CBC Interpretation Flashcards
CBC is drawn from which colour tube?
Lavender
What is included in the differential?
Breakdown of white blood cells
Abs = absolute value
Pct = percentage
Abs value is more useful
When would you want a CBC with diff?
When there is an abnormal WBC count to see the breakdown
Which two terms will you see for neutrophils?
ANC = absolute neutrophil count
Grans Abs
PMN = polymorphonuclear neutrophils
What are the granulocytes cells? What are they for?
Which is most common?
Neutrophils — 60%, bacterial, 5 segments
Eosinophils — parasites
Basophils — allergic
Mast — allergic
Eosinophils & Basophils comprise how much of WBCs?
2-5%
What is agranulocytosis?
ANC <200
What stimulates granulocyte production?
Growth factors in the bone marrow:
— granulocyte colony stimulating factor
— granulocyte macrophage stimulating factor
% of lymphocytes in WBCs?
Which immune system?
Which cells?
35%
Adaptive
B cells — make antibodies (gamma globulins = antibodies)
T cells — CD8 and CD4
NK cells — innate immunity
What do monocytes differentiate into in the marrow or tissue?
Macrophages
What are the terms for low WBC count?
Low lymphocyte count?
Low neutrophil count?
ANC < 200
Leukopenia
Lymphopenia > often secondary to viral suppression of the bone marrow
Neutropenia > medications, malignancy etc. high risk of infection
Agranulocytosis = ANC <200
Most common cause of neutropenia?
Drug-induced
Antibiotic, anti-thyroid, anti-seizure, anti-neoplasticism medications
What are PMNs?
Polymorphic neutrophils
What is the term for high WBCs?Causes? —2
Leukocytosis
— Infection
— Malignancy
What does basophilia often mean?
Hematologic malignancy
Less likely: hypersensitivity
Define “left shift”
Define “bands”
Increase in the number of immature WBC types, cell population has “shifted towards immature precursors”
acute infection
Bands = immature neutrophils
Have an unsegmented C or S shape nuclei
Increase in bands = left shift = bandemia
Neutrophilia causes 3
Bacterial infection
Malignancy
Smoking
Hemoglobin is?
How measured?
Primary protein in RBCs
Carries O2
Lysing RBC and measuring
What is hematocrit (Hct)
What is the quick way to calculate Hct?
% of RBCs in whole blood
35-40%
Take hemoglobin and x3
Which value is most commonly used? RBC, Hgbm, Hct?
Hemoglobin because best indicated of O2 carrying capacity of blood
What are RBC indices?
MCV
MCH
MCHC
RDW
MCV?
Mean corpuscular volume: size
Microcytic
Normocytic
Macrocytic
MCH?
Mean corpuscular hemoglobin
Hypochromic
Normochromic
Hyperchromic
hemoglobin is responsible for red colour!
MCHC
Mean corpuscular hemoglobin concentration
Average hemoglobin concentration
RDW
Large variation medical term?
Red cell distribution width
— variation in size of RBC, as %
Elevated RDW = anisocytosis
Terms for low hemoglobin
And high hemoglobin (2)
Low: anemia
High: erythrocytosis/polycythemia
What is anemia?
Normal levels in men and women
Decreased hemoglobin concentration
Females: <12
Males: < 14
What is hemoconcentration
When you have a falsely elevated hemoglobin concentration because the plasma volume has decreased, and this could be due to dehydration, and you could see these S/S
Dehydration
Tachycardia
Decreased skin turgor
Hypotension
Dry mucous membranes
If you give fluids, hemoconcentration would go back to normal
Describe anemia in pregnancy
Plasma volume increases a lot in pregnancy 40%
Dilutes out your hemoglobin, so it drops physiologically
Reticulocyte count (order separately) — what is it?
When?
How much
normally?
Measure amount of RBC precursors
See these in anemia where the bone marrow is compensating for the anemia by producing more RBC precursors. If this is not happening, there is a problem with the bone marrow to not produce those reticulocytes
0.5-2.5 % is normal
Platelet abnormalities - low/high
Thrombocytopenia:
Low, poor production, destruction, medications, chemo
Thrombocytosis:
Myeloproliferative disease
Reactive: infection, anemia, blood loss, post-splenectomy
Describe the short hand stick diagram
notice they are broken down by cell lines
WBC
RBCs (down the middle, hemoglobin and hematocrit)
Platelets
What are three cell lines:
RBC
WBC
Platelets
If more than one cell line abnormal?
Just one cell line?
+1 cell line: Primary bone marrow problem
One cell line: likely proliferative
What is the term for more than one cell line with reduced values?
Bi-cytopenia
(Cytopenia = decrease in a cell line, doesn’t specific)
Term for all cell lines being down?
Pancytopenia
Likely malignancy
What are abnormal cells under a peripheral smear? Examples and what could they mean?
Size, pallor, segmented, sickle cells, poikilocytes, target cells, bite cells, Howell-Jolly bodies, basophilic stippling, nucleated RBCs, schistocytes, spherocytes
blasts — leukemia
Immature granulocytes
Promyelocytes
Metamyelocutes
Bands
Auer rods
