CBC popcorn

Question 1

Increased retic count is a/w and increase in what two CBC findings?

Answer 1

Increase in MCV (macrocytosis) and RDW

Question 2

RBC lifespan is shortened by what 4 things

Answer 2

1. Uremic toxins
2. Elevated BG
3. Inflammatory cytokines
4. Infectiosn

Question 3

MCV <80 =?

>100 = ?

Answer 3

<80= microcytosis

>100= macrocytosis

Question 4

RDW refers to what

Answer 4

ranges of cell sizes

Question 5

What is anisocytosis?

Answer 5

Abnormalities of size

correlates w/ RDW

Microcystosis and macrocytosis are examples

Question 6

What is Poikilocytosis? What does this suggest?

Answer 6

Abnormalities of shape

Suggests defect in the precursor cells in RBC maturation

Question 7

What is hyperchromasia

Answer 7

RBC darker in color due to dehydration or presence of spherocytes

Question 8

Target cells

Answer 8

Thalassemia

Hemoglobinopathy, liver dz

Question 9

Basophilic stippling- 3

Answer 9

Thalassemia

alcohol abuse

lead/heavy metal poisoning

Question 10

Rouleaux formation

Answer 10

Multiple myeloma

Question 11

Shistocytes and Helmet cells- 3

Answer 11

1. Heart valve
2. DIC
3. Thrombotic thrombocytopenic purpura (TTP)

Question 12

Heniz Bodies- 3

Answer 12

G6PD deficiency

Autoimmune hemolytic anemia

thalassemia

Question 13

Bite cells- 2

Answer 13

G6PD deficiency

Hemolytic anemia

Question 14

Howell- Jolly Bodies- 3

Answer 14

1. Sickle cell anemia
2. Hemolytic or megaloblastic anemia
3. s/p splenectomy

Question 15

Smudge cells

Answer 15

CLL

Question 16

Blasts (e.g. lymphoblasts, myeloblasts) on peripheral smear

Answer 16

ALWAYS abnormal

Suggests malignancy

Question 17

When does Koilonychia occur in anemia

Answer 17

chronic anemia

Question 18

What does anemia w/ normal retic count (or slightly elevated) suggest?

Answer 18

Iron/B12 deficiency

OR

maturation problem (e.g. myelodysplastic syndrome)

Question 19

What do you have to do with the retic count with anemia

Answer 19

must be corrected to the extent of the anemia

Question 20

Normal or inadequate response to anemia?

Corrected retic >3?

Corrected retic <2?

Answer 20

> 3= normal response

< 2= inadequate response

Question 21

What is the easy way to figure out if the bone marrow is compensating for the anemia?

Answer 21

if Hgb + retic is > 15

Question 22

What is the most sensitive test to detect iron deficiency?

Answer 22

Ferritin

(marker of iron storage)

Question 23

Decrease ferritin = ?

Increased ferritin = ?

Answer 23

Decr = iron deficiency

Incr = Hemochromatosis (can also see w/ hemolytic and megaloblastic anemia)

Question 24

Other than hemochomatosis, what 2 other conditions might ferritin be increased in?

Answer 24

1. Inflammation

2. Infection

(ferritin is an acute-phase reactant)

Question 25

Transferrin can decrease when

Answer 25

various acute inflammatory reactions

+/- chronic illness and liver disease

Question 26

What 4 conditions will Transferrin saturation be increased in?

Answer 26

1. Hemolytic anemia
2. Megaloblastic anemia
3. Sideroblastic anemia
4. Hemochromatosis

Question 27

What is the best iron test for hemochromatosis?

Answer 27

Transferrin saturation