Hematology (CBC, bone marrow, reticulocyte, ESR, flow cytometry, anemia, coagulation) Flashcards
What is the type of blood drawn for a CBC?
Venous blood
What tube top is used for a CBC? What does it contain?
Lavender. Contains EDTA to prevent coagulation.
What is the threshold for obtaining a CBC?
Very low. Anything from fever to fatigue.
What are the four tests on the CBC fishbone?
WBC, Hgb, Hct, Plts (Left, top, bottom, right)
Hct is how many times Hgb?
3 times
What is MCV?
Mean Corpusular Volume. Size of RBC.
What is MCH?
Mean Corpusular Hemoglobin. Average Hgb in a RBC. Relates to color.
What is MCHC?
Mean Corpuscular Hemoglobin Concentration. Mean content of total Hgb. Relates to color.
What is RDW?
Red Cell Distribution Width. Variation in size of RBCs.
What is MPV?
Mean Platelet Volume. Average volume (size) of platelets.
Normal Hgb range in male and females?
Male=14-18. Female=12-16
Normal Hct range in males and females?
Male=42-40%. Female=36-44%
Normal RBC range in males and females?
Males=4.5-5.9 E6; Females=4.0-5.1 E6 µL
Why do women how lower average blood indicies than men?
Menstural cycles
What is the MVC range for both men and women? (Hint: Same in both)
80-100 fL
Normal RBC value? (for our exam)
4.0 - 5.5 E6/µL
Normal Hemoglobin Hgb range? (for our exam)
12-15 g/dL
Normal Hct % value? (for our exam)
36-45%
Normal WBC range? (for our exam)
5000 to 10,000/µL
Normal Platelet (Plts) range? (for our exam)
150,000 to 400,000/µL
What are the five WBCs on a CBC differential?
Neutrophils, Lymphocytes, Monocytes, Eosinophils, Bananas
What is the saying to remember the five types of WBCs and the order they are found in?
Never Let Monkeys Eat Bananas (Neutrophils, Lymphocytes, Monocytes, Eosinophils, Basophils).
What is the normal Neutrophil percent and absolute value range? (Don’t need to memorize for test.)
54-62%, 2500-7500
What is the normal Lymphocyte percent and absolute value range? (Don’t need to memorize for test.)
25-33%, 1500-3500
What is the normal Monocyte percent and absolute value range? (Don’t need to memorize for test.)
3-7%, 200-800
What is the normal Eosinphil percent and absolute value range? (Don’t need to memorize for test.)
1-3%, 60-600
What is the normal Basophil percent and absolute value range? (Don’t need to memorize for test.)
Less than 1%, less than 100
What is the range for Mild Neutropenia? (Need to know for test!)
ANC greater than 1000 and less than 1500
What is the range for Moderate Neutropenia? (Need to know for test!)
ANC greater than 500, less than 1000
What is the value for Severe Neutropenia? (Need to know for test!)
Less than 500. Requires reverse precaution to protect them from the world like a helicopter parent.
Neutrophils relate to what type of infection?
Bacterial
What does Normocytic mean for erythrocyte cell size?
6-9 µm
Define Anisocytosis of erythrocytes
Variation in cell size
What is a Microcytic erythrocyte?
Erythrocyte cell smaller than 5µm
What is a Macrocytic erythrocyte?
Erythrocyte larger than 10µm
What is the cytic cell size test and values?
MCV (80-100)
What are the chromic color tests and values?
Normochromic MCH (27-34) and MCHC (33-35)
What does CBC stand for?
Complete Blood Count
What are the four terms to describe hemoglobin color?
Normochromic (normal), Anisochromic (variation in color), Hypochromic (decreased color), Hyperchromic (increased color)
Target RBCs are seen in _____ while fragments of RBCs are seem when a patient has a ____
Targets in alcoholics; artificial valve shearing RBCs
When does an RBC have a nucleus and when doesn’t it?
Has nucleus while in bone marrow, not in peripheral circulation
What is one reason to order a CBC with manual diff?
