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Labs Flashcards

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1
Q

CBC

A

Complete blood count; helps in evaluating symptoms, diagnosing and determining the stages of a disease

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2
Q

If abnormal CBC, should obtain?

A

Peripheral blood smear

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3
Q

CBC specifics

A

Total WBC, WBC differential, RBC, hemoglobin concentration, hematocrit, platelet count, red cell indices

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4
Q

Normal WBC

A

4500-11000 cells/mm^3

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5
Q

Normal RBC

A

4300000-6000000 cells/mm^3 for males and 3500000-5500000 cells/mm^3 for females

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6
Q

Normal hemoglobin

A

13.6-17.5 g/dL for males and 12.0-15.5 g/dL for female

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7
Q

Normal hematocrit

A

39-49% for male, 35-45% for female

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8
Q

Normal Platelet

A

150000-450000 cells/mm^3

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9
Q

Red blood cells

A

Most abundant cell in blood, tissue oxygenation, limited lifespan, contain up to 300 hemoglobin molecules, develop in bone marrow and under erythropoietin

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10
Q

RBC levels increased/decreased

A

increased in dehydration, secondary polycythemia, with increase wbc; decrease in anemia

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11
Q

Hemoglobin

A

Oxygen-carrying protein, reason for red color, two pairs of polypeptide chain and 4 complexes of heme; panic if below 7-8 g/dL; hypertriglyceridemia and increased WBC cause false positive

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12
Q

Hgb levels increased/decreased

A

increased in hemoconcentration, polycythemia, extreme exercise; decrease in macrolytic anemia, normocytic anemia, microcytic anemia

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13
Q

HCT

A

percentage of whole blood volume composed of erythrocytes

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14
Q

HCT levels increased/decreased

A

Increased in Hemoconcentration, polycythemia, exercise; decreased in all anemias, same as Hgb

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15
Q

Mean corpuscular volume

A

Average volume of red cells

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16
Q

MCV levels increased/decreased

A

Increased in liver disease, alcohol abuse, HIV, hemochromatosis, megaloblastic anemia, reticulocytosis, newborns, drugs; decrease in iron deficiency, thalassemia, sideroblastic anemia, hereditary spherocytosis

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17
Q

Mean corpuscular hemoglobin

A

Indicates amount of hemoglobin per RBC in absolute units

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18
Q

MCH levels increased/decreased

A

Increased in macrocytosis, hemochromatosis; decreased in microcytosis, hypochromia

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19
Q

Mean corpuscular hemoglobin concentration

A

Average hemoglobin concentration in RBC

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20
Q

MCHC increased/decreased

A

Increased marked spherocytosis; decreased in hypochomic anemia, sideroblastic anemia, high WBC, low Hb or high MCV or RBC

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21
Q

RDW

A

Red blood cell distribution width; measures the degree of anisocytosis (variation in RBC size); determined with an automated counter

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22
Q

RDW increased/decreased

A

Increased in anemia, liver diseases

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23
Q

WBC

A

Leukocytes, defend the body against infection, act primarily in the tissue, classified by structure and function

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24
Q

WBC increased/decreased

A

Increased infection, inflammation, leukemias, corticosteroids, stress, smoking, allergies; Decreased infections, myelosuppression, autoimmune neutropenia, alcoholism, hypersplenism

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25
Q

Granulocytes

A

Neutrophils, basophils, eosinophils, capable of ameboid movement

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26
Q

Neutrophils

A

Best understood, 55% total leukocyte count, early inflammation,die within 1-2 days

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27
Q

Neutrophils increase/decrease

A

Increase infection (bacterial or early viral), stress, inflammation; decrease aplastic anemia, chemotherapy, B12 deficiency

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28
Q

Eosinophils

A

Large coarse granules, 2-4% total count, ingests antigen-antibody complexes, induced by IgE by parasites

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29
Q

Eosinophils increase/decrease

A

Increase allergic states, drug rxn, parasitic invasion, skin disorders; decrease acute inflammation, stress, drugs

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30
Q

Basophils

A

Less than 1% total count, similar to mast cells, contain histamine and heparin

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31
Q

Basophil increase/decrease

A

Increased in hypersensitivity rxns*, drugs, myeloproliferative disorders

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32
Q

Agranulocytes

A

Monocytes, macrophages, lymphocytes; contain fewer granules than granulocytes

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33
Q

Monocytes/macrophages

A

Monocytes are immature macrophages, participate in inflammatory response, formed and released by bone marrow

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34
Q

Monocytes increase/decrease

A

Increased in inflammation, infection, malignancy, tuberculosis; decrease in BACTERIAL infection

35
Q

Lymphocyte

A

20-40% total count, primary immune cell, reside as T, B or plasma cells

36
Q

Lymphocyte increase/decrease

A

Increase viral infection*, ALL and CLL, drug, allergy, autoimmune; decrease in immune deficiency syndromes

37
Q

Peripheral Blood Smear

A

Provide important info about defects in RBC production. also reveals variations in cell size and shape

38
Q

Platelets

A

Thromocytes, not true cells, but cytoplasmic fragments, lack nucleus/DNA, 1/3 reserved and stored in spleen; important for normal hemostasis

39
Q

Thrombopoietin

A

Main regulator of circulating platelet mass, produced by liver

40
Q

Platelet increase/decrease

A

Increase in acute blood loss, post-splenectomy, tissue injury, infection; decrease in drugs, alcohol, infection (HIV*), platelet antibodies (idiopathic thrombocytopenic purpura)

41
Q

Platelet levels importance

A

Detrimental in pts with bleeding disorder; not an issue until below 20,000/mcL; no surgery unless above 50,000/mcL

42
Q

Blood clot

A

Fibrin strands that stabilize the platelet plug and traps other cells such as erythrocytes, phagocytes, and microorganisms

43
Q

What initiates the coagulation system?

