CBC

Question 1

what are the components of the CBC (11)

Answer 1

RBC count, 
Hb, 
MCV(mean cell volume), 
Hematocrit, 
MCH(mean cellular Hb)
MCHC(mean cellular hb conc)
RDW (red cell dist width)
WBC count
Platelet count
Differential WBC count
Mean Platelet volume

Question 2

when is a CBC especially useful? (6)

Answer 2

when you suspect sepsis/severe infxn, blood cancer, hemolysis, malnut/malabsorb, autoimm dz, or chronic bleeding

Question 3

what id the most important RBC value and why?

Answer 3

Hb, b/c it’s the most important component of RBC, may have normal RBC count but those cells are hypochromic (which would be anemia bc lack of Fe)

Question 4

what is the RV for RBC count (ref value) (UNITS TOO)

Answer 4

4-6 x 10^6 /uL or 10^12/L

Question 5

what is the RV for Hb (ref value) (UNITS TOO)

Answer 5

12-17 g/dL

Question 6

what is the RV for MCV(mean cellular volume) (ref value) (UNITS TOO)

Answer 6

80-100 fL in adults (<80=microcytic(anemia/thalasemia) (>100=macrocytic(folate def, liver dz, hyperlipidemia)

Question 7

what is the RV for HCT

Answer 7

36-54%

Question 8

what is the RV for MCH

Answer 8

27-33 pg

Question 9

what is the RV for MCHC

Answer 9

32-36 g/dL

Question 10

what is the RV for RDW

Answer 10

<14%

Question 11

we start out life with a __ (lower or higher) Hb; and women have a slightly ____ Hb

Answer 11

lower (11 is good fro a 4-6yo)

lower

Question 12

Normal total WBC count for adult

Answer 12

4,000 -11,000 /L or 4-11 x 10^3/uL

Question 13

what are the 5 parts of total WBC count?

Answer 13

Neutrophils (PMN), lymphocytes, monocytes, eosinophils, basophils

Question 14

relative percentage of neutrophils

Answer 14

50-70%

Question 15

relative percentage of lymphocytes

Answer 15

20-40%

Question 16

relative percentage of monocytes

Answer 16

<8%

Question 17

relative percentage of eosinophils

Answer 17

<5%

Question 18

relative percentage of basophils

Answer 18

<2%

Question 19

what percent of neutrophil s/b bands? what does an elevation mean?

Answer 19

<10%; you are having a reaction/stress (infection, exercise, trauma)

Question 20

normal WBC count at birth?

Answer 20

10,000 -25,000/uL

Question 21

normal WBC count for an infant?

Answer 21

8,000 - 15,000 /uL

Question 22

normal wbc count for 4-7 yo?

Answer 22

6,000 - 15,000 /uL

Question 23

normal wbc count for 8-18yo?

Answer 23

4,5000 -13,500 /uL

Question 24

normal wbc for pregnant woman?

Answer 24

12,000 - 15,000

Question 25

Describe the physiologic anemia of infancy

Answer 25

babies are born with high HCT and Hb, when they are born there is a dramatic inc in O2 sats. This triggers the kidney to dec production of EPO and therefore induces anemia in the infant.

Question 26

what is “left-shift”? when does it occur?

Answer 26

increase in the # of circ immature neutrophils (bands, myelocytes, metamyelocytes, etc, what are norm only seen in BM)
sepsis, apendicitis, trauma, stress, acute phase of liver

Question 27

what is the acute phase of the liver?

Answer 27

liver stops making albumin, d/t stress, trauma, serious infection (causes left shift)

Question 28

If you have a normal WBC count can you r/o infection?

Answer 28

NOOOOOoooOOOo

can be low or normal in many infxns

Question 29

Left shift looks a lot like _____ or ______

Answer 29

Chronic Myelogeous Leukemia (CML) - adults w/philly chromo

OR Acute Lymphoblastic Leukemia (ALL) - children high blasts in BM, bruising, low PLT, anemia, gray looking

Question 30

It’s a good idea to do what before getting a BM biopsy for elevated WBC/blasts….

Answer 30

get 2 CBCs 1 week apart to r/o left shit/infxn

Question 31

Start at leukopenia/neutropenia

Answer 31

this slide is post leuk vs left shift