Anemia I: CBC, erythrp, RBC studies, types of anemia

Question 1

3 requirements for erythropoeisis

Answer 1

Fe
Folate
B12

Question 2

Role of 2,3 DPG

Answer 2

Decreases O2 affinity & promotes O2 release

Question 3

Normal WBC value

Answer 3

4 000 – 10 000 cells/ µl

Question 4

Normal Hgb

Answer 4

M-13.5 – 17.5 g/dL

F-11.5 – 15.5 g/dL

Question 5

HCT

Answer 5

W-40% (+/- 5%)

M-45% (+/- 5%)

Question 6

Normal platelet count

Answer 6

145 000-370 000 cells/ µl

Question 7

RBC Count

• Normal value
• Role

Answer 7

Red Blood Cell Count
4.7 - 6.1 Million/ µL
• Number of RBC per millimeter used to calculate MCV
• MCV= HCT(%) x 10/RBC (millions/microL)

Question 8

Reticulocyte Count

• Normal value
• Role

Answer 8

Reticulocyte Count
1% of RBC
• Reticulocyte Count Index: Corrected RC because in anemia RBC is low so RC is inflated
• High RC indication of hyperactive bone marrow
• Inappropriately low reticulocyte count in the face of anemia is an indication of bone marrow that is not functioning well

Question 9

MCV

• Normal value
• Role

Answer 9

Mean Corpuscular Volume (MCV)
80-98 fl (femtoliters 10-15)
•	Volume of all RBC divided by the number of RBC
o	Classification of the anemia
o	Elevated: Macrocytic
o	Normal: Normocytic
o	Decreases: Microcytic
•	Estimated by peripheral smear
•	MCV= HCT(%) x 10/RBC (millions/microL)

Question 10

MCH or MCHC

• Normal values
• Role

Answer 10

32-37 g/dL

Mean corpuscular hemoglobin (MCH)

o Measure of the average mass of hemoglobin per RBC
o Classification
 Hypochromic (iron deficiency or thalassemia)
 Hyperchromic (sickle cell disease, heredity spherocytosis & Hgb C disease)

Mean Corpuscular hemoglobin Concentration (MCHC)

o Concentration of hemoglobin in a given volume of packed RBC
o High values: hereditary spherocytosis, sickle cell disease
o Low values: Iron deficiency: thalassemia

Question 11

Red Cell Distribution

• Normal values
• Role

Answer 11

Red Cell Distribution Width
11.5-14.5%

• Measure of the degree of variation in RBC size = SD RBC/MCV
• Helps to identify mixed population of cells
• Classifications
o anisocytosis = ↑RDW (increased variability in RBCs size)
o Isocytosis = Normal variability in RBC size
o No pathologic condition associated with a low RDW

Question 12

Patients usually male above 50 who present with anemia think

Answer 12

Colon cancer

Question 13

Family history of anemia think

Answer 13

Thalassemia or sickle cell disease

Question 14

Alcohol abuse produces what type of anemia

Answer 14

macrocytic anemia

Question 15

What is the connection between kidney disease & anemia

Answer 15

Kidney produces Epo so if its injured Epo levels might be low

Question 16

Why do we check TSH levels when a patient has anemia

Answer 16

• Hypothyroidism: Hypothyroidism associated with normocytic anemia (reticulopenia, low levels of Epo, hypoplasia of erythroid linage, acancytoisis)