242/243: Intro to CBC, Approach to Anemias, Anemia CBL Flashcards
RBC characteristic associated with autoimmune hemolysis
Spherocyte (Dark RBC with no central pallor)
What is the next diagnostic step when RBC agglutination is found on a blood smear?
Warm up the sample, look again
(And probably run labs again to get accurate values for RBC count, MCV)
What could result in a falsely high RBC count? (2)
Marked leukocytosis (WBCs contribute more than expected)
Giant platelets (Platelets counted as RBCs)
Describe the RBC morphology in iron deficiency anemia
Microcytic, hypochromic anemia
Cells are little and pale
What shape will RBCs be if there is excess RBC membrane relative to the its volume?
Target cells
- Macro target cells: liver disease*
- Micro target cells: Hemoglobinopathy (thalassemia, HbgE, HgbC)*
What is the finding indicated by the arrows?
What is the DDx? (3)
Spherocytes
- Hereditary spherocytosis
- Autoimmune hemolytic anemia
- Burns
RBC characteristic associated with hereditary elliptocytosis
Ovalocyte
Also associated with B12/folate deficiency, iron deficiency
Are symptoms of orthostatic hypotension, headache, and tachycardia more likely with acute or chronic anemia?
Acute
No time for compensatory mechanisms to develop -> more symptoms
A patient with sickle cell disease has this finding
What does it indicate?
Splenic failure
List 4 clinical scenarios in which you would see increased numbers of immature RBCs on a peripheral blood smear
- Newborns (<5 days old)
- Brisk hemolysis
- Myelodysplasia
- Extramedullary hematopoiesis (blood cells being made outside of the bone marrow, seen in myelofibrosis)
Intravascular hemolysis will cause red blood cells to be what shape?
Schistocytes
Caused by microangiopathic hemolytic anemias
What could result in a falsely low RBC count? (3)
RBC agglutination (Multiple RBCs counted as one)
Microcytosis (RBCs too small to be counted)
Rouleaux formation (myeloma, inflammatory disorders)
What does mean corpuscular hemoglobin (MCH) measure?
The amount of hemoglobin in each RBC
Vs MCHC, which measures hemoglobin concentration in a given volume of packed RBCs
What does mean corpuscular Hb concentration (MCHC) measure?
Hemoglobin concentration in a given volume of packed RBCs
Vs. MCH, which measures amount of hemoglobin per RBC
What could cause a falsely low platelet count? (3)
Clotted sample
Platelet clumping
Frequent giant platelets