CBC Flashcards
Reticulocyte
immature RBCs
elevated in hemolytic anemia
measures the effectiveness of erythropoiesis
reticular network of ribosomal RNA visible when stained with methylene blue on microscopy
**not part of the CBC
differential CBC vs CBC
Regular CBC does not break down the #’s and Types of WBCs
Leukocytosis
elevated leukocytes
leukocytes >11
- indication for a differential
- causes of elevation:
- INFECTION →should always look at previous CBCw and trends
- steroids (mild elevation)
- cancers
- catastrophic events (trauma, MI surgery)
Leukopenia
decreased leukocytes
agranular leukocytes
lymphocytes and monocytes
granular leukocytes
basophil, neutrophil, eosinophil
Neutrophils
Polymorphonuclear neutrophils (PNMs) “Polys”
- fight bacteria and fungus
- attracted by chemokines
- de-granulate antimicrobial proteins
- Two forms:
- bands and segs
- segmented: senior/mature cell
- bands: baby/immature cell
- bands and segs
- Left shift! → recruits the immature band form
- Absolute #: 1.8-7.7K
Segmented Neutrophil
Senior/mature cell
normal = 50-62% of WBCs
Banded Neutrophil
Baby/immature cell
normally only 3-5% of WBCs
WBC count
4.5-11K
RBC
4.5-5.9M
Hgb
14-18g/dL
Hematocrit
40-52
- percentage of packed RBC to total volume of blood
- HCT is approx HGB x 3
- calculated RBC x MCV
MCV
Mean Cell Volume ( SIZE )
80-100 fL
microcytic <80fL
macrocytic >100fL
MCH
Mean Corpuscular Hgb (average hgb/RBC)
27-33pg
MCHC
Mean Corpuscular Hgb Concentration (REDNESS)
32-36%
normochromic= normal redness
hypochromic = less red
hyperchromic = more red
Platelet count
1.30-4.00K/MM3
RDW
Ratio of Distribution Wide
how variable is the size of the RBCs
0.0-14.7%
MPV
mean platelet volume
6.8-10.0fL
ANC
Absolute Neutrophil Count
1.8-7.7K/MM
- mild neutropenia 1000-1500 cells/MM
- increased risk of infection
- ANC < 500 cells/MM severe neutropenia
- pt will fail to control local flora/common pathogens
- lots of infections!
- pt will fail to control local flora/common pathogens
- includes both bands and segs!
What can trigger demargination of neutrophils aside from infection?
- steroids
- major trauma
- both will cause a small increase in ANC (absolute neutrophil count)
Lymphocytes
- 1.0-4.8K/MM3 (16-45%)
- fight viral infections
- important in antibody formation
- types of Lymphocytes:
- B cells
- helper T cells
- cytotoxic T cell
- regulatory T cell
- natural killer cell
Monocytes
0.1-0.8K/MM3
- 3-10% of WBCs
- attracted by chemokines and differentiate into macrophages and dendritic cells
- fight both viral and bacterial infections
- in TB:
- form wall around the MTB= create a granuloma
Eosinophils
0.0-0.5K/MM3
- Normal range: 0-7%
- present in tissues and mucous membranes
- fight parasites and helminths
- elevated in allergic response
- release toxic granules that can cause extreme reaction
Basophils
0.0-0.2K/MM3
- 0-2%
- contain heparin and histamine
- large dark granules
- allergy and stress response
- can be elevated in leukemia
how to remember the WBCs
Never Let Monkeys Eat Bananas
- Neutrophils: 1.8-7.7K
- Lymphocytes: 1.0-4.8K
- Monocytes: 0.1-0.8K
- Eosinophils: 0.0-0.5K
- Basophils: 0.0-0.2K
Thrombocytopenia
low plateletes
increased bleeding risk
caused by decreased production, increased destruction or sequestration
Thrombocytosis
high platelets
increased clotting risk
- reactive: overproduction after infection, traumatic event, splenectomy
- essential: myeloproliferation (blood cancer)
Echinocytes
Burr Cells
small blunt projections, uniformly spaced over the red cells
ccells maintain the central pallor
liver disease
uremia
Acanthocytes
Spur Cells
irregular projections
associated with cirrhosis
Sickle Cell Anemia
- inherited HbS gene from both parents
- abnormally shaped cells that cause stacking or sticking
- chronic low level anemia due to hemolysis hbg 8-10
- impaired splenic function
- small infarcs in the spleen
- Howell-Jolly Bodies on smear
- fragment of nucleus left over in RBC (usually cleaned out by the spleen)
Rouleaux Formation
stacked RBCs in linear distrubtion
appearance of stacked coins
indication of multiple myeloma
WBCs during acute bacterial infx vs later bacterial infx
acute bacterial: PMNs, bands
later stages: lymphocytes increase
overall: WBC = high
WBCs during acute viral infx
lymphocytes are predominant
- overall WBC may be normal or decreased
- can also be slightly elevated but not as high as bacterial
CRP
not part of CBC, c-reactive protein
direct measurement
- higher CRP = more inflammation in your body
- isn’t unique to one disease
- can help monitor disease progress and flares
- Shows up before ESR
- produced by the liver when it is exposed to immune complexes
- peaks at 36-50 hours
- half life of 5-7 hours
ESR
erythrocyte sedimentation rate
(not part of CBC)
increased ESR = sinking faster
indirect measurement: indicator of inflammatory process
- high ESR signals high levels of inflammation in the body
- can help to evaluate how well tx is working
- pts with autoimmune disease will have a high ESR
- associated with fibrinogen
- peaks at 7-10 days
- half-life measured in weeks
Procalcitonin
produced by cells in the body often in response to bacterial infx or tissue injury
can be used to identify systemic bacterial infections and sepsis
- <0.5micrograms/L = systemic infection unlikely
