Quiz 2: CBC Flashcards
1
Q
Hematopoietic stem cells reside in?
A
Bone marrow
2
Q
How many erythrocytes are produced every hour?
A
10^10
3
Q
How many leukocytes are produced every hour?
A
10^8
4
Q
Hematopoietic stem cells and can differentiate into all # lineages?
A
10
5
Q
What are the 10 cell lineages?
A
erythrocytes, platelets, neutrophils, eosinophils, basophils, monocytes, T and B lymphocytes, natural killer cells, and dendritic cells
6
Q
Thrombocytes aka
A
platelets
7
Q
Can disorder that decreases RBCs can result in:
A
iron deficiency
8
Q
What are signs of anemia?
A
fatigue, light headed, pale, brusing, conjunctival pallor
9
Q
What is the most common type of anemia?
A
Iron-deficiency anemia
10
Q
Vitamin-deficiency anemia
A
low levels of vitamin B12 or folate from poor diet
11
Q
Vitamin B12 and B9 (folic acid) are required for?
A
erythropoiesis
12
Q
Aplastic anemia
A
body stops erythropoisis
13
Q
Hemolytic anemia
A
Destruction of RBCs resulting from multiple causes
14
Q
Anemia of chronic disease:
A
occurs in the presence of multiple chronic conditions, results from decreased RBC production by bone marrow, chronic inflammatory and neoplastic states that impair RBC production
15
Q
Sideroblastic anemia:
A
bone marrow produces abnormal RBCs which prevent iron form being incorporated into in hemoglobin
16
Q
Thalassemia:
A
body produces abnormal alpha or beta chain of hemoglobin, genetic cause, more common in certain ethnic groups
17
Q
What is the most important/most ordered blood test?
A
CBC
18
Q
Name five types of WBC?
A
monocyte, eosinophil, basophil, lymphocytes, neutrophil
19
Q
WBC normal:
A
4.5-11.0 x 10^3/uL
20
Q
WBC count includes:
A
all WBCs together
21
Q
WBC aka
A
leukocyte
22
Q
Word for elevated WBC count
A
leukocytosis
23
Q
Word for decreased WBC count
A
leukopenia
24
Q
WBC commonly increased in: (leukocytosis)
A
infections (mostly bacterial), corticosteroids, smokers
25
Conditions resulting in leukopenia:
infections (viral, parasitic, some bacterial), decreased production (bone marrow malignancy or defect, chemotherapy, nutritional deficiency--B12, folate), radiation treatment for cancer, benign ethnic leukopenia, alcohol abuse, poor nutrition, gastric bypass (impaired folic acid absorption)
26
The majority of mature WBCs are?
neutrophils (60%)
27
An increase or decrease in total WBC count is usually a reflection of change in?
neutrophil count
28
Leukocytosis is often called
neutrophilia
29
Leukopenia is often called
neutropenia
30
Leukocytosis AKA
granulocytosis
31
formula for absolute neutrophil count:
Total WBC count x % neutrophils
32
Neutrophils normal %
50-70% of WBCs
33
Normal absolute neutrophil:
1.8-7.8 x 10^3/uL
34
Neutrophils come in two forms:
band neutrophils, segmented neutrophils
35
Band neutrophils:
less mature nucleus
36
Segmented neutrophils:
mature nucleus
37
Left shift:
there is a higher predominance of immature neutrophils present on a particular CBC
38
When does a left shift normally occur?
infection or inflammatory response
39
Severe neutropenia values:
500 (0.5 x 10^3)
40
Pts with severe neutropenia are at risk for:
overhwhelming and life threatening bacterial infection
41
Moderate neutropenia:
500-1000
42
Mild neutropenia:
1000-1500
43
Three types of lymphocytes:
T cells, B cells, and natural killer (NK) cells
44
What is the function of lymphocytes?
