CBC Flashcards
newborns tend to have higher or lower WBC compared to adults
higher
elevated neutrophils differential diagnosis
- bacterial infection
- leukemia
- inflammation (RA)
- medications
- steriods, epinephrine
- stress
- cigarette smoking
polymorphonuclear cell
- granulocytes
- neutrophils
- eosinophils
- basophils
eosinophils are elevated with what conditions
- allergic reaction
- parasitic infection
- Neoplasm (includes leukemia)
basophils are elevated with what conditions
- myeloproliferative disease
- leukemia (CML)
name the nongranuloctyes
- Lymphocytes
- T cells and B cells
- monocytes
elevated lymphocytes differential diagnosis
- acute viral infections
- lymphocytic leukemia
common myeloid progenitor cell line form what cells
- eosinophil
- basophil
- neutrophil
- monocyte
- megakaryocyte -> platelets
- RBC
vocab for high and low neutrophils
- neutrophilia and neutropenia
vocab for high and low lymphocytes
- lymphocytosis and lymphocytopenia
vocab for high and low monocytes
- monocytosis and monocytopenia
vocab for high and low eosinophils and basophils
- eosinophilia and eosinopenia
- basophilia and basopenia
common causes of leukocytosis
- bacterial infection
- inflammation
- neoplasm
- steroid use
common causes of leukopenia
- overwhelming bacterial infection
- bone marrow failure
- drug toxicity
- autoimmune disease
what is a “Left shift”
- typical response to acute bacterial infection
- leukocytosis
- neutrophilia
- bands (baby neutrophils)
- bands enter circulation when neutrophil production is highly stimulated
- often see lymphocytopenia
metamyelocytes
the development of early neutophilic cells
neutropenia differential diagnosis
- viral infection
- aplastic anemia (no cell line being produced)
- overwhelming bacteria infection (esp. elderly)
- drugs
- chemo
- sulfa, antithyroid meds, phenothiazines
atypical lymphocytes are present in what condition
mononucleosis
lymphocytopenia differential diagnosis
- corticosteroids
- immunodeficiency disease
- late stage HIV
Eosinopenia differential diagnosis
- corticosteroids
- acute stress or inflammatory conditions
Monocytosis differential diagnosis
- chronic inflammatory disorders
- ulcerative colitis
- collagen vascular diseases
- viral infections
Monocytopenia differential diagnosis
corticosteroid therapy
basopenia differential diagnosis
- acute allergic reactions: basophils move out of circulation and into the tissue
- hyperthyroidism
- stress reactions
if WBC count is abnormal and clinical picture is benign, think what
medications!
pregnant women have what leukocyte count
elevated WBC
RBC life span
120 days, at the end, RBC is extracted by the spleen
hematocrit
measure of the percentage of the total blood volume that is made up by RBC
- Hct is approximately 3 times that of the Hgb concentration
polycythemia
high percentage of RBC
increased RBC count differential diagnosis
- dehydration
- COPD
- polycythemia vera
decreased RBC count differential diagnosis
- anemia
- bleeding/ Fe deficiency
- B12, folate deficiency
- hemolytic anemia
- cirrhosis
- pregnancy
- bone marrow failure
conditions that cause a reduced production of RBCs
- B12, folate, iron deficiency, bone marrow failure
- renal failure (decreased erythropoietin)
MCV
measure of average RBC size
- microcytic
- normocytic
- macrocytic
MCH
weight of Hgb in RBC
MCHC
Hgb concentration
- hypochromic, normochromic, hyperchromic
RDW
measure of variation in RBC size
- indicates degree of anisocytosis
anisocytosis
condition characterized by RBCs of variable and abnormal size
What hemoglobin levels would you consider transfusion
- Hgb < 8 g/dl
- eldery person with CAD: Hgb < 10 g/dl
Microcytic anemia (decreased MCV) differential diagnosis
- iron deficiency
- lead poisoning
- thalassemia
thalassemia
hereditary disorder characterized by reduced synthesis of globin chains
peripheral smear of thalassemia minor
target cells
condition in which RBCs will be small (dec MCV) but total RBC count may be normal or elevated
thalassemia
- microcytosis out of proportion to degree of anemia
method used to diagnose thalassemia
hemoglobin electrophoresis
macrocytic anemia differential diagnosis (inc MCV)
- Vitamin B12 deficiency
- folate deficiency
normocytic anemia differential diagnosis
- anemia of chronic disease
- renal failure
- acute blood loss
polycythemia is associated with what conditions
- increased Hgb/Hct levels
- dehydration
- polycythemia vera
- smoking and COPD
- high altitude
relative vs absolute polycythemia
- relative: artifact of concentration
- due to decreased plasma volume: dehydration
- absolute: true increase in RBC mass
- polycythemia vera
- secondary polycythemia
secondary polycythemia
- due to increased erythropoetin production
- tissue hypoxia is a major cause
- COPD and living at high altitude
polycythemia vera
- bone marrow disorder characterized by overproduction of erythroid cells
CBC findings in polycythemia vera
- elevated Hgb/Hct
- increased red blood cell mass
- leukocytosis
- thrombocytosis
clinical presentation
- HA, dizziness, tinnitus, blurred vision
- fatigue
- pruritus following warm shower or bath
- PE
- engorged retinal veins
- thrombosis
- splenomegaly
polycythemia vera
treatment of polycythemia vera
phlebotomy: taking blood out usually a liter at a time
what can happen if platelet count falls below <20,000
patient may bleed spontaneously
thrombocytosis differential diagnosis
- malignancy
- polycythemia vera
- post splenectomy
thrombocytopenia differential diagnosis
- idiopathic thrombocytopenic purpura
- thrombocytic thrombocytopenic purpura
- leukemia
- cirrhosis
- DIC
- hemolytic anemia
idiopathic thrombocytopenic purpura
- autoimmune: develops antibodies against own platelets
clinical presentation
- mucosal and skin bleeding
- possible antecedent viral infection
- petechiae, purpura, epistaxis, menorrhagia
- platelet count low
- other blood counts and peripheral smear normal
idiopathic thrombocytopenic purpura
treatment of idiopathic thrombocytopenic purpura
- usually self limited in children
- adults: corticosteroids
- if unresponsive: splenectomy
