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Year 3 OSCE > Interpretation Of A Full Blood Count > Flashcards

Interpretation Of A Full Blood Count Flashcards

1
Q

Increased reticulocytes

A

Blood loss
Haemolytic anaemia

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2
Q

Increased red cell count

A

Dehydration
Polycythaemia rubra Vera

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3
Q

Decreased red cell count

A

Diluted- Pregnancy
Production failure- Bone marrow failure
Loss- Bleeding

NB- any type of Anaemia

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4
Q

Microcytic anaemia

A

TAILS
Thalassaemia
Anaemia of chronic disease
Iron deficiency
Lead
Sideroblastic anaemia

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5
Q

Normocytic anaemia

A

Acute blood loss
Haemolytic anaemia
Renal failure
Pregnancy

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6
Q

Macrocyclic megaloblastic anaemia

A

Decreased folate
Decreased B12
Drugs ie. methotrexate, valproate, phenytoin

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7
Q

Non-megaloblastic macrocytic anaemia

A

Alcohol
Reticulocytosis
Liver disease
Hypothyroidism

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8
Q

Investigations for haemolytic anaemia

A

Urinalysis- urinary urobillinogen, haemoglobinura, urinary haemosiderrin
Blood- FBC (normocytic anaemia), lactate dehydrogenase and unconjugated bilirubin
Blood film- red cell fragments (schistocytes), sickle cells, Heinz bodies, reticulocytes, spherocytes
Coombs test
Osmotic fragility testing (membrane abnormalities)
Hb electrophoresis
Enzyme assays (G6PD)

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9
Q

Acquired causes of haemolytic anaemia

A

DIC
Lead poisoning
Metallic heart valves

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10
Q

Relative polycythaemia (decreased plasma volume)

A

Acute- dehydration
Chronic- obesity, HTN, alcohol, smoking

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11
Q

Absolute polycythaemia (increases red blood cells)

A

Primary- polycythaemia rubra vera (myeloproliferative neoplasm- increased RBC, WBC, platelets)
Secondary- chronic hypoxia leading to increased erythropoietin eg. COPD, altitude or renal cell carcinoma (EPO secreting tumour)

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12
Q

Thrombocytopenia causes

A

Decreased production- bone marrow infiltration, aplastic anaemia

Increased destruction/ consumption;

Non-immune- DIC, TTP, HUS, HIT, liver disease (hypersplenism)

Primary immune- ITP

Secondary immune- SLE, viruses, CLL

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13
Q

Investigations for thrombocytopenia

A

Blood film and bone marrow biopsy
Viral serology eg. HIV/ Hep C
LFT’s
Lactate dehydrogenase
Serum vitamin B12 and folate
Coagulation screen
Acute phase proteins- infection

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14
Q

Thrombocytosis causes

A

Primary- essential thrombocythaemia, myeloproliferative disorders

Secondary (reactive)- leading, inflammation, infection, malignancy, post splenectomy

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15
Q

Investigations for thrombocytosis

A

Blood film and bone marrow biopsy
Acute phase proteins
JAK2 mutation (myeloproliferative disease)
Ferritin- chronic bleed

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16
Q

Pancytopenia causes

A

Bone marrow infiltration- myeloma, lymphoma, TB, acute leukaemia etc.

Muelosuppression- chemotherapy, lead, irritation, infection eg. HIV

Impaired haematopoiesis- vitamin B12/ folate deficiency, aplastic anaemia

Peripheral destruction of blood cells- hyperslenism, PNH

17
Q

Investigations for pancytopenia

A

Blood film and bone marrow biopsy
Lactate dehydrogenase (haemolysis and myeloproliferative disorders)
Serum vitamin B12/ folate (impaired haematopoesis)
Reticulocytes
Electrophoresis and immunoglobulins (myeloma)
Viral serology- HIV, EBV, CMV, parvovirus
Autoimmune profile
Serum direct antiglobulin test

18
Q

Increased serum urea

A

Dehydration, GI bleeding, increased protein catabolism eg. Infection, high protein intake

19
Q

Decreased serum urea

A

Malnutrition, liver disease, pregnancy

20
Q

Acute kidney injury

A

Rise in serum creatinine >50% from baseline, or urine output <0.5ml/kg/hour for 6 hours

21
Q

Haemanitics

A

B12
Folate
Ferritin (can be raised due to infection)

22
Q

Iron studies

A

Look at table in gallery

23
Q

Investigations for Polycythaemia

A

FBC- WCC and platelets (&RBC) raised in primary absolute polycythaemia (PRV)

EPO level- renal cell carcinoma

If PRV suspected- JAK2 mutation testing and bone marrow biopsy (PRV is a myeloproliferative neoplasm)

24
Q

RCC vs Haematocrit

A

RCC- the concentration of red blood cells in the blood

HCT- percentage of the total blood volume accounted for by red blood cells (affected by the MCV- mean corpuscular volume)

25
Q

Colour of red cells

A

Normocytic and macrocytic anaemia- most are normochromic

Microcytic anaemia- microchromic anaemia (except anaemia of chronic disease- normochromic)

26
Q

Polycythaemia

A

Increased volume percentage of red blood cells in the blood

27
Q

Causes of neutropenia

A

Viral- HIV, EBV
Drugs- cytotoxics eg. Chemotherapy, carbimazole, clozapine
Benign ethnic neutropaenia (African and Afro Caribbean, no treatment)
Haematological malignancy
Rheumatological conditions (SLE)
Severe sepsis
Haemodialysis

Year 3 OSCE (61 decks)

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