Hematology 1 Flashcards
science of blood and the blood forming tissues
hematology
condition with diminished oxygen-carrying capacity of the blood
anemia
failure to produce or release mature forms of cells into the peripheral blood or cells destroyed in marrow
ineffective hematopoiesis
formation of blood cells in sites other than bone marrow; primarily liver and spleen
extramedullary hematopoiesis
destruction of red blood cells
hemolysis
thin film of EDTA anticoagulated blood on a glass slide; stained and examined microscopically
peripheral blood smear
an increase in the immature forms of cells in the peripheral blood
shift to the left
blood cell production that starts before birth and continues throughout life
hematopoiesis
where does hematopoiesis occur in an embryo?
yolk sac
where does hematopoiesis occur in a fetus? (4)
thymus
spleen
liver
bone marrow
where does hematopoiesis primarily occur after birth?
bone marrow
in hematopoiesis, what are the 3 protein stimulators?
erythropoietin
thrombopoietin
interleukins
in hematopoiesis, what are the 2 protein inhibitors?
interferons
lymphotoxins
where is erythropoietin produced?
kidneys
what are the 3 granulocytes of WBCs? (BEN)
basophils
eosinophils
neutrophils
how is a differential done?
manual peripheral blood smear
which 2 tubes can be used for a bone marrow biopsy?
EDTA
sodium-heparin
measures the amount of protein that transports oxygen
hemoglobin
measures packed RBCs
hematocrit
parameters that reveal size and amount of Hgb in individual RBCs
RBC indices
average size of RBCs
MCV
average amount of Hgb in RBCs
MCH
average concentration of Hgb in RBCs
MCHC
variability in RBCs volumes (shape of RBC)
RDW
mean platelet volume
PLT
% of each individual type of WBC present
differential
why do males have more RBCs than females?
they have androgens that stimulate hematopoiesis
how to calculate MCV?
Hct/RBC
how to calculate MCHC?
Hgb/Hct
what does an increase in RDW mean?
increased variation in volume/size
what would inclusions in a blood smear indicate?
infection
what would granulation in a blood smear indicate?
toxicity
poikilocytosis
abnormal shape
anisocytosis
variation in size
immature RBC with residual RNA; newly released from bone marrow
reticulocyte
protein in blood that carries free hemoglobin to liver for metabolism & excretion
haptoglobin
breakdown product of heme catabolism
bilirubin
why is there an increased level of reticulocytes in anemia?
not being transformed into mature RBCs (erythrocytes)
information about bone marrow output of RBCs
reticulocyte count
information about rate of destruction of RBCs
bilirubin
lab that gives information about cause of microcytic anemias
iron studies
what 2 labs give information about the cause of macrocytic anemia
folic acid
B12
what time frame does retic indices reflect changes?
in the last 18-24 hrs
retic Hb content in real time; measures the functional availability of iron during Hb synthesis
CHr
what does a decreased level of CHr indicate?
early marker of iron-restricted erythropoiesis
what lab value is the strongest predictor of iron deficiency and iron deficiency anemia in children < 2 yo?
CHr
why do we use CHr in regards to kidney disease?
assess iron status of patients with CKD on hemodialysis who are receiving EPO and IV iron
what are 2 examples of microcytic and hypochromic anemia?
iron deficiency
thalassemia
what are 2 examples of normocytic and normochromic anemia?
aplastic
sickle cell
what are 4 examples of macrocytic and normochromic anemia?
Pernicious anemia
Megaloblastic anemia
Hemolytic anemia
Liver disease
what is the most common cause of microcytic hypochromic anemia?
iron deficiency
decreased hemoglobin production due to insufficient iron
iron deficiency
inherited microcytic hypochromic anemia, due to decreased hemoglobin production
thalassemia
lab that indicates the total volume of iron the body stores
serum ferritin
transfers iron through the blood to various tissues
transferrin
protein capacity to carry iron
TIBC
excess iron that can no longer be stored as ferritin
hemosiderin
where is transferrin produced?
liver
what happens if iron is low in the body?
body makes more transferrin to bind iron and increase cellular uptake
what is serum ferritin in microcytic hypochromic anemia?
low
what is TIBC in microcytic hypochromic anemia?
normal-high
what is serum iron level in microcytic hypochromic anemia?
low
what is % saturation in microcytic hypochromic anemia?
low
how to treat microcytic hypochromic anemia?
iron + stool softener
after treating microcytic hypochromic anemia with iron, what should we do if the patient is still anemic and microcytic?
do hemoglobin electrophoresis to determine presence of thalassemia
who is thalassemia common in?
african americans
SE asians
what is the most common normocytic normochromic anemia?
Anemia of Chronic Disease (ACD)
what is Anemia of Chronic Disease also known as?
Anemia of Inflammation (AI)
what is serum iron in normocytic normochromic anemias?
low
what is serum ferritin in normocytic normochromic anemias?
increased
what is TIBC in normocytic normochromic anemias?
normal-low
what can normocytic normochromic lead to in long standing cases?
microcytic hypochromic
a result of mutation in beta gene resulting in a mutant hemoglobin, Hb S, forming rigid aggregates
sickle cell anemia
how can sickle cell anemia be diagnosed? (2)
solubility test
Hb electrophoresis
hypo proliferative anemia that leads to pancytopenia
aplastic anemia
to diagnose aplastic anemia, bone marrow must be at <25% + low: (2)
granuloctye count
plt count
what is the follow up test for macrocytic anemia?
blood smear
reticulocytosis associated with hemolysis due to a hemorrhagic event
macrocytic anemia
what is MCV in macrocytic anemia?
elevated
in alcoholism, if MCV > 110, what should we look for?
megaloblastosis due to folate deficiency
what cause of macrocytic anemia has an effect on RBC membrane, present target cells, and can also be hemolytic?
liver disease
what anemia indicates vitamin B12 or folate deficiency?
megaloblastic anemia
the presence of what is highly sensitive and specific for megaloblastic anemia?
hyper-segmented neutrophils
in megaloblastic anemia, what value increases with feeding?
serum folate
