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CBC Flashcards

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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
Eosinopenia
Decreased eosinophil count - Corticosteroids (the opposite of Addison’s disease)* - Acute stress or inflammatory conditions
26
What is a common/useful parameter of infection?
Total neutrophil count
27
What is used for dx & px?
Serial WBC & differential counts
28
Acute leukemia
Bone marrow shows a predominance of the most immature elements (myeloblasts)
29
Platelet count RR
150,000-400,000
30
Platelet fxn
- Initiates coagulation cascade | - Hemostasis
31
Critical platelet count
<50,000 or > 1 million
32
What could happen if platelet count <20,000?
Spontaneous bleeding
33
Thrombocytosis
Increased platelet count (>400,000) - Malignancy* - Polycythemia vera - Postsplenectomy syndrome - Drugs (estrogens, oral contraceptives)
34
Thrombocytopenia
Decreased platelet counts (<100,000) - ITP - TTP
35
What is thrombocytopenia associated w/ ?
- Leukemia - Cirrhosis - DIC (disseminated intravascular coagulation) - Anemia (hemolytic, pernicious)
36
ITP is most common in ...
Children | - Also common in AIDS
37
ITP etiology
Autoimmune: - Develops antibodies against own platelets - Massive phagocytosis of platelet-antibody immune complexes occurs in the spleen
38
ITP hx
- Usually asymptomatic except for mucosal & skin bleeding due to decreased platelets - Antecedent viral infection
39
ITP PE
- Petechiae - Purpura - Epistaxis - Menorrhagia
40
ITP lab findings
- Platelet count low < 10,000 | - Other blood counts & peripheral smear normal
41
ITP tx/px
- Self-limited in children - In adults – corticosteroids - If unresponsive to medical therapy, possible splenectomy
42
What % of people will develop chronic ITP?
50-60%
43
RBC count RR
Male 4.7-6.1 x 10^6 | Female 4.2-5.4 x 10^6
44
Define: RBC count
of circulating RBCs in peripheral venous blood
45
What do RBCs contain?
Hemoglobin
46
What is the lifespan of RBCs?
120 days | - After this time, RBCs extracted by spleen
47
Hemoglobin RR
Male 14-18 | Female 12-16
48
Define: hemoglobin
Total amount of hemoglobin in the blood
49
Hgb fxn
Binds & transports O2
50
Hct count RR
Male 42-52% | Female 37-47%
51
Define: Hct
% of the total blood volume that is made up by RBC’s
52
Hct vs Hgb
Hct is 3 times that of the Hgb concentration
53
Increased RBCs - associated w/ what?
- Dehydration - COPD - Polycythemia vera
54
Decreased RBCs - associated w/ what?
Anemia - Bleeding / Fe deficiency - B12, Folate deficiency - Cirrhosis - Bone marrow failure - Pregnancy
55
Polycythemia/ erythocytosis (increased RBCs, Hct, Hgb) - associated w/ what?
- Dehydration - Polycythemia vera - Smoking & COPD - High altitude
56
Categories of polycythemia
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
Polycythemia vera etiology
Overproduction of erythroid cells
58
Polycythemia hx
- HA, dizziness, tinnitus, blurred vision - Fatigue - Pruritus following warm shower or bath
59
Polycythemia PE
- Engorged retinal veins - Thrombosis - Splenomegaly
60
Polycythemia lab findings
- Elevated Hgb/Hct - Increased RBC* - Leukocytosis - Thrombocytosis
61
Polycythemia tx
Phlebotomy
62
Causes of anemia (3)
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
MCV
Average RBC size | - Microcytic, normocytic, macrocytic
64
MCH
Weight of Hgb in RBC
65
MCHC
Hgb concentration | - Hypochromic, normochromic, hyperchromic
66
RDW
Variation in RBC size | - Degree of anisocytosis
67
Categories of microcytic anemia (Decreased MCV, small RBCs)
- Iron deficiency - Lead poisoning - Thalassemia
68
Iron deficiency
- Microcytic hypochromic (↓ MCV & ↓MCHC) - Usually due to chronic blood loss: GI bleed, menstrual blood loss
69
What does lead poisoning cause?
Mild microcytic hypochromic anemia w/ basophilic stippling on peripheral smear
70
Thalassemia
Hereditary, reduced synthesis of globin chains | - Associated w/ patterns of bands
71
Thalassemia minor
- RBCs will be small (↓ MCV), but total RBC count may be normal or elevated - Peripheral smear may reveal target cells & basophilic stippling
72
Thalassemia dx & components of this test
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
Normocytic anemia (normal MCV / normal-sized RBCs)
- Anemia of chronic disease (autoimmune diseases, malignancy) - Renal failure - Acute blood loss
74
Macrocytic anemia (↑MCV / big RBCs)
- Vitamin B12 & folate deficiency | * Alcohol consumption can cause a macrocytosis w/ or w/out anemia
75
Risk associated w/ anemia
Cardiac events
76
What should you consider if Hgb < 8, Hct < 24%?
Transfusion
77
Iron studies
- Iron level (serum iron): quantity of iron bound to transferrin - TIBC (Total Iron Binding Capacity) - Transferrin saturation - Ferritin * Ordered separately or grouped
78
What % of iron is found in hemoglobin?
70
79
Where is the other 30% of iron stored?
Ferritin & hemosiderin
80
Hemochromatosis
- Excess iron deposited in organs --> organ dysfunction | - Elevated LFTs
81
Types of hemochromatosis
- Primary: Genetic | - Secondary: Caused by repeated transfusions
82
TIBC
- Measures proteins available for binding mobile iron | - Measures transferrin
83
In what % of pts w/ iron deficiency is TIBC elevated?
70
84
Transferrin
- Main binding protein | - Negative acute-phase reactant protein
85
How is % of transferrin sat calculated?
(Serum iron level x 100%) / TIBC
86
What % of transferrin sat is seen in iron deficiency anemia?
< 15%
87
When would you see increased transferrin sat?
- Hemolytic, megaloblastic, sideroblastic anemia | - Hemochromatosis, other iron overload disorders
88
Ferritin
- 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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