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Diagnostics > CBC > Flashcards

CBC Flashcards

1
Q

Components of CBC

A
  • WBCs
  • RBCs
  • Hgb
  • Hct
  • Mean Cell Volume = MCV
  • Mean Cell Hgb = MCH
  • Mean Cell Hgb Concentration = MCHC
  • Platelet count = Plt ct
  • Differential (% & absolute # of each type of WBC)
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2
Q

WBC abnormalities

A
  • Infection
  • Inflammation
  • Neoplasm/malignancy
  • Drug rxns
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3
Q

Hgb/ hct abnormalities

A
  • Anemia

- Polycythemia

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4
Q

Platelet abnormalities

A
  • Bleeding disorders

- Hyper-coagulable

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5
Q

WBC count

A

Total # of WBCs

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6
Q

Differential

A

% of each type of leukocyte present in sample

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7
Q

What population tends to have higher WBC counts?

A

Newborns

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8
Q

Granulocytes

A
  • Granules in cytoplasm & multi lobed nucleus

- Aka. PMNs or “polys”

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9
Q

Neutrophils

A
  • Most common

- Phagocytosis of bacteria

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10
Q

Eosinophils

A

Allergic rxns

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11
Q

Basophils

A
  • Aka. Mast cells

- Allergic rxns

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12
Q

Nongranulocytes

A
  • Lymphocytes (T & B cells)

- Monocytes

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13
Q

What do lymphocytes do?

A

Fight acute viral infections & chronic bacterial infections

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14
Q

What do monocytes do?

A

Phagocytic cells capable of fighting bacteria (like neutrophils do)

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15
Q

Leukocytosis characteristics

A

> 10,000

  • Bacterial infection*
  • Inflammation
  • Neoplasm
  • Leukemoid response
  • Glucocorticosteroid use
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16
Q

Leukopenia

A

< 5000

  • Viral or bacterial infection
  • Bone marrow failure
  • Drug toxicity
  • Autoimmune disease
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17
Q

Define: leukocytosis

A

Increase of total WBC count w/ a left shift

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18
Q

The “left shift”

A
  • Elevated WBC count due to an increase in neutrophils & bands (baby neutrophils)
  • Bands enter circulation when neutrophil production is highly stimulated (ex. acute bacterial infection)
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19
Q

Leukemoid response

A
  • Development of early neutrophilic cells
  • Elevated WBC > 50,000
  • Associated w/ infection
  • Benign, typically resolves as primary condition resolves
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20
Q

Neutrophilia

A
  • Elevated neutrophil count
  • Leukemia
  • Inflammation
  • Medications
  • Stress
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21
Q

Neutropenia

A
  • Decreased neutrophil count
  • Viral infection
  • Aplastic anemia
  • Bacterial infection (esp. in elderly, as they may not be able to generate response)
  • Drugs
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22
Q

Lymphocytosis

A

Elevated lymphocyte count

  • Viral infections (Mononucleosis, hepatitis)
  • Lymphocytic leukemia
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23
Q

Lymphocytopenia

A

Decreased lymphocyte count

  • Corticosteroids*
  • Immunodeficiency diseases* (late stage HIV)
  • Leukemia
  • Radiation therapy
  • Sepsis
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24
Q

Eosinophilia

A 
Elevated eosinophil count 
"NAACP": 
- Neoplasm (includes leukemia)*
- Allergic rxns 
- Addison’s disease
- Collagen vascular disease (autoimmune diseases)
- Parasites
*And in the Valley, Coccidiomycosis (“NAACCP”)
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25
Q

Eosinopenia

A

Decreased eosinophil count

  • Corticosteroids (the opposite of Addison’s disease)*
  • Acute stress or inflammatory conditions
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26
Q

What is a common/useful parameter of infection?

A

Total neutrophil count

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27
Q

What is used for dx & px?

