Interpreting FBC Flashcards
what are pre-analytical issues
-was adequate volume of blood collected
-is sample from correct patient and adequately labeled
-were sensible clinical details given on the request form
-did the blood arrive at lab in good time
-did sample get booked into computer system and was a unique lab number allocated
-did blood get checked for clots
Hb for men is what
13.5-17.5 g/dL
Hb for women is what
11.5-15.5 g/dL
whats the normal MCV
80-95fl
whats the normal WCC
4-11x10^9/L
whats the normal platelet count
150-400 x10^9/L
how can WCC present like
leucopenia- low WBCs
leucocytosis- high WBCs
leukemia- high or low WBC
how can RBCs present like
anemia- low RBC
polycythemia- high RBCs
what are the 2 types of polycythemia and what can cause them
false- caused by dehydration
true- caused by hypoxia ( high altitude, cyanosis, COPD)
what can cause autonomous production of RBC
polycythemia rubra vera a myeloproliferative disorder
how can platelets present
thrombocytopenia- low platelets
thrombocytosis- high platelets
thrombocythemia- high platelets not caused by another health condition/disease ( >800)
when blood cells increase which line is it
normally a single line
what are the types of anemia and their MCV
microcystic- MCV<80fl
normocytic- MCV 80-95fl
macrocytic- MCV>95fl
what causes microcytic anemia
iron deficiency
thalassemia
lead poisoning
sideroblastic anemia
what causes normocytic anemia
hemolytic anemias
anemia of chronic disease or inflammation
after acute blood loss
renal disease, bone marrow failure, post chemotherapy
what causes macrocytic anemia- megaloblastic
vitamin B12 deficiency
folate deficiency
what causes macrocytic anemia- non-megaloblastic
alcohol
liver disease
myelodysplasia
aplastic anemia
hyper/hypo thyroidism
hemorrhage
what is the red cell distribution (RDW)
its an indication of dimorphic red cell population eg mixed hematinic deficiency
what happens to the RDW in microcytic anemia
iron deficiency is associated with increased RDW whereas thalassemia isnt
what happens to the RDW in macrocytic anemia
B12/folate deficiency is associated with increased RDW but other causes arent associated
what so you do when WBC are increased
look at the differential count to determine the specific line
what causes neutrophils to increase
bacterial infection
inflammation and necrosis
metabolic disorders-uremia, eclampsia, gout
corticosteroid therapy
myeloproliferative disease, chronic myeloid leukemia
treatment with myeloid growth factors eg. G-CSF
fever-cytokine release
what are the types of neutropenia
normal- 1.5
mild to moderate- >0.5-1.5
severe- <0.5
what can cause neutropenia
high risk infections of the mouth, throat, anus and skin
commensals and gram neg organisms
what medication can you give when a patient is neutropenic
prophylactic antibiotics- ciprofloxacin, augmentin, anti-fungals (amphotericin B), anti viral agents
granulocyte colony stimulating factor (neupogen)
whats reactive thrombocytosis
its when platelets increase in response to something for e.g. a bleed
thrombocythemia is a risk for what
blood clots
strokes
thrombocytopenia is a risk for what
bleeding
what are thresholds for thrombocytopenia
mild- 100-149
moderate- 20-99
severe- 10-20
very severe- <10
thrombocytopenia determines what
surgical procedures
thrombocytopenia is characterised by what
purpura
mucosal hemorrhage
prolonged bleeding after trauma
what are causes of thrombocytopenia
- Failure of platelet production
-drugs, chemicals, viral infections
-radiotherapy and chemo
-aplastic anemia
-HIV infection
-marrow infiltration, leukemia - Increased consumption of platelets
-autoimmune e.g. idiopathic thrombocytopenic purpura (ITP)
-drug induced e.g. heparin
-DIC
- thrombotic thrombocytopenic purpura (TTP) - Abnormal distribution of platelets
-splenomegaly
Indications for platelet transfusion
-thrombocytopenia with bleeding or invasive procedures
-thrombocytopenia <10
platelet transfusion is contraindicated where
autoimmune thrombocytopenia e.g ITP, TTP,
heparin induced thrombocytopenia
hemolytic uremic syndrome
(dont give platelets in cases of platelet concumption)
what improves iron absorption
vitamin C
what decreases iron absorption
phytate (phytic acid)
whats the lifespan of platelets
7 days
how much platelets do you give
1unit per 10kgs
