Hematology Flashcards
what makes up blood
plasma - 55% (water, proteins-albumin, nutrients)
cellular components-45%
- WBCs
- platelets
- RBCs
myeloid
RBCs and platelets eosinophils basophils neutrophils monocytes
lymphoid
b/t cells
NKCells
what is used to complete a CBC
what about: white cell differential count
peripheral blood smear
a CBC done by machine (almost always)
a WHITE CELL DIFFERENTIAL COUNT is done automated or by hand
PERIPHERAL BLOOD SMEAR done by hand, looking through microscope
where does blood for a peripheral smear come from?
what does it access?
when is it usually done?
comes from veins NOT marrow
look at cells under microscope to see size, shape, and contents
usually done when automated CBC is abnormal
what does a CBC look at
the common constituents of blood
- RBC,WBC, Platelets
- look at number and morphology
- access oxygen carrying capacity of RBCs
what does CBC not include
it includes a WBC DIFFERENTIAL
it does NOT include MANUAL COUNT
you have to order separately
what is in a complete blood count
RBC Hb Hct WBC platelet count
what does RBC count tell you?
why order it?
the number of RBCs in a volume of whole blood
order when: as part of CBC for screening or physical, or to monitor anemia, post surgery, meds
what are the causes of low RBC count
hemorrhage hemolysis dietary deficiency genetics (sickle) drug ingestion marrow failure chronic illlness (tumor, sepsis, hiv) organ failure
causes of high RBC count
chronic hypoxia (COPD, heart disease)
polycythemia vera
what are the red cell indices
Mean cell volume (MCV)
Mean cell hemoglobin (MCH)
mean cell hemoglobin concentration (MCHC)
red cell distribution width
MCV
mean corpuscular volume
helps to classify anemias
tells us overall avg size of RBC
in an MCV, what does a larger than normal RBC called?
smaller?
normal??
larger= macrocytic
smaller= microcytic
normal= normocytic
common causes of macrocytosis
folate, B12 def
chronic liver dz, alcholism
chemo
cardioresp abnormalities
HIV on treatment
aka everything but FE and thalassemia
causes of microcytosis
chronic Fe def
thalassemia- blood disorder with less hb than normal
what are common causes of normocytosis (other than healthy)
anemia of chronic disease
MCH
mean corpuscular hemoglobin
quantity (weight) of hemoglobin in avg RBC
it is very closely correlated to MCV and therefore is redundant and ADDS LITTLE TO THE EVALUATION
MCHC
average concentration of hemoglobin in the average RBC
correlates with degree of chromasia (redness of RBC)
chromasia
redness of RBC
what is a pale RBC called
what is a dark RBC called
normal?
pale= hypochromic
dark= hyperchromic (alteration in shape may cause this on automated result)
normal= normochromic
RDW
Red cell distribution width
tells us how variable the sizes of RBCs are
what does anisocytosis mean
red cells of varying sizes
aka RDW
RDW are never _____________, only ____ or _____
never low,
only normal or high
what do high RDWs tell you?
low RDWs?
high= may precede detectable anemia (good for early detection) or deficiency anemia
NEVER LOW only normal or high
what is hematocrit
how do you get this
Hct
percent of whole blood that is RBCs
centrifuge to get
what is PCV
packed cell volume
indirect way of getting Hct
Hgb
hemoglobin
the molecule that transports oxygen in RBC
calculated figure on CBC
g/dL
hwo much does hemoglobin account for the hematocrit
1/3 of the value of hematocrit (hct)
if HCt= 45, then Hgb= about 15
what does a low HCT or Hgb tell you
anemia !!!
what are the two routes to anemia
inadequate production of RBCs !!!
loss or destruction of RBCS!!!!
ex: cirrhosis, hemolytic anemia, dietary def, renal disease
what does a high HCT or HGB tell you
polycythemia vera or congential heart disease
most often due to CHRONIC HYPOXIA (Smokers with emphysema, chronic pulmonary disease= COPD)
renal tumor
sever dehydration
how does abnormal HGB impact the body
too low= strains cardiopulmonary system= MI, angina, heart failure, stroke
too high= clumping, sludging, stroke
what are reticulocytes
young RBCs that just entered circulation (24-48 hours)
remnant of nuclear material
what does normal reticulocyte count indicate
funcitoning bone marrow
what could a high Reticulocyte count indicate
hemorrhage /anemia
hemolytic disease newborns
hemolytic anemia
treatment of iron, b-12 or folate def
decreased reticulocyte count
pernicious anemia (lack of b12)
folic acid def
fe def
aplastic anemia
radiation therapy
malignancy
what is a white blood cell count used for
what happens with age
evaluating for infection, neoplasm allergy, or immunosuppression
tend to be age related, decrease with age
what does a differential WBC count tell you
the types of WBC and their percentages of the total
-neutrophil (45%)= ex
may or may not be included
what are exs of leukocytosis
leukocytosis= high WBC
infection, malignancy, inflammation, thyroid storm
what are exs of leukocytopenia
leukocytopenia= decreased WBC
drug toxicity, bone marrow failure, dietary def, autoimmune disease!!!
what does neutrophilia indicate
high neutrophils
bacterial infection
what are band cells and what do they indicate
band cells= immature neutrophils
indicate bacterial infection
ACUTE INFLAMMATION
-stimulates bone marrow to release large numbers of neutrophils
what does lymphocytosis indicate
high lymphocytes
viral infection (high lymph)
what does eosinophilia indicate
high eosinophils
allergy of PARASITIC
what does basophilia indicate
means high basophil presence
indicates hypersensitivity rxn, ANAPHYLAXIS, myeloproliferative dz
what are the following for
monocytes
t cells
b cells
monocytes= fight bacteria via phagocytosis remain in system longer
t cells= immune reaction - killer cells
b cells= humoral response, produce abs
what is an ANC
absolute neutrophil count
determines someones risk of infection (if ANC too low, they cant have surgical procedure)
platelets
small
help with blood clot
fragments of cells
thrombocytopenia
lower than normal platelets
causes: chemo, meds, DIC, hypersplenism
thrombocytosis
elevated platelets
caused: anemia, chronic myelogenous leukemia, polycythemia vera
paresthesia
burning or prickling sensation (tingling)