form immunity against foreign proteins and pathogens
45
Natural killer cells are involved in:
destruction of tumor and virally infected cells
46
Lymphocyte %
20-40%
47
Absolute lymphocyte count:
1.8-4.8 x 10^3/uL
48
Lymphocyte levels are naturally higher in:
infants and young children
49
Absolute lymphocyte calculation:
Total WBC x % lymphs
50
Word for increased lymphocytes
Lymphocytosis
51
Word for decreased lymphocytes
Lymphocytopenia
52
Word for immature lymphocyte:
lymphoblast
53
Lymphocytosis occurs in infection, predominately:
Viral, less commonly bacterial
54
Viral infections associated with lymphocytosis:
mononucleosis, cytomegalovirus, primary HIV infection, viral pneumonia, measles, mumps, rubella, varicella
55
Bacterial infections associated with lymphocytosis:
Pertussis, Bartonella
56
Lymphocytopenia conditions:
bacterial/fungal sepsis, postoperative state, chemotherapy/radiation, malignancy, corticosteroids or immunosuppressant medication
57
Monocyte is the precursor of the:
macrophage
58
The function of the monocyte
help removed dead or damaged tissue by evolving into macrophages and removing cellular debris
59
What do macrophages secrete?
over 100 proteins that contribute to host defense and immunity
60
Normal monocyte %:
2-8% of WBCs
61
Absolute monocyte count
0.0-0.8 x 10^3/uL
62
Causes of increased monocytes:
bacterial infection, viral infection, parasitic infection, hematologic or myeloproliferative disorder, hemolytic anemia, autoimmune disorders
63
What do eosinophils do?
Who knows
64
Normal % Eosinophils?
0-7% of WBCs
65
Aboslute Eosinophil count:
0.00-0.45 x 10^3
66
Eosinophilia causes:
parasites, allergic disorders
67
Eosinopenia causes:
most acute or bacterial infections are associated with a decreased eosinophil count
68
Basophils are involved in?
parasitic infections and allergy related illnesses
69
Normal % basophils
0-3% of WBCs
70
Absolute basophil count
0.00-0.20 x 10^3/uL
71
Platelets are the x and the most x
smallest and most numerous
72
Normal platelet value:
150-450 x 10^3/uL
73
Thrombocytosis conditions:
infection, post surgery, malignancy, postsplenectomy, acute blood loss or iron deficiency, malignancy
74
Thrombocytopenia conditions:
lab error, drug induced, infection (HIV, Hepatitis C, Epstein Barr virus, sepsis, parasites)
75
RBC normal male
4.6-6.0 x 10^6/uL
76
RBC normal female
3.9-5.5 x 10^6/uL
77
Increased RBC count
cigarette smoking, dehydration, increase production of EPO by kidneys, bone marrow malignancy or disase, polycythemia
78
What's polycythemia?
abnormally high RBC count and corresponding high hemoglobin count
79
Decreased RBC count
anemia, bleeding, hematopoetic failure (radiation, toxins, tumors), poor nutrition (B6, B12, folate, iron), drug induced (antibiotics, NSAIDs)
80
Hemoglobin is naturally increased in:
newborns
81
Normal HGB value males:
13.6-17.2 g/dL
82
Normal HGB value women:
12.0-15.0 g/dL
83
Increased hemoglobin levels:
tobacco use and advanced COPD, alcohol use, dehydration (false elevation), living in high altitudes, EPO abuse
84
Decreased hemoglobin
acute blood loss anemia, malnutrition, renal failure, disorders of hemoglobin structure (thalassemia, sickle cell anemia)
85
Hematocrit normal values male:
41-50%
86
Female hematocrit normal values:
35-45%
87
What is hematocrit?
percentage of whole blood that is made up of RBCs
88
Hematocrit aka
Packed Cell Volume (PCV)
89
Hematocrit is increased in:
newborns and young
90
MCV =
mean corpuscular volume
91
MCHC =
mean corpuscular hemoglobin concentration
92
MCH =
mean corpuscular hemoglobin
93
RDW =
red blood cell distribution width
94
RDW refers to the variation of the RBC:
volume (not the diameter) of the erythrocyte from the standard deviation
95
RDW =
(SD of MCV / mean MCV) x 100
96
Higher RDW indicates
larger variation in RBC volume
97
Cells of varying size (word)
anisocytosis
98
What is the earliest manifestation of iron deficiency anemia?
