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Org Path Exam 2 > Heme II--blood count > Flashcards

Heme II--blood count Flashcards

1
Q

What does the CBC provide data on?

A

Red blood cells: number, size, hemoglobin content
White blood cells: total count, number and percentage for each type
Platelets: number, size

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2
Q

What are the platelet associated parameters for a CBC?

A

PLT – Platelet Count

MPV – Mean Platelet Volume

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3
Q

What is the normal RBC morphology? Size? Eoso or basiphillic? shape?

A

Circular biconcave disc-shaped
Lack of nuclei
Eosinophilic cytoplasm
Central area of pallor

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4
Q

How do we obtain the RBC count? What are the terms for abnormal RBC count?

A

Obtained using the Coulter principle
Abnormal values:
Anemia: decreased due to blood loss, peripheral destruction, or insufficient erythropoiesis in the marrow
Erythrocytosis/Polycythemia: increased due to reactive changes (smoking, renal cell carcinoma), thalassemia, or primary marrow neoplasm (polycythemia vera)

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5
Q

How do we obtain the hemoglobin concentration (HGB)? what are terms for abnormal levels?

A

-Determined spectrophotometrically after conversion to cyanmethemoglobin
Abnormal values:
Anemia
Erythrocytosis/Polycythemia

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6
Q

What is hematocrit (HCT) and how do we obtain the levels?

A

-Volume of red blood cells in whole blood
-Obtained directly or by calculation (HCT = RBC × MCV)
-Rule of thumb: HCT = ~ 3 × HGB
Abnormal values:
Decreased due to anemia or fluid overload
Increased due to erythrocytosis/polycythemia or dehydration

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7
Q

What is MCV?

A

MCV = Mean Corpuscular Volume (80-100fl)
Mean size of red blood cells
Determined directly using the Coulter principle or manually (MCV = HCT/RBC)
Abnormal values
Low MCV: microcytosis, iron deficiency anemia or thalassemia
High MCV: macrocytosis, megaloblastic anemia

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8
Q

How do we classify anemia in regards to MCV?

A

microcytic (MCV100)

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9
Q

What is MCH?

A

Mean Cell Hemoglobin
Mean quantity of hemoglobin in a single red cell
Parallels MCV: MCV goes up or down, MCH goes up or down
Calculated from directly determined HGB and RBC:
MCH = HGB / RBC
Abnormal values
Low MCH: hypochromatic, iron deficiency anemia
High MCH: hyperchromatic, megaloblastic anemia

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10
Q

What is MCHC?

A
  • Mean Cell Hemoglobin Concentration
    -Average concentration of hemoglobin in a single red cell or “concentration of hemoglobin in packed red cells”
    -Calculated from the directly determined HGB and the indirectly determined HCT: MCHC = HGB / HCT = MCH / MCV
    Abnormal values:
    Decreased in moderate to severe microcytic anemia
    Increased in hereditary spherocytosis
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11
Q

What is RDW?

A
  • Red Cell Distribution Width
  • Measure of the variability in size of red cells
  • The wider the red cell histogram, the higher the RDW
  • Increased in anemia and disease with RBC destruction (i.e. schistocytosis)
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12
Q

What causes neutropenia?

A

-this is a decreased neutrophil count
Infections: Gram-negative septicemia, typhoid and paratyphoid fevers, CMV, HIV, EBV, HCV, measles, HIV
-Drugs, medication, ionizing radiation
-Marrow diseases: leukemia, myelodysplastic syndromes, aplastic anemia
-Bone marrow infiltration by tumors
-Autoimmune disease: immune neutropenia, SLE, rheumatoid arthritis
-Congenital: cyclical neutropenia, familial benign chronic neutropenia, severe congenital neutropenia, congenital aleukia

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13
Q

What causes neutrophilic?

A
  • increased neutrophil count
  • Physiologic: neonates, exercise, emotion, pregnancy, parturition, lactation
  • Acute inflammation caused by infections
  • Acute inflammation caused by surgery, infarcts, autoimmune, etc.
  • Endocrine/metabolic: Cushing’s syndrome, thyrotoxicosis, uremia, etc.
  • Myeloproliferative neoplasms and myelodysplastic/myeloproliferative neoplasms
  • Malignant diseases: carcinoma, lymphoma, other solid tumors
  • Drugs: adrenaline, corticosteroids, lithium
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14
Q

What causes eosinopenia?

A
  • Drug induced: administration of corticotropin, corticosteroids, epinephrine or histamine
  • Acute inflammation or infection
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15
Q

What causes eosinophilia?

