Clinical Lab Lau PwrPnt Flashcards
If coagulation is prevented, the formed elements of the blood can be separated from the liquid portion which called what?
plasma
If blood is allowed to clot, the liquid portion expressed from the clot is called what?
serum - this differs from plasma in the loss of fibrinogen, which was used to form the fibrin threads of the clot
What infection will give you positive nitrates in the serum but no WBC?
chlamydia
What is the recommended amount of CSF that can be safely pulled from the body?
15ml, but per Lau this is too much CSF
What is the THE diagnostic sign for subarachnoid bleed?
xanthochromia
What color tube is used for CBC?
lavender; the tube also typically has heparin (or EDTA) in it to prevent clotting
What are some of the incidences where the WBC will not increase although there is an infection?
chemo patients, immunocompromised, HIV, burn patients, etc
What does a viral infection to do white count?
decreases;
True or False: all infections will cause leukocytosis
False
True or False: all immune suppression will show leukopenia
False
Why would you palpate the abdomen in a patient that presents with pharyngitis?
b/c it might be a viral infection caused by mono which will cause an enlarged spleen
What is the test done to see if a patient has Mono?
monospot test, a form of the heterophile antibody test: a rapid test for infectious mononucleosis due to Epstein–Barr virus (EBV
What are your 8 Human Herpes viruses?
Herpes simplex virus Type 1 (HSV-1) Herpes simplex virus Type 2 (HSV-2) Varicella Zoster Virus (VZV) (3) Epstein Barr virus (EBV) (4) Cytomegalovirus (CMV) (5) Human herpes virus 6 (exanthum subitum or roseola infantum) HHV 7 (causes disease infrequently) Human herpes virus 8 (Kaposi's sarcoma-associate herpes virus)
Will leukemia or neoplasms increase or decrease WBC?
increase
What does stress do to your WBC?
increase
A splenectomy causes an increased risk of sepsis due to what kind of organisms? Such as?
encapsulated - strep pneumo, klebsiella, haemophilus)
Post splenectomy, what happens to your white count?
increases
How can you tell the difference btwn inflammation and infection?
Look for a left shift which indicates the presence of infection - no shift indicates inflammation - A “left shift” refers to the presence of increased proportions of younger, less well differentiated neutrophils and neutrophil-precursor cells in the blood.
What are the two tests you can run that will DEF indicate inflammation over infection?
ESR and CRP: Erythrocyte sedimentation rate, C-reactive protein. In general both ESR and CRP measure the increase in inflammatory generated proteins. **Remember the ESR is NOT specific at all.
CRP is a direct measurement of C-reactive protein.
ESR indirectly measures many proteins associated with inflammation.
What vaccine is absolutely necessary post splenectomy?
pneumococcal vaccine
What will iron deficiency anemia do to white count?
decrease
What will hypersplenism do for the patient’s white count?
increase
What two things can lead to an overactive spleen?
polycythemia and the mono virus
What is one cancer chemo med that will cause bone marrow suppression and therefore decrease your patient’s white count? (2 names)
methotrexate, aka trexall; also used to treat Rheumatoid arthritis
Which Ab will cause aplastic anemia and drop white count severely?
chloramphenicol
What is the drug that is used to treat absence seizure (aka: petit mal - usually experienced by children) and is known to decrease white count?
ethosuximide aka zarontin
Where in the back does an abscess usually drain?
Lumbar triangle: The margins of the inferior lumbar (Petit’s) triangle are composed of the iliac crest inferiorly and the margins of two muscles – latissimus dorsi (posteriorly) and external abdominal oblique (anteriorly). The floor of the inferior lumbar triangle is the internal abdominal oblique muscle. The fact that herniations occasionally occur here is of clinical importance.
In what state will a patient’s RBC be elevated?
dehydration or also polycythemia
Under what three conditions will a patient’s RBC count be depressed?
dilution, anemia, or hemorrhage
What do the following do to hemoglobin levels?
- anemia
- pregnancy
- dehydration
a. decreases,
b. decreases,
c. increases
What is known as the percentage of blood represented by the packed RBC mass?
crit - hematocrit
Hct is usually about ___x Hgb?
3x
For a patient with abdominal injury, the crit should be watched every ___ hours?
6
____ is a rapid bedside ultrasound examination as a screening test for blood around the heart (pericardial effusion) or abdominal organs (hemoperitoneum) after trauma.
FAST: Focused Assessment with Sonography for Trauma
What are the 5 areas that are accessed by the FAST exam?
- pouch of douglas 2. morrison’s pouch (between the liver and kidney) 3. pericardial space 4. splenorenal recess 5. abdominal aorta
What are the top two causes of increase crit and Hgb levels?
dehydration (hemoconcentration) and polycythemia vera; a close 3rd is also simply an increase in production caused by some physiologic effect such as high altitude, smoking, COPD, or CHF
What is the one cancer that will NOT cause anemia? Not initially anyway …
renal cell carcinoma
Where do most cancers metastasis to?
lungs
Microscopic RBC present in the urine is indicative of what?