A

Tissue Factor

44
Q

Cascade of clot

A

Burst of thrombin generation, converts fibrinogen to fibrin, reinforces platelet aggregate and anchors in to the vessel wall; thrombin also amplifies platelet activation and aggregation

45
Q

Prothrombin time and INR (international normalized ratio)

A

Evaluates the extrinsic and common coagulation pathways

46
Q

Prothrombin time importance

A

Most sensitive to deficiencies in the vitamin K dependent clotting factors (II,VII, and X); and less sensitive to fibrinogen deficiency and heparin; most common used test for monitoring warfarin therapy

47
Q

Warfarin therapeutic range is?

A

INR 2.0-3.0

48
Q

Partial thromboplastin time

A

evaluates the intrinsic and common coagulation pathways and adequacy of all coagulation factors except XIII and VII; commonly used to monitor heparin therapy

49
Q

Hemophilia A

A

congenital deficiency of coagulation factor VIII

50
Q

Hemophilia B

A

congenital deficiency of coagulation factor IX, Christmas disease

51
Q

Mode of inheritance for Hemophilia

A

X-linked recessive

52
Q

von Willebrand Disease

A

Most common inherited bleeding disorder, caused by missing of defective vWF, 1% of pop., autosomal dominant

53
Q

von Willebrand factor

A

aggregates platelets and prolongs half-life of factor VIII

54
Q

Iron Profile

A

Total iron, TIBC (total iron binding capacity), transferrin, % iron saturation

55
Q

Iron

A

67% total body iron is bound by heme and muscle cells, 30% is stored in macrophages and hepatic parenchymal cells as ferritin or hemosiderin, remaining 3% lost daily in urin, sweat, bile, and cell shedding

56
Q

Important question when getting profile

A

Does profile include ferratin

57
Q

Iron increased/decreased

A

Increase: hemolytic anemia, thalassemia, hemochromatosis; decrease: iron deficiency

58
Q

Transferrin

A

Major plasma transport protein for iron

59
Q

TIBC

A

Total iron capacity; calculated from tranferrin levels measured immunologically, each mole has two-binding site

60
Q

TIBC increase/decrease

A

Increase: iron deficiency anemia; decrease: hemochromatosis, thalassemia

61
Q

Ferritin

A

body’s major iron storage protein, correlate with total body iron stores, used to detect iron deficiency and to monitor response to iron therapy; more sensitive than iron and IBC in absence of liver disease

62
Q

Ferritin increase/decrease

A

increase: iron overload, acute or chronic liver disease; decrease: iron deficiency

63
Q

Ferritin importance

A

Liver disease increases serum ferritin and may mask diagnosis of iron deficiency

64
Q

Lead

A

Child screening occurs at 12 months and 4-6 years of age; cognition may be impaired by modest elevations of blood lead concentrations

65
Q

Vitamin B12

A

All comes from ingestion of foods of animal origin

66
Q

Vitamin B12 increase/decrease

A

Decrease: pernicious anemia; intermediate levels should be followed by the serum methylmalonic acid test

67
Q

Folate

A

Vitamin necessary for methyl group transfer in thymidine formation (DNA synthesis); deficiency can result in megaloblastic anemia

68
Q

Folate decrease

A

Vit B 12 deficiency (50-60%) since cellular uptake of folate depends on Vit B12

69
Q

Partietal cell antibodies

A

Antibodies to parietal cells have been detected in 90% of pts with pernicious anemia

70
Q

Methylmelanic Acid

A

Serum MMA is used to indirectly evaluate vit B12 status, confirms deficiency in pts

71
Q

Methylmelanic Acid increased in

A

Vit B12 deficiency

72
Q

Chronic Myeloid leukemia

A

elevated WBC, fatigue, night sweats, low-grade fever

73
Q

Acute leukemias

A

ALL comprise 80% of the acute leukemias, between 3-7 yo, AML primarily an adult disease with median age at presentation of 60 years

74
Q

Chronic Lymphocytic Leukemia

A

older pts, isolated lymphocytosis

75
Q

IgM

A

First produced in primary immune response

76
Q

IgG

A

highest response in secondary immune response, crosses placenta

77
Q

IgA

A

found in mucous membranes

78
Q

IgE

A

associated mainly with allergic reaction

79
Q

B cell

A

hemoral or antibody driven adaptive immunity

80
Q

T cell

A

cell mediated immunity

81
Q

NK cell

A

part of innate immune respnse

82
Q

Serum Protein electrophosesis

A

Method of separating proteins based on their physical properties, placed on specific medium and charge is applied; albumin and globulins

83
Q

Indications for SPE

A

paripheral neuropathy, multiple myeloma, hypercalcemia, rouleaux formations, lytic lesion, Bence Jones proteinuria

Clinical Science (5 decks)

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