CBC Flashcards by Jessica Valdez

WBC differential reference range %s

Neutrophils				40-85%
Lymphocytes				10-45%
Monocytes				3-15%
Eosinophils				0-7%
Basophils				0-2%

How well did you know this?

Not at all

Perfectly

Describe the 3 granulocytes

“BEN”

Basophils- allergic rxn, parasitic infections
Eosinophils- allergic rxn
Neutrophils- most abundant, phagocytosis of bacteria

How well did you know this?

Not at all

Perfectly

Describe the 2 nongranulocytes

Lymphocytes (T cells and B cells)

fight viral infections
chronic bacterial infections

Monocytes
-phagocytic against bacteria

How well did you know this?

Not at all

Perfectly

General causes of Leukocytosis > 10,000/mm³

Bacterial infection
Inflammation
Neoplasm
Leukemoid response
Glucocorticosteroid use

How well did you know this?

Not at all

Perfectly

General causes of Leukopenia < 5000/mm³

Viral infection
HIV
Overwhelming bacterial infection (esp in elderly)
Bone marrow failure
Drug toxicity
Autoimmune disease

How well did you know this?

Not at all

Perfectly

“Left shift” =

bacterial infection

an elevated WBC count due to an increase in neutrophils

How well did you know this?

Not at all

Perfectly

What is a leukemoid response?

Markedly elevated WBC >50,000/mm3

Development of early neutrophilic cells called metamyelocytes.

Associated with infection, benign, and resolves as condition resolves.

How well did you know this?

Not at all

Perfectly

Common causes of Neutrophilia

Bacterial Infections
Leukemia
Inflammation (RA)
Medications
Stress
Steroids (Cushing’s or meds), epinephrine (short duration ~20-30 minutes)

How well did you know this?

Not at all

Perfectly

Common causes of Neutropenia

Viral infection (# of lymphocytes up, # of neutrophils down)
Aplastic anemia
Overwhelming bacterial infection (esp in elderly)
Drugs

How well did you know this?

Not at all

Perfectly

Conditions associated with Lymphocytosis

Viral infections

Mononucleosis
Viral Hepatitis

Lymphocytic leukemia

How well did you know this?

Not at all

Perfectly

Conditions associated with Lymphocytopenia

Corticosteroids*
Immunodeficiency diseases* (late stage HIV)

Leukemia
Radiation therapy
Sepsis

How well did you know this?

Not at all

Perfectly

Associated conditions with Eosinophilia

"NAACP"
Neoplasms 
Allergic reactions 
Addison's disease 
Collagen vascular disease (autoimmune dz like Lupus) 
..and Coccidiomycosis
Parasites

How well did you know this?

Not at all

Perfectly

What is the allergy triad?

Asthma
Rhinorrhea (hay fever rhinitis)
Eczema (atopic dermatitis)

How well did you know this?

Not at all

Perfectly

Causes of Eosinopenia

Corticosteroids (the opposite of Addison’s disease)*

Acute stress or inflammatory conditions

How well did you know this?

Not at all

Perfectly

Describe pt histories to consider when evaluating WBC abnormalities

acute infection or inflammatory condition
medications
pregnancy or recent delivery
hematologic disease (e.g leukemia, myelodysplastic disease, sickle cell dz)
recent surgery/trauma (snake, insect bites)
splenectomy
recent vaccine
smoking
family hx

How well did you know this?

Not at all

Perfectly

Cigarette smoking is associated with what WBC abnormality?

neutrophilia

How well did you know this?

Not at all

Perfectly

Atypical lymphocytes, seen on a peripheral smear, is associated with what infection?

mononucleosis

How can you tell apart a leukemoid reaction from leukemia?

Elevated WBC >50,000/microL

Leukemoid response
Blood smear may show metamyelocytes and bands but rarely myeloblasts (the very immature forms) and bone marrow shows more cells but is otherwise typical.

Leukemia
Bone marrow shows predominance of the most immature elements (eg, myeloblasts)

Also with leukemia will see a persistent elevation of WBCs vs in leukemoid response it will be decrease as infection resolves.

What are metamyelocytes?

early neutrophilic cells

associated with Leukemoid response

Describe the reference range for platelets, critical values, and when you would transfuse?

RR is 150,000-400,000/mm³
Critical Values: <50,000 or >1 million
<10k severely increased bleed risk - transfuse

Describe possible causes of thrombocytosis

Platelets >400,000/mm³

Malignancy*
Polycythemia vera
Postsplenectomy syndrome
Drugs
Testosterone
Estrogens
Oral contraceptives

What is the term for a platelet count >400,000/mm³ ?

thrombocytosis

Conditions that may be assoc. with thrombocytopenia

Leukemia
Cirrhosis
DIC (disseminated intravascular coagulation)
Anemia (ex: hemolytic, pernicious)

What platelet disorder is most common in children and AIDS pts?

ITP (Idiopathic Thrombocytopenic Purpura)

Describe ITP (Idiopathic Thrombocytopenic Purpura)

Platelet count markedly low, usu. < 10,000. Other blood counts & peripheral smear normal Etiology - autoimmune More common in children and AIDS pts. Better prognosis and usually self limited in children. PE findings: Petechiae, purpura, epistaxis, menorrhagia

Where is erythropoietin made?

kidneys EPO triggers stem cell hematopoiesis to ↑ erythrocyte production

RBCs have no mitochondria. How do they produce energy?

Glycolysis

Define anisocytosis and poiliocytosis?

Anisocytosis - varying RBC size Poiliocytosis- varying RBC shape

Target cells are assoc. with what conditions?

Thalasemia or liver disease

Why might you see fragmented cells on a peripheral blood smear?

Foreign bodies in blood like from heart valve and thermal injury

Describe the etiology of polycythemia vera

Bone marrow disorder characterized by overproduction of erythroid cells Elevated Hgb/Hct = characteristic initial finding Increased RBC mass*

What conditions are assoc with secondary polycythemia?

Tissue hypoxia such as COPD & living at high altitude Due to increased EPO production.

How would you differentiate relative vs absolute polycythemia?

Relative - increases Hct but normal RBC mass Absolute - increased Hct and increased RBC mass

Pruritus following warm shower or bath is a complaint seen in what hematological condition?

Polycythemia vera Other possible sxs HA, dizziness, tinnitus, blurred vision, fatigue

Describe possible causes of microcytic anemia

- Iron deficiency (usually secondary to chronic blood loss) - Lead poisoning (would also see basophilic stippling) - Thalasemia (target cells + basophilic stippling on peripheral blood smear)

Causes of normocytic anemia

Anemia of chronic disease e.g, autoimmune diseases, malignancy Renal failure Acute blood loss

Causes of macrocytic anemia

Vitamin B12 deficiency Folate deficiency Also ETOH can cause a macrocytosis with or without anemia

Transferrin is also a negative acute-phase reactant protein, what does this mean?

In various acute inflammatory reactions, levels decrease May also decreased w/ chronic illness and liver disease (transferrin is a protein produced in liver)

What is the BEST iron test for hemochromatosis?

Transferrin saturation (would be increased) Transferrin sat (%) = serum iron level/TIBC x 100%

In iron deficiency anemia, would you expect TIBC to increase or decrease?

increase Less iron = less protein binding of iron = increase in the protein available to bind iron = increase in TIBC

Describe ferritin

Marker of iron storage Can be most sensitive test to detect iron deficiency ↓ ferritin = decrease iron storage = iron deficiency ↑ ferritin = iron excess (e.g. hemochromatosis)