CBC Flashcards
study of blood and its formed elements
hematology
about ___% of total blood volume is plasma
55
about ___% of blood volume is formed elements
45
about ___% of blood volume is erythrocytes
44
about ___% of blood volume is WBC and platelets
1
________ are responsible for preventing blood loss from hemorrhage and exert their main effect on the blood vessel wall
platelets
_______ is the cellular formation, proliferation, differentiation and maturation of blood cells
hematopoiesis
name the 6 hematopoietic tissues/organs
liver spleen thymus bone marrow lymph nodes RES
T or F
normally only mature cells are released into peripheral blood
true
when does hematopoiesis begin?
about the 19th day of gestation
where in a normal adult are blood cells made?
bone marrow of the axial skeleton
bone marrow contains a hematopoietic or a pluripotential ____ _____ that can differentiate, proliferate and renew into any mature blood cell
stem cell
hematopoiesis is stimulated by _____ (3)
erythropoietin, leukopoietin and thrombopoietin
erythropoietin is produced by the ______
kidney
postnatally, erythrocytes, granulocytes, monocytes and platelets are normally produced in the _______.
bone marrow
where are lymphocytes produced?
secondary lymphoid organs such as spleen and lymph nodes, as well as bone marrow and thymus
hematopoiesis starts with what kind of cell?
stem cell
_______ is the primary regulator of erythropoiesis
erythropoiesis
how long does cell division take?
3-5 days
once hemoglobin synthesis is completed, how long does it take for a red blood cell to mature before it is released into circulation?
1-2 days
describe the shape of a RBC
biconcave disc
lifespan of a RBC
120 days
what is the main function of a RBC
transport hemoglobin
protein that delivers oxygen from the lungs to tissue and cells and transports carbon dioxide from the cells
hemoglobin
RBC’s are ___% hemoglobin and ___% water
90
10
T or F
RBC’s have a nucleus
false
T or F
RBC’s are firm and unbendable
false
they are flexible and deformable to pass into micro-circulation
T or F
normal concentration of RBC’s vary with age, sex and geographic location
true
these 2 groups of people generally have lower CBC counts
females and children
normal RBC count for adult male
4.5-6 million/mm3
normal RBC count for adult female
4.0-5.5 million/mm3
normal RBC count for children
4.0-5.5 million/mm3
low RBC count
anemia
high RBC count
polycythemia
packed cell count/packed cell volume/percentage of total blood volume made up of RBCs
hematocrit
T or F
hematocrit can drop during menses
true
T or F
A patient only has anemia if RBC, hemoglobin and hematocrit are low
false
anemia will occur if any of the values are decreased
what does MCV stand for and what is it a measure of
mean corpuscular volume
size of RBCs
what does MCH stand for and what is it a measure of
mean corpuscular hemoglobin
weight of RBCs
(indicates color)
what does MCHC stand for and what is it a measure of
mean corpuscular hemoglobin concentration
hemoglobin concentration
what are the 3 cell sizes
normocytic (normal)
microcytic (too small)
macrocytic (too big)
Hgb content (3)
normochromic (normal)
hypochromic (not enough hemoglobin)
hyperchromic (too much hemoglobin)
aka hyperchromic
polychromasia
T or F
anemia can be congenital
true
anemia is classified by what 2 things
cell size and color
T or F
anemia is an indication of an underlying disorder
true
name the anemia
decreased MCV
decreased MCH/MCHC
microcytic hypochromic
RBCs are too small and color is too light
name the anemia
normal MCV
normal MCH/MCHC
normocytic normochromic
size and color of the RBCs is normal, but RBC count is low
name the anemia
increased MCV
normal MCH/MCHC
macrocytic normochromic
RBCs are too big but color is fine
name the anemia
increased MCV
increased MCH/MCHC
macrocytic hyperchromic
RBCs are too big and color is too dark
T or F
anemia indicates a decreased ability of oxygen carrying capacity
true
3 general causes of anemia
decreased RBC production
increased destruction
blood loss
4 causes of microcytic hypochromic anemia
iron deficiency anemia
anemia of chronic disease
thalassemia
chronic blood loss
___% of the time anemia of chronic disease results in normocytic anemia, ___% of the time it is microcytic
75
25
4 causes of macrocytic normochromic anemias
vitamin B12 deficiency
folic acid deficiency
alcoholism
liver disease
4 causes of normocytic normochromic anemia
anemia of chronic disease (ACD)
acute blood loss
hemolytic anemia (eg sickle cell)
aplastic anemia
____ is an essential component of hemoglobin, myoglobin and many enzymes
iron
how much of total iron is in the RBCs
2/3
iron is stored in what 2 forms
ferritin
hemosiderin
iron is transported by _______
transferrin
T or F
very little iron is lost in the body
true
mostly by GI tract, menses and urine
most common cause of anemia worldwide
IDA
acute bleeding results in what type of anemia
normocytic normochromic
