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Medical Diagnostics > Platelets and WBCs > Flashcards

Platelets and WBCs Flashcards

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USMLE® Step 1 flashcards
1
Q

What is the smallest element in the blood?

A

Platelets (thrombocytes)

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2
Q

Where are platelets formed?

A

Bone marrow

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3
Q

What is the lifespan of a platelet?

A

7-9 days

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4
Q

What is the main role of platelets?

A

Vascular integrity, blood clotting

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5
Q

What does a platelet count tell us?

A

Number of circulating platelets (NOT if they are adequately functioning or not)

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6
Q

What is the normal range for platelet count for adults?

A

140,000-400,000 mm^3

150-450 x 10^3

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7
Q

What are critical values for platelet levels?

A

< 20,000 = spontaneous bleeding

> 1,000,000 = increased viscosity and inappropriate clotting

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8
Q

What can interfere with the number of platelets we have?

A
  • High altitudes
  • Strenuous exercise (increased levels)
  • Menses (decreased levels prior)
  • Drugs (estrogens, oral contraceptives will increase levels, chemotherapy, H2 blockers will decrease levels)
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9
Q

What is the term for too many platelets?

A

Thrombocytosis
-Examples: polycythemia vera, post splenectomy syndrome (the spleen is responsible for killing off thrombocytes so if you don’t have a spleen you will have a high amount of them), iron deficiency anemia, rheumatoid arthritis

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10
Q

What is the term for too few platelets?

A

Thrombocytopenia

-Examples: hypersplenism, hermorrhage, leukemia

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11
Q

What should you do if a pt has a platelet count of <30,000?

A

Requires urgent referral (because <20,000 is spontaneous bleeding)

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12
Q

What should you do if a pt has a platelet count of 30,000-100,000?

A

Judgement depending on context. Urgent referral if bleeding. Watch pts levels, did it drop drastically? Has it been slowly dropping over a period of time or did it all of a sudden drop?

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13
Q

What should you do if a pt has a platelet count of 100,000-145,000?

A

Keep an eye on their count. Run follow up counts. Refer if progressive without obvious cause

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14
Q

What does Mean Platelet Volume (MPV) measure?

A
  • Volume of a large number of platelets
  • Indicates the uniformity of size of the platelet population
  • Similar to MCV for RBCs
  • SIZE
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15
Q

What do petechiae result from?

A

Bleeding under the skin

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16
Q

What is the key description of petechiae?

A

Flat to the touch, non-blanching, pinpoint round spots

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17
Q

How do purpura differ from petechiae?

A

Purpura are bigger than petechiae

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18
Q

What are the three i’s of WBC’s?

A

Infections, inflammation and immune responses

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19
Q

What is a CBC with differential?

A

WBC count with a percentage of each type

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20
Q

What is the normal range of WBCs in an adult?

A

5,000-10,000 mm^3

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21
Q

What WBC count identifies a patient as VERY sick?

A

> 15,000

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22
Q

What WBC count signifies a infection?

A

12,000-15,000

23
Q

What WBC count is an inflammatory/immune rxn?

A

10,000-12,000

24
Q

Do older adults (70-80+) mount larger (high WBC count) or smaller (lower WBC count) immune responses when sick?

A

Smaller. If you have an older adult, think 10-12 WBC count is VERY sick
-This is why many older people didn’t get as sick from the COVID vaccine as we did, because they don’t mount as high of an immune response

25
Q

What factors can effect a WBC count?

A
  • Time of day (lower in morning, later afternoon peak)
  • Age, gender
  • Smoke, 30% increase in total WBC
26
Q

What is a high WBC count called?

A

Leukocytosis

-Examples: infection, hemorrhage, trauma, leukemia

27
Q

What is a low WBC count called?

A

Leukopenia
-Examples: viral infections, bone marrow disorders, spleen disorders, immune problems (MS meds tell immune system to “settle down” = lower WBC count), AIDS

28
Q

All infections cause ______, but not all ______ is a infection

A

Inflammation, inflammation

29
Q

The inflammatory process is triggered by ___ ______

A

Cell injury

30
Q

What are the two subdivisions of Leukocytes?

A
  1. Phagocytes
    - Granulocytes
  2. Immunocytes
    - Agranulocytes
31
Q

What are the 3 types of granulocytes?

A
  1. Neutrophils
  2. Eosinophils
  3. Basophils
    * Contain a multilobed nucleus
32
Q

What are the two types of agranulocytes?

A
  1. Monocytes
  2. Lymphocytes
    * Non lobular nuclei
33
Q

What is the most numerous and most important leukocyte?

A

Neutrophils

34
Q

What is the main role of neutrophils?

A
  • Highly motile - first to arrive in response to acute inflammation or infection
  • Primary defense against microbial invasion through phagocytosis
35
Q

What are immature neutrophils called?

A

Bands (nucleus is not multi segmented)

36
Q

Are bands typically found in circulating blood?

A

NO. They are seen in the blood when a big infection is present and help is needed

37
Q

What is the normal range for Neutrophils?

A

3,000-7,000 mm^3

60-70% of total WBC (0-3% are band cells)

38
Q

What does a left shift indicate?

A

Abnormal number of immature cells are being released into peripheral blood prematurely (bands are being pushed out) - sign of infection

39
Q

We must have a ______ immune system in order to release bands

A

Healthy (no bands means poor immune system)

40
Q

What are some causes of a left shift?

A
  • Infections
  • Intoxications
  • Tissue necrosis
  • Leukemia
  • Pernicious anemia
  • Hyposplenism
41
Q

What does the Absolute Neutrophil count measure?

A

Infection fighting cells in the body
number of WBC x %(segs + bands)
If ANC <1000 = increased risk of infx
if ANC <150 = increased risk of serious infx

42
Q

What does a high eosinophil count alert us to?

A

Parasitic disease or allergies

43
Q

What is a normal eosinophil count?

A

0-0.7 x 10/L

0-3% of total WBC count

44
Q

What does a high basophil count alert us to?

A

Chronic inflammation

45
Q

What is a normal basophil count?

A

.15-.50

0-1% of total WBC count (least amount)

46
Q

When is the only time we should expect to see blast cells?

A

Leukemia (blast cells are so immature that they are not found in peripheral blood)

47
Q

What two things do you know if you see Auer Rods?

A
  1. The population of cells you’re looking at are malignant
  2. The malignancy involves the neutrophil series
    * See Auer Rods = think cancer!
48
Q

What are the largest WBC?

A

Monocytes

49
Q

What is the role of monocytes?

A

Body’s second line of defense against infection

-Produce the antiviral agent called interferon

50
Q

What is a normal monocyte count?

A

1.0-5.0

3-7% of total WBC

51
Q

What is the second most numerous WBC?

A

Lymphocytes

52
Q

What is the role of lymphocytes?

A

Important role in immune system

  • B and T lymphocytes
  • B = memory
  • T = master immune cells
53
Q

What is a normal lymphocyte count?

A

1500-4000 cells/mm^3

20-30% of total WBC count

Medical Diagnostics (10 decks)

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