CBC

Question 1

What’s the standard range for WBC?

Answer 1

4.8 1000mL - 10.8 1000mL

Question 2

What’s the standard range for RBC?

Answer 2

4.7 1000mL - 6.1 1000mL

Question 3

What’s the standard range for Hgb?

Answer 3

14 g/dL - 18 g/dL

Question 4

What’s the standard range for Hct?

Answer 4

42 - 52%

Question 5

What’s the standard range for MCV?

Answer 5

81 um3/RBC - 98 um3/RBC

Question 6

What’s the standard range for MCH?

Answer 6

27 pg -31 pg

Question 7

What’s the standard range for MCHC?

Answer 7

32 - 36%

Question 8

What can we tell looking at WBC?

Answer 8

Generally points to infection

Question 9

What other factors affect WBC values?

Answer 9

Stress, meds and trauma can increase WBC count. Also, infections by amebiases and yellow fevers do not increase WBC.

Question 10

What WBC differentials help provide a more detailed analysis?

Answer 10

Netrophils, Lymphocytes, Monocytes, Eosinophils, Basophils and Bands

Question 11

What are neutrophils?

Answer 11

Predominant WBC at 40- 70%. Engulfs invading organisms.

Question 12

What are Lymphocytes?

Answer 12

20- 40% of WBC

Consists of B Cells and T Cells.

Question 13

What are B Cell and T Cell lymphocytes?

Answer 13

B Cells create and secrete antibodies.
T Cells are “helpers” and seek and destroy virally infected or abnormal cells. Also secretes proteins that help B Cell function.

Question 14

What are Monocytes?

Answer 14

2- 8% of WBC

Destroy gram negative bacterias and helps boost other WBC activity.

Question 15

What are Eosinophils?

Answer 15

5% of WBC
Responds to parasites and some other bacterias that cause vasoconstriction
Helps to increase small vessel permeability.

Question 16

What are Basophils?

Answer 16

< 5% of WBC
Same effect as Eosinophils
Called in after an allergic response

Question 17

What are Bands?

Answer 17

< 3% of WBC

They are immature WBCs that are released from the bone marrow

Question 18

What’s the standard range for RBC?

Answer 18

Male: 4.7 to 6.1 million cells per microliter (cells/mcL)
Female: 4.2 to 5.4 million cells/mcL

Under these ranges indicate Anemia

RBC Typing is a factor of AGE not Function

Question 19

What are Reticulocytes?

Answer 19

Young RBC that have been released in the last 48 hours.
ID by their large size and presence of certain proteins
Released at the same rate as old RBC are destroyed

Question 20

What are Hemoglobin?

Answer 20

These transport gases for lung exchange

Generally used as indicator of Anemia or Polycythemia

Question 21

Low Hemoglobin can indicate?

Answer 21

Associated with Hypoxia

Hemorrhage can lead to acute loss of Lung function

Question 22

What is Hgb Value?

Answer 22

How much Hgb is in 100 mL of blood

Question 23

What is Hct?

Answer 23

Hematocrit is the centrifuged red sediment (RBC) vs the plasma fluid.
Is describes the interplay between Fluid Volume, RBC count and RBC size

Question 24

Low Hct can indicate?

Answer 24

Pt with fluid overload.

Question 25

High Hct can indicate?

Answer 25

Pt with dehydration

Question 26

High Hct followed by a delayed drop in Hct can indicate?

Answer 26

The drop is due to vasoconstriction. Values can indicate Blood loss. But this is an unreliable measure.

Question 27

Low Hct followed by high Hct can indicate?

Answer 27

Diabetes, related to Hyperglycemic Macrocytosis. When glucose is pulled into the RBC.

Question 28

What are the Red Cell Indices?

Answer 28

MCV, MCH, MCHC, RDW

Question 29

What is MCV and what are the 3 possible outcomes?

Answer 29

Mean Corpuscular Volume is the first index on the CBC and it is a measure of the average volume of the RBC.
3 possible outcomes are Microcytic, Normocytic and Macrocytic Anemias.

Question 30

What are the common causes for Microcytic Anemia?

Answer 30

Most commonly causes are:
1. Iron deficiency (usually from chronic blood loss)
2. From B Thalessemia minor.
These are very different conditions and can be differentiated using the Mentzer Index.

Question 31

What is the Mentzer Index?

Answer 31

When exploring a Microcytic Anemia, MCV/RBC.and look at the value.
If > 13, it is Iron Deficiency
If < 13, it is B Thalassemia

Question 32

What are the common causes for Macrocytic Anemia?

Answer 32

3 Most Common causes are

1. Alcohol abuse
2. Folic Acid deficiency
3. Vit B 12 deficiency

It is important to treat BOTH Folic Acid deficiency AND Vit B12 deficiency.

Question 33

What is important to note about Macrocytic Anemia as related to Vit B12 deficiency?

Answer 33

If mistaken for Folic Acid deficiency and Only Folic acid is given as treatment, it can lead to psychosis, ataxia and other neurological deficits similar to M.S.

For Vit B12 Deficiency also test for.

1. Reduced vibratory sensations in lower extremities
2. Yellow/Blue Color blindness.

This are precursors of Severe, permanent neuro damage.

Question 34

What is MCH?

Answer 34

Mean Corpuscular Hemoglobin is an undicator of how much Hgb is in the blood.

Question 35

What are the 3 types of Anemias related to MCH?

Answer 35

1. Hypochromic - Low MCH - suggests Iron deficiency, chronic blood loss or thalassemia
2. Normochromic - Normal MCH - suggests acute blood loss, renal/ bone marrow failure, hypometabolic states (esp Diabetes).
3. Hyperchromic - High MCH - suggests Alcohol abuse, low Folic Acid or B12, and estrogen administration

Question 36

What is MCHC?

Answer 36

AT roughly 33%, it shows how tightly the Hgb is packed in a RBC.

Measured by Hgb/Hct OR MCH/MCV2