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Clin Lab Medicine > Hematology I > Flashcards

Hematology I Flashcards

1
Q

RBC

A

most numerous blood cell, approx 4.5 trillion per liter of adult blood, predominately hemoglobin, lifespan on 120 days, produced in bone marrow and destroyed in spleen

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2
Q

Normal RBC’s have a ______ shape

A

concave

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3
Q

Early RBC’s are formed from ___________

A

bone marrow stem cells

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4
Q

hemoglobin

A

protein that carries oxygen, comprises about 95% of RBC, size and color of RBC is directly proportional to amount of hemoglobin, composed of iron and protein chains

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5
Q

Can RBC’s replicate?

A

no

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6
Q

What is the lifespan of an RBC?

A

120 days

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7
Q

How do RBC’s interact with the spleen?

A

they are trapped and destroyed here. Due to RBC’s losing enzymes and surface membranes

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8
Q

How is hemoglobin broken down?

A

into heme and protein

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9
Q

How is heme broken down?

A

free iron and bilirubin

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10
Q

anemia

A

deficiency of RBC’s

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11
Q

How can severe anemia be clinically tested for?

A

pallor or pale appearance

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12
Q

What is the only way to test the severity of an anemia?

A

lab test

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13
Q

polycythemia

A

increase in RBC’s

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14
Q

CBC

A

complete blood count, most common test to evaluate blood cells, gives RBC, WBC, platelets, size and shape, lavender blue top with anticoagulant

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15
Q

What is the difference btwn a CBC and a CBC-diff?

A

a CBC-diff gives the the subset breakdown of the WBC composition by cell type

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16
Q

What is the purpose of the anticoagulant in the CBC tube?

A

it combats the clotting nature of the platelets

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17
Q

What are the 3 ways that a CBC can provide poor results?

A
  1. ) failure to mix tube with anticoagulant, tube clots
  2. ) inadequate filling of tube, anticoagulant dilutes sample, falsely low results
  3. ) possible increase RBC concentration from overexposure to tourniquet or standing
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18
Q

average RBC count X average cell size

A

MCV (mean cell volume)

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19
Q

hemoglobin in CBC

A

gold standard of CBC, measured on ability to absorb light

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20
Q

RBC count

A

cells counted by laser beam as they pass through a sizing chamber, also determines size of cells

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21
Q

RBC indicies

A

most useful way of determining RBC size and hemoglobin content, also called a MCV

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22
Q

hemocrat in %
____________
RBC content in millions per uL

A

MCV

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23
Q

What two tests rarely provide additional information to the MCV?

A
  1. ) MCH

2. ) MCHC

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24
Q

RDW

A

standard deviation on the MCV, measures uniformity in size of RBC, normal RDW often excludes iron deficiency, high RDW has a huge differential diagnosis

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25
Q

As EPO increases, so should _______

A

production of new RBC’s

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26
Q

reticulocyte count

A

most reliable measure of rate of RBC production, reported as percentage of total RBCs, highlights immature RBCs

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27
Q

What should be the response to anemia?

A

normal bone marrow increases RBC production, therefore increasing reticulocyte count

28
Q

peripheral blood smear

A

used when etiology of anemia is unclear, not a direct diagnosis of disorders, guides further testing

29
Q

bone marrow examination

A

bone marrow and aspirate and biopsy is end all and be all test, can confirm diagnoses, done in pelvic crest, biopsy is performed simultaneously, patient not sedated

30
Q

iron deficiency

A

most common cause of microcytic anemia, occurs in 8% of children and menstruating women

31
Q

iron tests measure both ________ and ___________

A

deficiency and overload

32
Q

hemachromocytosis

A

iron overload

33
Q

serum iron

A

measures iron that is bound to transferrin, provides indirect measure of rate of delivery to tissues, iron levels are up to 40% higher in morning than later in day, affected by menstrual bleeding

34
Q

Should a patient take a iron containing medication on the morning of the blood draw?

A

no

35
Q

serum levels can be low in ___, ____,and ____

A

acute inflammation
liver disease
nephritic syndrome

36
Q

[transferrin]

A

iron transporting protein, measured directly or estimated using TIBC (total iron binding capacity), production is inversely related to body stores

37
Q

low body stores of transferrin =

A

high transferrin

38
Q

high body stores of transferrin =

A

low transferrin

39
Q

How can you estimate the [transferrin]?

