Overview Of Anaemia Flashcards
What are the cellular elements of blood
RBCs, WBCs, Platelets
Define
A. Plasma
B. Serum
Obtained from anti-coagulated blood
Liquid part of blood that is allowed to clot
Blood is collected in tubes that contain
Anticoagulants
What anticoagulant has :
Purple top
Blue top
Green top
EDTA
Trisodium Citrate
Heparin
What anticoagulant is associate with finding:
CBC
Test for Coagulation
Molecular studies, cytogenetics, lymphocyte count
EDTA
Trisodium Citrate
Heparin
True or False, WBC counts may be inaccurate issuing automated methods
True
What are the different functions of the blood
Deliver nutrients, oxygen and hormones to tissues (red cells)
Collect waste from cellular metabolism (WBC’s)
Deliver cells to tissues for protection against the external environment (WBC’s)
To prevent leakage by closing holes in blood vessels (platelets and clotting factors)
What are the fluid elements of blood
Plasma Serum Water Electrolytes Proteins (clotting factors, antibodies, transport proteins)
What anticoagulant is used to find CBC
EDTA- Purple top
What anticoagulant is used to test for coagulation
Trisodium Citrate- Blue top
What anticoagulant is used in molecular studies, Cytogenetics, lymphocyte count
Heparin- green top
Why are WBC inaccurate using automated methods
Aggregated cells
Nucleated red cells
Incomplete lysis of cells
WBC Agglutination
What method and prcedure is used in finding the morphology of blood cells
Fingerstick method
Smeared on glass side
Stained using Wright or May- Grunwald- Giemsa Stain
Smear is then examined at 10x to 20x
Smear is first _____ before going on to higher power for WBC Differentials
Scanned
What should RBCs be accessed for
size, shape, haemoglobin distribution
Presence of Inclusion
What term is used to describe a variation in size
Anisocytosis
What term is used to describe a variation on shape
Poikilocytosis
What term is used to describe a poor haemoglobinisation
Hypochromia (Low MCH)
What term is used to describe a lack of central area of pallor
Sphrenocytes
What term is used to describe cells that are larger than normal
Macrocytes (High MCV)
What term is used to describe cells that are smaller than normal
Microcytes (Low MCV)
What are the RDW and MCV characteristics of Anaemia of chronic disease
Heterozygous thalassemia
Normal RDW and Low MCV
What are the RDW and MCV characteristics of Iron Deficiency and S-thalassemia
Elevated RDW and Low MCV
What are the RDW and MCV characteristics of Aplastic Anaemia, Liver Disease, Chemotherapy
Normal RDW and High MCV
What are the RDW and MCV characteristics of Folate/B12 deficiency , Myelodysplastic Syndrome
Elevated RDW and High MCV
What are the RDW and MCV characteristics of Anaemia of chronic disease and Acute blood loss or haemolysis
Normal RDW
Normal MCV
What are the RDW and MCV characteristics of Early iron, B12, folate deficiency, Chronic liver disease, Sickle cell disease
Elevated RDW and Normal MCV
How many white blood cells should be assessed for manual differential Count
100
What cells are included in an immature WBC
Bands, Metamyelocytes, Myelocytes, Promyelocytes, blases
What is prepared from bone marrow aspirate
Cytology
What is accessed from the bone marrow biopsy
Cellularity and infiltration
What are the sites for bone marrow evaluation in children
Anterio-medial tibia
What are the sites for bone marrow evaluation in adults
Sternum
Anterior and Posterior Iliac Crest
What is used to stain the bone marrow for a biopsy
Haematoxylin and eosin
What is ESR
Erythrocytes Sedimentation Rate
What does the ESR reflect
The tendency of blood to settle more rapidly in some disease states
An increase in the rate of ESR represents an increase in what proteins
Fibrinogen, Immunoglobin and other acute phase proteins
Red cell _______ and ________ May also affect rate of fall of ESR
Shape and numbers
True or false, ESR increases in rate in normal humans
True
Name a disease that ESR is useful I. Follow the course
R.A Hodgkins
What method is ESR measured ?
