CBC Flashcards
1
Q
What does the CBC measure (4)
A
- RBC
- WBC
- Platelets
- % of RBC
2
Q
What color tube is a CBC collected in and why?
A
Lavender- and it contains an anticoagulant (prevents the cells from sticking together)
3
Q
What are 3 possible collection problems in a CBC?
A
- Failure to mix in anticoagulant
- Inadequate filling
- Standing/Tournequating the patient too long (increase [RBC])
4
Q
What are the normal levels for hemoglobin?
A
Male: 13.5-16.6
Female: 12.0-15.0
5
Q
Describe hemoglobin
A
-Protein that carries oxygen
-Comprises 95% of RBC protein
-Size and color of the RBC depend on hemoglobin
-Most reliable measurement in CBC
6
Q
What 2 things combine to form hemoglobin?
A
Iron and protein chains
7
Q
What 4 things make up a hemoglobin molecule?
A
- Alpha group
- Beta group
- Iron
- Heme group
8
Q
What are the normal levels for hematocrit?
A
Male: 41-50%
Female: 36-44%
9
Q
What is hematocrit?
A
The percentage of blood occupied by RBC
10
Q
How is hematocrit calculated?
A
Automated systems calculate the hematocrit from RBC count times the average cell size
11
Q
What is the average RBC’s (10^6/ml)
A
Male: 4.5-5.5
Female: 4-4.9
12
Q
Characteristics of RBC
A
-Average adult has 4.5-6 trillion/liter of blood
-Hemoglobin makes up the majority of RBC
-Non-dividing
-Average life span of 100-120 days
-Produced in bone marrow and destroyed in spleen
13
Q
Characteristics of normal RBC
A
-Concave
-Fluffy
-Deep red (because of hemoglobin)
14
Q
Production of RBC
A
-Bone marrow stem cells transform into RBC
-Contain receptors for erythropoietin
-Called erythrocytes
15
Q
This is a hormone secreted by the kidneys that increases the rate of production of RBC in response to falling levels of oxygen in the tissues
A
Erythropoietin
16
Q
Where is erythropoietin produced in an adult and fetus?
A
Adult- renal cortex
Fetus- Liver
17
Q
What does EPO stimulate the production of?
A
RBC from the bone marrow
18
Q
What happens as RBC age?
A
-Lose enzymes
-Lose surface membranes
-This makes them less able to pass through the spleen
19
Q
What 2 things does hemoglobin break down into?
A
- Heme (iron)
- Protein
20
Q
What does heme break down into?
A
-Free Iron
-Bilirubin
(and the body uses these for other reasons)
21
Q
Disease characterized by low/deficient RBC
A
Anemia
22
Q
Disease characterized by excessive RBC
A
Polycythemia
23
Q
What does RDW stand for?
A
Red Cell Normal Distribution Width
24
Q
What is the normal value for RDW?
A
25
This measures the degree of uniformity in size of RBC
Red Cell Distribution Width (RDW)
26
Patients with small RBC will have a high/low RDW?
High- they are far away from the normal mean
27
What does MCV stand for?
Mean cell volume
28
Mean cell volume
Average cell size
29
What is the normal values for MCV?
80-100
30
MCH
Mean cell hemoglobin
31
What is the normal value for mean cell hemoglobin?
27-31
32
What does MCHC stand for?
Mean cell hemoglobin concentration
33
What is the normal MCHC value?
32-36
34
What is the normal platelet count?
100,000-450,000
35
What is ferratin?
-Iron complex containing 23% iron
-Directly related to total iron stores
-Good marker for iron deficiency
-Widely distributed to the tissues
36
What are normal ferratin levels?
13-300
37
Baby, immature erythrocytes
Reticulocytes
38
As EPO levels increase, the rate of RBC production should..
INCREASE
39
T/F: The number of reticulocytes is the most reliable measure of the rate of RBC production?
True
40
The number of baby RBC will be directly/indirectly related to the number of RBC that we will have later on
DIRECTLY
41
Describe a peripheral blood smear...
Smear the blood on a slide and count the number of each component under a microscope
42
Describe a bone marrow examination?
