Lecture 1: Introduction to Hematology (ENOCHS)

Question 1

What are the 3 things involved in anemia?

Answer 1

Reduction in RBC count
Reduction in Hgb
Reduction in RBC mass

Question 2

Define polycythemia.

Answer 2

Increase in the total number of RBCs.
Increase in amt of Hgb.
Increase in RBC mass.

Question 3

Define anisocytosis.

Answer 3

Variable RBC size.

Measured by RDW (RBC Distribution Width)

Question 4

Define Poikilocytosis.

Answer 4

Variable RBC shape.

Measured via peripheral blood smear?

Question 5

Define polychromasia.

Answer 5

Increased reticulocyte count in peripheral blood smear.

Question 6

Define hypochromia.

Answer 6

Central pallor that is greater than 1/3 of the RBC.

Question 7

Define micro and macrocytosis.

Answer 7

RBC size.

Question 8

How much of our body weight does whole blood make up?

Answer 8

7-8%

Question 9

How much blood does the average male have? Female?

Answer 9

Male = 12 pints
Female = 9 pints

Question 10

What are the 5 functions of blood?

Answer 10

O2 and nutrient transport
Clotting
Immune response
Waste transport
Temperature regulation

Question 11

Why do males generally have more blood?

Answer 11

Combination of larger physical size + testosterone production induces minor RBC production in the bone marrow.

Question 12

What 4 components make up whole blood?

Answer 12

Plasma (55%)
RBCs (45%)
WBCs & platelets (<1%)

Question 13

What layer of whole blood are WBCs and platelets in?

Answer 13

Buffy coat, which is found in the middle of plasma and RBCs.

Question 14

What is plasma derived from?

Answer 14

Water and salt from the large intestine.

Question 15

Where are RBCs derived from?

Answer 15

Main site: Bone marrow
Secondary sites: liver & spleen

Question 16

What is plasma mainly made of?

Answer 16

90% water.
10% proteins, hormones, insulin, electrolytes, and nutrients.

Question 17

What are the primary functions of plasma?

Answer 17

Transporting RBCs, proteins, antibodies, etc.
Maintain BP

Question 18

What is the primary function of an RBC?

Answer 18

Oxygenating tissue.

Question 19

What are the two functions of Hgb?

Answer 19

Carrying O2 from lungs to tissues.
Carrying CO2 from tissues to lungs.

Question 20

What hormone is responsible for RBC production?

Answer 20

EPO
Erythropoietin, produced by the kidneys.

Minor ones include testosterone and thyroid hormone.

Question 21

Where are most RBCs made?

Answer 21

Bone marrow.

Question 22

What is the lifespan of an RBC?

Answer 22

4 months, 120 days.

Question 23

What describes the shape of a normal RBC?

Answer 23

Flexible, bright red biconcave disc.

Question 24

What are the 5 types of WBCs?

Answer 24

Neutrophils (most abundant)
Lymphocyte
Monocyte
Eosinophil
Basophil

Note:
Never Let Monkeys Eat Bananas

Also keeps them in order of abundance

Question 25

When do I see a left band shift? Lymphocytosis?

Answer 25

Left band shift = Bacterial infections. Lymphocytosis = Viral infections.

Question 26

What is unique about a platelet?

Answer 26

No nucleus. It is a cell fragment.

Question 27

What hormone stimulates platelet production?

Answer 27

Thrombopoeitin, made by the liver and kidney.

Question 28

Where can I find extra platelets?

Answer 28

Spleen

Question 29

What is the lifespan of a platelet?

Answer 29

7-10 days.

Question 30

What is the typical differential breakdown of a diff?

Answer 30

50-70% neutrophils 0-5% band neutrophils 20-40% lymphocytes 2-6% monocytes 1-4% eosinophils 0-1% basophils

Question 31

What factors increase Hgb?

Answer 31

Male Young infants High altitude Smokers

Question 32

What factors decrease Hgb?

Answer 32

Pregnancy Female

Question 33

Why does smoking increase Hgb?

Answer 33

Left shift in Hgb dissociation curve due to inefficient Hgb. The body produces more Hgb to compensate.

Question 34

What is hematocrit?

Answer 34

RATIO of RBC volume to blood volume. Hct = (RBC * MCV)/10 Hct = Hgb x3

Question 35

Who has the higher range of Hct?

Answer 35

Males.

Question 36

What is MCV?

Answer 36

Mean corpuscular volume, aka individual RBC size.

Question 37

What describes MCV status?

Answer 37

Microcytosis Normocytosis Macrocytosis

Question 38

What is MCH?

Answer 38

Mean Corpuscular Hemoglobin, aka Amt/weight of Hgb per RBC. (Directly related to RBC size)

Question 39

What describes MCH status?

Answer 39

Hypochromia Normochromia Hyperchromia

Question 40

How is MCH calculated?

Answer 40

MCH = (Hgb/RBC) x 10

Question 41

How are anemias categorized?

Answer 41

MCV and MCH status, such as a normocytic hypochromic anemia.

Question 42

What is MCHC?

Answer 42

Mean Corpuscular Hemoglobin Concentration, aka average Hgb concentration in each RBC. It is a ratio of Hemoglobin to Hematocrit.

Question 43

How is MCHC calculated?

Answer 43

Hgb/Hct

Question 44

What is RDW?

Answer 44

RBC Distribution Width, aka Percentage of RBCs OUT of normal range in terms of size. Directly related to MCV changes.

Question 45

What is increased RDW known as?

Answer 45

Anisocytosis. Often includes reticulocytosis.

Question 46

What is the difference between thrombocytosis and thrombocythemia?

Answer 46

Thrombocythemia is technically primary thrombocytosis, aka idiopathic. Overall, it just means high platelet counts.

Question 47

What is MPV?

Answer 47

Mean platelet volume, aka average size of platelets.

Question 48

When do I see increased MPV? Decreased MPV?

Answer 48

Increased MPV = increased platelet production bc young platelets are big. Decreased MPV = decreased platelet production.

Question 49

What is the purpose of a peripheral blood smear?

Answer 49

Manually assessing blood cell morphology and cell counts. Visualizing neoplastic cells from bone marrow.