A

use a TIBC (total iron binding capacity)

40
Q

serum ferritin

A

iron protein complex containing 23% iron, directly related to total iron stores, good marker for iron deficiency, widely distributed in the tissues

41
Q

high body stores of ferritin =

A

high ferritin

42
Q

low body stores of ferritin =

A

low ferritin

43
Q

What can tissue damage falsely elevate?

A

serum ferritin levels

44
Q

anemia

A

decrease in the amount of hemoglobin, most patients experience a decrease in [RBC] upon hospital admittance due to fluid moving into vessels, most common RBC disorder

45
Q

What are the 2 mechanisms of anemia?

A
  1. ) decreased RBC production
  2. ) decreased RBC survival

*careful balance between RBC production and survival

46
Q

microcytic anemia

A

decreased RBC size indicates defective synthesis of hemoglobin, associated with hypochromia, caused by iron deficiency and thalassemia, lead toxicity in young children

47
Q

iron deficiency

A

most common cause of anemia, results from decreased iron intake or increased loss of iron due to chronic blood loss, early deficiency depletes bone marrow and cellular iron stores, serum ferratin levels drop, best test for Fe deficiency in normal adults is ferratin

48
Q

thalassemia

A

2nd most common reason for microcytic anemia, inherited defect in the genes controlling globin chain synthesis, common in SE Asians and Africans, both alpha and beta, produces very small RBC’s

49
Q

alpha thalassemia

A

disorder common in persons of African ancestry, less O2 delivery to tissues, deficiency causes deletion of hemoglobin S chains

50
Q

beta thalassemia

A

deletion or reduction in the beta chain, produces decreased hemoglobin synthesis and microcytosis, hemoglobin A chains affected

51
Q

lead poisoning

A

usually seen in children, zinc almost always increased in anemia due to lead poisoning, zinc : 1/lead

52
Q

macrocytic anemia

A

commonly due to B12, folate deficiency, or myelodysplastic disorder, large cells, high MVC with or without anemia often present with alcohol abuse or liver disease

53
Q

anemia in renal failure

A

defective production of EPO, degree of underproduction directly related to progression of disease, end stage renal disease/failure will produce virtually no EPO

54
Q

synthetic EPO is available, however there is a high risk for _________

A

cancer

55
Q

anemia of chronic disease

A

pathogenesis unknown, bone marrow resistant to EPO, serum ferratin is low or increased

56
Q

bone marrow replacement

A

large percentage of bone marrow is replaced by abnormal cells, bone marrow biopsy needed for diagnosis, due to malignancies

57
Q

aplastic anemia

A

failure of bone marrow due to decreased production, accompanied by low WBC and platelets, causes include cancer, chemotherapy, medications, virus

58
Q

normocytic anemia due to hemolysis

A

10% anemia due to decreased RBC survival, MCV normal or slightly increased, intrinsic or extrinsic, body kills RBC’s

59
Q

hemoglobinopathies

A

RBC’s under stress, sickle due to environment or illness, 1 out of 500 African persons, mutation in beta chain

60
Q

glucose 6 phosphate dehydrogenase deficiency

A

causes hemolysis of RBC when exposed to infection or oxidant drugs

61
Q

autoimmune hemolytic anemia

A

part of autoimmune diseases such as lupus, can also be due to drugs that attach to RBC membranes, for antibody against self, antibody + RBC = destroyed by spleen

62
Q

hemolytic disease of the newborn

A

mom produces antiobodies, attack RBC’s of baby

63
Q

polycythemia

A

increase in RBC mass over normal, increased hemoglobin or hematocrit, less common than anemia

64
Q

secondary polycythemia

A

increased RBC production due to overproduction of EPO, causes renal cell carcinoma, renal cysts

65
Q

polycythemia vera

A

EPO levels usually decreased, inappropriate overproduction of RBC’s, RBC up, WBC up, platelet up, spleen is overworked, platelets usually increased along with WBC’s

Clin Lab Medicine (3 decks)

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