Hematology Flashcards
Normal platelet count:
150,000-300,000
Platelet count increased in:
Active bleeding
Post-splenectomy
Myeloproloferative diseases (slow growing blood cancers in which the bone marrow makes too many abnormal rbcs)
Platelet count decreased in:
DIC, TTP, HIT, ITP, drugs
EDTA- dependent agglutination
PT/INR normal:
11-14 s
What does the PT/iNR evaluate?
Extrinsic and common pathways
What is the PT/INR most sensitive to?
Vitamin-K dependent clotting factors 2, 7, 9, 10
PT/INR is used to monitor:
Coumadin
What is the PT/INT elevated in?
Liver disease Coumadin therapy DIC Hereditary factor deficiencies in 10, 5, 7, and 1 Massive blood transfusions
What is the normal PTT?
26-34 s
What does the PTT evaluate and what is it used to monitor?
Evaluates then intrinsic and common clotting pathways
Used to monitor heparin therapy
PTT is increased in:
Deficiency in specific coagulation factors in the intrinsic pathway except for factor 13
DIC
Nonspecific inhibitor (lupus anticoagulant)
Heparin, Coumadin, and direct thrombin inhibitors
Normal fibrinogen?
150-400 mg/dL
Fibrinogen increased in:
Inflammatory states
Pregnancy
Smoking
Fibrinogen decreased in:
Liver disease
DIC
Hereditary dysfibrinogenemia
D-diner normal?
Less than 500
What does the d-dimer represent?
Represents fibrin degradation of a blood clot after fibrinolysis.
D-dimer is elevated in:
DVT, DIC, PE, malignancy
WBC normal?
4-10000
RBC normal?
3.5-5 million/mm3
HGB normal:
12-17 grams
HCT normal?
36-52%
MCV normal?
82-94 fL
MCH normal?
27-31 ph
MCHC normal?
32-35%
RDW normal?
10-12.5%
RBCs elevated in:
Dehydration
Bone marrow disorders (p. Vera)
RBCs decreased in
Anemia’s
Hemolysis
Hemoglobinopathies
MCV is the:
Size of the WBC
Less than 80- microcytic
80-100 normocytic
Over 100- macrocytic
What is MCH?
Hemoglobin content of RBC. Gives it color
What is MCHC?
A measure of the average color of the RBCs.
MCHC is decreased in:
Iron def anemia and thalassemia (hypochromic)
Normal in macrocytic anemia’s
What is RDW?
A measure of the variability of the size of the RBCs.
Elevated in iron def anemia
What is anisocytosis?
Variable size of RBCs
What is poikilocytosis?
RBCs abnormal with variable shapes. Seen in severe iron deficiency anemia
WBCs consist of what and in order of most to least:
Neutrophils 55-70% Lymphocytes 30-35% Monocytes 1-10% Eosinophils 2-5% Basophils 0-1%
Immature WBCs increased in:
Trauma
Leukemias
Immature WBCs decreased in:
Viral infections
Autoimmune disorders (SLE)
Bone marrow disorders (aplastic anemia)
H/H elevated in:
P. Vera Dehydration Burns High altitudes Smoking / COPD
H/H decreased in:
Anemia’s Bleeding Hemoglobinopathies DIC Other bone marrow disorders
What is TIBC?
Total-iron bonding capacity- a measure of available transferrin that is left inbound to iron.
When is TIBC elevated?
If there is not enough iron to transport, as seen in iron- def anemia.
When iron count is low
Iron levels elevated in:
Hemochromatosis
Multiple transfusions
Lead poisoning
Hemolytic anemia
Iron level decreased in:
Iron def Nephrotic syndrome Hypothyroidism Anemia of chronic disease Chronic renal failure Infections
What is HP?
Haptoglobin is synthesized by the liver and is a transport glycoproteins which serves as a carrier for free hemoglobin.
When is HP decreased?
In: Hemolytic anemias TTP Drugs (methyldopa) Artificial heart valves
MMA is elevated in?
B12 deficiency
MMA is only accurate if:
Renal function is normal
Vitamin B12 is decreased in:
Pernicious anemia
Vegans
IBS
Gastrectomy patients
Low values of vitamin B12 indicates?
Macrocytic anemia
Folic avid decreased in:
Malnutrition
Excessive uptake (pregnancy)
Hemolytic anemia
Acute leukemia’s
What is direct Coombs?
Detects antigen-antibody complexes on the RBC. Positive in hemolytic anemia.
Normal sodium?
135-145
Sodium level increased in:
Hyperaldosteronism
Dehydration
Inadequate water intake
CKD
Sodium decreased in:
Adrenal insufficiency Excess free water SIADH Hyperglycemia Volume overload Drugs (NSAIDs, diuretics, SSRIs)
Na and hyperglycemia know:
Na falls 1.6 for every 100mg/dL increase of glucose over 100
Corrected sodium = measured Na + [1.6(glucose-100)/100]
Microcytic anemia’s:
Iron def anemia
Thalassemia
Iron def anemia is:
Microcytic and hypochromic
Anemia of chronic kidney disease is:
Hypoproliferative, normocytic, normochromic
Macrocytic anemias?
Vitamin B12 and folate