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CBC & Iron Studies Flashcards

1
Q

Components of CBC

A

WBC, RBC, Hgb, Hct, Mean cell volume, mean cell Hgb, Mean cell Hgb concentration, Platelet count, differential

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2
Q

White Blood Cell Ranges

A

Adult: 5000-10000
Child <2: 6200-17000
Newborn: 9000-30,000 (normalizes over 2 weeks)

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3
Q

White Blood Cell Components

A 
Neutrophils: 40-85%
Lymphocytes: 10-45%
Monocytes: 3-15%
Eosinophils: 0-7%
Basophils: 0-2%
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4
Q

Granulocytes

A

Have granules in cytoplasm and mugltilobed nuclei
AKA PMNs or Polys

Neutrophils, eosinophils, basophils

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5
Q

Agranulocytes

A

Lymphocytes, Monocytes

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6
Q

Abnormal Leukocytes

A

Leukocytosis: >10,000; bacterial infection, inflammation, neoplasm, leukamoid response, glucocorticosteroid use, Left Shift

Leukopenia: <5000, viral, overwhelming bacterial infection, bone marrow failure, drug toxicity, autoimmune

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7
Q

“Left Shift”

A

Elevated WBC count due to increase in neutrophils and bands, often with reciprocal decrease in lymphocytes

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8
Q

Leukemoid Response

A

Development of early neutrophilic cells
WBC >50,000
Benign, typically resolves with condition (as opposed to Leukemia which continues to rise)

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9
Q

Neutrophilia

A

Elevated neutrophil count

Bacterial infections, leukemia, inflammation, medications (steroids, epi), stress

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10
Q

Neutropenia

A

Decreased neutrophil count

Viral infection, aplastic anemia, overwhelming bacterial infection, drugs (chemo, sulfa, thyroid, phenothiazines)

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11
Q

Lymphocytosis

A 
Elevated lymphocyte count
Viral infections (mono/hepatitis), lymphocytic leukemia
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12
Q

Lymphocytopenia

A

Decreased lymphocyte count

Corticosteroids, immunodeficiency diseases (HIV)

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13
Q

Eosinophilia

A

Elevated eosinophil count
“NAACP”
Neoplasm, Allergies, Addison disease, Collagen vascular disease, Parasites; coccidiomycosis

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14
Q

Eosinopenia

A

Decreased eosinophil count

Corticosteroids, acute stress/inflammatory conditions

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15
Q

What does elevated neutrophils mean?

A

BACTERIAL INFECTION

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16
Q

What is a diagnostic sign of mono?

A

Atypical lymphocytes on smear

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17
Q

Leukemoid reaction

A

Leukocytosis over 50,000
peripheral blood smear shows metamyelocytes and bands, rarely myeloblasts
Bone marrow shows more cells but otherwise typical
Acute leukemia bone marrow shows predominance of immature elements

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18
Q

Markedly elevated WBC (low neutrophils, high leukocytes), enlarged cervical/axillary lymph nodes, easily palpable spleen

A

Leukemia

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19
Q

Platelets

A

Normal 150,000-400,000
Crtical <50,000 or >1million
High platelets associated with clotting risk
5-10k needed to maintain vascular integrity

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20
Q

Thrombocytosis

A 
Increased platelets (>400,000)
Malignancy, polycythemia vera, postsplenectomy syndrome, drugs
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21
Q

Thrombocytopenia

A 
Decreased platelets (<100,000)
ITP more common of the 2 types
Could be associated with Leukemia, cirrhosis, DIC, anemia
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22
Q

Idiopathic Thrombocytopenia (ITP)

A

More common in kids/AIDS pts
Autoimmune phagocytosis of platelets
Gums, nose and skin bleeding, petechiae, purpura, epistaxis, menorrhagia
Treated with corticosteroids or splenectomy

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23
Q

Red Blood Cells

A 
AKA erythrocytes
Live 120 days
No nucleus or mitochondria
Production stimulated by erythopoeitin
Extracted by spleen
Range: male 4.7-6.1x10^6, female 4.2-5.4x10^6
24
Q

