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MEH 2023 > Interpreting FBC > Flashcards

Interpreting FBC Flashcards

1
Q

Reasons for errors in lab results

A

Specimen collection: mix up, wrong blood in tube, wrong bottle, pooling (mixed two samples), poor technique

Delivery: Specimen delayed/not delivered, wrong delivery method

Specimen analysis: Specimen mix up (booking in, incorrect clinical details, wrong test requested, test variability, technical error

Responsive action: Results not reviewed, reflex tests not carried out, right result to wrong patient

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2
Q

What must a sample be for FBC analysis?

A

k-EDTA anticoagulated
Chelated calcium ions
(stops blood coagulation)

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3
Q

FBC analyser

A

Closed system
Easy maintenance
Copes with high numbers of samples

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4
Q

Spectrophotometry

A

Amount of light absorbed by sample (proportional to amount of absorbent compound within it)

Need hypotonic solution to lyse cells

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5
Q

Flow cytometry

A

Single file line of cells
Counts as passes through light beam
(more scatter = big cell)

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6
Q

What is packed cell volume/haematocrit?

A

Proportion of blood that is made up of RBC (assess polycythaemia)
Centrifuged to visualise

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7
Q

Layers of centrifuged blood

A

Plasma - water, proteins, nutrients, hormones

Buffy coat - white cells, platelets

Haematocrit - RBC

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8
Q

Hb

A

Concentration of haemoglobin in blood (Hb mass per plasma volume)
Acute bleed/dehydration effects results

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9
Q

RCC - red cell count

A

Number of RBC in given volume of blood (assess anaemia/erythrocytosis)

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10
Q

Red cell count high and low

A

Low - iron deficiency anaemia

High - thalassaemia trait, true polycythaemia (in polycythaemia caused by reduced plasma RCC will not be raised)

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11
Q

MCV (mean cell volume)

A

Determines cause of anaemia

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12
Q

Increased MCV =

A 
Megaloblastic anaemia (B12/Folate)
Liver disease
Alcohol 
Haemolytic anaemia (reticulocytes = large)
Hypothyroidism 
Drugs (HIV)
Myeloma
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13
Q

Decreased MCV =

A

Iron deficiency
Thalassaemia
Anaemia of chronic disease

(TIA)

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14
Q

RDW - red cell distribution width

A

Shows variation in size of RBC

If increased - anisocytosis (different sizes)

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15
Q

what can RDW be used for in regards to anaemia?

A

Assess timeline/cause

Increased in recent anaemia development and haemolysis (reticulocytes)
Normal in thalassaemia

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16
Q

MCH - mean cell haemoglobin

A

Measure of haemoglobin in each RBC

Assess anaemia

17
Q

MCH results

A

Reduced in iron deficiency, thalassaemia and haemoglobinopathy
Raised in macrocytic anaemia
Normal in mixed deficiency

18
Q

Reticulocyte count use

A

Measures number of young blood cells (size and RNA content)

19
Q

When will reticulocytes be raised?

A 
Haemolytic anaemia 
Recent blood loss
Response to iron, folate, B12 replacements
EPO stimulation 
Recovery from bone marrow suppression
20
Q

When will reticulocytes be reduced?

A

Haematinic deficiency (eg iron, folate etc)
Bone marrow failure
Parvovirus (targets precursors)

21
Q

Hypochromic vs hyperchromic

A

Hypo = low MCH (pale, less Hb)

Hyper = high MCH (dense, more Hb)

22
Q

Polychromatic meaning

A

Reticulocytes present

23
Q

Poikilocytosis

A

Abnormally shaped RBC

24
Q

Anisocytosis

A

Variation in size of RBC

25
Q

RBC inclusions

A

Howell jolly bodies - DNA/nuclear fragments
Basophilic stippling - RNA inclusions
Heinz bodies - denatured haemoglobin
Pappenheimer bodies - Iron inclusions

26
Q

FBC results iron deficiency

A

LOW: Hb, MCV, MCH, MCHC
HIGH: RDW (different sizes of RBC)
LOW/NORMAL: reticulocytes (inappropriately normal)

27
Q

Blood film iron deficiency

A

Microcytic
Hypochromic
Pencil cells
Target cells (few)

28
Q

Vit B12/Folate deficiency blood results

A

LOW: Hb, Hct
HIGH: MCV, RDW and MCH
LOW/NORMAL: reticulocyte (inappropriately normal)

29
Q

Blood film vitb12/folate deficiency

A

Hypersegmented neutrophils
Oval macrocytes
Teardrops

30
Q

Other macrocytosis causes

A

Alcohol/smoking
Drugs interfering with DNA synthesis (methotrexate)
Bone marrow failure

31
Q

Haemolysis blood results

A

LOW: Hb (could be normal)
HIGH: MCV (could be normal, RDW
Normal MCH

ELEVATED reticulocytes

32
Q

Blood film haemolytic anaemia

A

Spherocytes
Schistocytes
Polychromasia (reticulocytes)

MEH 2023 (8 decks)

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