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Visceral Disorders > Exam 2 - CBC > Flashcards

Exam 2 - CBC Flashcards

1
Q

What is the term for the study of blood and its formed elements?

A

Hematology

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2
Q

Plasma makes up what percentage of the total blood volume?

A

55% (formed elements - 45%)

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3
Q

What is the breakdown of erythrocytes vs WBC/platelets in the total blood volume?

A

44% = erythrocytes, 1% = WBC/platelets (remember formed elements = 45% total)

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4
Q

What protein is found in RBCs and functions to transport oxygen and carbon dioxide to and from all the body tissues?

A

Hemoglobin

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5
Q

What is the purpose of platelets?

A

Prevent blood loss from hemorrhage

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6
Q

Where do we see the main effect of the platelets?

A

Blood vessel wall

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7
Q

What is the term for cellular formation, proliferation, differentiation, and maturation of blood cells?

A

Hematopoiesis

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8
Q

What are the hematopoietic tissues and organs?

A

Spleen, lymph nodes, thymus, bone marrow, liver, reticuloendothelial system (RES)

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9
Q

Are all RBCs released into peripheral blood from their original organs?

A

Only mature cells

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10
Q

When does hematopoiesis begin in the fetus?

A

19th day of gestation

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11
Q

Where are blood cells manufactured in normal adults/

A

Marrow of the axial skeleton

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12
Q

Which hormone is responsible for stimulating the stem cells to differentiate and proliferate into RBCs?

A

Erythropoietin

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13
Q

Where is erythropoietin produced?

A

Kidneys

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14
Q

Where are erythrocytes, granulocytes, monocytes, and platelets produced postnatally?

A

Bone marrow

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15
Q

Where are lymphocytes produced?

A

Secondary lymphoid organs: spleen, lymph nodes, intestinal lymphoid tissue, bone marrow, and thymus

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16
Q

What is the lifespan of a RBC?

A

120 days

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17
Q

What is the main function of a red blood cell?

A

Transport hemoglobin

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18
Q

What is the ratio of hemoglobin to water of a RBC?

A

90% hemoglobin, 10% water

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19
Q

When a patient is suspected of having an infection, what tests are commonly run and helpful to have done?

A

CBC and ESR

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20
Q

What levels are measured with a traditional CBC?

A

Hemoglobin, hematocrit, RBC indices, WBCs, platelets

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21
Q

What is the term for lower than normal RBC count? Higher?

A

Lower = anemia, Higher = polycythemia

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22
Q

What is the adult male normal for RBC count?

A

4.5-6.0 million/mm(3)

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23
Q

What is the adult female normal for RBC count?

A

4.0-5.5 million/mm(3)

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24
Q

What is the normal child count for RBCs?

A

4.0-5.5 million/mm(3)

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25
Q

What is the normal adult male count for hemoglobin? Females?

A

Males = 13-18mg/dL, Females = 11-16 mg/dL

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26
Q

In general, what does a decreased hemoglobin count signify?

A

Decreased oxygenation of the tissues (tired, less energy)

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27
Q

What does hemoglobin do again?

A

Transports oxygen and CO2

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28
Q

What is the hematocrit a measurement of?

A

Percentage of total blood volume made up of RBCs (packed cell volume)

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29
Q

What is the adult male normal range for hematocrit? Female?

A

Male = 42-52%, Female - 37-47%

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30
Q

If a patient has a hematocrit of 47%, then what percentage of the total blood volume is made up of plasma?

A

53%

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31
Q

We can diagnose a patient with anemia if ANY of what levels are low?

A

RBCs, hematocrit, or hemoglobin

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32
Q

What is the usual mathematical relationship between hemoglobin and hematocrit?

A

HGB X 3 = HCT

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33
Q

What is the usual mathematical relationship between hematocrit and RBC count?

A

HCT X 11 = RBC count

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34
Q

RBC indices provide what insight?

A

Size (MCV), weight (MCH), hemoglobin concentration (MCHC)

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35
Q

What is MCV?

A

Mean corpuscular volume (average volume/size of the RBC)

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36
Q

What are the different measurement levels of MCV?

A

Normal = 80-100 cubic microns, Microcytic = 100

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37
Q

How do we measure MCV?

A

HCT divided by number of RBC

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38
Q

What is MCH?