UTI
What is the triad for renal cell carcinoma?
- painless hematuria 2. flank pain 3. abdominal mass
What is the effect of both acute and chronic splenomegaly on crit and Hgb?
acute: HIGH chronic: LOW
______ are are inclusions within red blood cells composed of denatured hemoglobin. They are also indicative of what disorder?
Heinz bodies; hemolytic anemia - are present in g6pd patients especially after taking sulfur drugs
When in the one time you can give a G6PD patient a sulfur drug?
To treat PCP
Does crit and Hgb change instantly or is it observed over time?
takes several hours to show drop
What is the treatment for DIC?
stop all current meds and wait
A measure of the average red blood cell volume (i.e. size) that is reported as part of a standard complete blood count.
MCV - mean cean corpuscular volume
What is MCV in microcytic anemia? normocytic? macrocytic?
low, normal, high
What is the MCC of microcytic anemia?
iron deficiency
What ist the MCC of macrocytic anemia?
vit B12 deficiency, folate acid deficiency, or intrinsic factory def.
Which type of RBCs are increased during hemolysis?
reticulocytes - immature RBCs. Low retic means decrease in production; high retic count means an increase in production
What percent of an adult RBC should be reticulocytes? neonates?
.5 to 1% vs. 3 to 6%
What does anemia to do reticulocyte count?
elevate
What happens to platelet count with hemorrhage and polycythemia?
increases
Blood hyperviscosity does what to ESR?
decreases it
What happens to ESR during liver disease?
decreases
What are the two types of thrombocytopenia? Briefly explain
Idiopathic thrombocytopenic purpura (ITP) is the condition of having an abnormally low platelet count (thrombocytopenia) of unknown cause (idiopathic). Thrombotic thrombocytopenic purpura (TTP or Moschcowitz syndrome) is a rare disorder of the blood-coagulation system, causing extensive microscopic clots to form in the small blood vessels throughout the body.
Which thrombocytopenia typically follows a viral infection?
idiopathic thrombocytopenic purpura - per Lau treat with steroid
Which thrombocytopenia is associated with hemolytic uremic syndrome?
Treatment of thrombotic thrombocytopenic purpura is a medical emergency, since the hemolytic anemia and platelet activation can lead to renal failure and changes in the level of consciousness.
White blood cell count (the leukocyte count) above the normal range in the blood. It is frequently a sign of an inflammatory response, most commonly the result of infection, and is observed in certain parasitic infections.
leukocytosis
What is the pathology behind an excess of WBC but zero immature WBC?
leukemia
What is the pathology behind an excess of WBC and a large presence of mature WBC?
infection
What are the 4 types of leukemia?
Chronic lymphocytic leukemia (CLL): often, people diagnosed with the disease are over age 55. It almost never affects children.
Chronic myeloid leukemia (CML): It mainly affects adults.
Acute lymphocytic (lymphoblastic) leukemia (ALL): ALL affects lymphoid cells and grows quickly. ALL is the most common type of leukemia in young children.
Acute myeloid leukemia (AML): it occurs in both adults and children.
Normal Range for Hbg Males and Females?
13-18 and 12-16
Normal Range for Hct Males and Females?
42-52% and 37-48%
What is determined by dividing: crit/rbc?
mcv - usually 82-98
What is determined by dividing: Hbg/rbc?
mch - mean corpuscular hemoglobin - usually parallels mcv - usually 26-32
What do sulfonamides do to white count?
decrease
True or False: Blast forms of cells are not always pathologic.
FALSE - blasts forms are always abnormal
What does bandemia tell you?
indication of sepsis. Bandemia refers to an excess of band cells (immature white blood cells) released by the bone marrow into the blood.
Granulocytes (neurtophils, eosinophils, and basophils) will all increase or decrease when under the influence of epinephrine and corticosteroids?
INCREASE
Acetazolamide will do what to white count?
decrease - it is a sulfur drug; as is bactrim
A bacterial infection will cause what kind of shift?
left shift
Cold agglutination, Hemolytic anemia, and Bullous myringitis is the triad for what?
mycoplasma
An autoimmune disease characterized by the presence of high concentrations of circulating antibodies, usually IgM, directed against red blood cells.
Cold agglutination
Drug induced Warm Antibody Autoimmune Hemolytic Anemia can be caused by which drug discussed in class?
methyldopa
B cells are identified by CD __(#) marker
19
NK cells are identified by CD ___(#) marker
16
all t cell carry CD __(#) surface marker
3
helper t cells are ____ suppressor t cells are ___
cd4; cd8
What should the CD4/CD8 ratio be?
greater than 1
CD4 count less than what is an indication of high risk for HIV/AIDS patients?
less than 200
True or False: Blast forms are not seen in the peripheral blood smear of normal patients.
True
Life span of RBC
120 days
