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Biochemistry Exam #3 > Complete Blood Count > Flashcards

Complete Blood Count Flashcards

1
Q

What is the definition of anemia?

A

Abnormally low blood hemoglobin concentration in whole blood samples

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2
Q

Is anemia a disease or is it a sign of disease?

A

Anemia is NOT a disease, it is a sign of disease

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3
Q

What are the two primary causes of anemia?

A
  • Premature destruction of RBCs and/or acute blood loss

- Insufficient production of RBCs

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4
Q

What is erythropoiesis (describe the process in 3 steps)? Where does this occur?

A

Erythropoiesis is the production of RBCs in the bone marrow

  1. Demand of RBCs triggers signal that leads to stem cell differentiation into blast cells - a single BFU-E can divide into a colony of 1000+ RBCs
  2. As erythropoiesis progresses, a series of blast cells (BFE-U) will form that decrease in size with each division
  3. Before becoming a mature RBC (erythrocyte), reticulocytes are formed
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5
Q

What is a reticulocyte and what are 4 characteristics of a reticulocyte? What percentage of the RBC population do they make up?

A

Reticulocyte: immature RBC that make up 0.5-1.5% of the population of circulating RBCs

  • 20% larger than immature RBC
  • No nucleus
  • Contain some ribosomes and mRNA
  • Only contain 80% of Hb found in mature RBCs
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6
Q

What is the general lifespan of one RBC and where are they destroyed (3)?

A

RBCs live for 120 days, then they are destroyed in the spleen, liver or bone marrow

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7
Q

How long does it take for a reticulocyte to mature? How is this different in a person with anemia?

A

Reticulocytes take 72 hours to mature, with 48 hours in bone marrow and 24 hours in circulation
- With anemia, reticulocytes are needed for their HB and instead spend 24 hours in bone marrow and 48 hours in circulation

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8
Q

For pro-normoblasts, reticulocytes and mature RBCs, are the following yes or no:

  • Nuclear DNA present?
  • Cytoplasmic RNA present?
  • Present in bone marrow?
  • Present in circulation?
A

Pro-normoblasts:

  • Nuclear DNA present: Yes
  • Cytoplasmic RNA present: Yes
  • Present in bone marrow: Yes
  • Present in circulation: No

Reticulocytes:

  • Nuclear DNA present: No
  • Cytoplasmic RNA present: Yes
  • Present in bone marrow: Yes
  • Present in circulation: Yes

Mature RBCs:

  • Nuclear DNA present: No
  • Cytoplasmic RNA present: No
  • Present in bone marrow: No
  • Present in circulation: Yes
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9
Q

What is erythropoietin, and where is it produced? What is the signal for synthesis?

A

Erythropoietin (EPO): hormone secreted by the kidneys that stimulates the process of RBC production
- EPO receptors are found in bone marrow and synthesis signal is renal hypoxia

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10
Q

In patients with chronic kidney failure, how is EPO administered? What is this used to prevent (clinically)?

A

Recombinant EPO must be injected regularly to prevent severe anemia
- At least one healthy kidney is needed to produce EPO naturally

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11
Q

What are the five ways in which EPO works to stimulate RBC production?

A
  • Increased number of CFU-E cells via inhibition of CFU-E apoptosis
  • Increased Hb synthesis
  • Increased iron absorption
  • Increased rate of erythroid differentiation
  • Stimulated production/premature release of reticulocytes from bone marrow
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12
Q

What is found to be elevated in many types of anemia, and what is it? (hint: think Hb lecture)

A

Hb allosteric inhibitor, 2,3-BPG

- It helps to carry more O2 to the tissues by making it harder for oxygen to bind Hb

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13
Q

What are the nutrient requirements for:

  • Adequate cell division? (2)
  • Adequate Hb synthesis? (4)

What is the consequence if any of these nutrients are lacking?

A

Adequate cell division:

  • Folic acid
  • Vitamin B12

Adequate Hb synthesis:

  • Dietary protein (AAs)
  • Iron
  • Copper
  • Vitamin B6

If any of the above nutrients are missing, there will be reduced erythropoiesis leading to anemia

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14
Q

What is RBC in terms of laboratory evaluation?

A

Concentration of RBCs per a give volume of whole blood

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15
Q

What is Hb in terms of laboratory evaluation?

A

Concentration of hemoglobin in a given volume of whole blood

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16
Q

What is HCT in terms of laboratory evaluation?

A

Hematocrit: volume percentage of whole blood occupied by RBCs

17
Q

What is Reticulocyte Count? What are the two types and what does each measure?

A

Reticulocyte count: reflects levels of erythropoiesis in bone marrow

  • Observed reticulocyte count (OR): represents number of reticulocytes as percentage of RBCs (typically 0.5-1.5%)
  • Corrected reticulocyte count (CR): corrected to prevent an overestimation in anemic individual
18
Q

What is the equation for Observed Reticulocyte Count (OR)?

A

OR = (# of reticulocytes / # of RBCs) x 100

19
Q

What is the equation for Corrected Reticulocyte Count (CR)?

A

CR = (Patient’s HCT / mean normal HCT) x OR value

20
Q

What are the corpuscular indices used to determine? What are the three types of corpuscular measurements in terms of laboratory evaluation?

A

Determine the morphological classification of anemia (color, size)

  • Mean Corpuscular Volume (MCV)
  • Mean Corpuscular Hb (MCH)
  • Mean Corpuscular Hb Concentration (MCHC)
21
Q

What does the Mean Corpuscular Volume (MCV) measure? What are the three result ranges and what does each indicate?

A

Mean Corpuscular Value (MCV) measures the average volume of circulating RBCs

  • Microcytic: <80 (smaller than average size)
  • Normocytic: 80-100 (average size)
  • Macrocytic: >100 (larger than average size)
22
Q

What is the equation for MCV?

A

MCV = HCT / RBC x 10

23
Q

What does the Mean Corpuscular Hemoglobin (MCH) measure? What is the average result range?

A

Mean Corpuscular Hb (MCH) measures the quantity of Hb in the average circulating RBC
- Average: 26-32 pg

24
Q

What is the equation for MCH?

A

MCH = Hb / RBC x 10

25
Q

What does the Mean Corpuscular Hemoglobin Concentration (MCHC) measure? What are the two result ranges and what does each indicate?

A

MCHC measures the concentration of Hb in the average circulating RBC

  • Normochromic: 31-37% (normal color)
  • Hypochromic: <31% (pale)
26
Q

What are the two equations used for MCHC?

A

MCHC = Hb/HCT x 100

MCHC = MCH/MCV x 100

27
Q

What does the RBC Distribution Width (RDW) measure? In what two groups of patients is this test typically elevated?

A

RDW is a statistical measurement of the variability in RBC size; elevated in:

  • Alcoholics
  • Nutritional anemias
28
Q

What is the equation for RDW?

A

RDW = standard deviation of MCV / MCV

29
Q

What should happen to the reticulocyte count after administration of iron supplements to a person with iron deficiency anemia?

A

Increased reticulocyte count (WNL or elevated)

30
Q

If RBC’s tested are microcytic and hypochromic, what is the likely cause of their anemia?

A

Chronic iron deficiency anemia

31
Q

If RBC’s tested are normocytic and normochromic, what is the likely cause of their anemia?

A

Acute blood loss anemia

32
Q

If RBC’s tested are macrocytic and normochromic, what is the likely cause of their anemia?

A

Folic acid deficiency anemia

33
Q

What happens to the levels of EPO and 2,3-BPG in an anemic individual?

A
  • EPO is increased

- 2,3-BPG is increased

Biochemistry Exam #3 (8 decks)

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