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Foundations III > CBC > Flashcards

CBC Flashcards

1
Q

How long does it take for RBCs to from from stem cells?

A

7 days

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2
Q

How long do RBCs live?

A

~120 days

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3
Q

How long does it take for reticulocytes to mature in circulation?

A

1 day

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4
Q

What is a normal retic count? Why?

A

RBC production should equal destruction.

So, RBCs are destroyed at a rate of 0.8%-1%

Normal reticulocyte count 1-2%

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5
Q

IF you have a high amount of reticulocytes, what will the CBC look like?

A

INCREASED MCV

INCREASED RDW

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6
Q

Normal WBC

A

5,000-10,000/mm3

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7
Q

Normal Hemoglobin

A

Men: 14-18 g/dL

Women: 12-16 g/dL

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8
Q

Hematocrit

A

percentage of whole blood made up of RBCs

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9
Q

Mean Cell Volume (MCV)

A 
>100 = macrocytosis
80-100 = normocytic
<80 = microcytosis

(fL - fenoliters)

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10
Q

Mean Cell Hemoglobin (MCH)

A

weight of the hemoglobin in the RBC

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11
Q

Mean Cell Hemoglobin Concentration (MCHC)

A

Normal: ~31-35%

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12
Q

Red Cell Distribution Width (RDW)

A

Range in cell size

Normal: 12-15%

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13
Q

Anisocytosis

A
  • abnormalities of size

- correlates with RDW

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14
Q

Poikilocytosis

A
  • abnormalities in shape

- suggests defect in the precursor cells

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15
Q

Hyperchromasia

A

Causes:

  1. dehydration
  2. spherocytes
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16
Q

Polychromasia

A

-blue staining RBCs

17
Q

Peripheral smear: target cells

A

Suggests:

  1. Hemoglobinopathy
  2. Thalassemia
  3. Liver disease
18
Q

Peripheral smear: Basophilic stippling

A
  • represent ribosomal precipitates
    1. Thalassemia
    2. Alcohol abuse
    3. Lead/heavy metal poisoning
19
Q

Peripheral smear: Rouleaux formation

A

Associated with Multiple myeloma

20
Q

Peripheral smear: Fragmented cells

A
  1. Schistocytes
  2. Helmet cells

Associated with:

  • Mechanical heart valve
  • DIC
  • Thrombotic thrombocytopenic purpura (TTP)
21
Q

Heinz bodies

A

Aggregates of denatured hemoglobin

Seen in:

  • G6PD deficiency**
  • Autoimmune hemolytic anemia
  • Thalassemia
22
Q

Bite cells

A

Removal of hemoglobin precipitate by macrophages

Seen in”

  • G6PD deficiency**
  • hemolytic anemia
23
Q

Howell-Jolly Bodies

A

Small, round remnants of DNA

Seen in:

  • Sickle cell
  • Splenectomy
  • Hemolytic anemia
  • Megaloblastic anemia
24
Q

Smudge cells

A

Indicates that the lymphocytes are fragile

Seen in:
Chronic lymphocytic leukemia (CLL)

25
Q

What conclusion is to be made from seeing blasts, immature cells (ex. lymphoblasts, or myeloblasts) on peripheral smear?

A

ALWAYS abnormal finding

-suggests malignant hematologic disorder

26
Q

If you see reticulocytosis with anemia, what should you think?

A
  • hemolysis

- blood loss

27
Q

Anemia with normal reticulocyte count. What does this suggest?

A

substrate problem (ex. Fe deficiency, Vitamin B 12 deficiency)

or

Maturation problem (ex. myelodysplastic syndrome)

28
Q

Corrected retic count

A

= reticulocyte% x (patient hematocrit/45)

If corrected is >3 =normal
If corrected is <2= inadequate

29
Q

Clinical pearl to see if bone marrow is compensating for the anemia

A

retic count + hemoglobin = should be close 15

Ex. 6.4 + 8.2 = 14.6 [this is normal! bm is compensating for anemia]

30
Q

Serum Iron (Fe)

A

amount of iron in blood, bound to transferrin

70% of total iron

31
Q

Ferritin

A

Measure of stored iron

30% of total iron

32
Q

Total iron binding capacity (TIBC)

A

-total potential space available on RBC for Fe to bind

33
Q

Transferrin

A

-protein that binds to iron and transports to the bone marrow to be incorporated in hemoglobin

34
Q

Transferrin saturation

A

Amount of transferrin available for binding mobile iron

Ex. will be very HIGH in hemachromatosis. Also elevated in hemolytic, megaloblastic, sideroblastic anemia.

<15% in Fe deficiency anemia
Normal is 20-50%

35
Q

What is the most sensitive test to detect iron deficiency

A

Ferritin

36
Q

What does a low ferritin ssuggest

A

Fe deficiency

37
Q

What does a high ferritin suggest?

A

hemochromatosis

38
Q

Acute-phase reactants

A

Ferritin - elevated with inflammation and infection, but not iron storage issue

Transferrin - decreased (negative acute-phase reactant) with acute inflammation. Can also be decreased if liver dx since transferrin is made in the liver

39
Q

What is the best iron test for hemochromatosis?

A

Transferrin saturation

Foundations III (34 decks)

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