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Diagnostic Laboratory Medicine 2 Flashcards

1
Q

What does CBC stand for?

A

Complete Blood Count

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2
Q

What is the average amount of circulating blood?

A

5 liters

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3
Q

What is the average amount of plasma circulating at any given time?

A

3 liters

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4
Q

What is the average amount of cells circulating at any given time?

A

2 liters

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5
Q

Where is plasma derived from? What does it do?

A

Intestines and lymphatic system, vehicle for movement

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6
Q

Give examples of the composition of blood

A

Red Blood Cells, White Blood Cells, Platelets

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7
Q

The “normal range” in adults refers to the lower and upper limits observed in ____% of the normal population

A

95%

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8
Q

T/F - Outlying values are always abnormal

A

False - 2.5% of the normal population have values that exceed the 95% confidence interval limits

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9
Q

Normal values for children are based on ___ and ___

A

age and sex

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10
Q

Name the 5 types of white blood cells

A

neutrophils, eosinophils, basophils, monocytes, and lymphocytes

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11
Q

What is the name for white blood cells

A

Leukocytes

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12
Q

What is the function of leukocytes?

A

Fight infection and defend the body

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13
Q

What is the process called where leukocytes fight infection and defend the body?

A

Phagocytosis

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14
Q

White blood cells produce, transport, and distribute _____ as part of the immune response to a foreign substance (____)

A

antibodies in response to foreign antigens

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15
Q

Where are the cells in blood produced?

A

Bone marrow

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16
Q

T/F - Leukocyte and differential counts by themselves can diagnose

A

False, they are of little value unless the results are related to the clinical condition of the patient

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17
Q

T/F - Specific patterns of leukocyte response can be expected in various types of diseases

A

True

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18
Q

Give examples of agranulocytes (no granules)

A

Lymphocytes, Monocytes

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19
Q

What is another name for agranulocytes

A

Mononuclear leukocytes

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20
Q

Name the granulocytes

A

Neutrophils “segs”, eosinophils, basophils

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21
Q

Name the 2 broad categories of white blood cells

A

Agranulocytes and granulocytes

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22
Q

Which WBC is also known as SEG

A

Neutrophils

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22
Q

What is another name for granulocytes

A

polymorphonuclear leukocytes or polys or PMNs

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23
Q

(Agranulocytes/granulocytes) have a multi lobed nucleus

A

Granulocytes (Neutrophils/Basophils/Eosinophils)

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24
Q

Which leukocytes make up 45-65% of WBC count?

A

Neutrophils

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25
Q

Which leukocytes make up 20-40% of WBC count?

A

Lymphocytes

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26
Q

Which leukocytes make up 3.0-9.0% of WBC count?

A

Monocytes

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27
Q

What is the name for High total WBC count?

A

Leukocytosis

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28
Q

What is the name for Low total WBC count?

A

Leukopenia

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29
Q

Give examples for Leukocytosis

A

**Acute bacterial infections, **Leukemia, Myeloproliferative disorders, Certain Meds (Steroids), Sun or UV light, stress, exercise, pain, cold/heat, anesthesia

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30
Q

Give examples for Leukopenia

A

**Viral infections, **Overwhelming bacterial infections “Degenerative LEFT SHIFT,” Leukemia, Hodgkin’s lymphoma, Malignancies, Certain meds, hypersplenism, bone marrow disorders, pernicious anemia, pancytopenia (all cells are low)

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31
Q

Name the four conditions of myeloproliferative disorders

A

Essential thrombocythemia, polycythemia vera, chronic myelocytic leukemia, and agnogenic myeloid metaplasia

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32
Q

Increase in total WBC count

A

leukocytosis

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33
Q

Most common cause of leukocytosis? Followed By?

A

NEUTROPHILIA, followed by lymphocytosis
It is uncommon to see increased eosinophils or monocytes

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34
Q

Leukocytosis is most frequently due to a normal ____ ____ response to relatively benign causes such as ?

A

bone marrow, Inflammation, Infection, Smokers, Normal variations, Drugs!

