Hematology 1 Flashcards

1
Q

The most commonly ordered lab test

Information on Cellular elements of blood: concentration & characteristics

A

CBC

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2
Q

Normal RBC counts

A

males 4.5 – 5.9 x 106 cells/L; females 4.1 – 5.1 x106 cells/L

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3
Q

RBC count below normal

A

anemia

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4
Q

RBC count above normal

A

polycythemia

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5
Q

Increased production of immature RBCs

A

Reticulocytosis

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6
Q

Normal range of Hemoglobin

A
males= 14 – 17.5 g/dL;
females= 12.3 – 15.3 g/dL
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7
Q

Low hemoglobin

A

anemia

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8
Q

Normal range of hematocrit

A

males 42-50%;

females 36- 45%

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9
Q

Low hematocrit

A

anemia

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10
Q

Normal range of MCV

A

80- 96 fL/cell

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11
Q

Causes of High MCV

A

“macrocytic”

Causes= Vitamin B12 or Folate deficiency

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12
Q

Causes of Low MCV

A

“microcytic”

Causes = Iron deficiency

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13
Q

Normal range of MCH

A

27- 33 pg/cell

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14
Q

Causes of High MCH/Normochromic

A

Causes= Vitamin B12 or Folate deficiency (normochromic)

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15
Q

Causes of Low MCH/Hypochromic

A

Causes = Iron deficiency = hypochromic (pale)

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16
Q

Normal range of RDW

A

11.5 – 14.5%

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17
Q

High RDW

A

indicates variation in RBC size= “anisocytosis”

Seen in Iron deficiency or macrocytic anemias

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18
Q

Normal range of reticulocytes

A

0.5 to 2.5% of total RBCs

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19
Q

Causes for ↑’s in reticulocytes

A

Acute RBC destruction or loss

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20
Q

Causes of ↓’s in reticulocytes

A

Bone marrow suppression

21
Q

Presentation of anemia

A
Fatigue/ Somnolence
Decreased concentration
↑Weakness/ ↑Shortness of breath
↓Blood Pressure/ ↑Heart rate/ Shock
Heart Failure/ Vertigo/ Syncope
22
Q

RT is a 65 y/o male presents with a
1 month h/o weakness, fatigue & frequent drowsiness
RBC count: 2.5 X 1012 cells/L (4.5- 6 X 1012)
Reticulocytes: 2% (

A

Microcytic Hypochromic Anemia

23
Q

necessary for DNA synthesis in all cells

found in meats, eggs, & diary products

A

vitamin B12

24
Q

Causes of vitamin B12 deficiency

A
Dietary deficiency (e.g., alcoholism)
Intrinsic factor deficiency (e.g., autoimmune, surgery)
25
Q

Test to diagnose vitamin B12 deficiency

A

“Schillings test”

26
Q

necessary for DNA synthesis in all cells

Found in leafy green vegetables & broccoli

A

Folic acid deficiency

27
Q

Causes of folic acid deficiency

A

Pregnancy/ Diet deficiency/ “Celiac disease”

28
Q

What if there are Normal

B12/ FA levels but low MCV

A

Drug-induced macrocytic anemia

e.g., Alcohol & Chemotherapy

29
Q

Lab evaluation of Iron deficiency

A

Serum Ferritin
Serum Iron
Total Iron Binding capacity (TIBC)*
Percent Iron saturation

30
Q

Storage form of iron

A

Serum Ferritin

31
Q

Normal range of serum ferritin

A

> 10- 20 ng/mL

32
Q

Limitation of serum ferritin

A

falsely elevated in infections, fever, inflammatory reactions

33
Q

Normal range of serum iron

A

50- 150 μg/dL

34
Q

Measures iron bound to transferrin

A

serum iron

35
Q

Limitations of serum iron

A

Large diurnal variation = use with TIBC

36
Q

Normal range of TIBC

A

250 - 410 ng/mL

37
Q

Measures iron binding capacity of transferrin

A

TIBC

38
Q

Normal range of percent iron saturation

A

20- 50%

39
Q

Findings in Iron deficiency anemia

A

decreased ferritin, serum iron, percent iron saturation
increased TIBC
normal reticulocytes

40
Q

Causes of normocytic anemia

A

Blood loss, Hemolysis, or Chronic diseases

41
Q

Testing for hemolytic anemia

A

Coomb’s test

42
Q

Findings in Chronic Disease (Chronic infections, inflammatory diseases, neoplasms)

A

Decreased serum iron, TIBC, iron saturation

Normal reticulocytes and ferritin

43
Q

Findings in acute blood loss and hemolytic anemia

A

Increased reticulocytes

Normal MCH, MCV, RDW

44
Q
RT has a history of osteoarthritis, peptic ulcer disease, and smoking.
Ferritin:		Decreased
Transferrin:	Decreased
TIBC:		Increased
Serum Iron:	Decreased
MCV:		70 fL/cell 	
Reticulocytes:	2 %
Which of the following does this patient exhibit?
Anemia of Chronic disease
Anemia from acute blood loss
Anemia from hemolysis 
Anemia from Iron deficiency
A

Anemia from Iron Deficiency

45
Q

Measures rate at which RBCs settle from blood

Settle faster when combined with inflammatory proteins

A

Erythrocyte sedimentation rate (ESR)

46
Q

Normal range of ESR

A

1- 15 mm/hour (male)

1- 20 mm/hour (female)

47
Q

Causes for an Increase in ESR

A

Rheumatoid arthritis, Systemic Lupus Erythematosus

48
Q

Causes for a Decreased ESR

A

Heart failure, liver failure, sickle cell disease, corticosteroids

49
Q

Uses for ESR

A

Low specificity & sensitivity = Used for monitoring inflammatory disease