chronic bleeding results in what type of anemia
microcytic hypochromic
IDA is usually due to what
chronic blood loss
worldwide, the most important cause of IDA is ______
parasitic infections
in adults over 50, the most common cause of IDA is what
chronic GI bleeding from ulcers or cancer
in developed countries where parasitic infections are less common, the principal cause of IDA is _____
menses
iron is necessary for the formation of ____
heme
the average diet consists of 10-20mg of iron and only ___% of it is absorbed
10
________ is the most common cause of IDA
chronic blood loss
unusual cravings for specific foods or unusual substances
pica
pagophagia
pica for ice
T or F
TIBC is an indirect measurement of the amount of transferring in the blood
true
TIBC in IDA is (high/low)
low
anemia of chronic disease aka
anemia of inflammation
with anemia of chronic disease red blood survival is (increased/decreased) and _______ fails to compensate
decreased
bone marrow
anemia of chronic disease has a (high/normal/low) TIBC
low
if anemia of chronic disease is related to kidney disease then it is known as _______
ARD (anemia renal disease)
T or F
thalassemia is a hereditary disorder
true
thalassemia is characterized by reduced synthesis of _______ of ______
globulin chains
hemoglobin
thalassemia is what kind of anemia
microcytic hypochromic
two types of thalassemia
alpha
beta
alpha thalassemia is primarily seen in people from what 2 places?
China
southeast asia
beta thalassemia is primarily in people of what origin?
mediterranean
3 levels of thalassemia
minor- trait is present
intermedia
major- life threatening anemia and other changes
thalassemia major aka
cooley’s anemia
mediterranean
thalassemia major
homozygous or heterozygous
homo
thalassemia major clinical problems
growth failure bone deformities marrow expansion widened diploic space hair on end appearance on skull facial abnormalities pathological fractures hepatosplenomegaly jaundice gallstones
thalassemia minor
homozygous or heterozygous
heterozygous
T or F
thalassemia minor patients are clinically normal and require no treatment
true
which kind of thalassemia patients require regular transfusions
major
in thalassemia patients, iron parameters are (high/normal/low)
normal
TIBC in thalassemia is ______
normal
how is alpha and beta thalassemia differentiated?
hemoglobin electrophoresis
what are the 4 microcytic hypochromic anemias
IDA
thalassemia
ACD
chronic blood loss
TIBC
IDA
ACD
thalassemia
increased
decreased
normal
4 causes of macrocytic normochromic anemia
vitamin B deficiency
folic acid deficiency
alcoholism
liver disease
in macrocytic normochromic anemia MCV is (increased/normal/decreased)
increased
megaloblastic macrocytic normochromic anemia is likely due to deficiency of ______ or _____
folate (B9)
cobalamin (B12)
______ is necessary to convert folic acid to its active form needed in the formation and function of RBC’s
vitamin B12
in megaloblastic anemia, RBC’s are abnormally _____, have a _____ life span and ______ oxygen carrying capacity
large
shortened
decreased
B12 requirements increase with _____ and _____
pregnancy
malignancy
intrinsic factor is produced in the _____ of the stomach
gastric mucosa
anemia from B12 deficiency
pernicious anemia
________ is the most common cause of B12 deficiency/pernicious anemia
deficiency of intrinsic factor
intrinsic factor is needed to ________
absorb B12 in the small intestine
the second most common cause of vitamin B12 deficiency is ______
lack of gastric acid necessary to separate B12 from its binding proteins
the third most common cause of B12 deficiency is _____
malabsorption- due to diseases of the terminal ilium (worm infestation, inflammatory bowel disease, malabsorption syndromes)
B12 deficiency signs and symptoms
lemon-yellow skin color premature graying weakness sore tongue GI symptoms (diarrhea, abdominal pain) paresthesia loss of vibratory sensation irritability emotional instability neuropsychiatric disorders
raw beef tongue
B12 deficiency
1 out of 4 people with pernicious anemia develop ______
stomach cancer
folic acid deficiency is due to _____
decreased intake
folic acid requirements increased with (3)
pregnancy
infancy
malignancy
over time B12 deficiency cause ______
neurologic symptoms such as numbness, tingling, depression, memory loss and irritability
severe cases of folate deficiency may result in _____ and _____
depression
dementia
4 normocytic normochromic anemias
ACD
acute blood loss
hemolytic anemia
aplastic anemia
severe life threatening syndrome that is from a decreased production of all cell lines
aplastic anemia
prognosis for aplastic anemia is ____
poor
anemia that is due to increased RBC destruction
hemolytic anemia
extravascular RBC breakdown occurs in the ______
RES (reticuloendothelial system)
intravascular RBC breakdown is ___
rare
________ is a serious chronic hemolytic anemia
sickle cell anemia
sickle cell anemia is first manifested when?