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35
Q

Inflammatory conditions like ? cause an increase in WBC

A

Crohn’s disease, ulcerative colitis, arthritis, many others

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36
Q

Infectious conditions like ? cause an increase in WBC

A

UTI, skin infections, pharyngitis, STDs, appendicitis, pancreatitis, colitis

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37
Q

It has been estimated that the WBC count in smokers is raised by ____% with a doubling of absolute ____ count in pts who smoke two packs per day

A

25%, neutrophil

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38
Q

T/F - Study followed pts for 20 years with WBC elevations ranging from 11,000-25,000 who were perfectly healthy

A

True

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39
Q

Inhalation (snorting/smoking) or Injecting any foreign substance causes (elevated/decreased) WBC count

A

elevated

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40
Q

An extreme WBC count should cause you to think of what dx?

A

Bone marrow pathologies like leukemia, cancer, autoimmune diseases

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41
Q

When looking at leukocytosis, it is important to also look at ____ and other components like ?

A

lineage, hemoglobin, platelets

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42
Q

History + Clinical findings such as ? may increase suspicion for an underlying bone marrow disorder in leukocytosis

A

weight loss and enlarged lymph nodes, liver, and spleen

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43
Q

T/F - Some pts have absolute increase in one WBC element but not elevation in total WBC so you should employ specific terms which describe the actual state of affairs in a given pt

A

True

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44
Q

A decrease in total WBC is due to a decrease in ____ and/or ____

A

neutrophils and/or lymphocytes

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45
Q

Low WBC (often neutrophils) indicates ____

A

immunosuppression

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46
Q

T/F - Chronic use of alcohol, benzodiazepines, and Z-drugs can lower WBC but sobriety can improve numbers

A

True

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47
Q

Chronic use of ? lowers WBC

A

ALCOHOL, benzodiazepines, Z-drugs

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48
Q

What is the most numerous and important type of leukocyte in body’s reaction to inflammation?

A

NEUTROPHILS

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49
Q

Which cells are the primary defense against microbial invasion through phagocytosis

A

Neutrophils

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50
Q

T/F - Neutrophils can cause some tissue damage by release of enzymes and endogenous pyogens

A

True

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51
Q

If you see BANDS, you know there is an immature state of development of ?

A

Neutrophils

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52
Q

Increase in absolute number of neutrophils in response to invaders or tumor cells

A

Neutrophilia

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53
Q

Lower neutrophils are found in which population

A

African Americans

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54
Q

? respond to acute, localized, and general bacterial infections as well as some fungal, spirochetes, parasitic, and rickettsial infections

A

Neutrophils

55
Q

is a response to inflammation such as vasculitis, rheumatoid arthritis, gout, and pancreatitis

A

Neutrophilia

56
Q

Neutrophilia is a hallmark of ???

A

Chronic Myelogenous Leukemia

57
Q

BLASTS in ____ suggest ??

A

Neutrophilia, Acute Leukemia

58
Q

? is a response to tissue necrosis (MI, burns, tumors)

A

Neutrophilia

59
Q

A dx of Polycythemia Vera means the bloodwork shows ?

A

Neutrophilia

60
Q

When _____ is discovered during the evaluation of a febrile pt, propensity to infection dominates

A

neutropenia

61
Q

Low WBC indicates ?, so pts are likely to have rapidly worsening infections

A

immunosuppression

62
Q

Name some causes of neutropenia

A

stem cell disorders, drugs, chemicals, hematopoietic diseases (anemia), autoimmune diseases, splenic sequestration, NSAIDS, Chronic illnesses (HIV, Hepatitis, Autoimmune), B12 deficiency, folate deficiency, nutritional deficiencies

63
Q

T/F - neutrophilia is a natural response to pregnancy

A

False, neutroPENIA is normal until labor

64
Q

_____ contain one third of all histamine in the body

A

Eosinophils

65
Q

Neutrophils + ____ are capable of phagocytosis

A

Eosinophils

66
Q

____ are used to dx allergic infections, assess severity of infestations with worms, other large parasites

A

Eosinophils

67
Q

Causes of eosinophilia

A

ALLERGIES, HAY FEVER, ASTHMA, Autoimmune conditions (Lupus, RA), parasitic infection, chronic skin disease (eczema/pemphigus), SPIDER BITES, BEE STINGS, VENOMS, Endocrine disorders like Addisons, Hodgkins, CML

68
Q

Eosinopenia is caused by ____ ____ production, like Cushings Syndrome

A

Adrenal Steroid Production - Cushings syndrome (acute adrenal failure)

69
Q

Eosinopenia can also indicate that the pt is on ?

