Krafts Flashcards
What is the MCV
Mean RBC volume
Normal ranges are 80-100 fL
Determines normocyticity or macrocyticity
What is the Hct?
hematocrit.
Volume of packed blood cells.
Not used too often because of abnormalities in the cells causing artificially high hct
What is MCH?
Weight of Hgb in the average RBC
Not frequently used
What is the MCHC?
Concentration of Hgb in average RBC
Differentiates between hypochromic and normochromic anemias (no such thing as hyperchromic)
Can be determined by looking at zone of central pallor in microscope
What is the RDW?
RBC distribution width
Standard deviation of the RDW
Used to differentiate between anemias with minimal anisocytosis (difference in size)
What order of steps should be used to check the blood?
- Estimate RBC concentration
- Look at variation in RBC size
- Look at variation in RBC shape
- Look at hemoglobin concentration per cell
- Look for reticulocytes
- Look for other weird things
- Look at platelets (number and size)
- Look at WBC’s (number, morphology)
- WBC differential
What does iron deficiency anemia present as?
RBC size, difference in size, chromia, shape
Microcytic
Increased poikilocytosis,
Increased anisocytosis
Hypochromia
Why might normal ferritin still mean a patient has iron deficient anemia?
Ferritin is an acute reactant to inflammation and be temporarily increased
What are the two (related) most likely causes of megaloblastic anemia?
Folate/B12 deficiency
B12 can also present affect _____, causing _____, a more chronically detrimental disorder.
Myelin, causing subacute combined degeneration
What are the 5 regular and not-so-regular causes of B12 deficiency?
- Diet
- Pernicious anemia: autoantibodies to parietal cells, causing less B12 uptake
- Pancreatic disease: Can’t make stuff to liberate B12-IF
- Ilium disorder: Can’t absorb
- Tapeworms or bacteria: Tapeworms/bacteria can eat up the B12 in your diet
4 regular causes of folate deficiency?
- Diet
- Alcohol abuse
- Jejunal disease
- Drugs: some chemotherapeutic drugs are folate competitors.
What abnormal white cell will you also see in a megaloblastic anemia?
Hypersegmented neutrophil
What is an easy-to-see sign of increased bone marrow activity?
Increased reticulocytes
What test do you use to determine if a hemolytic anemia is immune mediated?
DAT: Direct antiglobulin test
Antibodies attach to cells coated with human antibodies and clump together
Cells that look like they got a bite taken out of them are evidence of…
G6PD deficiency
What is the inheritance of G6PD deficiency?
On the X chromosome
What are some things that would cause severe hemolysis in a person with G6PD deficiency?
H2O2, fava beans, antimalarials, aspirin, sulfonamides
What are some causes of mature neutrophilia?
Infection (bacterial)
Inflammation
Stress/hormones
When do you see Dohle bodies?
During toxic conditions (infection)
What color is primary granulation?
Purple
What are some causes of immature neutrophilia?
Infection (bacterial)
Inflammation
Severe anemia
Something filling up the marrow
Of the causes of immature neutrophilia, which is most malignant? Benign?
Benign: Left shift
Malignant: leukoerythroblastic reaction (benign if super low hgb)
Who has the highest lymphocyte counts? Lowest?
Highest: Infants
Lowest: adults
Causes of mature lymphocytosis?
Infectious lymphocytosis
Pertussis
Acute stress
Causes of Reactive lymphocytosis?
INFECTIOUS MONO
Pediatric viral infections
Viral hepatitis
Immune disorders
Four signs of CML (Chronic myeloid leukemia)
Super high WBC (almost all neutrophils)
Lots of immature cells
Basophilia
LAP increased (leukocyte alkaline phosphatase)
What’s the best way to tell benign from malignant neutrophilia?
Cytogenetics
Indications for eosinophilia?
Drugs, Asthma, skin diseases, parasites
What are three indications for monocytosis
Infection
Autoimmune
Malignancy
