CBC Notes Flashcards
Study of blood
Hematology
- Plasma = 55%
- RBC = 44%
- WBC and platelets = 1%
Protein in RBC that functions to transport oxygen and carbon dioxide
Hemoglobin
Tissues responsible for producing and maturing blood cells
Hematopoetic tissues (perform Hematopoiesis)
-Spleen, lymph nodes, thymus, bone marrow, liver, the RES
T/F Only mature blood cells are released into peripheral blood
True
Hormones that stimulate hematopoiesis.
- Erythropoietin (from kidney)
- Leukopoietin
- Thrombopoietin and others
Primary regulator of erythropoiesis
Erythropoietin (EPO)
- Division take 3-5 days
- Remain in bone marrow for 1-2 days to mature before release into circulation
Life span of a RBC
- Main function of RBC
- Main components of RBC
120 days
- Transport HgB
- 90% hemoglobin and 10% water
Signs and symptoms to order a CBC
Tons
-Weakness, fatigue, apathy, lassitude, pallor, brittle nails, dyspnea, tachycardia, etc. etc.
If a chest X-ray appears to show pneumonia, why would we order a CBC?
Help check if the pneumonia is being caused by a viral, bacterial, or fungal pathogen
X-ray shows increased RPI and RTI. What are potential causes for this?
-What labs would be helpful?
SOL = Blood, Pus, Tumor, Edema
-CBC and ESR
X-ray with open growth plates shows demineralization. Is this normal?
NO!
- Open growth plates = child = anytime demineralization occurs outside of what age group/amount for the age we would normally suspect, consider it pathologic
- Need biochemical profile, metabolic panel, and CBC
What is normally reported if a CBC is requested?
- RBC
- Hemoglobin
- Hematocrit
- RBC indices
- Platelets
(may see other info)
As a general rule, women and children have _____ lab counts than males
Women/children = Lower counts compared to males
What does it imply if hematocrit is 45%?
45% of blood volume consists of RBCs while 53% consists of plasma
If hematocrit, RBC, or hemoglobin are low, it indicates what general condition?
Anemia
T/F RBC is 4.2 (normal), Hct is 25 (low), and HgB is 9 (low). Lab works shows that the patient does NOT have anemia because of normal RBC
FALSE
RBC. Hct, HgB all can be used to determine anemia if more than 1 is low or even low normal. Don’t know what specific type without getting the indices
Indice that provides information about the size of the RBC
MCV
HgB weight (HgB/RBC)= MCH
HgB concentration (HgB/Hct) = MCHC
(MCH and MCHC determine color while MCV determines size)
Patient has anemia. Indices show decreased MCV and MCH/MCHC. What do the RBCs look like?
Microcytic Hypochromic
(MC type)
Patient has anemia. Indices show normal MCV and MCH/MCHC. What do the RBCs look like?
Normocytic Normochromic
Patient has anemia. Indices show increased MCV and normal/increased MCH/MCHC. What do the RBCs look like?
Macrocytic normochromic or Hyperchromic
3 general RBC causes of anemia
1) Decreased production
2) Increased breakdown
3) Blood loss
(classified by RBC morphology = cell size)
4 pathologies that produce microcytic hypochromic anemia
Indices = low MCV and MCH/MCHC
1) IDA (MC by far)
2) Anemia of Chronic Disease (25% microcytic, 75% normocytic)
3) Thalassemia
4) Chronic Blood Loss (really an IDA)
4 pathologies that cause macrocytic normochromic anemia
Increased MCV, Normal or increased MCH/MCHC
1) Vitamin B-12 deficiency
2) Folic Acid (B-9) deficiency
3) Alcoholism
4) Liver disease
What macrocytic normochromic anemias are considered megaloblastic?
B-9 and B-12 deficiency Anemias
Alcoholism and liver disease causes nonmegaloblastic anemias
4 pathologies that cause normocytic normochromic anemia.
Normal MCV, MCH/MCHC
1) Anemia of Chronic Disease (75% of the time, 25% microcytic)
2) Acute blood loss
3) Hemolytic Anemia (like Sickle Cell)
4) Aplastic Anemia
CBC 5 year old African American male. Any findings?
- WBC = 7.1 (N)
- RBC = 4.2 (N)
- HgB = 9 (Low)
- Hct = 25 (Low)
- MCV = 75 (low)
- MCH = 24 (Low)
- MCHC = 32-36 (low)
- Platelets = 200 (N)
Patient has Anemia based on low HgB and Hct
-Since indices show microcytic hypochromic anemia (low MCV, MCH/MCHC), the patient has either Chronic Blood Loss, IDA, Thalassemia, or ACD
IDA is most common though and nothing else indicates CBL, Thalassemia or ACD
Protein responsible for transporting iron
Transferrin
T/F Very little iron is lost in the body. Most is done by cells in the GI tract or through menses and urine
True
What is the most common cause of an IDA would wide?
GI blood loss
Acute bleeding results in ____cytic ___chromic anemia while chronic blood loss results with _____cytic ____chromic anemia
Acute = normocytic normochromic anemia
Chronic = microcytic hypochromic anemia
MC of IDA in developed countires
Blood lost during menses
-Developing = GI bleeds
Iron is necessary for the formation of what part of hemoglobin?
Heme
- Vast majority is in hemoglobin (70-95%)
- Intake and excretion for iron is 1-2 mg/day
Pica for ice seen with IDA. May disappear with correction of IDA.
Pagophagia
Protein molecule to bind iron. Measures the extent to which iron-binding sites in the serum can be saturated. Binding sites in serum are almost entirely dependent on circulating transferrin, this is really an indirect way to measure the amount of transferrin in the blood
Total Iron Binding Protein (TIBC)