A

Drugs - ACTH, epinephrine, thyroxine, prostaglandins

70
Q

What cells are found only in leukemia or leukomoid blood pictures?

A

Eosinophilic myelocytes

71
Q

Basophilia can be indicative of ?

A

Granulocytic (myelocytic) and acute basophilic leukemia, myeloproliferative disorders, Hodgkins disease

72
Q

Basopenia can be indicative of ?

A

Acute phase of infection, thyroid disorders, stress reactions like pregnancy, MI, prolonged steroid use

73
Q

Monocytes are (granulocytes/agranulocytes)

A

Agranulocytes

74
Q

What is the body’s second line of defense?

75
Q

Which cells perform a scavenger function clearing the body of debris?

76
Q

These cells remove injured and dead cells, microorganisms, insoluble particles from blood from respiratory, GI, and GU organs

77
Q

Short term monocytosis can be due to ?

A

recovery from chemotherapy or drug-induced neutropenia, infectious (fungal) or inflammatory conditions

78
Q

Persistent monocytosis should be considered to be due to ?

A

Myeloproliferative disorder, such as CML (chronic myelomonocytic leukemia)

79
Q

___ migrate to areas of inflammation in both early and late stages of process

A

Lymphocytes

80
Q

___ are the source of serum immunoglobulins and cellular immune response

A

Lymphocytes

81
Q

T/F - All lymphocytes are made In bone marrow

82
Q

Where do B cells mature?

A

bone marrow

83
Q

Where do T cells mature?

84
Q

_____ cells control the antigen-antibody response that is specific to the offending antigen. have ‘memory’

85
Q

Give examples of T cells

A

CD4 helper T cells, killer cells, cytotoxic cells, CD8 suppressor T cells

86
Q

T/F - Plasma cells are normally in blood

87
Q

Plasma cells are fully differentiated ___ cells

88
Q

Lymphocytosis is prominent in ____ infections

89
Q

What could be causes of lymphocytosis

A

CMV, **Mononucleosis, HIV, hepatitis, Toxoplasmosis, bacterial infections like TB or pertussis

90
Q

Mononucleosis is characterized by what

A

ATYPICAL LYMPHOCYTES

91
Q

T/F - You can dx pt with mono just from atypical lymphocytes

92
Q

reasons for lymphopenia

A

chemo, radiation, Hodgkins, AIDS, malignancies, severe debilitating illness

93
Q

total number of erythrocytes in a ____ of blood is RBC count

A

microliter

94
Q

High RBC count is suspicious of ?

A

thalassemia trait

95
Q

Low RBC count is suspicious of ?

A

blood loss or anemia

96
Q

H&H means

A

Hemoglobin and Hematocrit

97
Q

general indicator of anemia or polycythemia

A

Hemoglobin and Hematocrit

98
Q

O2 carrying capacity of blood (Hgb, Hb)

A

Hemoglobin

99
Q

packed cell volume (Hct)

A

Hematocrit

100
Q

MCV meaning and what does it indicate

A

Mean Corpuscular Volume , SIZE OF RBC

101
Q

MCH meaning and what does it indicate

A

Mean Corpuscular Hemoglobin,, WEIGHT OF RBC

102
Q

MCHC meaning and what does it indicate

A

mean corpuscular hemoglobin content, CONCENTRATION of HEMOGLOBIN IN RBC

103
Q

Key diagnosis for anemias is ?