A

Mean corpuscular hemoglobin (average weight of total hemoglobin)

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39
Q

What does mean corpuscular hemoglobin indicate?

A

Color of RBC

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40
Q

How do we measure MCH?

A

HGB divided by number of RBC

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41
Q

What are the different measurement levels of MCV?

A

Normochromic = 27-31pg, Hyperchromic = >31, Hypochromic =

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42
Q

What is another term for hyperchromic?

A

Polychromasia

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43
Q

What is MCHC?

A

Mean corpuscular hemoglobin concentration (measure of average concentration of percentage of hemoglobin within a single RBC

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44
Q

How do we measure MCHC?

A

Hgb/Hct

45
Q

What are the different measurement levels of MCHC?

A

Normochormic = 32-36g/dL, Hypochromic = 36

46
Q

How do we classify types of anemia?

A

Cell size and color (Hgb content)

47
Q

Why is anemia important when diagnosed?

A

Indication of an underlying disorder

48
Q

How does the body usually try to compensate for anemia?

A

Increased RBC production, heart rate, and respiration

49
Q

What usually causes anemia?

A

1 decreased RBC production 2 increased breakdown of RBCs 3 blood loss

50
Q

What type of anemias could present as microcytic hypochromic anemia (decreased MCV, MCH, and MCHC)?

A

Iron deficiency anemia (IDA), anemia of chronic disease (ACD), thalassemia, chronic blood loss

51
Q

What types of things can lead to microcytic normochromic anemia?

A

Vitamin B12 or folic acid deficiency, alcoholism, liver disease

52
Q

What types of anemias could present as normocytic normochromic anemia?

A

Anemia of chronic disease (ACD), acute blood loss, hemolytic anemia (like sickle cell), aplastic anemia

53
Q

What is unique about the presentation of anemia of chronic disease?

A

75% presents as normocytic normochromic, 25% presents as microcytic

54
Q

Iron is stored in what two forms?

A

Ferritin, hemosiderin

55
Q

What protein transports iron?

A

Transferrin

56
Q

What is a common cause of blood loss anemia?

A

Heavy menstrual flow

57
Q

What is the most common cause of anemia worldwide usually from GI blood loss?

A

Iron deficiency (IDA) (30% of world’s population)

58
Q

Acute blood loss results in what form of anemia? Chronic blood loss?

A

Acute = normocytic normochromic, Chronic = microcytic hypochromic (really an IDA)

59
Q

What is the most common cause of chronic blood loss?

A

GI blood loss

60
Q

What is the most important cause of IDA worldwide?

A

Parasitic infection caused by worms in which intestinal bleeding can lead to undetected blood loss in stool

61
Q

What is the most common cause of IDA in post-menopausal adults over 50 years old?

A

GI bleeding from nonparasitic causes like gastric ulcer, duodenal ulcer, or GI cancer

62
Q

What is the principal cause of IDA in developed countries?

A

Blood lost during menses in premenopausal women

63
Q

Which gender is more likely to develop IDA in developed nations?

A

Females

64
Q

What mineral is necessary for the formation of heme?

A

Iron

65
Q

Chronic use of what medication can also lead to IDA?

A

Aspirin

66
Q

What is the unusual sign of IDA is commonly seen?

A

Pica or pagophagia

67
Q

How can severe IDA affect the tongue and nails?

A

Smooth tongue, brittle nails

68
Q

Total iron binding capacity (TIBC) can be an indirect measurement of what other substance?

A

Amount of transferrin in blood

69
Q

What does TIBC measure?

A

Extent to which iron-binding sites in the serum can be saturated

70
Q

How do low levels of iron and ferritin affect levels of TIBC?

A

TIBC is increased (more protein available)

71
Q

What are anisocytes?

A

RBCs of unequal size

72
Q

What are poikilocytes?

A

Abnormally shaped RBCs

73
Q

How can we differentiate ACD from IDA?

A

ACD has normal or decreased iron, normal to increased ferritin, and low/normal TIBC

74
Q

How can we differentiate thalassemia from IDA?

A

Thalassemia has normal iron parameters although more microcytosis

75
Q

What is another name for anemia of chronic disease?

A

Anemia of inflammation

76
Q

What are the iron parameters for ACD?

A

Low serum iron, low TIBC*, normal/increased ferritin

77
Q

What are examples of conditions that can lead to ACD?

