Lab Normals Flashcards
Learn the normal lab values
Normal WBC count
4.0 - 10.5 x10^3/ul
Normal lymphocyte pecentage
14 - 46%
normal neutrophil percentage
40 - 74%
normal absolute lymphocytes
0.7 - 4.5 x10^3/uL
normal absolute neutrophils
1.8 - 7.8 x10^3/uL (1500 - 8000)
normal monocyte percentage
4 - 13%
normal eosinophil percentage
0 - 7%
normal basophil percentage
0 - 3%
What does erythrocyte sedimentation rate (ESR) measure?
a measure of inflammation, how quickly the RBCs settle to the bottom of a test tube
What is the dx of increased WBC?
leukocytosis
What is the dx of decreased WBC?
leukopenia
normal absolute eosinophils?
0 - 600
normal absolute basophils?
0 - 200
normal absolute monocytes?
0 - 800
normal absolute lymphocytes?
1000 - 4500
Describe a neutrophil’s appearance
multilobed, purple nucleus, light purple granulomas, pink plasma
Describe an eosinophil’s appearance
bilobar nucleus, red granulocytes, red plasma
Describe a basophil’s appearance?
unilobar, large purple granulomas that take up most of the cell, purple plasma
Describe a monocyte’s appearance
Large purple nucleus sometimes horseshoe shaped, fine granules, blue/gray/purple cytoplasm
Describe a lymphocyte’s appearance
Large purple nucleus takes up circumference of cell, small cell the size of a RBC, no granules
Which cells are considered phagocytes? (4)
neutrophils, eosinophils, basophils, monocytes
What are potential causes of lymphocytosis?
infection, leukemia, lymphoma
What are potential causes of lymphocytopenia?
acquired or inherited immunodeficiency, chemo or radiation induced destruction of lymphocytes
Locations of adult red bone marrow (6)
pelvic bone, ribs, proximal portion of the humerus/femur, cranium, vertebra, sternum
Where are RBC made? (2)
red bone marrow (active)
yellow bone marrow (inactive)
Function of neutrophils? (3 major)
- chief phagocytes of acute inflammation
- first to arrive on the scene within 30 min
- most numerous WBC
What are immature neutrophils called?
bands (there are few in peripheral blood)
What are mature neutrophils called?
segmented “segs” (47 - 63% of neutrophils)
What causes increase in neutrophils?
acute bacterial infections (increase in bands in peripheral circulation), stress, trauma
What causes neutropenia?
cancer, organ transplant
What is considered neutropenia?
low absolute neutrophil count less than 1000/mm^3
Types of T-cells (4)
supressor, cytotoxic, helper, regulatory
What are B lymphocytes?
the primary cells of the ummune response and create specific immunity
2 Characteristics of monocytes?
potent phagocyte, synthesize and scretes cytokines
what does a low monocyte count usually indicate?
malignancy, acute and chronic monocytic leukemia
what does a high monocyte count indicate?
acute bacterial infections and TB
When are basophils elevated?
hypersensitivity or inflammatory reactions, parasitic infections, hypothyroidism, ulcerative colitis, varicella
what is the importance of granules?
they contain powerful enzymes to kill microorganisms and phagocitic debris
When do eosinophil levels rise?
allergic reactions, parasitic infections, asthma, drug reactions, severe poison ivy
“worms, wheezes and weird diseases”
General pathology of leukemia
nonfunctional cancerous WBC proliferate and increase in concentration, proliferate as immature leukocytes and crowds out the mature blood cells
Clinical manifestations of leukemia (9)
pallor, fatigue, SOA, weight loss, fever/chills, bone pain, lymphadenopathy, spleenomegaly, bruising (petechia, ecchymoses)
What is ecchymoses?
bruising greater than 1 cm
Diagnostic tests for leukemia (2)
CBC with diff, bone marrow aspiration
What do you expect to see on a CBC in a person with leukemia?
anemia, leukopenia, thrombocytopenia
characteristics of Hodgkins Lymphoma
painless, progressive rubbery enlargement of a single or group of nodes (neck, chest, underarms)
When is the normal onset of hodgkins lymphoma
20-34 yo, 70-79yo
What is found on the test to diagnose hodgkins lymphoma?
“reed sternberg cells”
with a lymph node biopsy
(large B lymphocytes with more than 1 nucleus)
Manifestations of non-hodgkins lymphoma
painless, superficial lymphadenopathy, night sweats, frequent infections
What cells does non-hodgkins lymphoma affect?
t or b lymphocytes, can arise in lymph nodes or other organs
Clinical manifestations of multiple myeloma
none initially, bone pain, anemia, frequent infections, bleeding
Pathology of multiple myelomas?
plasma cells that are derived from B lymphocytes produce abnormal antibodies and make the blood thick and can damage the kidneys, the plasma crowds out normal cells
