Lab Results

Question 1

What do haemoglobin levels indicate?

Answer 1

Haemoglobin (Hb) g/L
Normal: M 130-180; F 115-165
High: Erythrocytosis/polycythaemia
Low: Anaemia

Question 2

What do Mean Cell Volume levels indicate?

Answer 2

Mean Cell Volume (MCV) fL
Normal: 78-98
High: Macrocytic
Low: Microcytic

Question 3

What do Mean Cell Haemoglobin levels indicate?

Answer 3

Mean cell haemoglobin (MCH) pg
Normal: 27-32
High: (Hyperchromic)
Low: Hypochromic

Question 4

What do Reticulocyte count levels indicate?

Answer 4

Reticulocyte count x10^9/L
Normal: 25-85
High: Reticulocytosis
Low: Reticulocytopenia

Question 5

What do White Cell Count levels indicate?

Answer 5

White cell count (WCC) x10^9/L
Normal: 4-11
High: Leucocytosis
Low: Leucopenia

Question 6

What do Neutrophil levels indicate?

Answer 6

Neutrophils x10^9/L
Normal: 2-7.5
High: Neutrophilia
Low: Neutropenia

Question 7

What do Lymphocytes levels indicate?

Answer 7

Lymphocytes x10^9/L
Normal: 1.5-4.5
High: Lymphocytosis
Low: Lymphopenia

Question 8

What do Monocytes count levels indicate?

Answer 8

Monocytes x10^9/L
Normal: 0.2-0.8
High: Monocytosis
Low: Monocytopenia

Question 9

What do Eosinophils levels indicate?

Answer 9

Eosinophils x10^9/L
Normal: 0.04-0.4
High: Eosinophilia
Low: (Eosinopenia)

Question 10

What do Basophils levels indicate?

Answer 10

Basophils x10^9/L
Normal: 0.01-0.1
High: Basophilia
Low: (Basopenia)

Question 11

What do Platelets levels indicate?

Answer 11

Platelets x10^9/L
Normal: 150-400
High: Thrombocytosis/thrombocythaemia
Low: Thrombocytopenia

Question 12

What is Polycythaemia?

Answer 12

Polycythaemia = Increased concentration of red cells. Haematocrit (HCT) is raised.

Absolute (increased red cell mass):
Primary – Polycythaemia Rubra Vera (myeloproliferative condition),
Secondary – Increased EPO (Chronic hypoxia {COPD, altitude}, renal tumours).

Relative (reduced plasma volume): Acute dehydration, alcohol

Question 13

What are causes of anaemia?

Answer 13

Microcytic Hypochromic:
Iron deficiency,
Thalassaemia,
Lead poisoning,
(Some cases of chronic disease).

Normocytic Normochromic:
Chronic disease,
Bone marrow failure,
Acute blood loss,
Haemolytic anaemia,
Mixed iron/B12/folate deficiencies.

Macrocytic:
B12/folate deficiency,
Reticulocytosis/Haemolysis,
Liver disease,
Pregnancy,
Alcohol,
Myelodysplasia.

Causes of:
Iron deficiency – chronic blood loss (menstrual, GI), reduced intake (diet, gastrectomy, coeliac disease), increased demand (growth in children, pregnancy);
Folate deficiency – reduced intake (diet, alcohol, malabsorption - coeliac disease/gastrectomy/etc), increased requirements, drugs (methotrexate, phenytoin);
B12 deficiency – reduced intake (dietary, malabsorption - pernicious anaemia/gastrectomy/terminal ileal disease).

Question 14

What are causes of Haemolytic anaemia?

Answer 14

Inherited:
Haemoglobinopathies – Sickle cell disease, thalassaemia;
Membrane defects – Hereditary spherocytosis or elliptocytosis;
Enzyme defects – G6PD.

Acquired:
Immune-mediated – Autoimmune haemolytic anaemia;
Non-immune mediated – Microangiopathic haemolytic anaemia (MAHA) (e.g. DIC, TTP), valve haemolysis, infection (e.g. malaria).

Question 15

What is pancytopenia?

Answer 15

!Red Flag!
Deficiency of all 3 blood components - red cells, white cells, and platelets.

Non-haematological - B12/folate deficiency, Liver disease (hypersplenism), severe infection, chemotherapy, bone marrow infiltration (TB, carcinoma),
Haematological - Leukaemia, myelodysplasia, myelofibrosis, aplastic anaemia, lymphoma, myeloma.

Question 16

What does abnormal neutrophils indicate?

Answer 16

High (>7.5x10^9/L): Neutrophilia:
Bacterial infections, Inflammation/necrosis, Corticosteroids, Malignancy, Myeloproliferative disorders

Low (<2x10^9/L): Neutropenia:
Post chemotherapy, Viral infections, Drugs, B12/folate deficiency, Bone marrow failure (myelodysplasia, leukaemia, infiltration), Autoimmune

Question 17

What does abnormal lymphocytes indicate?

Answer 17

High (>4.5x10^9/L): Lymphocytosis:
Viral infections, Chronic lymphocytic leukaemia (CLL), Chronic infections, Other chronic leukaemias & lymphomas

Low (<1.5x10^9/L): Lymphopenia:
Viral infection, HIV, Post chemotherapy/radiotherapy, Drugs (e.g. steroids), Bone marrow failure/haematological malignancies

Question 18

What does abnormal monocytes indicate?

Answer 18

High (>0.8x10^9/L): Monocytosis:
Infection, Chronic inflammatory/infective disorders (e.g. RA, IBD, SLE, TB), Malignancies (e.g. myelodysplasia, leukaemia)

Low (<0.2x10^9/L): Monocytopenia:
Acute infections, Corticosteroids, Haematological malignancies

Question 19

What does abnormal eosinophils indicate?

Answer 19

High (>0.4x10^9/L): Eosinophilia:
Allergy (asthma, hayfever…), Parasite infections, Skin disease, Drug reactions, Malignancy (e.g hodgkins disease), Hypereosinophilic syndrome

Low (<0.04x10^9/L): Eosinopenia: N/A

Question 20

What does abnormal platelets indicate?

Answer 20

High (>400x10^9/L): Thrombocytosis/thrombocythaemia:
Primary – essential thrombocytosis, other MPDs;
Secondary – Inflammation, infection, malignancy, post-splenectomy, iron deficiency

Low (<150x10^9/L): Thrombocytopenia:
Increased destruction – Immune (ITP, SLE, drugs); Non–immune (MAHA (DIC TTP, HUS), hypersplenism);
Decreased production – bone marrow failure, B12/folate deficiency, myelosuppression