Heme Overview with Lab Eval

Question 1

Cytoses

Answer 1

Too Many Cellular Element

Question 2

Cytopenias

Answer 2

Too Few Cellular Elements

Question 3

Erythrocytosis is Generally Associated with what?

Answer 3

Chronic Hypoxia such as in COPD, Smoking or Living at High Altitudes

Question 4

Leukopenia May Be due to what?

Answer 4

Primarily Due to Marrow Failure as Might Be Seen in a Myelodysplastic Syndromes
Secondary to Drugs, Infections, Cancers or Connective Tissue Diseases (MINI)

Question 5

Leukocytosis May Be due to what?

Answer 5

Primarily Due to a Bone Marrow Abnormality as Might Be Seen in a Myeloproliferative Disorder or Acute or Chronic Leukemias
Secondary to Drugs, Infections, Cancers or Inflammatory Conditions (MINI)

Question 6

Thrombocytopenia May Be due to what?

Answer 6

Primarily Due to Marrow Failure as Might Be Seen in a Myelodysplastic Syndromes
Secondary to Drugs, Infections, Cancers or Connective Tissue or Autoimmune Diseases (MINI)

Question 7

Thrombocytosis May Be due to what?

Answer 7

Primarily Due to a Marrow Abnormality as Might Be Seen in a Myeloproliferative Disorder
Secondary to Drugs, Infections, Cancers or Bleeding (MINI)

Question 8

What are the components of a CBC?

Answer 8

White Blood Cell Count (WBC)
Red Blood Cell Count (RBC)
Hemoglobin (Hgb)
Hematocrit (Hct)
Mean Corpuscular Volume (MCV)
Mean Corpuscular Hgb (MCH)
Mean Corpuscular Hgb Concentration (MCHC)
Platelet Count
Red Cell Distribution Width

Question 9

Reticulocyte Count

Answer 9

Reticulocytes- young, immature, non-nucleated RBCs

Indication of RBC production by bone marrow. The blue clumed supra-vital stain indicates residual ribosomal RNA

Question 10

Hemoglobin

Answer 10

main component of erythrocytes and serves as a vehicle for the transportation of oxygen and carbon dioxide

Question 11

Normal levels for HCT and Hgb for men and women?

Answer 11

Adult Men HCT 42% -52%
Adult Men Hgb 14 g/dL – 16 g/dL
Adult Women HCT 36% - 46%
Adult Women Hgb 12g/dL – 14 g/d

Question 12

Microcytic- Low MCV what are you going to think it is??

Answer 12

Advanced Iron Deficiency Anemia
Thalasemia trait
Sideroblastic anemias (some cases)
Lead Poisoning
Anemia of  Chronic Disease/Inflammation (some cases

Question 13

Normocytic- Normal MCV

Answer 13

Bone Marrow Aplasia/Hypoplasia
Renal/Liver Disease
Myelofibrosis
Myelodysplasia (most cases)
Hemolytic anemia
Acute post-hemorrhagic anemia
Anemia of  Chronic Disease/Inflammation (most cases)
Mixed microcytic and macrocytic anemia
Mild Iron Deficiency Anemia

Question 14

Macrocytic- High MCV

Answer 14

B12 Deficiency
Folate Deficiency
Prior cancer chemotherapy
Myelodysplasia (some cases – but is most commonly normocytic)
Hypothyroidism
Liver Disease

Question 15

Neutrophils

Answer 15

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

Question 16

lymphocytes

Answer 16

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

Question 17

monocytes

Answer 17

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

Question 18

eosinophils

Answer 18

Attack parasites; limit inflammation associated with allergic reactions (1-4% of total WBCs)

Question 19

basophils

Answer 19

Release histamines that cause inflammation; release anticoagulants, which prevent blood clots (0.5-1.0% of total WBCs)

Question 20

Lifespan of WBC and platelets

Answer 20

platelets= 7 days
WBC= 1 day

Question 21

Leukocytosis has a WBC count of what?

Answer 21

> 10,000

Question 22

What is the next step after identifying leukocytosis?

Answer 22

getting a peripheral smear