Hematology Lab Values Flashcards
Increased Hematocrit
Primary/secondary polycythemia
Congenital/acquired heart and lung disease
High altitude
Heavy smoking
Hematocrit
Calculated from MCV and red cell number
Percentage volume of red cells in a given volume of blood
Men normals: 40-54%
Women normals: 37-47%
Decreased Hematocrit
Anemia - iron, megaloblastic (B12), chronic disease, sickle cell
Acute/chronic blood loss
Hemolysis
Dilution
Alcohol/drugs
MCH
Mean Cellular (Corpuscular) Hemoglobin
27-31 pg
Amount of hemoglobin in the average red cell
Increased MCH
Decreased MCH
Increased: Macrocytosis (megaloblastic anemia, high reticulocyte count)
Decreased: Microcytosis (iron deficiency, sideroblastic anemia, thalassemia)
MCHC
Mean Corpuscular Hemoglobin Concentration
33-37 g/dL
Average concentration of Hgb in a given volume of red cells
Increased MCHC
Decreased MCHC
Increased: Very severe prolonged dehydration; Spherocytosis
Decreased: Iron deficiency anemia, overhydration, thalassemia, sideroblastic anemia
MCV
Mean Corpuscular Volume
78-98
Average volume of rbc
Measured directly with the automated cell counter
Normal MCV
Anemia of chronic disease
Acute blood loss
Primary bone marrow failure
Increased/Macrocytosis MCV
Megaloblastic anemia (B12/folate)
Macrocytic normoblastic anemia
Anemia of chronic disease
Decreased/microcytosis MCV
Iron deficiency
Thalassemia
Polycythemia
RDW
Red Cell Distribution Width
11.5-14.5%
Measure of the degree of anisocytosis (variation of rbc size)
Determined with an automatic counter
Increased RDW
Many anemia types - iron, pernicious, folate, thalassemia
Liver disease
Basophilic Stippling DDx
Lead or heavy metal poisoning
Thalassemia
Severe anemia
Burr Cells (Acanthocytes)
Severe liver disease
High levels of bile, fatty acids, or toxins
Heinz Bodies
Howell-Jolly Bodies
Sickling
Heinz Bodies: Drug-induced hemolysis
Howell-Jolly Bodies: Asplenia
Sickling: sickle cell anemia
Helmet Cells
Microangiopathic hemolysis (TTP/HUS/HELLP)
Hemolytic transfusion reaction
Transplant rejection
Nucleated RBCs
Severe bone marrow stress
Marrow replacement by tumor
Extramedullary hematopoiesis
Polychromasia
Bluish red cell on routine Wright stain
Suggests reticulocytes
Schistocytes DDx
DIC
Microangiopathic anemia
Severe burns
Drug effect
Spherocytes DDx
Hereditary spherocytosis
Immune hemolysis
Severe burns
ABO transfusion reaction
Target Cells (Leptocytes)
Thalassemia
Hemoglobinopathies
Liver disease
Any hypochromic anemia
Splenectomy aftermath
WBC Morphology Abnormalities
Auer Rods: AML
Dohle Inclusion Bodies: Severe infection, burns, malignancy, pregnancy
Hypersegmentation: Megaloblastic anemia
Toxic Granulation: Severe illness (sepsis, burn, high fever)
