Chapter 3 Hematology Flashcards
Microcytic
Small cell: MCV < 80
Normocytic
Normal size: MCV= 80-96
Macrocytic
Abnormally large cell: MCV > 96
Normochromic
Normal color: MCHC = 31-37
Hypochromic
Pale: MCHC < 31
What is the RDW?
An index variation in RBC size. Greater than 15% indicates that new cells differ in size when compared with older cells
How are the MCV and RDW interpreted together?
In an evolving microcytic anemia, as MCV decreases, RDW increases
In an evolving macrocytic anemia, as MCV increases, RDW increases
What is the first line treatment for all anemias?
Treat the underlying cause
What are the most common causes of Normocytic normochromic anemia with NL RDW?
Anemia of chronic disease
Chronic Kidney disease
Acute blood loss
What are the lab value norms for normocytic normochromic anemia?
HB= low
HCT= low
RBC= low
MVC= NL
MCHC= NL
RDW= NL
What are the most common causes of Microcytic hypochromic anemia with elevated RDW?
Iron deficiency
Plumbism (lead toxicity)
What are the lab value norms for microcytic hypochromic anemia with elevated RDW?
HB= low
HCT= low
RBC= low
MCV= low
MCHC= low
RDW= high
What are the most common causes of microcytic hypochromic anemia with normal RDW?
Alpha or beta thalassemia minor
What are the at-risk ethnic groups for alpha thalassemia minor
Asian, African ancestry
What are the at-risk ethic groups for beta thalassemia minor
African, Mediterranean, middle eastern
What are the lab value norms for microcytic hypochromic anemia with NL RDW?
HB= low
HCT= low
RBC= high
MCV= low
MCHC= low
RDW= NL
What is the next step test for microcytic hypochromic anemia with NL RDW
hemoglobin electrophoresis
What are the most common causes of macrocytic normochromic anemia with elevated RDW
vitamin B12 deficiency especially pernicious anemia
folate deficiency anemia
What are the lab value norms for macrocytic normochromic anemia with elevated RDW
HB= low
HCT= low
RBC= low
MCV= high
MCHC= NL
RDW= high
What is the next step test for macrocytic normochromic anemia with elevated RDW
Serum vitamin B12 and RBC folate
What are the common causes of drug-induced macrocytosis without anemia
alcohol (excess)
antiepileptic drugs
What are the lab value norms for drug-induced macrocytosis without anemia?
HB= NL
HCT= NL
RBC= NL
MCV= high
MCHC= NL
RDW= NL
What is the most common type of anemia in childhood, pregnancy and women during reproductive years?
Iron deficiency anemia
What is the most common type of anemia in the elderly?
Anemia of chronic disease
What should a person on a vegan diet supplement with?
Vitamin B12
What is the name of the murmur on a patient that has not been previously identified? It is present with anemia.
Hemic
Ginseng, Gingko, Fish oil, Garlic
potentially associated with increased bleeding risk
