Heme Overview Hammond

Question 1

What is erythrocytosis generally associated with?

Answer 1

Chronic hypoxia (COPD, smoking, living in high altitudes)

Question 2

Cytopenia =

Answer 2

Too few cellular elements

Question 3

Cytosis =

Answer 3

Too many cellular elements

Question 4

How do we assess cytopenia/cytosis?

Answer 4

Concentration of each cellular element

Question 5

What is MINI?

Answer 5

A way to brainstorm ddx - Metabolic, Infectious, Neoplastic, Inflammatory

Question 6

Describe Hgb blood test

Answer 6

• Part of a CBC

- Indirect measurement of total body RBC count

Question 7

Describe HCT

Answer 7

• Measures percent of RBCs per blood volume

- Indirect measurement of total body RBC mass

Question 8

Describe MCV

Answer 8

Measures average volume (size) of a RBC

Question 9

Describe MCHC

Answer 9

Measures average concentration of Hgb within a single RBC

Question 10

Describe red cell distribution width (RDW)

Answer 10

Indicates variation in RBC size

Question 11

Describe reticulocytes

Answer 11

Young, immature, non-nucleated RBCs

Question 12

What does reticulocyte count indicate?

Answer 12

RBC production by bone marrow

Question 13

Micro vs. normo vs. macrocytic anemia

Answer 13

• Micro: low MCV
• Normo: normal MCV
• Macro: high MCV

Question 14

Describe neutrophils

Answer 14

Engulf and destroy small bacteria and foreign substances (55-70% of total WBCs)

Question 15

Describe lymphocytes

Answer 15

-Some destroy foreign cells by causing their membranes to rupture
-Some develop into cells that produce antibodies
(20-40% of total WBCs)

Question 16

Describe monocytes

Answer 16

Give rise to leukocytes that engulf and destroy large bacteria and substances (2-8% of total WBCs)

Question 17

Describe eosinophils

Answer 17

-Attack parasites
-Limit inflammation a/w allergic reactions
(1-4% of total RBCs)

Question 18

Describe basophils

Answer 18

• Release histamines that cause inflammation
• Release anticoagulants
  (0. 5-1.0% of total WBCs)

Question 19

Which type of WBC is most prevalent?

Answer 19

Neutrophils (55-70% of total WBCs)

Question 20

Which type of WBC is least prevalent?

Answer 20

Basophils (0.5-1% of WBCs)

Question 21

Life span of RBCs?

Answer 21

About 100-120 days

Question 22

Life span of WBCs?

Answer 22

1 day

Question 23

Life span of platelets?

Answer 23

7 days

Question 24

What defines leukocytosis?

Answer 24

WBC count over 10,000

Question 25

How to differentiate primary BM problems vs. secondary blood cell abnormalities?

Answer 25

• Primary BM problems usually affect more than 1 cell line

- Secondary blood cell abnormalities may affect 1 cell line only

Question 26

What are PMNs (polys)? Which are most/least mature?

Answer 26

• Polymorphonuclear neutrophils
• Most mature: segmented
• Less mature: bands

Question 27

Define left shift

Answer 27

Increased bands (commonly due to acute bacterial infection)

Question 28

Define right shift

Answer 28

Increased segmented neutrophils

Question 29

What is the most ominous cause of increased basophils?

Answer 29

Mast cell leukemia or CML

Question 30

Define leukopenia

Answer 30

WBC count under 3,000

Question 31

Causes of leukopenia

Answer 31

• Viral infections, sepsis, BM suppression

- If it’s not obvious, it’s DRUGS

Question 32

What does BM biopsy show in acute leukemia?

Answer 32

Hypercellular with 20-100% blasts

Question 33

Lab findings of CML

Answer 33

• H/H and platelets normal
• Increased lymphocytes
• Anemia
• Thrombocytopenia

Question 34

Where is bone marrow biopsy obtained?

Answer 34

Posterior iliac crest (site of choice) or sternum