CBC Flashcards
CBC Components
Red Blood Cell Count, Red Blood Cell Indices (MCV - Mean Corpuscular Volume, MHC - Mean Corpuscular Hemoglobin, MCHC - Mean Corpuscular Hemoglobin Concentration, RDW - Red Cell Distribution Width). Peripheral Smear, Platelet Count, Hematocrit, Hemoglobin, White Blood Cell Count, White Blood Cell Differential.
CBC Used to
Make Diagnosis, Narrow Differential, Guide for further diagnostic testing
Complaints Supporting CBC
Fever, Fatigue, Dyspnea, Bleeding, Bruising, Heme Positive, Weightloss, Lymphadenopathy, Dizziness (not vertigo), Palpitations, Angina, Jaundice)
RBC
Life span 120 days, Biconcave, no nucleus, B12, Fe, Folate for production, flexible, contains Hemoglobin, formation stimulated by erythropoietin, removed by spleen.
Red Blood Cell Count
Male: 4.7 - 6.1 Females: 4.2 - 5.4 Anemia = >10% below normal Erythocytosis = excess RBC’s
RBC Indices
Helpful in categorizing anemias, classifies RBC into size, hgb concentration
Hematocrit (Hct) - Measures packed RBC volume (PCV)
Male: 42 - 52 % Female: 37 - 47 Critical 60%
Hemoglobin (Hgb) - in peripheral venous system
Male: 14 - 18 g/dL Female: 12 - 16 g/dL Pregnant > 11g/dL
Rule of Threes/Normal Values
Hct = 3 x Hgb Hgb = 3 x RBC Count
RBC, Hgb, Hct Causes of Decrese
Hemorrhage, hemolysis, dietary deficiency (B12, folate), genetic defect, drugs, marrow failure, chronic illness, marrow/organ failure, hemo-dilution (too much fluid to fast)
RBC, Hgb, Hct Causes of Increase
Hemoconcentration, Chronic hypoxia - COPD, Smoking. Polycythemia vera, high altitude living, drugs.
Mean Corpuscular Volume (MCV)
Reflects average size of RBC. MCV = (Hct x 10) / RBC Normal: 80-95 fL = normocytic 95 fL = macrcytic cells
Mean Corpuscular Hemoglobin (MCH)
Average amount (weight) of Hgb in each RBC MCH = Hgb / RBC Normal: 27 - 31 pg
Mean Corpuscular Hemogobin Concentration (MCHC)
Average concentration of Hgb in a RBC MCHC = Hgb / Hct Normal: 32 - 36 % <32 % hypochromic (pale RBC) 32 - 36% normochromic
Red Cell Distribution Width
Cell size variability Reference Range: 11 - 14.5 % If elevated, considerable size variation (anisocytosis)
Peripheral Smear
Looks at abnormal shapes (pikilocytosis), staining patterns.
Target Cells
Hemoglobinopathies, Thalassemia
Burr Cells
Uremia, Liver Disease, Post Splenectomy (no spleen for RBC’s to be degraded)
Spherocytes
Hereditary Spherocytosis, Acruired immunohemolytic anemai.
It almost always refers to hereditary spherocytosis. This is caused by a molecular defect in one or more of the proteins of the red blood cell cytoskeleton, including, spectrin, ankyrin, Band 3, or Protein 4.2. Because the cell skeleton has a defect, the blood cell contracts to its most surface-tension efficient and least flexible configuration, a sphere. The sphere-shaped red blood cells are known as spherocytes. Though the spherocytes have a smaller surface area through which oxygen and carbon dioxide can be exchanged, they in themselves perform adequately to maintain healthy oxygen supplies. However, they have a high osmotic fragility–when placed into water, they are more likely to burst than normal red blood cells. These cells are more prone to physical degradation.
Heinz Bodies
G6PD deficiency, Alpha Thallasemia.
Heinz bodies are formed by damage to the hemoglobin component molecules, usually through oxidations, or the change of an internal amino acid residue(from an inherited mutation).
Howell-Jolly Bodies
Myelodsyplasia, Post splenectomy, Sjogren syndrome antibody.
Nuclear remnants vs. denatured DNA (Heinz bodies)
Basophilic Stippling
Lead Poisoning
These dots represent accumulations of rRNA and are always pathological.
Schistocytes (Helmet Cells)
Artificial valve (chews RBC), Dissemiinated intravascular coagulation, thrombotic thrombocytopenic purpura, Hemolytic uremic syndromes.
Neutrophils and Pahgocytes
1st on the scene
Concentration increases during inflammation
2 types of Lymphocytes
B-lymphocytes (~5%)
T-lymphocytes (~90%)
Not easily distinguished unless activated
Eosinophil
Basophil
Release Histamine
Monocytes
