Quiz 2 Flashcards
Total WBC count
4.5 - 11.0 x 10^3/uL
% of neutrophil count
50-70% of WBC count
Absolute neutrophil count calculation
1.8-7.9 x 10^3/uL
Platelet count
150-450 x 10^3/uL
RBC count males
4.6-6.0 x 10^6/uL
RBC count females
3.9-5.5 x 10^6/uL
Hgb Male
13.6-17.2 g/dL
Hgb Female
12.0-15.0 g/dL
Hematocrit Male
41-50%
Hematocrit Female
35-45%
Total iron binding capacity %
66% (250-400mcg/dL)
sodium
136-142 mEq/L
potassium
3.5-5.0 mEq/L
glucose
70-110 mg/dL
BUN
8-23md/dL
Creatinine male
0.7-1.3 mg/dL
Creatinine female
0.6-1.1 mg/dL
Bilirubin (total)
0.3-1.2 mg/dL
HgbA1C
non diabetics
4.0-5.6%
HgbA1C diabetic diagnosis
greater than or equal to 6.5%
HgbA1C
poorly controlled diabetic
> 8%
HgbA1C goal for diabetic pt
7%
Troponin I
<0.03ng/mL
Troponin T
<0.1ng/mL
Cholesterol
<200mg/dL
ESR
0-20mm/hour
TSH
0.5-5.0 uIU/mL
Iron deficiency anemia
decreased iron in body
blood loss, pregnancy, poor diet, gastric bypass
most common
Vitamin deficiency anemia
low levels of B12/folate (required for erythropoesis)
poor diet
Aplastic anemia
body stops making new RBCs
chemicals, drugs, autoimmune disease
rare
Hemolytic anemia
destruction of RBCs
multiple causes (genetics, infection)
Anemia of chronic disease
decreased RBC production in bone marrow
chronic inflammatory and neoplastic states–impair RBC production
Sideroblastic anemia
abnormal production of RBCs preventing iron from binding to Hgb
multiple causes
Thalassemia
abnormal alpha/beta chain of Hgb
genetic cause
more common in certain ethnic groups
Normocytic anemia
Hgb/Hct decreased but MCV normal
acute blood loss, anemia of chronic disease
most frequently encountered anemia
Microcytic anemia
MCV decreased <80fl
thalassemia
most common cause of iron deficiency anemia
Macrocytic anemia
MCV increased >100fl
alcoholism, B12 folate deficiency, liver disease
White blood cells
monocyte eosinophil basophil lymphocyte neutrophil
WBC count purpose
measure all white blood cells
Elevated WBC count
leukocytosis
bacterial infections, steroids, smokers
Decreased WBC count
leukopenia
viral and parasitic infections, some bacterial
decreased production 2/2 cancer, chemo, B12 deficiency, alcohol abuse, poor nutrition
African American descent
WBC count fluctuations
exercise
pain
pregnancy
emotional responses
WBC w/differential
neutrophils purpose
60% of WBCs are neutrophils
important to get % as well as actual count
Elevated WBC w/diff neutrophils
leukocytosis
left shift–higher presence of immature cells (band)
occurs in infection
Decreased WBC w/diff neutrophils
leukopenia
severe neutropenia= high risk of life threatening bacterial infection
mild and moderate risks
WBC w/diff lymphocytes purpose
measure T, B, and NK cells
form body’s immunity
20-40%
Elevated WBC w/diff lymphocytes
lymphocytosis
mostly viral (mono, CMV, HIV, pneumonia, MMR, varicella)
some bacterial (pertussis, bartonella)
levels higher in infants/children
Decreased WBC w/diff lymphocytes
lymphocytopenia
bacterial/fungal sepsis
post-op state, chemo, radiation, malignancy, steroids, immunosuppressants
immature lymphocyte=blast
WBC w/diff monocytes purpose
measure monocyte level
causes of elevated WBC w/diff monocytes
bacterial, viral, parasitic infection
hematological/myeloproliferative disorder, hemolytic anemia, autoimmune
monocytes
precursor to macrophage, fxn to remove damaged/dead tissue
WBC w/diff eosinophils purpose
measure eosinophils
not really sure
Elevated WBC w/diff eosinophils
eosinophilia
