Complete Blood count

Question 1

Fluid

Answer 1

aka plasma. 90% water. Salts, glucose, proteins, hormones

Question 2

Serum vs plasma

Answer 2

Serum is plasma minus clotting proteins. Depends on test needed.

Question 3

Blood film

Answer 3

thin layer of cells prepared on slide. Important adjunct with CBC.

Question 4

Source of Normal CBC references

Answer 4

Normal average +/- 2 standard deviations.

Question 5

HGB

Answer 5

Hemoglobin. 135-175 g/L

Question 6

RBC

Answer 6

Red blood cells. 4.3-6 10^12/L. Not commonly referred to.

Question 7

HCT

Answer 7

(fraction of blood occupied by RBC). Hematocrit. .41-.52 L/L

Question 8

MCV

Answer 8

Mean cell volume. 80-100 fL (femtoliter). Important, classify anemia.

Question 9

MCHC

Answer 9

Mean cell hemoglobin concentration. 320-360 g/L. Not common.

Question 10

RDW

Answer 10

Red cell distribution width. variation in size of RBC. %. <15.6. High number indicates various sizes, lower means more uniform

Question 11

Anemia and values

Answer 11

Low Hb. Male: <120g/L.

Question 12

Anemia classification

Answer 12

Based on MCV. Microcytic 100fL.

Question 13

Causes of micro- and macrocytic

Answer 13

Micro: low Fe, chronic disease, thalassemia, Pb poison. Macro: low Vit B12 or folate, very high reticulocyte count, EtOH, liver disease, myelodysplasia, thyroid disease

Question 14

PLT

Answer 14

Platelets. Form fibrin net for clot. 140-450 10^9/L.

Question 15

WBC

Answer 15

White blood cells. 4-11 10^9/L.

Question 16

CBC vs CBCD

Answer 16

D for differential. WBC counted as absolute and D for percentage.

Question 17

NEUT

Answer 17

Neutrophils 1.8-7.5 10^9/L. bacterial infection (HOOH etc), phagocytosis results in breakdown of Neut also - makes pus

Question 18

LYMPH

Answer 18

Lymphocytes 1-4.5 10^9/L. Immunity vs viruses and memory, Ab. 70% T, 30% B

Question 19

MONO

Answer 19

Monocytes 0-1.1 10^9/L. bac, fungi. Clean up after neutrophils

Question 20

EOS

Answer 20

Eosinophils 0-.7 10^9/L. Parasites, allergic reaction.

Question 21

BASO

Answer 21

Basophils 0-.3 10^9/L. Deep blue. Allergy (releasee histamine)

Question 22

Polymorphonuclear cells

Answer 22

aka granulocytes. Multilobed nuclei.

Question 23

Pediatric vs Adult CBC

Answer 23

Can be very different. Children have much higher lymphocyte to neutrophil ratio

Question 24

Bone marrow

Answer 24

Adult: pelvis, vertebrae, cranium, ribs, sternum, ends of long bones. Kids: almost everywhere

Question 25

Organization of bone marrow

Answer 25

Craz. Cluster of cells supported by blood vessels, fat, sinus spaces (exit for mature cells)

Question 26

Hematopoiesis

Answer 26

Blood cell formation. Amplification, differentiation, stem cells. Coordinated by GF and cytokines. Don’t know the map but appreciated.

Question 27

Hematopoietic stem cells

Answer 27

Low concentration. Circulate on occasion then back to marrow (can harvest for treatment).

Question 28

Neutrophil maturation

Answer 28

myeloblast, then myeloids (immature: promyelocyte, myelocyte, metamyelocyte, bands), then neutrophil.

Question 29

Left shift

Answer 29

More immature blood cells in peripheral blood. Can be result of stress (infection) or disease (leukemia).

Question 30

Blasts

Answer 30

If blasts are in peripheral blood, could be acute leukemia, acute stress (hemorrhage, blood loss) or diseases of bone marrow (cancer, or infection in marrow). Always a red flag.

Question 31

Reticulocytes

Answer 31

immature RBC. Still anuclear.

Question 32

infection reaction

Answer 32

pathogens trigger inflammatory cells to release GF and cytokines, which recruit WBC from reserves. Can eventually affect PLT number and mild anemia

Question 33

Increased NEUT

Answer 33

infection, inflammation (cancer), stress, necrotic tissue, medication (steroids), disease in marrow.