E3 WBC Patho & CBC interpretation

Question 1

What is the most abundant cell in the blood?

Answer 1

RBC (erythrocytes)
Men:48%
Women: 42%

Question 2

What is the primary responsibility of erythrocytes? & what carries the O2?

Answer 2

Tissue oxygenation (hemoglobin carries O2)

Question 3

What do WBC (leukocytes) due and the 5 kinds?

Answer 3

Protect immune function & inflammation
1. Neutrophils
2. Lymphocytes
3. Monocytes
4. Eosinophils
5. Basophils
*add to 100%

Question 4

What are the Granulocytes

Answer 4

WBCs w/ a nucleus in several lobes & granules
-Release mediators w/ inflammatory & immunity properties
1. Neutrophils (50-67%)
2. Eosinophils (0-3%)
3. Basophils (0-2%)

Question 5

What are Agranulocytes?

Answer 5

WBCs w/ nucleus but have very few to none granules
-Don’t release mediators but still participate in inflammatory or immune processes
1. Lymphocytes (24-40%)
2. Monocytes (4-9%)

Question 6

Neutrophils

Answer 6

-First to arrive at site of inflammation
-Bands (immature) & Segs (mature)
-Increased with ACUTE BACTERIAL infections and TRAUMA
-Early stage of infection, Acute
-Ex. Strep throat

Question 7

Lymphocytes

Answer 7

-Primary cells of immune response
-Increase with CHRONIC INFECTION & ACUTE INFECTION
-T & B cells (Fighting & Memory)
-Live in lymphoid tissue not bloodstream
-Ex. Chronic infection could be MRSA on foot

Question 8

Monocytes

Answer 8

-Phagocytosis
-Increase with BACTERIAL INFECTIONS & CANCER
-Not as much as neutrophils

Question 9

Eosinophils

Answer 9

-Increase with ALLERGIC REACTIONS or PARASITIC infections
-Worms, wheezes and weird diseases

Question 10

Basophils

Answer 10

-Increase with ALLERGIC REACTIONs (hypersensitivities, inflammatory reactions)
-Not as much as Eosinophils

Question 11

Hemoglobin Men vs women #

Answer 11

-Oxygen carrying capacity
-Men 13.5-17.5
-Women 12-15.5

Question 12

What does it mean if your hemoglobin is low?

Answer 12

BLEEDING, folate/B12 deficiency, cancers, kidney & liver disease

Question 13

What does it mean if your hemoglobin is high?

Answer 13

Polycythemia, COPD, high altitude, heavy smoking

Question 14

What is hematocrit? Men vs women #?

Answer 14

-Percentage of blood that is made of packed RBCs
-40% means 40mL per 100mL of blood
-Men: 41-50%
-Women: 36-44%

Question 15

What does low hematocrit mean?

Answer 15

-Anemia
-Bleeding
-Bleeding disorder
-FLUID IMBALANCE

Question 16

What does high hematocrit mean?

Answer 16

-polycythemia
-COPD
-Dehydration
-Shock
-Congenital heart disease

Question 17

Mean Corpuscle Volume (MCV)

Answer 17

Size of erythrocytes

Question 18

Mean Corpuscle Hemoglobin (MCH)

Answer 18

Amount of hemoglobin in erythrocytes by weight

Question 19

Normal WBC amount and what is it called when its low or high?

Answer 19

5,000-10,000/mm3
Increased = leukocytpsis
Decreased = leukopenia

Question 20

CBC with diff

Answer 20

Total number of WBCs in mm3 and determination of the proportion of each of the 5 WBCs in a sample of 100 WBCs

Question 21

CBC with diff interpretation: An increased % in one type means a ______ in % of another type. But, the absolute # of the second type ______

Answer 21

Decrease
Does not change

(We are not losing lymphocytes or neutrophils when the % goes up of another type but we are just gaining a %)

Question 22

Client gets severe bacterial infection, WBC = 20,000/mm3. With a bacterial infection almost all of the increase will be _________

Answer 22

Neutrophils

Question 23

WBC 13,000
Seg Neutrophils 70% (47-63)
Band Neutrophils 8% (0-4)
Lymphocytes 15% (20-30)
Monocytes 4% (3-8)
Eosinophils 2% (1-6)
Basophils 1% (0-2)

Answer 23

Acute Bacterial infection
(Immature neutrophils present)

Question 24

WBC 14,200
Seg Neutrophils 26% (47-63)
Band Neutrophils 4% (0-4)
Lymphocytes 59% (20-30)
Monocytes 8% (3-8)
Eosinophils 2% (1-6)
Basophils 1% (0-2)

Answer 24

Viral infection or chronic bacterial infection
(Maybe MONO or some some other type of chronic ulcertive wound)

Question 25

WBC 11,700
Seg Neutrophils 39% (47-63)
Band Neutrophils 7% (0-4)
Lymphocytes 29% (20-30)
Monocytes 3% (3-8)
Eosinophils 22% (1-6)
Basophils 1% (0-2)

Answer 25

Worms, Wheezes, Weird Diseases
Allergic reaction, parasitic, asthma attack

Question 26

What else to look for w/ infection

Answer 26

-Increased temp
-Fever is not a disease, but a sign that the body is responding to an infection
-Fever may decrease or stop growth of microorganisms

Question 27

Leukopenia

Answer 27

-Low neutrophil count (<1000/mm3)
-Most often cancer pts
-Susceptible to bacteria infections (Can be life threatening)
-Neutropenic precautions

Question 28

What are neutropenic precautions?

Answer 28

-Good hygiene
-Avoid contact w/ sick people
-Avoid raw fruits, veggies, grains
-Keep door closed

Question 29

Leukopenia Pharmacological treatment?

Answer 29

Hematopoietic agents
Drug: Filgrastim or Pegf ilgrastim
Class: Granulocyte Colony Stimulating Factors (G-CSF)

Question 30

MOA of Filgrastim

Answer 30

Promotes proliferation, differentiation, activation of cells that make granulocytes

Question 31

Indications of Filgrastim

Answer 31

-Malignancies
-Chemo-induced leukopenia
-Activation of cells that make granulocytes

Question 32

Route and Adverse Effects of Filgrastim

Answer 32

IV or SQ
Bone pain & leukocytosis

Question 33

MOA of Pegf ilgrastim

Answer 33

Increased production of neutrophils

Question 34

Route and Adverse effects of Pegf ilgrastim

Answer 34

SQ
Bone Pain
Pegylated = delayed excretion by the kidneys (Very long half life)