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HEMATOLOGY 1 > Lesson 7: Erythrocyte Indices > Flashcards

Lesson 7: Erythrocyte Indices Flashcards

1
Q

CASE 1
25 yr old patient with history of fatigue,
RBC: 3.7 x 106 / ul
Hb: 8.0 g/dl
MCV: 62 fl
MCH: 19.0 pg
MCHC: 27 g/dl
WBC: 5.3 X 109/l
Platelets: 400 x 109 /l
What is the impression of this case?

A

Microcytic Hypochromic Anemia

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2
Q

Erythrocyte or RBC indices?

A

Are three values that will show up on a laboratory form which gives the results of your CBC.

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3
Q

The erythrocyte indices include:

A

🞑 the mean corpuscular volume (MCV)
🞑 mean corpuscular hemoglobin (MCH)
🞑 mean corpuscular hemoglobin concentration (MCHC)

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4
Q

How to calculate MCV?

A

hematocrit ÷ rbc count x 1000

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5
Q

How to calculate MCH?

A

hemoglobin ÷ rbc count

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6
Q

How to calculate MCHC?

A

hemoglobin ÷ hematocrit

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7
Q

Why is RBC indices done?

A
  • Anaemia does not have a single cause. It includes a variety of conditions with the same symptom - the person’s blood does carry as much oxygen as it should.
  • To find out what disorder is causing the anaemia you need to know what type of anaemia it is.
  • The erythrocyte indices reflect the size and hemoglobin content of individual red blood cells.
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8
Q

Abnormal erythrocyte indices are:

A

Helpful in quickly narrowing down the potential causes, and thus classifying, the different types of anaemia. This allows the medical practitioner to prescribe the correct treatment.

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9
Q

How anaemias are classified using the erythrocyte indices:

A
  1. MCV, MCH and MCHC are all normal
  2. MCV, MCH, and MCHC are all decreased
  3. Increased MCV with variable MCH and MCHC
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9
Q

How anaemias are classified using the erythrocyte indices:

A
  1. MCV, MCH and MCHC are all normal
  2. MCV, MCH, and MCHC are all decreased
  3. Increased MCV with variable MCH and MCHC
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10
Q

MCV, MCH and MCHC are all normal

A

normocytic, normochromic anaemia (RBC’s size and hemoglobin content are within normal limits), most often caused by acute blood loss

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11
Q

MCV, MCH, and MCHC are all decreased

A

microcytic, hypochromic anaemia (RBC’s are smaller and their hemoglobin content is much less) - most often caused by iron deficiency but sometimes by impaired production of hemoglobin

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12
Q

Increased MCV with variable MCH and MCHC

A

macrocytic anaemia (RBC’s are larger ) - most often caused by Vitamin B12 deficiency (due to pernicious anaemia) and folic acid deficiency

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13
Q

What is Mean Corpuscular Volume (MCV)?

A
  • The most important of the erythrocyte indices.
  • It calculates the average size of individual red blood cells.
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14
Q

Normal size cells in MCV is called?

A

Normocytic

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15
Q

Smaller size cells in MCV are called?

A

Microcytic

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16
Q

Larger size cells in MCV are called?

A

Macrocytic

17
Q

True or False:
MCV values are higher than in newborns and infants.

A

True

18
Q

What is the normal MCV range of adult men?

A

80-98 fl (femoliters)

19
Q

What is the normal MCV range for adult women?

A

96-108 fl

20
Q

What are the causes of low MCV?

A

a. Iron deficiency anaemia
b. Lead poisoning
c. Genetic diseases
d. Copper deficiency
e. Vitamin deficiency eg. B6 and C
f. Low stomach acid (Hypochlorhydria) -
g. Rheumatoid arthritis.
h. Haemolytic anaemia
i. Having one’s spleen removed (splenectomy)

21
Q

What is Thalassemia major and thalassemia minor?

A

an inability to manufacture sufficient quantities of globin chains.

22
Q

What is sideroblastic anaemia ?

A

an inherited disorder that
prevents red blood cells from making sufficient hemoglobin.

23
Q

What is Low stomach acid (Hypochlorhydria)?

A

hampers the uptake of certain minerals and vitamins.

24
Q

What is Haemolytic anaemia?

A

A disorder in which the red blood cells are destroyed faster than the bone marrow can produce them.

25
Q

What are the causes of high MCV results?

A

a. Hereditary anaemia
b. Megaloblastic anaemias which include:
* Pernicious anaemia
* Folic acid deficiency
*Vitamin B12 deficiency
c.Reticulocytosis
d. Diseases or disorders such as:
* Aplasia
* Myelofibrosis
* Hyperglycemia
* Cold agglutinins
* Manganese deficiency
e. Liver disease
f. Hypothyroidism
g. Drugs (anti-convulsants)
h. Treatment with the anti-HIV drugs eg. AZT (Retrovir or Zidovidune).

26
Q

What kind of anemia is Vitamin B12 deficiency?

A

pernicious anaemia

27
Q

What is reticulocytosis?

A

A reticulocytes are immature cells with a relatively large size compared to a mature red blood cell.

28
Q

What is aplasia?

A

A condition in which RBC precursors in bone marrow are nearly absent.

29
Q

What is myelofibrosis?

A

fibrosis of the bone marrow.

30
Q

What is hyperglycemia?

A

an increase in plasma glucose.

31
Q

Cold agglutinins?

A

Abnormal proteins in the blood which at high level can cause a form of anaemia.

32
Q

An MCV within the normal range means the cells are normocytic. The patient may still present with anaemia.
This may be due to :

A

An acute haemorrhage

33
Q

What is hypochromasia?

A
  • decreased MCH associated with macrocytic anaemia since larger cells tend to have more hemoglobin.
34
Q

What is Mean Corpuscular Hemoglobin Concentration (MCHC)?

A

This calculates the average amount of haemoglobin per red blood cell
Or to be more scientific, ‘the average haemoglobin concentration per unit volume (100 ml) of packed red cells’.

34
Q

What is Mean Corpuscular Hemoglobin Concentration (MCHC)?

A

This calculates the average amount of haemoglobin per red blood cell
Or to be more scientific, ‘the average haemoglobin concentration per unit volume (100 ml) of packed red cells’.

35
Q

A low MCHC means?

A

A 100ml of packed red blood cells contain less haemoglobin than normal and a high MCHC means that there is more haemoglobin in 100ml of packed red blood cells.

36
Q

Decreased MCHC values may be due to:

A

a. Iron deficiency anaemia
b. Thalassemia
c. Blood loss
d. Vitamin B6 deficiency

37
Q

Pernicious anaemia

A

A condition where the MCV and MCHC differ. The MCV is high but the MCHC is normal.

38
Q

What is Spherocytosis?

A

a relatively rare disorder, in which the RBC’s are small and round (rather than the normal biconcave) and therefore hold more hemoglobin, there is an increase in the MCHC.

39
Q

There is a condition where the MCV and MCHC differ:

A

As any increase in MCHC is limited by the amount of haemoglobin that will fit inside a RBC it is not very common to find any significant increase and thus the MCHC is used to distinguish a patient with Spherocytosis.

HEMATOLOGY 1 (3 decks)

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