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PCM III Test 2 > Anemia/CBC/Blood smears > Flashcards

Anemia/CBC/Blood smears Flashcards

1
Q

Anemia

A

laboratory measurement indicating the red cell mass measurement (Hgb or Hct) in a patient is:
< than 2.5 percentile value of reference range

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2
Q

3 reasons to be anemic?

A

blood loss, hemolysis, decreased RBC production

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3
Q

microcytic, normocytic, macro?

A

MCV = mean cell volume

microcytic = 100

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4
Q

microcytic anemias?

A

iron defic.
anemia of CD
thalassemia
lead toxicity

“I love the CD’s”

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5
Q

normocytic anemias?

A
  • hemolytic
  • aplastic anemia
    -hypersplenism
    -acute bleeding
    -anemia of CD- renal failure
    -hemodilution
    -uremia
    -marrow -replacement/fibrosis
    sickle cell anemia
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6
Q

macrocytic anemias?

A

B12 deficiency
Folate deficiency
alcoholic liver disease
MDS

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7
Q

MCHC

A

mean cell hgb. concentration

= : average hemoglobin concentration in a volume of red cells in grams/dL; surrogate measure of hemoglobin concentration within an average sized red cell.

Reference Range = 33 - 37 gm/dL

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8
Q

normochromic normocytic anemia?

A

think hemolytic anemia

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9
Q

retics?

A

Immature erythrocytes contain remnant endoplasmic reticulum & ribosomal RNA (Rough ER) that forms a reticulum (net) within RBC cytoplasm

**This remnant Ribosomal RNA reticulum stains blue with Methylene Blue (seen as blue speckles)

Retics circulate 2-3 days before all ribosomal structures are extruded - they are present normally in 2% of population

  • provide a measure of the rate of production and release of red cells by the marrow into the peripheral blood

adults: .5-1.5%
kids: 3-7% retics

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10
Q

reticulocytosis

A

release of retics from marrow 3-4 days after an acute episode of hemorrhage

(reticulocyte count) should peak in 6-10 days

causes:
Acute blood loss or hemorrhage

Acute hemolysis

Hemolytic anemia

Response to therapy (Fe or other
nutritional correction of deficiency)

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11
Q

iron deficiency anemia vs. anemia of CD?

A

IDA:

  • ferritin is low
  • TIBC is high
  • serum iron - low
  • hepcidin low

ACD:

  • ferritin is high
  • TIBC is low
  • serum iron is low
  • hepcidin high
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12
Q

hemolytic anemia

A 
retics: high
coombs test: positive
haptoglobin: low
bilirubin: elevated (conj and unconj.)
RDW: high 
peripheral smear: fragmented RBCs, spherocytes,
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13
Q

differentiating b/t cells

A 
neutrophils = 3-5 lobes
monocytes = kidney lobes
lymphocytes: no lobes, just a circle
eosinophils: 2 lobes
basophils: just dots
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14
Q

normal number of RBCs?

A

4-6 x 106/μL

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15
Q

anisocytosis

A

variation in the SIZE of cells that are normally uniform, especially such a variation in red blood cells.

ex: Fe defic, sideroblastic anemia, MDS, B12/folate defic.

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16
Q

hypersegmented neutrophils?

A

B12 defic, folate defic.

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17
Q

Poikilocytosis

A

variations in RBC SHAPE

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18
Q

macroovalocytes

A

oval cells that are large - seen in megaloblastic anemia

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19
Q

schistocytes

A

fragmented erythrocytes

seen in TTP, DIC, HUS, defective heart valves, hemolytic anemias

20
Q

acanthocyte

A

“burr cell”

RBC w/ irregularly spaced projections = liver disorders

21
Q

Codocyte

A

“target cell” - seen in sickle cell and thalassemias

22
Q

dacrocyte

A

tear drop cell- seen in myeloproliferative disorders, myelofibrosis, pernicious anemia and thalassemias

23
Q

stomatocyte

A

folded RBC that mimcs lips/mouth/slit like appearance

seen in hemolytic anemias

24
Q

2 classic poikilocytes of SSD?

A

sickle cells, target cells

25
hypochromic?
think thalassemia, IDA, sideroblastic anemia
26
decreased central pallor? more red?
hereditary spherocytosis AI hemolytic anemia
27
rouleax
stack of coins - seen in MM - due to elevated plasma fibrinogen/globulins
28
clumping of RBC/s?
due to cold agglutinins
29
pyknotic ?
dense nucleus seen in RBCs - these are immature RBC progenitors not normally seen in blood indicates “stressed” bone marrow unable to meet increased red cell requirements. They are seen in patients undergoing hemolytic crises.
30
what do you think of if see retics and nucleated RBCs?
Indicative of hemolytic process, stress, hypoxemia, or myelofibrosis- Except in newborns
31
basophilic stippling
"inclusion bodies" round, dark-blue granules in reticulocytes on smears stained with supra vital stains (brilliant cresyl blue). granules are precipitated ribosomes and mitochondria. Classic finding in lead poisoning.
32
howell-jolly bodies
"inclusion bodies" They are nuclear fragments of condensed DNA, 1-2 µm diameter, normally removed by the spleen. Seen in severe hemolytic anemias and in post-splenectomy patients (below).
33
normal WBC range?
4.0-10.9 x 103/ μL
34
neutrophils range?
50-60% Elevated in bacterial infections, stress, corticosteroid therapy (see demargination) Immature forms often present with elevated count
35
lymphocytes range?
30-40% of circulating WBCs | Elevated in viral infections (Epstein-Barr, etc.)
36
smudge cells?
Fragile lymphocytes (smudge or basket cells) are common in chronic lymphocytic leukemia (CLL)
37
atypical lymphocytes?
mono
38
eosinophils/basophils?
Eosinophils - < 5% Elevated in parasitic infections, allergies Basophils - < 1% Elevated in chronic myelogenous leukemia (CML)
39
left shift?
: increase in immature forms in peripheral blood due to increased production: Infections, myeloid cancers see predominance of band cells (immature) over segmented cells (mature cells)
40
dohle bodies
inclusions in neutrophils seen in sepsis! Seen in systemic infectious or inflammatory disease Often accompanied by a left shift, toxic granulation and cytoplasmic vacuoles
41
hypersegmented neutrophils?
> 5 lobes | Can be seen in megaloblastic anemias
42
reduced lobulation of mature neutrophils?
Pelger-Huet anomaly Often associated with myelodysplastic syndromes
43
blasts
indicate WBC neoplasia (myeloid= leukemia or lymphoid= lymphoma)
44
plasma cells
indicate lymphoid neoplasia (e.g., multiple myeloma)
45
normal platelet count?
150,000-450,000/μL
46
giant platelets in periphery?
Suggest marrow response secondary to increased platelet destruction or consumption Congenital disorders Immune destruction Disseminated intravascular coagulation (DIC) Hemolytic uremic syndrome (HUS) Thrombotic thrombocytopenic purpura (TTP)

PCM III Test 2 (6 decks)

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