Malaria. Need to count cells very carefully.
RBC 3.3, Hgb 9, Hct 27, MCH 22.6, MCHC 31.4, MCV 69.7, WBC 4.5
Microcytic Hypochromic Anemia. Microcytic as MCV 69.7 is microcytic (80-100), Hypochromic as MCH 22.5 (27-34) and MCHC 31.4 (33-35), RBC is anemic 3.3 (4-5.5).
RBC 2.9, Hgb 10.6, Hct 31.6, MCH 35.0, MCHC 33.7, MCV 117.6, WBC 3.5
Macrocytic Normochromic Anemia. Macrocytic as MCV 117.6 (80-100), Normochromic as MCH 35.0 (27-34) and MCHC 33.7 (33-35), Anemic as RBC 2.9 (4-5.5)
RBC 2.9, Hgb 9.2, Hct 27.8, MCH 28.0, MCHC 34.7, MCV 87.6, WBC 4.5
Normochromic Normocytic Anemia. Normochromic MCH 28.0 (27-34) and MCHC 34.7 (33-35), Normocytic MCV 87.6 (80-100), Anemic as RBC 2.9 (4-5.5).
RBC 2.9, Hgb 9.2, Hct 27.8, MCH 28.0, MCHC 34.7, MCV 87.6, WBC 3.1, Plts 88
Pancytopenia, low WBC, low RBC, low Ptl.
RBC 4.5, Hgb 14.0, Hct 42.2, MCH 29.6, MCHC 34.8, MCV 90.2, WBC 16.5 Neutrophils 75%, Lymphocytes 19%, Monocytes 5%, Eosinophils 1%, Basophils 0%
Neutrophil line is elevated. Bacterial infection.
RBC 4.5, Hgb 14.0, Hct 42.2, MCH 29.6, MCHC 34.8, MCV 90.2, WBC 13.1, Neutrophils 53%, Lymphocytes 38%, Monocytes 7%, Eosinophils 2%, Basophils 0%
WBC is high. Diff is elevated. Lymphocytes are elevated=viral
RBC 4.5, Hgb 14.0, Hct 42.2, MCH 29.6, MCHC 34.8, MCV 90.2, WBC 13.1, Neutrophils 53%, Lymphocytes 25%, Monocytes 7%, Eosinophils 15%, Basophils 0%
Increased Eosinophil. Parasitic or allergic.
What might the CBC of a dehydrated PT look like?
Decrease plasma. Falsely elevated RBC and H&H.
What would the CBC look like in a PT who was dehydrated but received IV fluids?
Normalize and drop in RBC and H&H back to normal.
What three values are low in Pancytopenia?
Low RBC, low WBC, low Ptl. Consider a bone marrow test.
What does a CBC evaluate?
Blood Cells in body (RBCs, WBCs)
What is a major reason to do a bone marrow biopsy?
Pancytopenia (low WBC, low RBC, low Ptl)
What are two absolute contradictions for a bone marrow biopsy?
Hemophilia, severe DIC
What is most common site for bone marrow aspiration?
Posterior Superior Iliac Crest (PSIC)
What is a “Dry Tap” in bone marrow aspiration?
No sample obtained
What is the Buffy Coat?
White blood cells
What is a Reticulocyte?
Immature RBC still has nucleus
What is the normal Reticulocyte Index Range? (Know for exam!)
2.0-3.0
What can RPI compensate for?
Anemia
What is an ESR test stand for?
Erythrocyte Sedimentation Rate
What does ESR measure?
Inflammation
Is ESR specific or non-specific?
Non-specific. Doesn’t tell you what is causing inflammation, only that inflammation is present.
What color top for ESR?
Purple
How is ESR measured?
In Purple Top and count number of RBCs that settle after 1 hour
What does Hemoglobin Electrophoresis use to check Hgb and what disease is it good at diagnosing?
Electric current that has proteins travel and settle into bands. Can check globin chains. Good for sickle cell disease and similar.