-Usually performed if the peripheral blood smear are inconclusive
-Gold Standard Test to document blood disorders
43
What are the 2 ways to do a bone marrow examination?
-Aspirate
-Biopsy
44
-insert need and take out fluid
-Usually adequate to evaluate most RBC disorders
-Will not recognize a number of non-uniform distributions
Aspirate
45
-Take a tissue sample
-Performed simultaneously with an aspirate
Biopsy
46
Describe serum iron
•Measures iron bound to transferrin
•Indirectly measures the rate of delivery to tissues
•Iron levels are 40% higher in the morning
47
What is transferrin?
Iron transporting protein
48
T/F: Production of transferrin is inversely related to body iron stores?
True
49
-Decrease in the amount of hemoglobin
-Most common blood disorder
Anemia
50
-Small cell anemia
-Decreased RBC size and pale color
Microcytic anemia
51
What are the normal levels for hemoglobin?
Male: 13.5-16.6
Female: 12.0-15.0
52
Describe hemoglobin
-Protein that carries oxygen
-Comprises 95% of RBC protein
-Size and color of the RBC depend on hemoglobin
-Most reliable measurement in CBC
53
What 2 things combine to form hemoglobin?
Iron and protein chains
54
What 4 things make up a hemoglobin molecule?
1. Alpha group
2. Beta group
3. Iron
4. Heme group
55
What are the normal levels for hematocrit?
Male: 41-50%
Female: 36-44%
56
What is hematocrit?
The percentage of blood occupied by RBC
57
How is hematocrit calculated?
Automated systems calculate the hematocrit from RBC count times the average cell size
58
What is the average RBC's (10^6/ml)
Male: 4.5-5.5
Female: 4-4.9
59
Characteristics of RBC
-Average adult has 4.5-6 trillion/liter of blood
-Hemoglobin makes up the majority of RBC
-Non-dividing
-Average life span of 100-120 days
-Produced in bone marrow and destroyed in spleen
60
Characteristics of normal RBC
-Concave
-Fluffy
-Deep red (because of hemoglobin)
61
Production of RBC
-Bone marrow stem cells transform into RBC
-Contain receptors for erythropoietin
-Called erythrocytes
62
This is a hormone secreted by the kidneys that increases the rate of production of RBC in response to falling levels of oxygen in the tissues
Erythropoietin
63
Where is erythropoietin produced in an adult and fetus?
Adult- renal cortex
Fetus- Liver
64
What does EPO stimulate the production of?
RBC from the bone marrow
65
What happens as RBC age?
-Lose enzymes
-Lose surface membranes
-This makes them less able to pass through the spleen
66
What 2 things does hemoglobin break down into?
1. Heme (iron)
2. Protein
67
What does heme break down into?
-Free Iron
-Bilirubin
(and the body uses these for other reasons)
68
Disease characterized by low/deficient RBC
Anemia
69
Disease characterized by excessive RBC
Polycythemia
70
What does RDW stand for?
Red Cell Normal Distribution Width
71
What is the normal value for RDW?
72
This measures the degree of uniformity in size of RBC
Red Cell Distribution Width (RDW)
73
Patients with small RBC will have a high/low RDW?
High- they are far away from the normal mean
74
What does MCV stand for?
Mean cell volume
75
Mean cell volume
Average cell size
76
What is the normal values for MCV?
80-100
77
MCH
Mean cell hemoglobin
78
What is the normal value for mean cell hemoglobin?
26-34
79
What does MCHC stand for?
Mean cell hemoglobin concentration
80
What is the normal MVHC value?
31-37
81
What is the normal platelet count?
100,000-450,000
82
What is ferratin?
-Iron complex containing 23% iron
-Directly related to total iron stores
-Good marker for iron deficiency
-Widely distributed to the tissues
83
What are normal ferratin levels?
13-300
84
Baby, immature erythrocytes
Reticulocytes
85
As EPO levels increase, the rate of RBC production should..
INCREASE
86
T/F: The number of reticulocytes is the most reliable measure of the rate of RBC production?
