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Summer 3 > CBC rev > Flashcards

CBC rev Flashcards

1
Q

Transports blood cells & other substances throughout the body

A

Plasma

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2
Q

–Transports oxygen throughout body (utilizing hemoglobin)

A

Red Blood Cells (RBC)

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3
Q

–Helps protect the body from infection and regulate the immune cells

A

White Blood Cells

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4
Q

–Involved in coagulation

A

Platelets

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5
Q
  • What is the production of RBC called?
  • What hormone is involved? Produced where?
A

Erythropoiesis

Erythropoietin / Kidneys

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6
Q
  • Where does the cellular production of RBCs occur?
  • How long does it take for RBCs to form stem cells?
  • Life span of a RBC?
A
  • Bone marrow
  • 7 days
  • 120 days
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7
Q

What are the 2 bone marrow abnormalities?

A
  • BM replaced by tumor cells –> leads to abnormal blood counts (such as lymphoma infiltration)
  • BM damaged by chemicals (benzene, abx) –> leads to aplastic anemia
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8
Q

What are reticulocytes and how long does they take to mature in the circultion?

A

Youngest circulating RBCs (larger than other RBC)

1 day

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9
Q

An increased retic count is associated with an increase in which 2 lab values?

  • Why?
A

MCV (mean cell volume) and RDW (red cell distribution width)

  • d/t the retics being larger in size
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10
Q

A RBC lifespan is 90-120 days

  • What 4 things can shorten the lifespan? (RBC destruction)
A
  • Uremic toxins
  • ↑ blood glucose
  • Inflammatory cytokines
  • Infections
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11
Q

Protein in RBC that carries oxygen

A

Hemoglobin

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12
Q

Percent of whole blood made up of RBCs

A

Hematocrit

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13
Q

4 Components of RBC indices

A
  • MCV (mean cell volume)
    • Macrocytosis
    • Microcytosis
    • Normocytic
  • MCH (mean cell hemoglobin / wt of hgb in RBC)
  • MCHC (mean cell hgb concentration)
  • RDW (red cell distribution width / range of cell sizes)
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14
Q

How are “normal” ranges for CBC components based?

A

Blood samples obtained from white men (20-60 yrs old) who are NOT taking meds.

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15
Q

What 3 things are seen on peripheral smear?

A
  • Abnormal size: anisocytosis
    • Correlates w/ RDW
    • Ex: microcytosis & macrocytosis
  • Abnormal shape: poikilocytosis
    • Defect in precursor cells
  • Abnormal color:
    • hypochromasia (pale d/t less hgb)
    • hyperchromasia (dark d/t dehydration or spherocytes)
    • polychromasia (blue stained d/t early release from BM)
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16
Q

Which cell on peripheral smear?

  • Hemoglobinopathy
  • Thalassemia
  • Liver disease
A

Target cells

(bull’s eye appearance)

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17
Q

Which abnormality on Peripheral Smear?

  • Blue granules
  • Ribosomal precipitates
  • Thalassemia
  • ETOH abuse
  • Lead/Heavy metal poisoning
A

Basophilic stippling

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18
Q

Which abnormality on Peripheral Smear?

  • Crescent-shaped RBCs
A

Sickle Cells

(sickle cell anemia)

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19
Q

Which abnormality on Peripheral Smear?

  • Multiple Myeloma
A

Rouleaux formation

(RBCs stack on each other like coins)

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20
Q

Which abnormality of Peripheral Smear?

  • Schistocytes
  • Helmet cells
  • Vascular FB (mechanical heart valve)
  • Disseminated intravascular coag
  • Thrombotic Thrombocytopenic Purpura
A

Fragmented Cells

21
Q

Which abnormality on Peripheral Smear?

  • Hgb precipitate on surface of RBC skeleton
  • Seen w/ crystal violet stain
  • G6PD deficiency
  • Autoimmune hemolytic anemia
  • Thalassemia
A

Heinz Bodies

22
Q

Which abnormality on Peripheral Smear?

  • Semicircular portions removed from cell margin
  • Caused by removal of hemoglobin precipitate by _____.
A

Bite Cells

23
Q

Bite Cells on a peripheral smear are associated w/ which 2 conditions?

A
  • G6PD deficiency
  • Hemolytic Anemia
24
Q

Which abnormality on Peripheral Smear?

  • Small, round remnants of nuclear DNA inside cell
A

Howell-Jolly Bodies

25
Q

Howell-Jolly Bodies (small round remnants of nuclear DNA inside cell) are associated with what 4 things?

