DIS - General Health Assessment - Week 10 Flashcards
List the 8 components of a full blood count.
Haemoglobin (Hb)
Red blood cell count (RBC)
Percentage of blood cells as a proportion of total blood volume (PCV)
Volume of red blood cells (MCV)
Average amount of haemoglobin in red blood cells (MCHC)
Number of white blood cells (WCC)
Percentage of different types of white blood cells
Number of platelets
Define haematocrit.
Percentage of blood cells as a proportion of total blood volume (PCV)
How is haemoglobin measured and in what kind of conditions is it elevated? Give an example.
Weight per volume
Elevated in polycythaemia conditions such as leukaemia
List four conditions where there can be reduced haemoglobin.
Anaemia
Blood loss
Autoimmune disease
Low iron intake
Is haemoglobin a broad or narrow marker?
Broad
What is the normal haemoglobin levels for adult males and females?
Male - 130 to 170g/L
Female - 120 to 150g/L
List three conditions that can cause reduced red blood cell count (RCC).
Anaemia
Bleeds (i.e. bowel)
Bone marrow dysfunction
Deficiency in what two vitamins or minerals can cause reduced red blood cell count (RCC)?
Vitamin B12
Iron
What condition can cause increased red blood cell count (RCC).
Polycythaemia - leukaemia
What is the normal red blood cell count for adult males and females?
Male - 4.5 to 5.5
Female - 3.8 to 4.8
What condition can cause increased haematocrit/packed cell volume? What about decreased?
Low - anaemia
High - polycythaemia vera
Does dehydration cause high or low haematocrit/packed cell volume?
High
What is polycythaemia vera and what does it cause overproduction of? Is it common or rare in individuals >60?
Condition of the bone marrow causing over production of red blood cells
List four systemic symptoms of polycythaemia vera.
Fatigue
Headache
Itching
Weight loss
List two ocular symptoms of polycythaemia vera.
Retinal vein occlusions
Cotton wool patches
What is the treatment for polycythaemia vera (3)?
No cure
Treatment by phlebotomy, chemotherapy, interferons
Is polycythaemia vera a life threatening disease?
Yes, without treatment
What is the normal haematocrit for males and females?
Males - 40 to 50%
Females - 36 to 46%
List two causes of low mean cell volume (MCV).
Iron deficient anaemia
Pregnancy
List three causes of high mean cell volume (MCV).
B12 deficiency
Liver disease
Alcoholism
What is pernicious anaemia caused by?
B12 deficiency
List four causes of low mean cell haemoglobin and mean cell haemoglobin concentration.
Anaemia caused by chronic disease
Folic acid/B12 deficiency
Iron deficiency
Thalassaemia - congenital blood disorders
What is the normal mean cell haemoglobin and mean cell haemoglobin concentration for adults?
MCH - 27 to 32pg
MCHC - 315 to 354g/L
What is red cell distribution width? What is it linked to (variance/mean)?
Calculates varying sizes of red blood cell volume in a sample
RDW is the variance, MCV is the mean
Give a possible cause for the following parameters:
Decreased MCV, normal RDW
Decreased MCV and RDW
Normal MCV, decreased RDW
Increased MCV and RDW
Decreased MCV, normal RDW - chronic disease
Decreased MCV and RDW - iron deficiency
Normal MCV, decreased RDW - B12 deficiency
Increased MCV and RDW - folate deficiency
What is the normal RDW for adults?
12.1 to 14.6%
List five causes of low platelet count.
Blood loss (i.e. bowel)
Warfarin
Enlarged spleen
Septicaemia
Bone marrow failure due to leukaemia
List three causes of high platelet count.
Chronic bleeding (i.e. gastric ulcer)
Leukaemia
Smoking
What is the normal platelet count for adults?
150 to 400
List three causes of low white blood cell count.
Liver spleen disorders
Bone marrow disorders
Exposure to toxic substances or radiation
List three causes of high white blood cell count.
Infection/inflammation
Tissue damage
Leukaemia
What is the normal adult white blood cell count?
4 to 10
What tends to trigger neutrophils and monocytes and what three things are associated with their levels in blood?
Bacteria and exogenous material
Associated with trauma, surgery, arthritis
What condition causes reduced lymphocyte levels in blood?
HIV
What two things can increase eosinophil levels in blood?
Parasites
Allergic response
What two things can increase basophil levels in blood?
Allergic response
Viral insult
What are the normal levels for the five main types of white blood cells?
Neutrophil - 2 to 7
Eosinophil - <0.5
Basophil - <0.1
Monocyte - <1.0
Lymphocyte - 1 to 3
What is erthyrocyte sedimentation rate and what is its specificity and sensitivity like?
Abnormal proteins from inflammation disease tend to stick to the RBCs and cause them to settle to the bottom of the sample more quickly
High sensitivity, low specificity
In what conditions does erythrocyte sedimentation rate tend to be increased?
Multiple inflammatory conditions
How does anaemia affect erythrocyte sedimentation rate and what should be done in conjunction when measuring it?
Anaemia can falsely increase ESR, so full blood count should be done
What is the normal erythrocyte sedimentation rate for adults?
<13mm/h
What kind of marker is C reactive protein (CRP)? When does it increase?
Inflammation marker
Increases signficantly with systemic infection
Does C reactive protein (CRP) have a high or low false negative rate? What is it used in association with?
Can get false negatives
-used in association with erythrocyte sedimentation rate
List three causes of chronic high CRP levels.
Diabetes
Hypertension
Cardiovascular disease
List four blood glucose tests.
Fasting blood sugar (FBS)
Random plasma glucose (RPG)
Oral glucose tolerance test (OGTT)
Glycosylated haemoglobin test (HbA1c)
What is meant by fasting?
Refraining from eating or drinking any liquids other than water for eight hours
What hormone is released when fasting and what does it do? What occurs in a diabetic? What does this mena for their blood sugar?
Glucagon is released, which stimulates increased blood sugar levels
A person with no idiabetes will release insulin to rebalance sugar levels
A person with diabetes will not produce enough or have insulin resistance
-their blood sugar levels will be significantly higher
What is the normal fasting blood sugar level for adults?
3.5 to 5.4
What does free glucose bind to? What does HbA1c measure?
Haemoglobin - HbA1c measures percentage of this
How long does a red blood cell live for on average and how does this affect the information provided by a HbA1c test?
Lives for ~90 days
HbA1c can be thought of as the measure of blood sugar over a three month period
What are the HbA1c values for the following:
Normal
Good control
Poor control
Trouble
Normal - <6.0
Good control - 6 to 6.9
Poor control - 7 to 7.9
Trouble - >8
For every 1.0 increase to HbA1c, what is the increased risk and for what?
For every 1.0 increase twice the risk of cardiovascular event within 10 years
List three thyroid function tests.
Thyroid stimulating hormone (TSH)
Thyroxin (T4)
Triiodothyronine (T3)
What does thyroxin drive?
Metabolism
What are TSH and T4 levels like with hyperthyroidism, primary hypothyroidism, and secondary hypothyroidism?
Hyperthyroidism - low TSH, high T4
Primary hypothyroidism - high TSH, low T4
Secondary hypothyroidism - low TSH, low T4