Westergren or Wintrobe Method
What are the units of measuring for ESR
Mm/hr
What is used in the clinical practice to diagnose if a person has Anaemia
Reduction in haemoglobin
Reduction in red cell count
What is the normal red cell count in: Men Women Infants (full term, cord blood) Children ( 1 year) Children (10-12)
- 5 +/- 1 x 10^12 l
- 8 +/- 1 x 10^12 l
- 0 +/- 1 x 10^12 l
- 4 +/- 0.8 x 10^12 l
- 7 +/- 0.7 x 10^12 l
What is the normal Haemoglobin level in : Men Women Infants (full term, cord blood) Children ( 1 year) Children (10-12)
15.5 +/- 2.5 g/dl 14 +/- 2.5 g/dl 16.5 +/- 3 g/dl 12 +/- 1 g/dl 13 +/- 1.5 g/dl
What is the normal Packed cell Volume (PCV : haematocrit) in : Men Women Infants (full term, cord blood) Children ( 3 months) Children (10-12)
- 47 +/- 0.07 (l/l)
- 42 +/- 0.05 (l/l)
- 54 +/- 0.10 (l/l)
- 38 +/- 0.06 (l/l)
- 41 +/- 0.04 (l/l)
What are the two main classifications of Anaemia
Pathogenic and aetiological classifications - based on the cause of Anaemia
Morphological classification- based on the characteristics of the red cell
Clinical investigation of a patient with Anaemia involves which two distinct steps
Determination of the morphological type of Anaemia
Determination of the cause of the Anaemia
What are the two aetiological classifications of Anaemia
Hypo- regenerative
Hyper-regenerative
What is Hypo- regenerative Anaemia was
Failure of the bone marrow production of red cells
What is hyper regenerative Anaemia
Increase in red cell destruction or consumption with a concomitant increase in red cell production
Each day, approximately _______ of the red cell pool needs to be replaced by young erythrocytes released from the bone marrow
0.8%
Differentiate between the mature red cells and and reticulocytes
Retuculocytes are larger and contain polyribosomal RNA material
What type of stains of the peripheral blood are used to detect the reticulate cells
Supravital stains
Reticulocyte provides an easy means in differentiating if the _______ or _______ as the source of Anaemia
Marrow or periphery
Anaemia + Low Reticulocyte count indicates what type of Anaemia
Hypo regenerative Anaemia
Anaemia + High Reticulocyte count indicates what type of Anaemia
Hyper regenerative Anaemia
What is the normal Reticulocyte % in :
Adults and children
Infants (full term,cord blood)
0-2-2%
2-6%
What is the major factor controlling the rate of red cell production
Oxygen content of the arterial blood
True or false , reticulocytes released under heavy erythropoietin stimulation remain in the peripheral blood longer than the usual one day maturation time of ‘no stress reticulocytes’
True
The Reticulocyte index checks for
Prolonged maturation time of the reticulocytes
The anaemia
What is the equation for finding the Reticulocyte index
Reticulocyte count % / maturation time (days)
X
Patient PCV / Normal PCV
What does it mean If the RI is
<2
>3
Hypo regenerative Anaemia
Hyper regenerative Anaemia
True or false, if the normal pallor is greater than a third of the diameter of the cell, it is macrocytic
False, it is hypochromic
The size and staining characteristics of the cell maybe measured by
Mean corpuscular haemoglobin
Mean corpuscular volume
Mean corpuscular haemoglobin concentration
What is the MCV (fl) equation
PCV x 1000/ RCC (10^12/l)
SI unit fl
What is the MCH (pg) equation
Haemoglobin (g/dL) x 10 / RCC (10^12/l) SI unit (pg)
What is the MCHC equation
Haemoglobin (g/dL) / PCV (l/l) SI unit (g/dL)
What is the normal MCV in Adults Infants (full term, cord blood) Children (1 year) Children (10-12 years)
85 +/- 8fl
106 fl
78 ± 8 fl
84 ± 7 fl
What is the normal MCH in adults
29.5 ± 2.5 pg
What is the normal Mean cell haemoglobin concentration (MCHC) in adults and children
33 ± 2 g/dl
True or false, Children and young adults can tolerate a much greater degree of chronic anaemia than older patients due to cardiovascular compromise with advancing age.
true
True or false, Symptoms occur at a higher haemoglobin level with rapidly developing anaemia e.g.
acute haemorrhage, than in a slowly developing chronic anaemia.
True
Describe the pallor in patients with
hemolytic anaemia
pernicious anaemia.
acute blood loss
Pallor + icterus
Lemon yellow pallor
Waxy dead whiteness + cold and moist palms
What is the partial pressure of oxygen when its saturation is 50%
27 mmHg
True or false, an increase in 2,3 DPG decreases the affinity of haemogloblin for oxgen and shifts curve to the right
true