CAMLPR Hematology Practice Test

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Punch out crenated RBCs with refractory blotches; what artifact is this and how to prevent?

Water artifact; dry slides faster and fix with methanol before staining

The main idea is a water-related artifact. When slides aren’t completely dry or moisture remains, water interacts with the smear during staining, causing red blood cells to shrink and crenate and producing irregular, blotchy, refractile appearances. This is best prevented by ensuring the smear dries promptly and by fixing the smear with methanol before staining, which dehydrates and fixes cells and minimizes water-induced changes. The other listed artifacts don’t produce the same crenated, blotchy RBC appearance: lipid artifact, stain artifact from longer staining, and hemolyte artifact from anticoagulant issues each have different morphological signs and causes.

Lipid artifact; chill slides

Stain artifact; increase stain time

Hemolyte artifact; use different anticoagulant