A
  • Sickle Cell Anemia
  • Hemolytic Anemia
  • Megaloblastic Anemia
  • S/P splenectomy
26
Q

Which abnormality on Peripheral Smear?

  • Remnants of cells indicating abnormally fragile lymphocytes
A

Smudge Cells

27
Q

Smudge Cells (remnants of cells indicating abnormally fragile lymphocytes) are associated w/ which condition?

A

Chronic Lymphocytic Leukemia (CLL)

28
Q

Which abnormality on a Peripheral Smear?

  • Immature cells
  • ALWAYS abnormal
  • Suggests a malignant hematologic disorder
A

Blasts

(Lymphoblasts, Myeloblasts)

29
Q

Anemia is not a diagnosis, it is a _____.

A

Symptom

30
Q

4 main causes of anemia

A
  • Blood loss #1
  • Destruction of blood
  • Substrate deficiency
  • Insufficient bone marrow
31
Q

What does anemia lead to?

A

Deoxygenation of tissue –> organs suffer from hypoxia

32
Q

Name a few sxs of anemia

A
  • fatigue
  • weakness
  • dizziness
  • SOB
  • CP
  • Postural Hypotension*
  • Pallor*
  • Palpitations (heart beat in ears)
  • Long term: Koilonychia (flattened nails)
33
Q

Reticulocytosis = elevated retic count w/ anemia, what is the cause? (2)

A

Hemolysis or Blood loss

34
Q

Anemia w/ normal retic count (or slightly elevated), what is the cause? (2)

A
  • Substrate problem (iron or B12 deficiency)
  • Maturation problem (myelodysplastic syndrome)
35
Q

How is a “corrected retic count” calculated?

  • What is a normal vs abnormal response?
A

Retic count is % of RBCs

WITH anemia, count must be corrected to extent of anemia.

Corrected = retic % X (pt hematocrit / normal hematocrit of 45)

  • >3 = normal response
  • <2 = inadequate response
36
Q

How do you know if the anemia is compensated? (Clinical Pearl)

A

Add retic count + hemoglobin

If they equal or come close to 15, anemia is compensated.

Ex: Hgb of 8.2 + retic of 6.4 = 14.6 (bone marrow is compensating)

37
Q

Which component of the iron study?

  • Amount of iron in the blood (quantity of iron bound to transferrin)
  • 70% of body’s iron found in the hemoglobin of RBCs
A

Serum Iron (Fe)

38
Q

Which component of the iron study?

  • Amount of stored iron
  • 30% of body’s iron is stored as ferritin & hemosiderin
A

Ferritin

39
Q

Which component of the iron study?

•The potential space available on a RBC for Fe to bind

A

Total Iron Binding Capacity (TIBC)

40
Q

Which component of the iron study?

•Protein that binds iron in the plasma and carries it to the bone marrow to be incorporated into hemoglobin

A

Transferrin

41
Q

Which component of the iron study?

•Amount of protein (transferrin) available for binding mobile iron

A

Transferrin Saturation

42
Q

Which component of iron study?

  • Marker of iron storage
  • Can be most sensitive test to detect iron deficiency
A

Ferritin

43
Q
  • A decreased iron storage = iron deficiency will cause which value to be high/low?
  • Iron excess (hemochromatosis), hemolytic anemia, megaloblastic anemia will cause which value to be high/low?
A
  • ↓ ferritin = dec. storage
  • ↑ ferritin = Iron excess
44
Q

Which iron study?

(Acute Phase reactant)

–May be elevated with inflammation & infection when no iron stores issue exists

–May be falsely normal with iron deficiency anemia (if there is coexistent inflammation/infection)

A

Ferritin

45
Q

Which iron study?

(Negative Acute Phase Reactant)

–Can decrease in various acute inflammatory reactions

–May also be decreased with chronic illness & liver disease (transferrin produced in liver)

A

Transferrin

46
Q
  • How is the % of transferrin & other mobile iron-binding proteins saturated w/ iron calculated?
  • What is a normal value range?
  • What is an abnormal value and what does it mean?
A
  • Transferrin sat % = (serum iron level X 100) / (TIBC)
  • 20-50%
  • <15% if they have iron deficiency
47
Q

What is the best iron test for hemochromatosis?

A

Transferrin

48
Q

Besides hemochromatosis, what other 3 conditions will have an increased transferrin saturation?

A
  • Hemolytic anemia
  • Megaloblastic anemia
  • Sideroblastic anemia

Summer 3 (12 decks)

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