DLM

Question 1

CBC-Hemoglobin

Answer 1

12-18g/dL

Indication of oxygen transport capacity of blood

Question 2

CBC- Hematocrit

Answer 2

38-54% Percent of blood composed of erythrocytes- 3x HGB

Question 3

CBC- MCV

Answer 3

Average volume of RBC
Macrocytic- large cells- due to B12 or folic acid deficiency
Microcytic- small cells- due to iron deficiency

Question 4

CBC- Platelet Count

Answer 4

150,000-450,000
Number of platelets in blood sample.
Thrombocytopenia-
viral illness, warfarin, petechiae
Thrmobocythemia- Risk of DVT, PE- estrogen, smoking, sedentary

Question 5

CBC- Mean Cell Hemoglobin (MCH)

Answer 5

27-33 picogram

Amount of hemoglobin in 1 RBC- used with MCHC to determine iron deficiency

Question 6

CBC- Mean cell hemoglobin concentration (MCHC)

Answer 6

33-37 g/dL

Hypochromic indicates iron deficiency

Question 7

CBC- Red cell distribution width

Answer 7

Distribution of size of RBCs- wide indicates varied cell sizes- mixed anemia or thalassemia

Question 8

CBC- White blood cell count

Answer 8

500-10,000mm2

Number of leukocytes in volume of blood- order differential to determine types of WBCs

Question 9

CBC- WBC differential

Answer 9

PMNs, Band neutrophils- Acute infection,
lymphocytes- viral infection,
monocytes- chronic infection,
eosinophils- allergy/worms basophils- chronic inflammation.

Question 10

Normocytic anemia

Answer 10

Hgb &Hct-low, MCV- normal

Question 11

Microcytic anemia

Answer 11

Hgb &Hct-low, MCV & MCHC- decreased

Question 12

Macrocytic anemia

Answer 12

Hgb &Hct-low, MCV increased

Question 13

Polycythemia

Answer 13

Hgb & Hct- high

Question 14

Leukocytosis

Answer 14

WBC increased- differential indicates type and reason

Question 15

Leukopenia

Answer 15

WBC decreased- differential leads to reason

Question 16

Thrombocytosis

Answer 16

Platelets >400,000- risk of excessive clotting

Question 17

Thrombopenia

Answer 17

Low platelet- risk of uncontrolled bleeding

Question 18

CBC- left shift

Answer 18

Increase in number of band (immature) cells. Indicates infection, leukemia, myeloprolifereative disorders, myelofibrosis, hemorrhage

Question 19

Fresh whole blood

Answer 19

All blood components- Indicated for hemorrhage >25% blood loss, cardiac surgery, emergencies

Question 20

Packed RBC

Answer 20

RBCs with small amt plasma and variable leukocytes- indicated to raise hematocrit, increase O2 carrying capacity

Question 21

Leukocyte poor blood

Answer 21

Decreased leukocyte levels- to reduce risk of agglutination rxn

Question 22

Frozen packed RBC

Answer 22

Stored for 10 years, preserve rare blood types- pts with severe retains to plasma protein

Question 23

Autologus packed RBC

Answer 23

Patients own blood stored for future use- elective surgery, stored 35 days before freezing

Question 24

Hemolytic transfusion reaction-

Answer 24

Mismatch of ABO blood typing- fever, chills, HA, hypotension. Prevention- hydration & diuresis

Question 25

Anaphylactic reaction

Answer 25

IgE mediated response to incompatible blood- shock, vasodilation. T with epi, airway mgmt, steroids

Question 26

Bone marrow biopsy

Answer 26

Diagnosis of leukemias- unexplained anemia, thrombocytopenia, leukopenia

Question 27

Lymph node biopsy

Answer 27

Diagnosis of lymphoma based on cellular morphology

Question 28

Total Iron Binding Capacity

Answer 28

Measures iron bound to transferrin- Increased in iron deficiency anemia

Question 29

Serum Ferritin

Answer 29

Indirect measure of iron stores- markedly reduced in iron deficiency anemia

Question 30

CBC

Answer 30

Low Hgb & Hct- indicates which type and deficiencies. Initial test

Question 31

Hemoglobin electrophoresis

Answer 31

Determination of types of hemoglobin present- Id thalassemia

Question 32

MMA

Answer 32

Metabolic intermediary of Vit B12- indicates anemia assoc with deficiency

Question 33

Reticulocyte count

Answer 33

Immature, nucleated RBCs- high in anemia- can't complete making the cells

Question 34

Bilirubin

Answer 34

Hemoglobin converted into bilirubin- high bilirubin indicates hemolytic anemia

Question 35

Bone marrow biopsy

Answer 35

Gold standard- invasive & expensive, only used with unexplained anemia- find errors in RBC factory

Question 36

Prothrombin Time

Answer 36

Extrinsic & common pathway- factors II, V, VII & X. Measures time to clot- increased time indicates abnormal. Less useful than INR.

Question 37

INR

Answer 37

Ratio of patient PT vs mean normal. More sensitive than PT. Monitor patients on warfarin. Measures extrinsic & common pathway factors

Question 38

aPTT

Answer 38

Screening test for deficiency & inhibitors of intrinsic pathway factors (VIII, IX, XI & XII) and common pathway. Report of clotting time, in seconds. Prolongation abnormal- heparin therapy, lupus,

Question 39

Bleeding time

Answer 39

Measure of platelet fxn. Not specific or sensitive. Small cuts on forearm and measure bleeding time. Not used

Question 40

D-dimer

Answer 40

Rule out thromboembolism. Elevated in VT, but not specific marker as may be elevated in other conditions. Measures fibrin degradation products.

Question 41

Fibrin split products

Answer 41

Increase may indicate primary or secondary fibrinolysis. Clot break down

Question 42

Factor assays

Answer 42

Determine etiology of prolonged PT or PTT, acquired or hereditary- hemophilias

Question 43

Direct Coombs

Answer 43

Detects antibody mediated destruction of RBCs- hemoytic uremic syndrome, Rh hemolytic disease

Question 44

Indirect Coombs

Answer 44

Detects presence of antibodies in body prior to transfusion, pregnancy

Question 45

Mixing study

Answer 45

Determine if abnormal PT/PTT is due to factor deficiency or antibody inhibitor. Correction of PT/PTT with normal plasma suggest factor deficiency. Failure to correct suggests ab inhibitor.