Hematology Lab Values

Question 1

Increased Hematocrit

Answer 1

Primary/secondary polycythemia

Congenital/acquired heart and lung disease

High altitude

Heavy smoking

Question 2

Hematocrit

Answer 2

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%

Question 3

Decreased Hematocrit

Answer 3

Anemia - iron, megaloblastic (B12), chronic disease, sickle cell

Acute/chronic blood loss

Hemolysis

Dilution

Alcohol/drugs

Question 4

MCH

Answer 4

Mean Cellular (Corpuscular) Hemoglobin

27-31 pg

Amount of hemoglobin in the average red cell

Question 5

Increased MCH

Decreased MCH

Answer 5

Increased: Macrocytosis (megaloblastic anemia, high reticulocyte count)

Decreased: Microcytosis (iron deficiency, sideroblastic anemia, thalassemia)

Question 6

MCHC

Answer 6

Mean Corpuscular Hemoglobin Concentration

33-37 g/dL

Average concentration of Hgb in a given volume of red cells

Question 7

Increased MCHC

Decreased MCHC

Answer 7

Increased: Very severe prolonged dehydration; Spherocytosis

Decreased: Iron deficiency anemia, overhydration, thalassemia, sideroblastic anemia

Question 8

MCV

Answer 8

Mean Corpuscular Volume

78-98

Average volume of rbc

Measured directly with the automated cell counter

Question 9

Normal MCV

Answer 9

Anemia of chronic disease

Acute blood loss

Primary bone marrow failure

Question 10

Increased/Macrocytosis MCV

Answer 10

Megaloblastic anemia (B12/folate)

Macrocytic normoblastic anemia

Anemia of chronic disease

Question 11

Decreased/microcytosis MCV

Answer 11

Iron deficiency

Thalassemia

Polycythemia

Question 12

RDW

Answer 12

Red Cell Distribution Width

11.5-14.5%

Measure of the degree of anisocytosis (variation of rbc size)

Determined with an automatic counter

Question 13

Increased RDW

Answer 13

Many anemia types - iron, pernicious, folate, thalassemia

Liver disease

Question 14

Basophilic Stippling DDx

Answer 14

Lead or heavy metal poisoning

Thalassemia

Severe anemia

Question 15

Burr Cells (Acanthocytes)

Answer 15

Severe liver disease

High levels of bile, fatty acids, or toxins

Question 16

Heinz Bodies

Howell-Jolly Bodies

Sickling

Answer 16

Heinz Bodies: Drug-induced hemolysis

Howell-Jolly Bodies: Asplenia

Sickling: sickle cell anemia

Question 17

Helmet Cells

Answer 17

Microangiopathic hemolysis (TTP/HUS/HELLP)

Hemolytic transfusion reaction

Transplant rejection

Question 18

Nucleated RBCs

Answer 18

Severe bone marrow stress

Marrow replacement by tumor

Extramedullary hematopoiesis

Question 19

Polychromasia

Answer 19

Bluish red cell on routine Wright stain

Suggests reticulocytes

Question 20

Schistocytes DDx

Answer 20

DIC

Microangiopathic anemia

Severe burns

Drug effect

Question 21

Spherocytes DDx

Answer 21

Hereditary spherocytosis

Immune hemolysis

Severe burns

ABO transfusion reaction

Question 22

Target Cells (Leptocytes)

Answer 22

Thalassemia

Hemoglobinopathies

Liver disease

Any hypochromic anemia

Splenectomy aftermath

Question 23

WBC Morphology Abnormalities

Answer 23

Auer Rods: AML

Dohle Inclusion Bodies: Severe infection, burns, malignancy, pregnancy

Hypersegmentation: Megaloblastic anemia

Toxic Granulation: Severe illness (sepsis, burn, high fever)