Main function of RBC

A

transportation of O2

25
Hemoglobin (Hgb, Hb)
Male 14-18g/dl, female 12-16 | binds and transports Oxygen
26
Hematocrit (Hct)
Male 42-52%, female 37-47% (total blood volume made up by RBC) approx 3x Hgb concentration Low=anemia, high=polycythemia
27
Anisocytosis
Varying size in RBC | Degree correlates with RBC width
28
Poliocytosis
varying shape in RBC
29
Target cells
Bulls eye appearance on peripheral smear suggesting thalassemia or liver disease
30
Fragmented cells
Foreign bodies in blood
31
Abnormalities causing increased RBC
Dehydration, COPD, polycythemia
32
Abnormalities causing decreased RBC
Anemia (B12, Fe, folate deficient; hemolytic, cirrhosis, bone marrow failure, pregnancy)
33
Polycythemia/Eryhtrocytosis
Increased RBC &Hgb/Hct levels Dehydrationm polycythemia vera, COPD, high altitude
34
Categories of Polycythemia
Relative>artifact of concentration, due to decreased plasma volume/dehydration Absolute>TRUE increase in RBC mass; polycythemia vera, secondary polycythemia
35
Polycythemia Vera
Bone marrow disorder-overproduction of erythroid cells Elevated Hgb/Hct increased RBC mass (differentiates between relative/absolute) Dizziness, pruriti following warm shower/bath, blurred vision, engorged retinal veins, thrombosis, splenomegaly Treated with phlebotomy
36
What is most common hematologic disorder in US?
Anemia
37
Anemia
Abnormal RBC size and shape Low Hgb Spoon nails (Koilonychia) &desire to eat weird things/dirt (Pica) Causes: Reduced production of RBC, Increased destruction of RBC, loss of RBC Hemoglobin: <12 females, <14 males
38
RBC Indicies of anemia
MCV, MCH, MCHC, RDW
39
Mean Cell Volume (MCV)
Measure of avg RBC size >100-macrocytic (large) 80-99 normocytic <80 microcytic
40
Mean Cell Hgb (MCH)
Weight of Hgb in RBC >31 Hyper-chromic (bright color) 27-31 normochromic <27 hypo chromic (pale color)
41
Mean Cell Hgb Concentration (MCHC)
Hgb concentration
42
RBC Width (RDW)
Measure of variation in RBC size
43
Iron deficient Anemia
Microcytic, hypochromic secondary to chronic blood loss (GI bleed, menstruation) Results from decrease in serum iron Decreased production of Hgb Low serum Fe, transferritin sat, ferritin High TIBC
44
Lead Poisoning
Microcytic hypo chromic with basophilic stippling on smear
45
Thalassemia
Hereditary disorder-reduced synthesis of global chains Minor more common than major-RBC small but normal or elevated count Smear may have target cells and basophilic stippling Hemoglobin electrophoresis for diagnosis
46
Normocytic Anemia
Normal MCV/normal sized RBC | Anemia of chronic disease (autoimmune, malignancy), renal failure, acute blood loss
47
Microcytic anemia
High MCV, big RBC Vitamin B12 or folate deficiency Macrocytosis can be caused by alcohol consumption as well
48
Megaloblastic anemia
B12/folate deficiency causes inhibition of DNA synthesis during RBC production>cell growth without division (large immature/dysfunction RBC)
49
Pernicious anemia
autoimmune destruction of gastric parietal cells>low intrinsic factor>low absorption of B12 Can lead to megaloblastic anemia
50
Iron studies
Serum iron, total iron binding capacity, transferring, transferrin saturation, ferritin 70% of body's iron in hemoglobin, 30% stored as ferritin &hemosiderin Supplied in diet, 10% of ingested iron absorbed iron bound to transferrin and carried in bone marrow
51
Serum Iron
measurement of quantity of iron bound to transferrin
52
Total Iron Binding Capacity (TIBC)
measurement of all proteins available for binding mobile iron Indirect measurement of transferrin Increased in 70% of pts with iron deficiency
53
Transferrin
Negative acute-phase reactant protein Decreases in acute inflammatory reactions and chronic illnesses/liver diseases Produced in liver
54
Transferrin saturation
% of transferring and other mobile iron-binding proteins saturated with iron serum ironx100%/TIBC <15% in pts with iron deficiency Increased with hemolytic, megaloblastic and sideroblastic anemia, hemochromatosis
55
Best iron test for hemochromatosis?
Transferrin saturation
56
Hemochromatosis
Excess iron deposited in liver, heart &other organs, causes severe organ dysfunction Primary-genetic Secondary (acquired)-repeating blood transfusion Low TIBC High Fe, transferritin sat. ferritin, LFTs
57
Ferritin
Marker of iron storage MOST SENSITIVE TEST FOR IRON DEFICIENCY low ferritin=decreased iron storage Acute-phase reactant, elevated with inflammation &infection when no iron stores exist

Diagnostics (7 decks)

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