Hematology Background Flashcards by Brooklynne Watkins

what values are provided in a complete blood count

RBC- total count of red blood cells

WBC- total count of white blood cells (differentials of each type of WBC if ordered)

Platelets- measure the number of platelets in the blood

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RBC

hematocrit
hemoglobin
MCH
MCHC
MCV
RDW

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WBC

neutrophils (%)
lymphocytes (%)
monocytes (%)
eosinophils (%)
basophils (%)

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hematocrit

% of red blood cells in the total blood

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hemoglobin

amount of Hgb molecules in blood, which carry O2

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MCH

average mass of Hgb inside a RBC

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MCHC

average concentration of Hgb in a RBC

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MCV

mean corpuscular volume

average size of single RBC

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RDW

red cell distribution width

calculates variation in size of RBCs

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what are RBC indices

MCH
MCHC
MCV
RDW

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what is the difference between MCH and MCHC?

MCH refers to the average mass of Hgb in a RBC, whereas MCHC refers to the average concentration of Hgb in an RBC

this difference matters because MCHC accounts for the size of the RBC (can be more accurate, shows if each RBC has the proper amount of Hgb)

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what are inclusions?

nutrients or pigments in an RBC with no activity (ex. glycogen, lipids, or pigments)

the composition and physiology of inclusions are specific to different types of inclusions

identifying the type of inclusion can help us identify diseases, disorders, or infection

mature RBCs should not have inclusions, but reticulocytes might have inclusions

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microcytosis

RBCs that are smaller than normal RBCs

identified by a low MCV

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macorcytosis

RBCs that are larger than normal RBCs

identified by a high MCV

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anisocytosis

RBCs that are unequal in size

identified by increased RDW

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poikilocytosis

an increase in abnormally shaped RBCs that make up 10% of greater of total RBCs

identified on peripheral smear

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macroovalocytes

enlarged, oval-shaped erythrocytes, commonly seen in megaloblastic anemia

identified by peripheral smear

hypochromia

RBC that has less hemoglobin than normal

less color than normal cells under a microsope

identified with decreased MCC/MCHC

hyperchromia

RBC that has more hemoglobin than normal

identified with increased MCH/MCHC

polychromasia

presentation of multicolored RBCs in blood smear

indicative of premature release or erythrocytes from bone marrow

reticulocytes still have inclusions with cause multicolor

schistocytes

RBC injury from damaged endothelium

identified by peripheral smear

think hemolytic anemia

bite cells

erythrocytes with an irregular membrane that is a result of splenic macrophage-mediated removal of denatured hemoglobin

identified with peripheral smear

sickle cells

sickle/crescent shape; can’t carry enough oxygen

identified with peripheral smear

target cells

“bullseye” appearance

increase in surface area to volume ratio

too much membrane not enough cell inside

can be seen in thalassemias

tear drop shaped cells

caused by altered bone marrow by fibrosis, granulomatous, inflammation OR can be an indication or extramedullary hematopoiesis

Howell Jolly Bodies

remnants of erythrocytes that are normally removed in the spleen only seen in patients who have had a splenectomy or asplenia type of inclusion seen in sickle cell anemia

Heinz bodies

indicative of oxidative damage to the hemoglobin in RBCs can be seen in thalassemia or G6PD deficiency type of inclusion often seen with bite cells

basophilic strippling

basophilic granules are found throughout cytoplasm indicates ribosomal fragments throughout cytoplasm and hematologic disease

pappenheimer bodies

abnormal basophilic granules of iron found inside RBCs on routine blood stains the patient has iron but cannot get the iron where it needs to go (to Hgb), which can cause sideroblastic anemia

leukoerythroblastic smear

this indicates a left shift in granulocytes and nucleated RBCs this is an abnormal finding and indicates major acute stress or bone marrow infiltration

blast cells

precursors of mature circulating blood cells can indicate leukemia if elevated when many blast cells are seen it is indicative that the bone marrow is responding rapidly to an issue

smudge cells

remnants of cells that lack identifiable cytoplasmic membranes of nuclear structures

what are reticulocytes?

immature RBCs

what are ways to measure the reticulocyte count?

absolute reticulocyte count reticulocyte percentage corrected reticulocyte count reticulocyte production index

all reticulocyte counts should be elevated with ______ to be a normal response

anemia

what is prothrombin time (PT)?

prothrombin time evaluates the time it takes for blood clotting to occur

which coagulation pathway does prothrombin time assess?

extrinsic and common pathway

what is partial thromboplastin time (PTT)

PTT evaluates time for clotting to occur

what is activated partial thrombin time (aPTT)?

measures the time for clotting to occur but a substance is added to the blood to make it clot faster

which coagulation pathways do PTT and aPTT assess?

intrinsic pathway of clotting

what is thrombin time (TT)?

thrombin time is a screening coagulation test that assess fibrin formation from fibrinogen in plasma

which coagulation pathway doe TT assess?

fibrin pathway