A

Chronic infection, inflammation, cancer, liver disease, RA, chronic renal disease

78
Q

Which is more common: ACD being microcytic hypochromic or ACD being normocytic normochromic?

A

Normocytic normochormic (75%)

79
Q

What causes thalassemia?

A

Genetically derived

80
Q

How does thalassemia directly cause anemia?

A

Reduced hemoglobin synthesis (either alpha or beta globulin chains)

81
Q

What type of anemia is thalassemia?

A

Microcytic hypochromic

82
Q

Which form of thalassemia is more common in China and Southeast Asia?

A

Alpha

83
Q

Which form of thalassemia is more common the Mediterranean?

A

Beta

84
Q

What is another name for thalassemia major (homozygous)?

A

Cooley’s anemia

85
Q

When do those with thalassemia minor (heterozygous) experience symptoms?

A

When under times of stress

86
Q

Which tends to have a lower MCV: thalassemia or IDA?

A

Thalassemia

87
Q

Which tends to have normal ish iron parameters: thalassemia or IDA?

A

Thalassemia (remember: more of a hemoglobin synthesis problem)

88
Q

What procedure is done to differentiate between alpha and beta thalassemia?

A

Hemoglobin eletrophoresis

89
Q

What is a patient MOST likely to have when a hair on end skull is seen upon X-ray?

A

Thalassemia

90
Q

If hair on end skull on X-ray is present but the patient has normocytic anemia, what is the diagnosis?

A

Sickle cell anemia

91
Q

What causes the hair on end appearance seen with thalassemia or sickle cell anemia?

A

Marked widening of the diploic space containing alternating bands of hypo intense trabeculae and hyperintense marrow

92
Q

What X-ray changes can be seen in thalassemia patients’ hands?

A

Lace-like trabeculae, osteopenia, thinned cortex

93
Q

Which microcytic hypochromic anemia presents with high TIBC? Low? Normal?

A 
High = IDA
Low = ACD
Normal = thalassemia
94
Q

What causes the destruction/anemia seen with macrocytic normochormic anemia?

A

Large RBCs cannot conform to small capillaries, and they fracture and hemolyze with shortened life span

95
Q

What occurs with the megaloblastic form of microcytic normochromic anemia?

A

Changes with RBC/WBC precursors: inhibition of DNA synthesis in RBC production (likely B9 or B12 deficiency)

96
Q

Which type of anemia can be either megaloblastic or nonmegaloblastic?

A

Macrocytic normochromic anemia

97
Q

What is probably the cause of nonmegaloblastic microcytic normochromic anemia?

A

Liver disease, alcohol

98
Q

Strict vegetarians are likely to have which vitamin deficiency that can lead to microcytic normochromic anemia?

A

B12

99
Q

What substance is produced by the gastric mucosa and is required in order for B12 to be absorbed by the small intestine?

A

Intrinsic Factor (IF)

100
Q

What is the most common cause of B12 deficiency?

A

IF deficiency (pernicious anemia)

101
Q

What is the second most common cause of B12 deficiency?

A

Lack of gastric acid necessary to separate B12 from its binding proteins

102
Q

What is the third most common cause of B12 deficiency?

A

Malabsorption cause by diseases of the terminal ilium (worms, IBD, malabsorption syndromes)

103
Q

What are signs and symptoms of B12 deficiency?

A

Lemon-yellow skin color, premature aging, sore tongue, GI symptoms, paresthesias, loss of vibratory sensation

104
Q

What causes pernicious anemia?

A

MC genetic, maybe dietary in strict vegetarians

105
Q

How can pernicious anemia end up causing great harm to the patient?

A

1/4 result in stomach cancer

106
Q

Which can result in neurologic symptoms: B9 or B12 deficiency?

A

B12 (numbness, tingling, memory loss, loss of balance, loss of bladder control)

107
Q

How does normochromic megaloblastic anemia affect MCV? Iron? Ferritin? MCH? RBCs? Hemoglobin?

A

Increased MCV, MCH, iron, and ferritin; Decreased RBCs and hemoglobin

108
Q

What substances are elevated in macrocytic normochromic NONmegaloblastic anemia?

A

Liver enzymes, bilirubin, MCV

Visceral Disorders (7 decks)

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