A

RBC size variation

104
Q

What is used to differentiate anemias and bone marrow abnormalities, contains material from newly released blood cells for 1-2 days before cell matures

A

Reticulocyte count

105
Q

RBC distribution width (RDW) measures variation in ____ of RBCs

106
Q

Dropping H&H can indicate ?. ESSENTIAL to address Hgb levels under ___ with follow up tests and ROS for bleeding

A

BLOOD LOSS, 9***

107
Q

____ may possibly cause elevated H&H results

108
Q

What users commonly have anemias and may see improving H&H over 6 week with sobriety?

A

Chronic alcohol, Z drug, amp/meth, benzodiazepines

109
Q

Serum folate levels will (rise/fall) after rapid alcohol intake

A

Fall, so do not drink alcohol while pregnant

110
Q

abnormal variation in size

A

anisocytosis

111
Q

abnormal variation in shape

A

poikilocytosis

112
Q

abnormal variation in color

A

polychromasia

113
Q

a condition where blood has lower than normal number of RBC and can happen if cells don’t contain enough Hgb

114
Q

a group of disorders passed down through families where there is abnormal production or structure of the hemoglobin molecule. Ex. sickle cell anemia

A

Hemoglobinopathies

115
Q

isolated decreased in plasma volume can elevate the hemoglobin, hematocrit, and RBC count

A

relative polycythemia

116
Q

cells with dark center and periphery and clear ring in between, seen in liver disease, thalassemia, iron deficiency anemia

A

target cells

117
Q

crescent shaped RBC

A

sickle cells

118
Q

spherical purple bodies in or on RBCs. seen with hyposplenism, sickle cell, thalassemia

A

Howell-jolly bodies

119
Q

where are platelets made

A

bone marrow

120
Q

2/3 of platelets are found ?, 1/3 found in ?

A

circulating blood, spleen

121
Q

? are necessary for blood clotting, vascular integrity, vasoconstriction, and adhesion activity

A

platelet activity

122
Q

MPV = ? - ordered at times in conjunction with a platelet count. What does it indicate?

A

Mean Platelet Volume, indicates the uniformity of size of platelet population

123
Q

Lab value of platelets assesses for ?

A

bleeding disorders, AKA Coagulopathies or Coagulation disorders

124
Q

____ of PTS WITH UNEXPECTED PLATELET INCREASES WILL HAVE A MALIGNANCY

125
Q

Thrombocytosis = ?, what does it indicate

A

Thrombocythemia, or ABNORMALLY HIGH PLATELET count. Indicates leukemia, lymphoma, SPLENECTOMY

126
Q

Pts with thrombocytosis have attributed it to ?

A

Substance abuse

127
Q

REACTIVE THROMBOCYTOSIS is a rebound effect that lasts up to ___ weeks without treatment needed other Than to abstain from substance abuse. Platelets may seen as high as ____-____

A

6 weeks, 600-900

128
Q

Reactive thrombocytosis is most commonly seen with ?

A

alcohol, opioids, meth, cocaine, stimulants

129
Q

Name the categories that you should be able to put results into

A

Infection (Viral, Bacterial), Anemia, Bleeding Disorder, Allergic Rxn, Leukemia

130
Q

What does thrombocytopenia indicate

A

ITP idiopathic thrombocytopenic purport, HIV, HEPARIN INDUCED THROMBOCYTOPENIA, CHF, alcohol toxicity, bacterial infections, renal insufficiency

131
Q

when medicine or drug causes body to produce antibodies that seek to destroy platelets

A

drug induced thrombocytopenia *ITP = Immune Thrombocytopenia

132
Q

chronic alcohol consumption causes bone marrow suppression and defective platelet formation, LOW PLATELETS

A

alcohol induced thrombocytopenia

133
Q

Studies show that low platelet count with alcoholic is a good indicator of development of ___ and ____

A

DTs and cirrhosis

134
Q

Give schematic number clockwise from L to R, 1 2(on top) 3 (on right), 4 (on bottom below 2)

A

WBC, Hgb, PLT, HCT

Diagnostic Laboratory Medicine (4 decks)

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