A

Serial WBC & differential counts

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28
Q

Acute leukemia

A

Bone marrow shows a predominance of the most immature elements (myeloblasts)

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29
Q

Platelet count RR

A

150,000-400,000

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30
Q

Platelet fxn

A
  • Initiates coagulation cascade

- Hemostasis

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31
Q

Critical platelet count

A

<50,000 or > 1 million

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32
Q

What could happen if platelet count <20,000?

A

Spontaneous bleeding

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33
Q

Thrombocytosis

A

Increased platelet count (>400,000)

  • Malignancy*
  • Polycythemia vera
  • Postsplenectomy syndrome
  • Drugs (estrogens, oral contraceptives)
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34
Q

Thrombocytopenia

A

Decreased platelet counts (<100,000)

  • ITP
  • TTP
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35
Q

What is thrombocytopenia associated w/ ?

A
  • Leukemia
  • Cirrhosis
  • DIC (disseminated intravascular coagulation)
  • Anemia (hemolytic, pernicious)
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36
Q

ITP is most common in …

A

Children

- Also common in AIDS

37
Q

ITP etiology

A

Autoimmune:

  • Develops antibodies against own platelets
  • Massive phagocytosis of platelet-antibody immune complexes occurs in the spleen
38
Q

ITP hx

A
  • Usually asymptomatic except for mucosal & skin bleeding due to decreased platelets
  • Antecedent viral infection
39
Q

ITP PE

A
  • Petechiae
  • Purpura
  • Epistaxis
  • Menorrhagia
40
Q

ITP lab findings

A
  • Platelet count low < 10,000

- Other blood counts & peripheral smear normal

41
Q

ITP tx/px

A
  • Self-limited in children
  • In adults – corticosteroids
  • If unresponsive to medical therapy, possible splenectomy
42
Q

What % of people will develop chronic ITP?

A

50-60%

43
Q

RBC count RR

A

Male 4.7-6.1 x 10^6

Female 4.2-5.4 x 10^6

44
Q

Define: RBC count

A

of circulating RBCs in peripheral venous blood

45
Q

What do RBCs contain?

A

Hemoglobin

46
Q

What is the lifespan of RBCs?

A

120 days

- After this time, RBCs extracted by spleen

47
Q

Hemoglobin RR

A

Male 14-18

Female 12-16

48
Q

Define: hemoglobin

A

Total amount of hemoglobin in the blood

49
Q

Hgb fxn

A

Binds & transports O2

50
Q

Hct count RR

A

Male 42-52%

Female 37-47%

51
Q

Define: Hct

A

% of the total blood volume that is made up by RBC’s

52
Q

Hct vs Hgb

A

Hct is 3 times that of the Hgb concentration

53
Q

Increased RBCs - associated w/ what?

A
  • Dehydration
  • COPD
  • Polycythemia vera
54
Q

Decreased RBCs - associated w/ what?

A

Anemia

  • Bleeding / Fe deficiency
  • B12, Folate deficiency
  • Cirrhosis
  • Bone marrow failure
  • Pregnancy
55
Q

Polycythemia/ erythocytosis (increased RBCs, Hct, Hgb) - associated w/ what?

A
  • Dehydration
  • Polycythemia vera
  • Smoking & COPD
  • High altitude
56
Q

Categories of polycythemia

A
  1. Relative:
    - Due to decreased plasma volume (dehydration) –> Elevated hct w/ normal RBC
  2. Absolute:
    - Polycythemia vera (bone marrow disorder) –> elevated hct w/ increased RBC
    - Secondary polycythemia: increased erythropoietin production. Tissue hypoxia = major cause
57
Q

Polycythemia vera etiology

A

Overproduction of erythroid cells

58
Q

Polycythemia hx

A
  • HA, dizziness, tinnitus, blurred vision
  • Fatigue
  • Pruritus following warm shower or bath
59
Q

Polycythemia PE

A
  • Engorged retinal veins
  • Thrombosis
  • Splenomegaly
60
Q

Polycythemia lab findings

A
  • Elevated Hgb/Hct
  • Increased RBC*
  • Leukocytosis
  • Thrombocytosis
61
Q

