Lab panels 1 Flashcards
Types of RBC
Hemoglobin
Hematocrit
MCV
MCH
MCHC
RDW
Blood made up of
RBC
Platelets
WBC
Types of WBC (5)
Neutrophils
Lymphocytes
Monocytes
Eosinophiles
Basophiles
Lab RBC
Standard:
-Male 4.2 - 5.8
-Female 3.8 - 5.1
Optimal:
M 4.2 - 4.9
F 3.9 - 4.5
ALARM:
-M > 5.8
-F > 5.1
Nutrients NB for RBC (10)
Iron, copper, zinc
Manganese, Vit C, B1, B3, B6, B12, folate
Anemia vs dehydration
Decreased RBC - anemia
Increased relative RBC concentration - Decreased blood plasma d/t dehydration
Short term dehydration labs
Hemoglobin
<14.5 (F)
<15 M
Hematocrit
<44% F
<48% M
RBC
<4.5 F
<4.9 M
Long term dehydration
Albumin >5.0
BUN >16
Total protein >7.4
Cx decreased RBC (6)
Anemia (iron, B12/folate, B6 and copper)
Internal bleeding /loss
Nutrient deficiency
Inflammation
Pregnancy
Chronic dx: ca, AI, kidney dx, sickle cell, thalassemia or hemolytic anemia
Cx RBC increased (5)
Dehydration
Hypoxia
Respiratory dx
Polycythemia Vera
Spleen hypofxn
Basics Hemoglobin (3)
Oxygen carrying molecule of RBC
HGB is in direct proportion to O2 binding capacity of blood
Testosterone use can = increased HGB and HCT
Hemoglobin Labs
Standard:
11.7 - 15.5 F
13.2 - 17.1 M
Optimal:
13.5 - 14.5 F
14 - 15 M
Alarm range
> 15.5 F
>17.1 M
Hemoglobin (anemia vs dehydration)
Decreased HGB = decreased RBC or anemia
Increased HGB = increased RBC production or decreased volume (dehydration)
Hematocrit
Measures % of RBCs in blood
Increased HCT = increased marrow production
Decreased HCT = blood loss or increased RBC destruction
Hematocrit Labs
SRR:
F 35% - 45%
M 38.5% g 50%
Optimal
F 37 - 44%
M 40-48%
Alarm range
F<32 or > 55%
M <32 or > 55
Hematocrit Decreased
Anemia
Nutrient def
Pregnancy
Bone marrow insufficiency
Increased breakdown of spleen or liver
Chronic dx
Hematocrit increased
Dehydration
Exogenous testosterone or hormone use
Hypoxia
Respiratory dx
Smoking
Polycythemia Vera
Spleen hypofxn
Hemoglobin management
Hematocrit management
Reticulocyte count
Young RBC
SRR 0.5 - 1.5
Optimal 0.5 - 1.5
Alarm >3
(microscopic bleeds, sickle cell, thalassemia)
Reticulocyte count
Increased- occult bleeding, increased haemolysis
Decreased - anemia
Anemia vs dehydration
Anemia - low RBC, hemoglobin and hematocrit
Dehydration - high RBC, hemoglobin and hematocrit
MCV
Mean capsular volume
Measures volume or size of RBC
Indicates: cell is normal, microcytic or macrocytic
May be normal with folic acid or iron deficiency anemia
SRR: 81 - 99
Optimal : 82 - 89.9
Alarm >99
MCV optimal and inc vs dec
82 - 89.9
Decreased:
Iron deficient anemia
B6 anemia
Heavy menstruation
Vitamin C def
Increased:
B12/folate anemia
Hypochlohydria
Alcoholism
Hypothyroid
Liver dx
Pernicious anemia
MCH what is it?
Mean Corpuscular Hemoglobin
Average weight of hemoglobin in RBC
Along with MCV can determine if B6, B12 or folic acid anemia
MCH labs
SRR
26 - 33
Optimal
28 - 31.9
Alarm > 33
MCHC what is it and labs
Mean Corpuscular Hemoglobin concentration
Measures then concentration of hemoglobin in RBC
SRR 32 - 36
Optimal 32 - 35
Alarm >36
MCV, MCH and MCHC
All increased: Hypochlohydria/b12/folate
All Decreased: iron deficiency, B6, heavy bleeding, vit C def
What is RDW
Random disturbution weight
Indicates consistency of size
Elevated RDW associated with folic / b12 anemia
RDW labs
SRR 11 - 15
Optimal 11.7 - 13
Alarm >16
Anemia - 5 primary classifications
Nutritional anemia
Anemia of chronic dx or inflammation
Hemolytic anemia (abnormal RBC breakdown)
Abnormal hemoglobin (thalassemia and sickle cell)
Aplastic anemia (bone marrow dysfunction)
Symptoms of anemia
Central - fatigue, dizziness, fainting
Muscular - weakness
Respiratory - shortness of breath
Intestinal - changed stool colour
Eye - yellowing
Heart - palpitations, rapid HR, chest pain, angina, heart attack
Skin - paleness, coldness, yellowness
Spleen - enlarged
Nutrient-deficient Anemia
Most commom: iron and folate/B12
20% woman
50% pregnancy
3% men
RBC, HGB, HCT key markers
Deficient vegans anemia symptoms
Craving ice
Craving dark chocolate
Nutrient-deficient Anemia sxs symptoms
Pale skin
Non - distinct lip colour
Vertigo
Frequent / low grade headaches
Tinnitus
Pounding pulse
Fatigue / drowsiness
Irritability
Poor brain function
Immune compromise pale mucous membranes /nail beds
Shortness of breath after minimal effort
Fissures( pointing down) of mouth
Concave/brittle nails
Husky voice
Tongue inflammation
Difficulty swallowing
Depression / anxiety
Anemia quick screen
Eyes for yellowing
Lip colour
Capillary refill
N-D anemia common causes
Poor iron intake
Hypochlohydria
Maldigestion
Nut deficiency
Malabsorption
Long term vegan/veg diet
Heavy menstrual bleeding
Uterine fibroids
Hemorrhoids
Occult GI bleeding (ulcers polyps, NSAID use)
Pregnancy
Intestinal parasites
Other Underlying causes of ND anemia
Decreased RBC bone marrow
Chemical suppression
Dysfunction
Increased RBC destruction (sickle cell anemia)
Increased number of RBCs held in spleen due to hypertension or chemo
Serum markers for anemia
Primary:
RBC, HGB, HCT
Secondary (for type):
MCV, MCH, MCHC
Iron panel