Blood -Schoenwald Flashcards
Sensitivity
Ability of a test to identify positive results in pts who actually have a disease. Higher the sensitivity the lower the chance of a false negative
Specificity
Assesses the portion of true negatives. If a test is positive it is highly likely that a person has a disease. The lower the specficity the higher the chance for a false positive.
White blood cell normal range
4,000- 10,500
Causes of an increase in WBC
inflammation, bacterial infection, leukemia, and some meds.
Causes of a decrease in WBC
some viral infections, chemotherapy, and bone marrow suppression.
Margination of granulocytes
when they are not actively working. they will go into cell walls until they are needed again
Left shift
when there are more than 8-10% increase in the number of bands present
What can cause hypersegmentation
vitamin B12 deficiency, folic acid deficiency
Six causes of Neutrophilia
Bacterial infection, some viral , stress, inflammatory disease, metabolic disorders, drugs
Five causes of Neutropenia
Bacterial infection, Viral infection, hypersplenism, chemo, lupus
Bacterial infections that cause neutropenia
Typhoid, tularemia, brucellosis
Viral causes of Neurtopenia
Hepatitis , influ, enza, measles, mumps, rubella, mono
Bacterial causes of lymphocytosis
pertusis, brucellosis
Viral cause of lymphocytosis
hepatitis, mono, mumps. CMV
Metabolic causes of lymphocytosis
hyperadrenalism, hyperthroidism
Chronic inflammatory causes of lymphocytosis
Ulcerative colitis, serum sickness, ITP
Immonodeficiency causes lymphocytopenia
HIV, congenital defects of cell mediated immunity, immunosuppressive medications
illness that cause lymphocytopenia
CHF, renal failure, advanced TB
Adrenal corticosteroid exposure causes of lymphocytopenia
predisone, ACTH producing pituitary hormones, adrenal gland hyperactivity
infections that cause Monocytosis
TB, bacterial endocarditis, hepatitis, syphilis
Granulomatous diseases that cause monocytosis
Sarcoid, ulcerative colitis
collagen vascular diseases that cause monocytosis
Lupus, RA, Polyarteritis
What does MCV measure
size of the average RBC. Mean corpuscular volume
What does MCHC measure
average concentration of hgb in RBC
What does MCH measure
measure of the weight of hgb in RBC
What does RDW measure
Red cell distribution, indicated variation of size of RBC.
What would a high RDW indicate?
multiple populations of cells. possibly a transfusion or a result of cancer
Ferratin
Major iron storage protein
Reticulocytes
immature red blood cells. It is used to determine bone marrow function and eval of erythropoietic activity.
Microcytic hypochromic anemia
iron deficiency, thalessemia, anemia of chronic disease, sideroblastic
iron deficiency anemia causes
loss of blood, insufficient dietary intake, pregnancy, malabsorption
What are you concerned for in a patient who is over 65 and has iron deficiency anemia?
Colon cancer
Normocytic normochromic anemia
Anemia of chronic disease, ferratin is usaully increased, IDA is decreased
Macrocytic anemia
B12 deficiency, and/or folic acid deficiency
Hemolytic anemia
anemia due to breakdown of RBC. etiology is varied
etiology of hemolytic anemia
blood disorders, hemoglobinopathies, autoimmune, hemolytic uremic syndrome, medications
Lab findings of hemolytic anemia
decreased RBC, Decreased hepatoglobin, increased LDH, increased potassium
anisocytosis
variation in size (1+, 2+, 3+, 4+)
poikilocytosis
variation in shape
spherocytes
no central pallor
schistocytosis
cell fragments- intravascular or mechanical trauma
stomatocytosis
liver disease
basophilic stippling
lead poisoning and megaloblastic anemia and thalassemia
Howell jolly bodies
Splenectomy, hemolysis, blue bodies
Heinz bodies
splenectomy and G6PD deficiency
How to eval anemia
CBC, reticulocyte count, haptoglobin, iron studies, ferritin, B12/ folic acid levels, TSH, colonoscopy
Causes of thrombocytopenia
autoimmune ITP, Bone marrow supression, DIC, artifact (EDTA present in lab tube), heparin
Causes of Thrombocytosis
Myeloproliferative disorders, infection, malignancy, iron deficiency
Acute phase reactants
ESR, CRP, Plt, ferritin
inverted differential
present with mono