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Laboratory evaluation of Red Blood Cells Flashcards

1
Q

What is in a CBC for RBC?

A

Erythrocyte count (RBC)
Hemoglobin (Hgb or Hb)
Hematocrit (Hct)
Red Cell Indices- go with size and volume of cells

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2
Q

Whats in a red cell indices?

4

A 
go with size and volume of cells
MCV
MCH
MCHC
RDW- lot of different sizes and shapes of cells. high when there is high variation
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3
Q

What other kind of tests can we look at RBC besides a CBC?

3

A
  1. Morphology
  2. Reticulocyte count- young cells(bigger still have some nucleus)
  3. Bone Marrow Aspiration/Biopsy
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4
Q

What is a Erythrocyte count (RBC) and what are the normal values

A

Number red blood cells per unit volume of whole blood

Normal values
Female: 4.2 to 5.4x 106 RBCs/µL
Male: 4.7 to 6.1 x 106 RBCs/µL

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5
Q

When does the erythrocyte count (RBC) decrease?

3

A

Anemia, which can be caused by:
Hemorrhage
Sickle Cell
Dietary deficiency, i.e. iron or B-12

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6
Q

When can erythrocyte count increase?

5

A 
Increased when too many are made and with fluid loss:
Higher altitudes
Diarrhea
Dehydration
Burns
Pregnancy
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7
Q

What does Hemoglobin (Hgb or Hb) measure?

A

Measures concentration of hemoglobin in anticoagulated (or capillary) whole blood
Grams of Hb/100mL whole blood
g/dL
Measures the amount of oxygen-carrying protein in the blood.
Reflects the number of RBC’s

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8
Q

What are the normal hemoglobin values for:
newborns?
females?
males?

A

Normals
Newborns: 14 to 20 g/dL
Female: 12 to 16 g/dL
Male: 13.5 to 18 g/dL

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9
Q

In what situations does hemoglobin decrease?

7

A 
Anemia
Hemorrhage
Nutritional deficiency
Renal disease
Cancers
Pregnancy
--Due to expanded blood volume
Certain drugs
--Antibiotics, ASA, sulfonamides
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10
Q

What does hemoglobin increase with?

6

A 
Increases with
Polycythemia vera
COPD
CHF
High altitudes
Severe burns
Dehydration
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11
Q

What does our hemocrit value tell us?

A

Packed cell volume (%)

Percentage of the total blood volume that is made up by RBC’s

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12
Q

What are the normal values for hemocrit?

A

Normal values
Female 37 to 47%
Male 42 to 52%

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13
Q

What would our hemocrit decrease with?

9

A 
Anemia
Hemorrhage
Dietary Deficiency
Bone marrow failure
Pregnancy
Malnutrition
Leukemia
Cirrhosis
Hyperthyroidism
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14
Q

What would our hemocrit increase with?

7

A 
Increases with:
Congential heart disease
Polycythemia vera
Dehydation
Erythocytosis
Eclampsia
Burns
COPD
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15
Q

Acute blood loss (anemia) is characterized by what?

A

low blood volume and low RBC

shows a normal HCT though

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16
Q

Chronic anemia is characterized by what?

A

High blood volume and low RBC levels (low HCT)

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17
Q

Non-anemic low hemocrit is caused by what?

A

volume overlaod

-normal RBC level and really high blood volume

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18
Q

How do we calculate Mean cell colume or MVC?

What does it measure?

A

MCV (fL) = (Hct/RBC) X 10
Example: MCV = (41/4.6) x 10 = 89 fL

Measure of the average volume, or size, of a single RBC

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19
Q

How do we interpret MVC?

3

A

Interpretation
Normocytic 80 to 97 fL
Microcytic 97 fL

20
Q

What is the MCV the go to lab for?

A

for determining the types of anemia

21
Q

When the MCV is increased the cell is said to be? And what is this caused by?

A

When increased value, the RBC is said to be abnormally large – Macrocytic

  • B-12 deficiency
  • Folic acid deficiency

Same for MCH

22
Q

When the MCV is decreased the cell is said to be? and what is this caused by?

A

When decreased value, the RBC is said t be abnormally small – Microcytic

  • Iron deficiency
  • Thalassemia

Same for MCH

23
Q

Neurological symtpoms are always associated with what kind of anemia?

24
Q

How do you calculate the Mean cell hemoglobin (MCH?

A

MCH = (Hgb/RBC) X 10

Example: MCH = (13.7/4.6) x 10 = 29.8 pg

25
Q

What is the MCH a measurement of ?

A

Measurement of the average amount (weight) of hemoglobin with a RBC

26
Q

What are the normal values for MCH?

A

Normal values: 27 to 32 pg

27
Q

How would you calculate the MCHC (mean cell hemoglobin concentration)?

A

MCHC = (Hgb/Hct) X 100

Example: MCHC = (13.7/41) x 100 = 33.4%

28
Q

What does the mean cell hemoglobin concentration (MCHC) measure?

A

Measure of the average concentration or percentage of hemoglobin within a single RBC

29
Q

What are the normal values/interpretation for MCHC?

A

Interpretation
Normochromic: 32 to 36%
Hypochromic:

30
Q

Decreased values of MCHC indicate what?

What can this be caused by?
2

A

the cell has a deficiency of hemoglobin and is said to be Hypochromic (lacking color- heme molecule)

Iron deficiency anemia
Thalassemia

31
Q

With normal MCHC values the anemia is said to be what?

A

Normocytic

Hemolyic anemia

32
Q

What can blood cells not be considered?

A

RBC’s cannot be considered hyperchromic

Only 37g/dl or hemoglobin can fit into the RBC

33
Q

What is RDW?

And what are its normal lab values?

A

Red cell distribution width (RDW)
An indication of the variation in the RBC size

Normal values (instrument dependent)
Typical range: 11.5 to 14.5%
34
Q

What is the RDW an indicator of?

What can cause this?
5

A

an indicator of the degree of anisosytosis, a blood condition characterized by RBC’s of variable and abnormal size

Iron deficiency anemia
B12 or Folate deficiency anemia
Sickle cell disease
Hemolytic anemias
Post-hemorrhagic anemias
35
Q

What test do we do for erythrocyte morphology?

A

blood smear

36
Q

What is a normal erythrocyte called?

A

discocytes

37
Q

Terms which describe cells color which is proportional to cell Hgb concentration
3

A

Normochromic
Normocytic
Polychromatophilic

38
Q

Terms that describe cell size?

4

A

Normocytic
Microcytic
Macrocytic
Anisocytosis

39
Q

Descriptive cell names used to describe variations in shape?

A

poikilocytosis

40
Q

What labs measure RBC production?

2

A

Reticulocyte count

Erythropoietin level

41
Q

What does a full CBC with a diff test?

9

A 
Red cell analyses
White blood cell count
Differential white cell counts
Relative & Absolute neutrophil count
Relative & Absolute lymphocyte count
Relative & Absolute monocyte count
Relative & Absolute basophil count
Relative & Absolute eosinophil count
Platelet count and indices
42
Q

What are the applications of a reticulocyet count?

3

A
  1. Evaluate pathophysiology of anemia
  2. Gives an indication of RBC production by the bone marrow and
  3. can assess erythropoietic response to anemia and therapy
43
Q

What does a bone marrow biopsy evaluate?

A

hematopoiesis

44
Q

What does a bone marrow biopsy tell you about RBCs, WBCs, and megakaryocytes?

A

number, size, and shape

45
Q

Wheres the best place to do a bone marrow biopsy?

A

pelvis and possibly sternum and ribs because they are hemopoetically active

Hematology (18 decks)

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