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Chapter 17
Laboratory hematology
General concepts
Laboratory tests are ordered and interpreted within the context of a specific patient as routine screening during a periodic examination, in the setting of an illness for diagnosis or follow-up, or for preoperative certification of normal. Clinical judgment is applied in both the selection of tests and in their interpretation, and unexpected results should be considered within the framework of the patient and the disease. Some unexpected results may require confirmation, particularly if the integrity of the specimen cannot be insured (eg, heparin contamination or delayed processing). Also, any laboratory result can be incorrect for a variety of reasons, from
Terminology
Specific laboratory testing
Automated cell counting Aperture-impedance counters Optical method counters Erythrocyte analysis Leukocyte analysis Platelet analysis Reticulocyte analysis Peripheral blood morphology Erythrocyte sedimentation rate Leukocyte alkaline phosphatase score Bone marrow aspirate and biopsy Immunocytochemical and immunohistochemical stains Preparation of bone marrow samples for ancillary studies Ancillary testing Flow cytometry Normal hematopoiesis Cytogenetics Molecular diagnostics Southern blotting Polymerase chain reaction Hemostasis and thrombosis Coagulation testing Overview of key points 1:1 mixing study Specific factor assays Expected ranges in pediatric patients Prothrombin time Activated partial thromboplastin time Combined abnormalities of PT and aPTT Thrombin time Fibrinogen assays Reptilase time von Willebrand factor assays Ristocetin cofactor and vWF antigen. VWF activity Disseminated intravascular coagulation Fibrinolysis Quantitation of platelets Evaluation of platelet function Platelet aggregation Platelet function analyzers The template bleeding time Assays for platelet antibodies Assays for heparin-induced thrombocytopenia Assays for thrombotic thrombocytopenic purpura and the von Willebrand factor cleaving protease (ADAMTS13) Bleeding in the absence of abnormal coagulation tests and platelet abnormalities Evaluation of thrombophilia | ||||||||||||||||||||||||||||||||||||||||||||||||||