A

-Infections: parasites, fungi
Allergic disorders
-Löffler’s syndrome, tropical pulmonary eosinophilia, idiopathic hypereosinophilic syndrome
-Leukemias, myeloproliferative neoplasms, myeloid and lymphoid neoplasms with abnormalities of PDGFRA, PDGFB or FGFR1
-Other malignant diseases: Mycosis fungoides, Sézary syndrome, Hodgkin’s disease, T-cell lymphomas metastatic carcinoma
-Churg–Strauss syndrome, systemic sclerosis, rheumatoid arthritis

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16
Q

What causes basopenia?

A
  • Acute hypersensitivity reactions, autoimmune urticaria, acute stress, hyperthyroidism, Cushing’s syndrome and pregnancy
  • Administration of progesterone, corticosteroids or corticotrophin
17
Q

What causes basophilia?

A

Mastocytosis, CML, polycythemia vera, essential thrombocythemia, myelofibrosis, basophilic leukemia, eosinophilic leukemia, and Ph-positive acute leukemia

18
Q

What causes monocytosis (increased monocyte count)?

A

May be a compensatory event in association with neutropenia
Causes:
Physiologic
Infants
Certain infections
Marrow disease: MDS, MDS/MPN, acute monoblastics and myelomonocytic leukemia
Hodgkin’s disease, carcinoma, multiple myeloma, malignant histiocytosis

19
Q

What cause monocytopenia?

A

aplastic anemia, Cyclic neutropenia, hemodialysis, severe thermal injuries, AIDS, hairy cell leukemia.

20
Q

What causes lymphopenia?

A

Usually depends on CD4+ T-cell since most circulating lymphocytes are CD4+ cells
Causes:
-Congenital: DiGeorge syndrome, ataxia telangiectasia, severe combined immunodeficiency (SCID)
-Acquired: drug or chemotherapy, HIV, malaria, tuberculosis, Cushing’s syndrome, uremia, SLE, advanced carcinoma and Hodgkin’s disease, aplastic anemia, agranulocytosis, and MDS

21
Q

What causes lymphocytosis (too many lymph cells)?

A

-Physiologic: infants and young children
-Certain viral infections: EBV, CMC, infectious hepatitis, chickenpox, smallpox, measles, rubella, mumps, influenza, primary HIV infection
-Pertussis, brucellosis, tuberculosis, secondary and congenital syphilis
-Chronic lymphoproliferative disorders, lymphomas
Post-splenectomy

22
Q

What causes thrombocytopenia?

A

Decreased platelet count
causes:
Peripheral destruction: idiopathic thrombocytopenic purpura (ITP), thrombotic thrombocytopenic purpura (TTP), hemolytic-uremic syndrome (HUS), disseminated intravascular coagulation (DIC)
Sequestration in spleen
Inadequate production: primary marrow disorders or metastatic tumor in the marrow
Inherited: Wiskott–Aldrich syndrome, May–Hegglin anomaly, Bernard–Soulier syndrome

23
Q

What causes thrombocytosis (increased platelet count)?

A
  • Primary marrow neoplasm: essential thrombocythemia, chronic myelogenous leukemia, polycythemia vera, myelofibrosis
  • Reactive: inflammation, surgery, hyposplenism/splenectomy/asplenia, iron deficiency anemia or hemorrhage
24
Q

What does iron deficiency anemia look like?

A

Small RBC
Larger central pale area
Target cells

25
Q

What does sickle cell anemia look like?

A

Bipolar spiculated shape
Banana shape
Sickle disease

26
Q

What are Howell-Jolly bodies in RBCs?

A

Morphology: single, dense, blue dot
Content: nuclear DNA remnant

Causes: 
Post-splenectomy
Functional asplenia
Megaloblastic anemia
Myelodysplasia
27
Q

What is a Heinz body in abnormal RBCs?

A

Not visible on Wright-Giemsa stain
Need to stain with supravital dye (crystal violet)
Denatured/oxidized hemoglobin attached to the inner cell membrane
Cause: G6PD deficiency
Associated with bite cells

28
Q

What is a Dohle body in abnormal WBCs?

A

Pale blue inclusion at the periphery of the cytoplasm
Infection, inflammation, burns or pregnancy
Contents: condensed RNA.

29
Q

What is a toxic granulation in abnormal WBCs?

A

↑ Numbers and prominence of 10 granules
Due to rapid cell division (not enough time to dilute)
Often associated with Döhle bodies and toxic vacuolization
Causes: bacterial infection, marrow recovery, G(M)-CSF

30
Q

What are hypersegmented neutrophils in abnormal WBCs?

A

More than five lobes

Associated with megaloblastic anemia

Org Path Exam 2 (8 decks)

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