True
87
The number of baby RBC will be directly/indirectly related to the number of RBC that we will have later on
DIRECTLY
88
Describe a peripheral blood smear...
Smear the blood on a slide and count the number of each component under a microscope
89
Describe a bone marrow examination?
-Usually performed if the peripheral blood smear are inconclusive
-Gold Standard Test to document blood disorders
90
What are the 2 ways to do a bone marrow examination?
-Aspirate
-Biopsy
91
-insert need and take out fluid
-Usually adequate to evaluate most RBC disorders
-Will not recognize a number of non-uniform distributions
Aspirate
92
-Take a tissue sample
-Performed simultaneously with an aspirate
Biopsy
93
Describe serum iron
•Measures iron bound to transferrin
•Indirectly measures the rate of delivery to tissues
•Iron levels are 40% higher in the morning
94
What is transferrin?
Iron transporting protein
95
T/F: Production of transferrin is inversely related to body iron stores?
True
96
What are the 2 pathogeneses of anemia?
1. Decreased production of RBC
2. Decreased RBC survival
97
-Small cell anemia
-Decreased RBC size and pale color
Microcytic anemia
98
What are some causes of microcytic anemia?
-Iron deficiency
-Thalassemia
-Lead Poisoning in Children
99
•Inherited defects in the gene controlling globin chain synthesis
•The type is determined by what gene is effected… alpha or beta
•Produces very small RBC
Thalassemia
100
• Common in people of African ancestry
• Alpha chains are needed for synthesis of normal hemoglobin
• Deficiency causes deletion of hemoglobin S chains
Alpha Thalassemia
101
• Deletion or reproduction of beta chain
• Produces decreased hemoglobin synthesis and microcytosis
• Hemoglobin A or the beta chains are effected
Beta Thalassemia
102
• Usually seen in children
• Decreased iron, increased lead, and increased zinc
Lead Poisoning
103
- High MCV indicates defects in cell maturation
- Commonly due to B 12 or folate deficiency
- Present in alcoholics
Macrocytic Anemia
104
- Failure of bone marrow production of RBC’s in response to anemia
- Common in patients with chronic illness
Normocytic Anemia
105
- Defective production of erythropoietin (EPO- A hormone secreted by the kidneys that increases the rate of production of red blood cells in response to falling levels of oxygen in the tissues)
- Low EPO
o Cant stimulate RBC production
Anemia in Renal Failure
106
- Pathogenesis is unknown
- Cells in marrow typically don’t respond to EPO stimulation
- Defect in mobilization of iron from macrophages to transferrin
- Low serum iron and low binding capacity and low transferrin
- Serum ferritin is normal or increased
Anemia of Chronic Disease
107
- Failure of bone marrow causes decreased production
- Accompanied by low WBC and platelets
Aplastic Anemia
108
- Any disorder where a large percentage of the bone marrow is replaced by abnormal cells
- Bone marrow biopsy is needed to confirm
Bone Marrow Replacement
109
- Decreased RBC survival is associated with hemoglobin variants of C and S chains
o Ultimately changes the cells shape
- Sickle cell anemia causes changes to the cells shape
- Mutation in the beta chain
- Allows stacking of hemoglobin which changes the shape of the RBC
Hemoglobinopathies
110
- G6PD is an X linked enzyme
- Deficiency causes hemolysis or RBC when exposed to infection or oxidant drugs
Glucose-6-Phosphate Dehydrogenase Deficiency
111
- Part of an autoimmune disease such as lupus
- Can be due to drugs that attach to membranes
- IgG antibodies develop against RBC causing decreased RBC survival
Autoimmune Hemolytic Anemia
112
- IgG antibodies are capable of passing the placenta
- Preventative
Hemolytic Disease of a newborn
113
- Increase in RBC mass over normal
- Increased hemoglobin and hematocrit
- Less common than anemia
Polycythemia
114
- Increased RBC production due to over production of EPO
- Caused by fibroid tumors
Secondary Polycythemia
115
- Inappropriate production of red blood cells
- Uncommon, seen in elderly
- Decreased EPO
- WBC and Platelets increase
- Diagnosis will be made when there is splenomegaly
Polycythemia Vera
