Hematopoiesis Lab Assessment

Question 1

Components of CBC

Answer 1

• RBC
• Hgb
• Hct
• Red cell indices: MCV, MCH, MCHC, RDW

*RDW- distribution width, this is high when there are many different shapes and sizes of cells.

• WBC
• Platelets
• these two are part of CBC, just not center of study at this point.

Question 2

Labs to evaluate RBC’s and erythropoiesis

Answer 2

CBC
Morphology
Reticulocyte count
Bone marrow 
EPO level
aspiration/biopsy

Question 3

Macrocytic anemia is what type of deficiency?

Microcytic?

Answer 3

• Macro: folic acid and B12 deficiency

- Micro: iron deficiency

Question 4

When might RBC count be decreased?

Increased?

Answer 4

-anemia: hemorrhage, sickle cell, dietary deficiency ex. iron, b12

Increased:

• higher altitudes
• diarhhea, burns, dehydration (false erythrocytosis, youre losing volume not cells.)
• pregnancy (volume overload)

Question 5

What does Hgb measure?

Answer 5

• conc. of hgb in anticoagulated whole blood
• amount of O2 carrying proetin in blood

*reflects the number or RBC

Question 6

When might hgb decrease?

Increase?

Answer 6

• anemia
• hemorrhage
• nutritional deficiency
• renal disease
• cancer
• pregnancy
• medications (Abx, ASA, sulfonamides)

Increase:

• polycythemia vera
• COPD
• CHF
• High altitudes
• Severe Burns
• Dehydration

Question 7

What is Hematocrit?

Answer 7

• packed cell volume (%)

* % of the blood that is RBC

Question 8

When might Hct decrease?

Increase?

Answer 8

• anemia
• hemorrhage
• dietary deficiency
• bone marrow failure
• pregnancy
• malnutrition
• leukemia
• cirrhosis
• hyperthyroidism

Increases:

• congenital heart disease
• polycythemia vera
• dehydration
• erythrocytosis
• eclampsia
• burns
• COPD

Question 9

What is MCV and what are the indices?

Answer 9

mean cell volume- measures average volume or size of single RBC
*useful in classification of anemias

• normocytic 80-97fL
• microcytic 97 fL

Question 10

What is MCH and what are the indices?

Answer 10

Mean cell hgb: measurement of avg. weight of hgb within a RBC

*b/c macro/microcytic cells have more/less hgb, MCH values closely resemble those for the MCV value.

Normal value- 27-32pg

Question 11

What is MCHC and what are the indices?

Answer 11

Mean cell hgb conc: avg conc or % of Hgb within a single RBC.
*the amount of hgb relative to the size of the cell per red blood cell.

• normochromic
• hypochromic
• color of RBC

Question 12

What disease states might a patient have hypochromic RBC?

Normcytic & normochromic?

Answer 12

Hypo= iron deficiency anemia, thalassemis

Normocytic & normochromic= hemolytic anemia

Question 13

What is RDW?

Answer 13

an indication of the variation in RBC size

*RDW will be high when all the cells are different sizes and shapes

Question 14

What is anisocytosis? What conditions may cause this?

Answer 14

a blood condition characterized by RBCs of unequal size.

• Iron deficiency anemia
• B12 or Folate deficiency anemia
• Sickle Cell disease
• hemolytic anemia
• post-hemorrhagic anemias

Question 15

What is poikilocytosis?

Answer 15

abnormally shaped RBC variation

Question 16

Applications of Reticulocyte counts?

Answer 16

• evaluate pathophys of anemia
• gives indication of RBC production by the bone marrow

*if reticulocytes are high you can rule out the anemia being caused by a bone marrow problem.

Question 17

How long does it take for RBC to mature? How long do they circulate?

Answer 17

• 1 week for RBC to mature from stem cell to RBC
• 24hr for reticulocyte to become RBC
• circulate 120days

*bigger on blood smear

Question 18

What are bone marrow biopsies useful for?

Answer 18

• evaluation of hematopoiesis, it reveals the number, size, and shape of the RBC’s, WBC, and megakaryocytes (plateletts) as they evolve in the bone marrow.
• do biopsy when you know its a bone marrow problem based upon labs, but you dont know which kind.