids? (3 pts.)1. 2. 3. 5. What is the diluent of choice for body fluid cell counts?6. Using the information provided below, calculate the body fluid WBC & RBC cell counts. No dilution wasmade. Show your work, and use correct units. (2 pts)W BC – The four large corner squares were used for the count.Side 1 = 81 Reported results Side 2 = 73RBC – All 25 small squares (of the center square) were used for the count.Side 1 = 47 Reported results Side 2 = 39EXERCISE 5: Body Fluid Cell Counts Body FluidsBody Fluids/Urinalysis ; MLAB 1311  11Body Fluids Lab5 - Cell Counts Points:Points are awarded for Pre-test (10pt.), Skills (20 pts. total: includes general pointsawarded for neatness, lab clean-up, teamwork, etc. Student counts are expected to bewithin ± 20% of instructor values), as well as successful and timely completion of StudyQuestions.Study Questions are due by the end of the next lab period, or as designated by the courseinstructor.Objectives:According to standards set by the instructor, the student will be able to:1. Correctly classify color and transparency2. Perform W BC and RBC cell counts on two body fluid specimens within ± 20%accuracy using the hemacytometer.3. Use appropriate recording format to report results .4. Use quality control results to determine the acceptability of test results.5. Answer all pre-test and study questions using related information found in thetextbook, lecture guide, and this lab procedure.Materials:1. Two body fluid specimens2. Capillary pipets, and Kimwipes3. Hemacytom eter with coverslip4. Lens cleaner, lens paper, and alcohol prep pads5. Microscope6. Cell Counter7. Petri dish with cover and dampened cottonballReferences:Current hematology course textbook.Current urinalysis / body fluids course textbook.Principle:CSF Cerebral Spinal Fluid fluid specimens are usually collected in three sterile tubes andlabeled 1, 2, and 3 in the order in which they are drawn. Tube 1 is used for chemical andserological tests. Tube 2 is used for microbiological tests. Tube 3 is used for cell countsand differentials. In rare cases, four tubes may be drawn in which case Tube 1 may notbe used. All body fluid testing should be performed immediately upon specimen receiptas deterioration of specimen components can occur rather quickly, however, CSFsamples are particularly important. The spinal puncture procedure has a number ofinherent risks and performed only when absolutely necessary. Some example of theseoccasions include: meningitis, suspected cerebral hemorrhage / stroke, leukemia andmalignancy, and to aid in diagnosing or confirming a CNS disorder. The appearance and color of the CSF, and most other body fluids can provide valuablediagnostic information about a patient's condition. Both color and clarity must be recordedon the report form. CSF is normally colorless and clear in appearance. Yellow, pink ororange are abnormal colors for CSF. A ‘xanthrochromic CSF specimen will have a yellowcolor that remains after centrifugation. It is important to note the appearance of all three of the CSF tubes shortly after drawing.If the #1 tube appears to contain blood / RBCs, but tubes 2 & 3 appear to have lesseramounts, it is likely that the blood is due to a traumatic tap, rather than the result of thepatient having a cerebral hemorrhage. The appearance of a small blood clot also indicatesa traumatic tap. Specimens from patients who have recently suffered a CNS hemorrhagewill be xanthrochromic and the microscopic differential exam may show inclusions in thecytoplasm of the macrophages.There are other laboratory characteristics of the CSF to be noted: The differential on normal CSF will result in 5/uL or less white blood cells (<3 / uLfornewborns) and no red blood cell are considered normal for either group. The chemistryprotein level is 15-45 mg/ dL and the glucose in CSF is @ 60-70 % of the patient’scurrent level. The most common types of CSF infection seen in adults are caused by SEXERCISE 5: Body Fluid Cell Counts Body FluidsBody Fluids/Urinalysis ; MLAB 1311  22pneumoniae, N meningitis, and S aureus - if the patient has a shunt.Immunocompromised populations of persons are more susceptible to CSF fungalinfections caused by cryptococcus, coccidioides, and candidia species. CSF infectionsin children are more commonly due to H influenzae, N meningitis, and S pneumoniae,while newborns more often have infections from group B strep or E coli. Synovial fluid can be colorless to a pale yellow; its clarity is generally clear, but may havesome slight cloudiness due to the presence of synovial cell debris and fibrin. Serousfluids, like synovial fluid is an ultrafiltrate of plasma and may be light yellow in color. Serous fluids are normally clear. Serous fluids come from the pleural, pericardial andperitoneal body cavities. Additional information on these fluids is available in your textbookand the lecture materials. W BC and RBC cell counts provide extremely important information for the diagnosis andtreatment of diseases involving CSF, serous, and synovial cavities. Infections,hemorrhages, and malignancies are of primary concern.Most body fluids specimens do not need to be diluted prior to plating on thehemacytometer since they normally do not contain many, if any, cells. When thespecimen is NOT diluted, the dilution factor (the number that is put in the calculationformula provided below) is “1".Should a dilution be necessary due to a high cell count, normal saline is the diluent ofchoice. When a dilution is required, the appropriate dilution factor must be included in theformula for calculating the results. See listed references for additional directions on useof the hemacytometer and performance of cell counts.Basic form ulafor calculation of manual cell countsProcedure:1. Thoroughly mix body fluid specimen.2. Record