parasites and allergic disorders
milde: 500-1500
Decreased WBC w/diff eosinophils
eosinopenia
acute bacterial infections
WBC w/diff basophils purpose
measure basophil count
least used part of CBC
Elevated WBC w/diff basophils
parasitic infection and allergies but uncommon
Decreased WBC w/diff basophils
uncommon
Platelets purpose
important to determine coagulation disorder
any bleeding/bruising should be thought of as platelet fxn issue
Elevated platelet count
thrombocytosis
reactive: infection, post-op, malignancy, post-splenectomy, acute blood loss
autonomous: malignancy
Decreased platelet count
thrombocytopenia
lab error, drug induced, infection, HIV, HCV, Epstein Barr, sepsis, parasites
RBC count purpose
measure RBC count
anemia
Panel includes quantity, size, weight, volume, width of RBC
Elevated RBC count
cigarette smoke, Dehydration, polycythemia (abnormally high RBC and Hgb count)
Decreased RBC count
anemia bleeding (GI and GYN) hematopoietic failure poor nutrition (lack of B6, B12, folate, iron) drug induced (abs, NSAIDs)
Hemoglobin (Hgb) purpose
HB carries O2
useful test
Elevated Hgb
tobacco, COPD, alcohol abuse
dehydration (false elevation)
increased in newborns
Decreased Hgb
acute blood loss, malnutrition, renal failure, disorders of Hgb structure (thalassemia, sickle cell)
Hematocrit (Hct)
% of whole blood made up of RBCs
packed cell volume
Mean corpuscular volume (MCV)
average volume of RBC
classify types of anemia
Elevated MCV
macrocytic
Decreased MCV
microcytic
Mean corpuscular hemoglobin concentration (MCHC)
portion of RBC taken up by Hgb
Elevated MCHC
increased Hgb
increased iron
increased color of RBC=hyperchromatic
Decreased MCHC
hypo chromatic (decreased Hgb)
less red color
Mean corpuscular hemoglobin (MCH)
weight of hemoglobin in RBC
rises and falls w/MCV
RBC distribution width (RDW)
measure variation in RBC volume
earliest manifestation of iron deficiency anemia
Anisocytosis
cells of varying size
elevated RDW
Reticulocyte count
not part of CBC
reticulocytes=immature RBCs (should be 1%)
f/u abnormal CBC
Increased reticulocyte count
hemolytic anemia
acute blood loss
severe anemia (reticulocytes released prematurely, more in circulation)
Decreased reticulocyte count
vitamin deficiency anemia, iron deficiency anemia, bone marrow failure, decreased EPO production
renal disease/failure
Hemoglobinopathies
alpha/beta thalassemia
Hb S–sickle cell
Hb C–mild anemia
Hb E–mild anemia (Asians)
Components of CMP
electrolyte fxn–sodium, potassium, chloride, carbon dioxide, anion gap
renal fxn–BUN, creatinine
liver fxn–bilirubin, alkaline phosphatase, AST, ALT
Reasons to order CMP
abdominal pain
glucose levels
potassium/renal fxn (HTN tx)
liver dysfunction/toxicity
Ion distribution
intracellular fluid: potassium
extracellular fluid: sodium
Plasma water increased
sodium and osmolality decreased
ADH secretion decreased
collecting renal tubule impermeable to water (water not reabsorbed)
Plasma water decreased
sodium and osmolality increased
ADH secretion increased
collecting renal tubule reabsorbs more water
Elevated sodium
hypernatremia
unreplaced water loss (elderly pt/people w/o free access to water)
Decreased sodium
hyponatremia
thiazide diuretics, renal insufficiency, inadequate sodium
Elevated potassium
increased intake
ACE inhibitors
crush injuries/infection
Decreased potassium
fluid/electrolyte loss
diuretics
decreased intake
Elevated glucose
diabetes acute stress response pregnancy pancreatitis corticosteroid therapy