early childhood
average life expectancy for people with sickle cell anemia
males 42
females 48
sickle cell anemia occurs almost exclusively in the ____ population
black
signs and symptoms of sickle cell
same as anemia as well as chest, abdominal and musculoskeletal pain
hand foot syndrome is seen with _____
sickle cell anemia
hair on end appearance is seen with what 2 anemias
thalassemia
sickle cell
sickle cell affects approximately __% of African americans
10
acute bleeding results in a _____cytic _____chromic anemia
normo
normo
chronic bleeding results in a ___cytic ____chromic anemia
micro
hypo
increase in erythropoiesis
polycythemia
in polycythemia RBCs, Hgb and hematocrit are all (increased/normal/decreased)
increased
3 types of polycythemia
polycythemia vera- primary
absolute polycythemia- secondary
relative polycythemia
common s/s of polycythemia (6)
red face high blood pressure low exercise tolerance joint pain splenomegaly itchiness, esp after a warm bath
polycythemia (rubra) vera is an absolute increase in ______
all cell types (RBC, WBC, platelets)
chronic myeloproliferative disorder with overproduction of erythrocytes
polycythemia
physiologic response to the need for more BC production due to an increased need for oxygen, pulmonary disorder or increase in erythropoietin
secondary polycythemia
secondary polycythemia is a normal adaptation to people who live where?
at high altitudes
secondary polycythemia generally occurs in people with what conditions
heart disease lung disease history of smoking COPD renal tumors
relative polycythemia is most often associated with ______
dehydration
primary polycythemia is really a malignancy of ____
bone marrow
polycythemia is the opposite of _____
anemia
relative polycythemia is due to a decrease in _____
plasma volume
ESR
erythrocyte sedimentation rate
____ is a measurement of the rate with which the RBCs settle in saline or plasma over a specific time period (one hour)
ESR
T or F
ESR is sensitive byt it is non specific and not diagnostic of a particular organ
true
ESR can be used to monitor disease progress: as disease worsens ESR (increases/decreases)
increases
_______ is stacking of the RBCs similar to a stack of coins as they stack they drop more rapidly
rouleaux formation
ESR (increases/decreases) with age
increases
ESR formula must be corrected in _____ because there are fewer cells
anemia
sore throat causes (increased/decreased) ESR
increased
appendicitis causes (increased/decreased) ESR
increased
with angina pectoris where there is no tissue damage, ESR is (increased/normal/decreased)
normal
MI (tissue destruction) causes ESR to (increase/decrease)
increase
ESR parallels ____
c reactive protein
a non-specific, acute phase reactant used to diagnose bacterial infections, connective tissue disorders, neoplastic disease and inflammatory disorders
c reactive protein
____ is an abnormal protein produced in the liver in response to tissue destruction/inflammation
C reactive protein
CRP is (more/less) sensitive than ESR
more
CRP increases (faster/slower) disappears (faster/slower) than ESR during recovery
faster
faster
RBC that vary in size frequently found in hemolytic anemia
anisocytes
increased numbers of reticulocytes seen in folate and B12 deficiency as well as in polycythemia
polychromasia
oval shape RBC, normally only small numbers are present, may be seen in IDA and megaloblastic anemia
ovalcyte
teardrop shaped RBC may be seen in ______
thalassemia
target cells are seen in (3)
thalassemia
ss
chronic liver
basophilic stippling is seen in ____
lead poisioning
stippling appearance is seen in (2)
thalassemia
hemolytic anemia
young immature non-nucleated RBCs
reticulocytes
