Indices Flashcards
1
Q
Hgb Male
A
14.0-18.0
2
Q
Hgb Female
A
12.0-15.0
3
Q
Hct Male
A
40-54
4
Q
Hct Female
A
35-49
5
Q
RBC Male
A
4.60-6.00
6
Q
RBC Female
A
4.0-5.40
7
Q
MCV Normal
A
80-100
8
Q
MCH Normal
A
26-32
9
Q
MCHC Normal
A
32-36
10
Q
MCV Formula
A
MCV = Hct X 10 / RBC
11
Q
MCH Formula
A
MCH = Hb X 10 / RBC
12
Q
MCHC Formula
A
MCHC = Hb X 100 / Hct
13
Q
WBC normal
A
4.5 - 11.5 x 10^9
14
Q
RDW normal
A
11.5 - 14.5
15
Q
RBC are decreased in
A
Iron deficiency Vitamin B6, B12, Folic Acid Chronic Disease Hereditary anemia(s) Toxic metals Catabolic Metabolism
16
Q
What chronic diseases can cause lower RBC
A
Liver dysfunction Kidney dysfunction (chemistry tests and BUN, creatinine may be abnormal)
17
Q
Why should you asses the RBC
A
Check for anemia and evaluate normal erythropoiesis
18
Q
What determines the number of RBCs
A
age sex altitude exercise diet pollution drug use tobacco/nicotine use kidney function etc.
19
Q
What does hemoglobin contribute to your blood
A
Red color
20
Q
What does hemoglobin contain and its function
A
iron, carries oxygen to the cells
21
Q
What ides the hemoglobin level indicate
A
amount of intracellular iron, which its value determines anemia
22
Q
What determines anemia
A
HCT, RBC, and the indices (MCV)
23
Q
Reasons hemoglobin is increased
A
Dehydration with prolonged or severe diarrhea Emphysema, severe asthma, or long standing respiratory distress Macrocytosis Adrenal cortex overactivity Polycythemia vera High altitube adaptation Splenic hypofunction Testosterone supplementation
24
Q
What causes macrocytosis
A
Deficiency of B6 or B12
Folic Acid
Hypothyroid
25
Reasons hemoglobin is decreased
```
Digestive inflammation (hidden or obvious blood loss)
Free radical pathology
Adrenal cortical hypofunction
Hereditary anemia
Hemodilution (pregnancy, edema)
Blood loss
Deficiency
Chronic disease
Bone marrow insufficiency
```
26
Reasons MCV is increased
```
Hereditary anemia
Megaloblastic anemia
Reticulocytosis
Artifact
Liver disease
Hypothyroidism
Drugs
AIDS treatment (Zidovidune)
```
27
Reasons MCV is decreased
```
Copper deficiency
Low stomach acid
Vitamine C insufficiency
Vitamin B6 deficiency
Rheumatoid arthritis
Toxic effects of lead and other toxic elements
Herediatry (thalassemias, sideroblastic)
Iron deficicency (blood loss, parasites, poor intake, low stomach acid)
After a splenectomy
Hemolytic anemia
```
28
What is MCH
Variation of the MCv. Indicates amount of hemoglobin in a single RBC
29
What is the RDW
Random Distribution of red cell Width
30
What does the RDW measure
How consistent the size of the red blood cells are.
31
Reasons the RDW is increased
```
B12 and Pernicious anemia
Folic acid anemia
IDA combined with other anemia
Hemolytic anemia
Transfusions
Sideroblastic anemia
Alcohol abuse
Various less common and hereditary anemias
```
32
Reasons RDW is decreased
IDA
Vitamin B6 anemia
Rheumatoid arthritis
33
What index effects hypochromasia
Low MCHC
34
What index effects microcyte/macrocyte
MCV
35
What does the MCV measure
volume in femtoliters
36
What cells are seen with high/low MCV
Small - microcytes
Big - macrocytes
Both - anisocytosis
37
What does MCH measure
hemoglobin by weight in picograms
38
What is MCH nonspecific for
hypochromasia
39
What does MCHC measure
% hgb concentration (reflects rule of 3)
40
What should the MCHC be
approx 33%
41
What does a low MCHC mean?
hypocchromasia
42
What does a MCHC above 36% mean
probable error
43
What does RDW measure
coefficient of variation of the RBC population = anisocytosis
44
Symptoms of IDA
Hypochromic, microcytic (not enough building materials to construct the cells)
Low hgb/hct - no symptoms/morphology until iron stores are depleted
Most common anemia
Mimicked by other conditions
45
How is IDA treated
Nutrition or iron supplements
46
What tests are done for IDA
Serum iron
Transferrin (elevated to carry any available iron)
Marrow stain: Perle's Prussian Blue (marrow will show absence of iron)
Others
47
Symptoms of Megaloblastic Anemia
Nuclear maturation issue resulting in large blasts
Oval macrocytes (MCV > 120)
hypersegemented neutrophils
HJ bodies, stippling, cabbot rings
Asynchrony in blasts (nucleus and cytoplasm mature at different rates, not in sync)
48
Causes of Megaloblastic Anemia
Folate/B12 deficiency (only made in the gut of animals)
| Nutritional
49
Anemias with decreased hgb synthesis
IDA
| Refactory anemia with ringed sideroblasts (RARS)
50
IDA treatment
Dietary, decrease in body stores of iron
51
How is RARS contracted
Hereditary - sex linked an autosomal recessive
Acquired: Primary Myelodysplasia
Secondary: toxins (lead, alcohol, drugs)
52
Types of cells seen in IDA
```
Hypochromic
Microcytic
Aniso
Poik
Elliptocytes
```
53
Types of cells seen in RARS
Ringed sideroblasts
| Lead - basophilic stippling
54
What does megloblastic anemia cause
decreased DNA synthesis
55
Causes of
| megaloblastic anemia - B12 deficiency
```
dietary
Malabsorption (pernicious anemia)
Racial - Scandinavia
Gastrectomy
Hemodyalisism HIV - AIDS
Drugs/alcohol
```
56
Causes of megaloblastic anemia - folic acid deficiency
Dietary - critical in pregnancy
Malabsorption - tropical sprue
Gluten-sensitive enteropathy
drug induced
57
Cell types in megloblastic anemia
Oval macrocytes
Hypersegmented neutrophils
Pancytopenia
Asynchrony Elliptocytes
58
Pancytopenia
deficiency in all 3 components of blood (red, white, platelets)
59
Treatment for megaloblastic anemia
```
Near immediate response to IM B12 (12-24 hrs)
Elevated retics (new methylene blue stain)
```
60
Untreated megaloblastic anemia
Neurological issues and death
61
Megaloblastic anemia test
```
Elevated LDH, Indirect bilirubin, Iron Serum and ferritin, erythropoietin
Gastric achlorhydria
Serum B12
Red cell folate
Schiling test
Methylmalonic acid
```
62
What anemia is cause by stem cell failure
Aplastic anemia
63
What is aplastic anemia
failure of blood cell production by the bone marrow
64
Types of aplastic anemia
Acquired and congenital
65
What is acquired aplastic anemia
Idiopathic (primary 40-70%)
| secondary to marrow damage from toxins, including radiation and immune responses
66
What is congenital aplastic anemia
Fanconi's anemia
dyskeratosis congenital
Dyserythropoetic CDA Type 1 and 2
67
Acquired aplastic anemia test results
pancytopenia that progresses with age
low retic count
morphology typically normal
may do bone marrow tap (replacement of tissue with fatty deposits)
68
Congenital aplastic anemia test results
untreated - patients usually die from infections or hemorrhage
Skeletal defects may be present
