Hematology Flashcards
normal platelets
150,000-450,000
Hgb males
14-18
Hgb females
12-16
What is hematocrit
proportion of RBCs in 1 mL of plasma
Hct males
42-52%
Hct females
37-47%
MCV
80-100
MCHC
31-37
MCH
25-35
TIBC
250-410
Serum ferritin
20-400
What is serum ferritin
storage form of iron
-most sensitive test for IDA
Serum iron
50-175
RDW
<15
Reticulocytes
0.5-2.5%
Poikilocytosis
seen with severe IDA
abnormal and variable shapes
anisocytosis
variable sizes of RBC
seen with IDA
normal folate
3.1-7.5
normal B12
> 250
normal WBC
5-10
Gold standard to diagnose hemoglobinopathies
hemoglobin electrophoresis
Secondary polycythemia can result from
- chronic smokers
- long-term COPD
- long-term residency in high altitudes
- EPO treatment
Most common anemia
IDA
IDA symptoms
- fatigue
- exertional dyspnea
- glossitis
- angular chelitis
- pica
Severe IDA symptoms
- koilonychia
- systolic murmur
- tachycardia
- heart failure
IDA labs
- low ferritin
- low serum iron
- high TIBC
- high RDW
- MCV <80
- MCH <25
Medication for IDA
- ferrous sulfate 325 mg PO TID between meals
- take with vitamin C
- treat for 3-6 months to increase ferritin stores
Ferrous sulfate interactions
-avoid antacids, dairy, quinolones, tetracyclines
How much elemental iron needed for replacement
150-200 mg/day
When to recheck hemoglobin with iron replacement therapy
1 month
What is thalassemia
- genetic disorder
- BM produces abnormal hgb
Ethnic groups at risk for thalassemia
- Mediterranean
- North African
- Middle Eastern
- Southeast Asian
Gold standard for thalassemia diagnosis
Hgb electrophoresis
Thalassemia labs
- normal iron panel
- microcytic, hypochromic
- aniscocytosis, poikilocytosis
Thalassemia treatment
- genetic counseling
- minor trait does not need treatment
If patient took an antacid, how long to wait before taking iron
4 hours
Gold standard for aplastic anemia
BM biopsy
What is aplastic anemia
-BM production slows or stops all the cells
pancytopenic
Anemia of chronic disease labs
- normocytic
- normochromic
- underlying chronic disease
What is vitamin B12 essential for
- neuron and brain health
- normal DNA production of RBC
- neurologic damage may be irreversible
Pernicious anemia
autoimmune disorder
destruction of parietal cells in fundus
results in B12 deficiency anemia
Vitamin B12 deficiency presentation
- older female
- gradual onset of paresthesias on feet or hands
- pallor
- pale conjunctiva
- glossitis
- difficulty walking
Vitamin B12 aka
cobalamin
Urine test for vitamin B12
24-hour urine for methylmalonic acid (MMA) elevated
Vitamin B12 deficiency labs
- macrocytic, hyperchromic
- decreased B12 levels
- homocysteine level: elevated
- antibody tests: antiparietal and anti-intrinsic factor antibody (test for pernicious anemia)
Vitamin B12 deficiency treatment
-lifetime supplement of B12
every day for 1 week IM
then weekly for 1 month
then monthly for life
Vitamin B12 deficiency peripheral smear results
- macroovalocytes
- hypersegemented neutrophils (>5)
Folate aka
Vitamin B9
When should neuro improvements be seen with vitamin B12 def
5-10 days
How long should folic acid deficiency be treated
1-4 months until hematologic recovery
Sickle cell anemia is autosomal ___
recessive
Diagnostic test for sickle cell anemia
Hgb electrophoresis
S/sx of sickle cell anemia
- ischemic necrosis
- renal or liver dysfunction
- priapism
- hemolytic episodes
- hyposplenism
- frequent infections
Sickle cell anemia treatment
- refer to heme
- genetic counseling
Thrombocytopenia treatment
- refer to heme
- prednisone for 4-6 weeks
- minimal bruising activities
- avoid ASA
Leukocytes are also called
segs or polys
When polys and lymphs are widely different consider
bacterial
If polys and lymphs are close in number, consider
viral
Which vitamin needs to be supplemented with a vegan diet
Vitamin B12
obtained through animal products
What is transferrin
measurement of the protein that binds iron to blood
What labs would be effected by taking iron supplement
serum iron
TIBC
transferrin
What is ferritin
iron storage protein
Gold standard for diagnosing IDA
absence of storage iron on BM stains
-ferritin levels drop
sickle cell crisis
- sudden severe pain
- tachypneic
- ulcers
- infection
Most common allergy in adults
crustaceans
Which form of iron is soluble
ferrous sulfate
Where does iron absorption occur
duodenum and proximal jejunum
Hemophilia is what kind of genetic disorder
X-linked recessive
Which age range is at greatest risk for IDA
toddler: 12-36 months
Which bleeding disorder is most common
von Willebrand disease
alpha thalassemia is more common in
-Asians like Chinese and Filipinos
beta thalassemia is more common in
- Mediterrnean
- Greece and Italy
Multiple Myeloma is a cancer of what cells
plasma cells