Polycythemia tx

A

Phlebotomy

62
Q

Causes of anemia (3)

A
  1. Reduced production of RBCs
    - B12, folate, iron deficiencies, bone marrow failure
    - Renal failure (↓erythropoietin)
  2. Increased destruction of RBCs
    - Hemolysis
    - Hemoglobinopathies, drugs
  3. Loss of RBCs
    - Bleeding
63
Q

MCV

A

Average RBC size

- Microcytic, normocytic, macrocytic

64
Q

MCH

A

Weight of Hgb in RBC

65
Q

MCHC

A

Hgb concentration

- Hypochromic, normochromic, hyperchromic

66
Q

RDW

A

Variation in RBC size

- Degree of anisocytosis

67
Q

Categories of microcytic anemia (Decreased MCV, small RBCs)

A
  • Iron deficiency
  • Lead poisoning
  • Thalassemia
68
Q

Iron deficiency

A
  • Microcytic hypochromic
    (↓ MCV & ↓MCHC)
  • Usually due to chronic blood loss: GI bleed, menstrual blood loss
69
Q

What does lead poisoning cause?

A

Mild microcytic hypochromic anemia w/ basophilic stippling on peripheral smear

70
Q

Thalassemia

A

Hereditary, reduced synthesis of globin chains

- Associated w/ patterns of bands

71
Q

Thalassemia minor

A
  • RBCs will be small (↓ MCV), but total RBC count may be normal or elevated
  • Peripheral smear may reveal target cells & basophilic stippling
72
Q

Thalassemia dx & components of this test

A

Hemoglobin Electrophoresis:

  • Detects abnormal forms of Hgb
  • Also used to dx sickle cell anemia
  • Different Hgb variations (eg. A1, A2, F, S)
  • Hgb from lysed RBCs placed on electrophoresis paper in an electromagnetic field - Hgb variants migrate at different rates & a pattern of bands is created
73
Q

Normocytic anemia (normal MCV / normal-sized RBCs)

A
  • Anemia of chronic disease (autoimmune diseases, malignancy)
  • Renal failure
  • Acute blood loss
74
Q

Macrocytic anemia (↑MCV / big RBCs)

A
  • Vitamin B12 & folate deficiency

* Alcohol consumption can cause a macrocytosis w/ or w/out anemia

75
Q

Risk associated w/ anemia

A

Cardiac events

76
Q

What should you consider if Hgb < 8, Hct < 24%?

A

Transfusion

77
Q

Iron studies

A
  • Iron level (serum iron): quantity of iron bound to transferrin
  • TIBC (Total Iron Binding Capacity)
  • Transferrin saturation
  • Ferritin
  • Ordered separately or grouped
78
Q

What % of iron is found in hemoglobin?

A

70

79
Q

Where is the other 30% of iron stored?

A

Ferritin & hemosiderin

80
Q

Hemochromatosis

A
  • Excess iron deposited in organs –> organ dysfunction

- Elevated LFTs

81
Q

Types of hemochromatosis

A
  • Primary: Genetic

- Secondary: Caused by repeated transfusions

82
Q

TIBC

A
  • Measures proteins available for binding mobile iron

- Measures transferrin

83
Q

In what % of pts w/ iron deficiency is TIBC elevated?

A

70

84
Q

Transferrin

A
  • Main binding protein

- Negative acute-phase reactant protein

85
Q

How is % of transferrin sat calculated?

A

(Serum iron level x 100%) / TIBC

86
Q

What % of transferrin sat is seen in iron deficiency anemia?

A

< 15%

87
Q

When would you see increased transferrin sat?

A
  • Hemolytic, megaloblastic, sideroblastic anemia

- Hemochromatosis, other iron overload disorders

88
Q

Ferritin

A
  • Marker of iron storage
  • Most sensitive test to detect iron deficiency
    ↓ ferritin = decrease iron storage = iron deficiency
    ↑ ferritin = iron excess (e.g. hemochromatosis)

Diagnostics (11 decks)

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