CBC Flashcards
Components of a CBC
- WBC
- Hgb
- HCt
- PLT
How do we check Hemoglobin?
- Red cells broken down to get hemoglobin in solution
- Free hemoglobin exposed to cyanide to form cyanmethemoglobin
- By shining light (540 nm) through the soln the concentration of hemoglobin can be determined.
Normal Hemoglobin Range for Men
14-18 mg/dL
Normal Hemoglobin Range for Women
12-16 mg/dL
What is the “Hematocrit”?
Relative volume of blood occupied by erythrocytes.
Normal Hematocrit Levels
41-52%
What is the normal Hemoglobin/Hematocrit Ratio?
1:3
How much should a hematocrit rise after one unit of blood is transfused?
3 points
DDx for Anemia
- IDA
- Bleeding
- B12 Deficiency
- Folate Deficiency
- Chronic Disease
- Leukemia
- Sickle Cell Disease
- Genetics?
- Myelodysplastic Syndrome
How do you evaluate a patient with suspected anemia?
- Determine Acuity
- Look at patient FIRST, not labs
- Past records will show old baselines.
If someone has been chronically anemic and is of Mediterranean descent and has an MCV of 60, what disease process should you be thinking of?
Thalassemia
Three potential CAUSES of anemia
- Decreased Production
- Increased Destruction
- Blood Loss
What can be a Decreased Production cause of Anemia?
- Nutritional Deficiency
- Bone Marrow Failure
- Hormone Deficiency
- Epo failure (Kidney failure where epo is made)
Examples:
- B12 Deficiency
- Folate Deficiency
- Aplastic Anemia
- Leukemia
- Myelodysplastic Syndrome
What can be a Increased Destruction cause of Anemia?
- Inherited Hemolytic Anemia
2. Acquired Hemolytic Anemia
Examples of Acquired Hemolytic Anemia
- Autoimmune Hemolytic Anemia
- Thrombotic Thrombocytopenic Purpura-Hemolytic Uremic Syndrome
- Malaria
- Mechanical Valve Replacement
Examples of Inherited Hemolytic Anemia
- Hereditary Spherocytosis
- Sick Cell Disease
- Thalassemia Major
This is a condition where RBS are like little spheres instead of biconcave discs and therefore do not go through the vessels well that can cause rupture.
Hereditary Spherocytosis
What can cause Thrombotic Thrombocytopenic Purpura-Hemolytic Uremic Syndrome (TTP/HUS)?
Antibiotics and some Viral Illnesses
Most common cause of Anemia?
Blood Loss
What can be a Blood Loss cause of Anemia?
- Traumatic or Apparent Bleeding
- Occult Bleeding
- Iatrogenic
Examples of Traumatic or Apparent Bleeding
- Melena
- Hematemesis
- Menometrorrhagia
Examples of Occult Bleeding
- Colonic Polyp
- Carcinoma
Examples of Iatrogenic Cause of Bleeding
- Blood Draws (esp. in infants)
- Dialysis
- Surgery
What is MCV?
Mean Corpuscular Volume
An indicator of how big the RBC is (macrocytic vs. normocytic vs. microcytic)
Normal Value of MCV?
80-98
This is the term for an MCV >98.
Macrocytic Anemia
Causes of Macrocytic Anemia
- B12 Deficiency
- Folate Deficiency
- Drugs
- Release of Immature Cells (from Bone Marrow)
- Cirrhosis
- Hypothyroidism
- EtOH
- Multiple Myeloma
RBCs should be the same size as a __________.
Neutrophil
This is the term for an MCV < 80.
Microcytic Anemia
What is the #1 cause of Microcytic Anemia
Iron Deficiency
Causes of Microcytic Anemia
- Thalassemias
- Sideroblastic Anemia
- Chronic Blood Loss?
- Anemia of Chronic Dz (rarely!!! Normally causes normocytic anemia)