Clinical Labs Flashcards
What is anisocytosis?
a medical term meaning that a patient’s red blood cells are of unequal size
What is poikilocytosis?
Abnormally shaped RBCs
What does normocytic mean?
Normal size of RBCs
What is the range of RBC volume?
80-100 fL
What does macrocytic mean?
Larger than average size of RBCs
What are the three main etiologies of anemia?
Blood loss
Impaired production
Impaired destruction
What does MCV measure?
Mean corpuscular volume (how large the RBCs are)
What is the normal % of lymphocytes?
25-50%
What is the normal % of monocytes?
2-12%
What is the normal % of eosinophils?
0-5%
What is the normal range of WBCs?
4-11
What is the normal range of RBCs?
4.5-6
What is the normal platelet count?
150-400
What is the normal % of neutrophils?
50-74%
What is the normal % of basophils?
0-2%
What does the reticulocyte count asses?
Assess the erythropioetic activity
What does ESR help to distinguish?
Active vs non-active disease
What is the final resort if you cannot determine the cause of an anemia?
Bone marrow exam
What is the normal percentage of reticulocytes?
0.5% -1.5%
What is the formula for the corrected reticulocyte count if there is anemia?
(HCT/45)*retic count
How do you distinguish between retriculocytes and mature RBCs?
Stain for RNA
What is the most common reason for anemia?
Fe deficiency
What is a chronic disease that causes anemia? Is this mico or macrocytic?
renal failure
Microcytic
Are thalessemias micro or marcocytic anemias?
Micro
Does Fe deficiency anemia present as micro or marcocytic?
Micro
What is siderblastic anemia? Is it micro or macrocytic?
a form of anemia in which the bone marrow produces ringed sideroblasts rather than healthy red blood cells (erythrocytes).[1] It may be caused either by a genetic disorder or indirectly as part of myelodysplastic syndrome,[2] which can evolve into hematological malignancies (especially acute myelogenous leukemia)
Micocytic
What are the three major tests for microcytic anemias?
Serum Fe
TIBC
Serum ferritin
What is the single best test for iron studies? What does it measure?
Serum ferritin
Measures circulating fraction of iron storage
What is the gold standard for diagnosin mild beta-thalassemias?
Hb electrophoresis
What is the serum iron in iron deficiency anemia? Anemia of chronic disease?
Both low
What is the TIBC in iron deficiency anemia? Anemia of chronic disease?
High in IDA
Low in ACD
What is the transfer saturation in iron deficiency anemia? Anemia of chronic disease?
both low
What is the serum ferritin in iron deficiency anemia? Anemia of chronic disease?
Low in IDA
increased in ACD
What is the marrow iron in iron deficiency anemia? Anemia of chronic disease?
absent in IDA
increased in ACD
What is the most common type of auto-immune hemolytic anemia?
SLE
What are the two types of hemolytic anemia from SLE? What are the antibodies involved in each?
Warm (IgG antibodies)
Cold (IgM antibodies)
Wha are the two types of allo-immune hemolytic anemias?
Transfusion reactions
Hemolytic disease of the newborn
What is the difference between direct and indirect Coomes test?
Direct = uses pts RBCs to detect antibodies. (antibody on antibody)
Indirect = detects antibodies in pts serum
When is the indirect Coombs test used?
For fetal testing of hemolytic anemia
Elevated neutrophils = what kind of infection?
Bacterial
Elevated lymphocytes = what type of infection?
Viral
Elevated eosinophils = what type of infection?
Parasitic or allergic
What are lymphomas?
Neoplasms that arise as discrete masses (like spleen, lymph nodes)
What are leukemias?
Lymphoid nepplasms with involvement of blood and bone marrow
What is the only way to differentiate leukemias that are coming from B cell vs T cells?
Immunophenotyping (identifying cell types by protein expression)
What is FISH used to detect?
Chromosomal aberrations
What are the protein markers for B cells?
CD19
CD20
CD21
CD22
What are the protein markers for T cells?
CD3
CD2
CD4
CD8
What are the two ways to perform immuphenotyping?
Immunohistochemisty
Flow cytometry
What are the three factors that you need to consider when assessing a pt for leukemias/lymphomas?
Age
Location
Sites/involvment
Are the masses associated with lymphomas painful or painless?
Painless
What are the characterisitcs that are evaluated with H&E uner high power?
Size
Nucleus
Chromatin
Cytoplasm
Immature lymphoid neoplasms come for what cells?
Lymphoblasts
Mature lymphoid neoplasms come from where?
Mature lymphocyte
What are the findings of IHC if there is a B cell lymphoma?
Only one type of ig light chain produced
What are the PCR findings of b cell lymphomas?
Ig heavy chain gene rearrangement
Loss of specific CD antigen = what cell type lymphoma?
T cell
What are the PCR findings for T cell lymphoma?
T cell receptor gene rearrangement
What are the five characteristics looked at when determining a neoplasm?
Clincial features Morphology Immunophenotype Cytogenetics Molecular analysis
What are the five main categories of lymphomas?
Precursor B Peripheral B Precursor A Peripheral A Hodgkin lymphoma
What is the most common cause of tumors in pts under 5 years old?
Acute leukemia
What is the most common cause of tumors in pts 5-9 years old?
Acute leukemia/brain
What is the most common cause of tumors in children 10 -19?
Lymphomas
What is the first stage of lymphoma?
Single lymph node region or extralymphatic site
What is the second stage of lymphoma?
Two or more LN regions or extralymphatic site on the same side of the diaphragm
What is the third stage of lymphoma?
LN regions or extralymphatic site on both sides of the diaphragm
What is the fourth stage of lymphomas?
Disseminated or diffuse inolvement of one or more extralymphatic sites
What does the A stand for in lymphoma staging? B?
Asymptomatic
B= symptomatic
What is the packed cell volume?
Same as hematocrit
What is the mean corpuscular Hb?
he average mass of hemoglobin per red blood cell in a sample of blood
What is the mean corpuscular hemoglobin concentration?
measure of the concentration of hemoglobin in a given volume of packed red blood cells
What is the red cell distribution width?
a measure of the range of variation of red blood cell (RBC) volume that is reported as part of a standard complete blood count. Usually red blood cells are a standard size of about 6-8 μm in diameter.