FBC interpretation Flashcards
causes of anaemia
ANAEMIA
Decreased production – nutritional deficiencies/malasorption, marrow failure, low level of hormones (EPO, thyroid hormones)
Increased production – haemolytic anaemia (congenital/acquired)
Bleeding
Haemodilution
MCV = mean cell volume
Anaemia with low MCV – microcytosis
Fe deficiency
thalassaemia
sideroblastic anaemia
Anaemia with high MCV – macrocytosis
folate or B12 deficiency alcohol abuse chronic liver disease hypothyroidism reticulocytosis myelodysplasia
Anaemia with normal MCV
chronic disease chronic renal failure pregnancy haemolysis bone marrow failure mixed haematinic deficiency (Fe, B12)
Macrocytosis
alcohol B12 deficiency folate deficiency myelodysplastic syndrome therapy with cytotoxics or immunosuppressants hypothyroidism
polycythemia
POLYCYTHAEMIA (Hb > 160g/L)
Relative (reduced plasma volume)
burns
severe dehydration
Absolute
polycythaemia ruba vera
myeloproliferative disorders
chronic hypoxia (OSA, Eisenmenger’s)
neutrophilia
NEUTROPHILIA
stress sepsis leukemoid reactions corticosteroids malignancy vasculitis
neutropenia
NEUTROPAENIA
infection
cytotoxic agents
idiosyncratic drug reactions (clozapine, carbimazole, sulphonamides, beta-lactams)
lymphopenia
LYMPHOPAENIA
simple stress response prior corticosteroid therapy autoimmune disease (SLE) infection: viral, severe sepsis, Tb, brucelliosis, histoplasmosis, HIV, CVM cytotoxic drugs radiation
lymphocytosis
LYMPHOCYTOSIS
infection: viral, Tb, toxoplasmosis, syphilis
thyrotoxicosis
leukaemia
lymphoma
monocytosis
MONOCYTOSIS
Tb leukaemia lymphoma myelodysplasia IBD convalescence from any infection
eosinophilia
EOSINOPHILIA
allergy Addisons parasitic infections sarcoidosis polyarteritis nodosa leukaemia lymphoma melanoma irradiation convalescence from any infection
basophilia
BASOPHILIA
infection: viral, Tb hypothyroidism IBD polysplenectomy leukaemia systemic mastocytosis haemolysis polycythaemia ruba vera
pancytopenia
PANCYTOPAENIA
Reduced Marrow Production
replacement of marrow (malignant cells) idiosyncratic Drug Reaction (chloramphenicol, sulphonamides, phenytoin, carbamazepine, gold) megaloblastic haematopoiesis (B12 deficiency) autoantibodies (SLE) myelofibrosis myelodysplasia toxins (benzene) cytotoxic agents overwhelming infections
Increased Peripheral Cellular Destruction
SLE
HIV infection
hypersplenism
paroxysmal nocturnal haemoglobinuria
thrombocytopenia
THROMBOCYTOPAENIA
Pseudothrombocytopaenia
- > film
- > blue tube
Decreased Production
bone marrow failure
pernicious anaemia
Increased Destruction
sepsis immune (ITP, TTP, HUS, HITTS) intravascular device (IABP, ECMO, PAC, bypass) drug induced (antibiotics, thiazides, H2 antagonists) antiphospholipid syndrome DIC HELLP haemolysis
Dilution
post resuscitation
massive transfusion
normal values
Haemoglobin (male) 13.0 – 17.0 g/dL
(female) 11.5 – 15.5 g/dL
White cell count 3.0 – 10.0 x 109/L
Platelets 150 – 400 x 109/L
Mean cell volume (MCV) 80 – 96 fL
Neutrophils 2.0 – 7.5 x 109/L Lymphocytes 1.5 – 4.0 x 109/L Monocytes 0.2 - 1.0 x 109/L Eosinophils 0 – 0.4 x 109/L Basophils 0 - 0.1 x 109/L Reticulocytes 25 - 100 x 109/L