RDW
99
MCV measures:
the average volume of the RBC by dividing the Hct/Hgb
100
MCV categorizes the size of RBC into three categories:
microcytic, normocytic, macrocytic
101
Word for decreased MCV
microcytic
102
Word for normal MCV
normocytic
103
Word for increased MCV
macrocytic
104
MCH measures:
the average weight of hemoglobin within the RBC by dividing the Hgb/RBC
105
MCH rises and falls with:
MCV
106
MCHC measures
the proportion of each RBC that is taken up by hemoglobin
107
Word for decreased concentration of hemoglobin
hypochromic (decrease MCH or MCHC)
108
Word for normal concentration of hemoglobin
normochromic (normal MCH/MCHC)
109
Word for increased concentration of hemoglobin
hyperchromic (increase MCH or MCHC)
110
Increased hemoglobin (increased iron) does what to color of RBC
increased red
111
What is the most frequently encountered anemia?
normocytic anemia
112
In normocytic anemia what is decreased and what is normal
Hgb/Hct decreased, but MCV normal
113
Normocytic anemia reflects:
decreased RBC production or increased RBC destruction
114
Normocytic anemia conditions:
acute blood loss, anemia of chronic diseases (75% of time), hemolytic anemia
115
In microcytic anemias, what is decreased?
MCV
116
The most common cause of microcytic anemia is:
iron deficiency anemia (usually hypochromic too)
117
Microcytic anemia conditions:
iron deficiency anemia, alpha-thalassemia, beta-thalassemia, anemia of chronic diseases (25% of time), lead poisoning
118
In macrocytic anemia what is increased?
MCV
119
Conditions of macrocytic anemia:
alcoholism, B12 or folate deficiency, liver disease
120
When do you order a reticulocyte count?
to follow up abnormal CBC results or to investigate for bone marrow disorders
121
What are reticulocytes?
immature red blood cells that are visible due to the presence of ribosomal RNA that turns blue when stained
122
Reticulocytes approximate about x% of RBCS
1%
123
Reticulocytes circulate about x days as reticulocytes then mature
1-2 days
124
Average lifespan of RBC:
100-120 days
125
When are reticulocytes released?
In cases of severe anemia (higher count)
126
When does low reticulocyte count occur?
bone marrow failure (EPO fails inf ace of anemia)
127
Increased reticulocyte count represents:
recent or ongoing RBC production and activity
128
Reticulocytes are increased in:
hemolysis or hemolytic anemia, actute blood losss
129
Decreased reticulocyte count represents:
decrease in RBC production
130
Reticulocytes are decreased in:
vitamin deficiency anemia, iron deficiency anemia, bone marrow failure, decreased EPO production (renal disease/failure)
131
Hemoglobin A:
composed of 2 alpha and 2 beta chains
132
Hemoglobin A2:
composed of 2 alpha and 2 delta chains
133
Hemoglobin F
composed of two alpha and 2 gamma chains
134
Adult hemoglobin:
two alpha and two beta
135
Fetal hemoglobin:
two alpha and two gamma chains
136
What's special about fetal hemoglobin?
higher oxygen affinity in utero
137
Alpha thalassemia
impaired production of alpha chains
138
Beta thalassemia
impaired or very reduced beta hemoglobin chains
139
Beta thalassemia is common in
mediterranean, asian, and african descent
140
Hemoglobin S
sickle cell trait or disase
141
Hemoglobin C
mild anemia
142
Hemoglobin E
mild anemia, common in Asian descent
143
Hemoglobin S, C, E, D result from variations in what hemoglobin chain?
beta
144
When is hemoglobin electrophoresis indicated?
evaluation of suspected hemoglobinopathies, following an abnormal CBC or finding of anemia, family studies
145
Increased hemoglobin A2
beta thalassemia or heterozygous for trait
146
Decreased hemoglobin A2
alpha thalassemia or heterozygous for trait
