Quiz 2: CBC Flashcards

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1
Q

Hematopoietic stem cells reside in?

A

Bone marrow

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2
Q

How many erythrocytes are produced every hour?

A

10^10

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3
Q

How many leukocytes are produced every hour?

A

10^8

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4
Q

Hematopoietic stem cells and can differentiate into all # lineages?

A

10

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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

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6
Q

Thrombocytes aka

A

platelets

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7
Q

Can disorder that decreases RBCs can result in:

A

iron deficiency

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8
Q

What are signs of anemia?

A

fatigue, light headed, pale, brusing, conjunctival pallor

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9
Q

What is the most common type of anemia?

A

Iron-deficiency anemia

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10
Q

Vitamin-deficiency anemia

A

low levels of vitamin B12 or folate from poor diet

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11
Q

Vitamin B12 and B9 (folic acid) are required for?

A

erythropoiesis

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12
Q

Aplastic anemia

A

body stops erythropoisis

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13
Q

Hemolytic anemia

A

Destruction of RBCs resulting from multiple causes

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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

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15
Q

Sideroblastic anemia:

A

bone marrow produces abnormal RBCs which prevent iron form being incorporated into in hemoglobin

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16
Q

Thalassemia:

A

body produces abnormal alpha or beta chain of hemoglobin, genetic cause, more common in certain ethnic groups

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17
Q

What is the most important/most ordered blood test?

A

CBC

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18
Q

Name five types of WBC?

A

monocyte, eosinophil, basophil, lymphocytes, neutrophil

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19
Q

WBC normal:

A

4.5-11.0 x 10^3/uL

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20
Q

WBC count includes:

A

all WBCs together

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21
Q

WBC aka

A

leukocyte

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22
Q

Word for elevated WBC count

A

leukocytosis

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23
Q

Word for decreased WBC count

A

leukopenia

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24
Q

WBC commonly increased in: (leukocytosis)

A

infections (mostly bacterial), corticosteroids, smokers

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25
Q

Conditions resulting in leukopenia:

A

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)

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26
Q

The majority of mature WBCs are?

A

neutrophils (60%)

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27
Q

An increase or decrease in total WBC count is usually a reflection of change in?

A

neutrophil count

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28
Q

Leukocytosis is often called

A

neutrophilia

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29
Q

Leukopenia is often called

A

neutropenia

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30
Q

Leukocytosis AKA

A

granulocytosis

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31
Q

formula for absolute neutrophil count:

A

Total WBC count x % neutrophils

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32
Q

Neutrophils normal %

A

50-70% of WBCs

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33
Q

Normal absolute neutrophil:

A

1.8-7.8 x 10^3/uL

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34
Q

Neutrophils come in two forms:

A

band neutrophils, segmented neutrophils

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35
Q

Band neutrophils:

A

less mature nucleus

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36
Q

Segmented neutrophils:

A

mature nucleus

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37
Q

Left shift:

A

there is a higher predominance of immature neutrophils present on a particular CBC

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38
Q

When does a left shift normally occur?

A

infection or inflammatory response

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39
Q

Severe neutropenia values:

A

500 (0.5 x 10^3)

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40
Q

Pts with severe neutropenia are at risk for:

A

overhwhelming and life threatening bacterial infection

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41
Q

Moderate neutropenia:

A

500-1000

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42
Q

Mild neutropenia:

A

1000-1500

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43
Q

Three types of lymphocytes:

A

T cells, B cells, and natural killer (NK) cells

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44
Q

What is the function of lymphocytes?

A

form immunity against foreign proteins and pathogens

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45
Q

Natural killer cells are involved in:

A

destruction of tumor and virally infected cells

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46
Q

Lymphocyte %

A

20-40%

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47
Q

Absolute lymphocyte count:

A

1.8-4.8 x 10^3/uL

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48
Q

Lymphocyte levels are naturally higher in:

A

infants and young children

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49
Q

Absolute lymphocyte calculation:

A

Total WBC x % lymphs

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50
Q

Word for increased lymphocytes

A

Lymphocytosis

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51
Q

Word for decreased lymphocytes

A

Lymphocytopenia

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52
Q

Word for immature lymphocyte:

A

lymphoblast

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53
Q

Lymphocytosis occurs in infection, predominately:

A

Viral, less commonly bacterial

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54
Q

Viral infections associated with lymphocytosis:

A

mononucleosis, cytomegalovirus, primary HIV infection, viral pneumonia, measles, mumps, rubella, varicella

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55
Q

Bacterial infections associated with lymphocytosis:

A

Pertussis, Bartonella

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56
Q

Lymphocytopenia conditions:

A

bacterial/fungal sepsis, postoperative state, chemotherapy/radiation, malignancy, corticosteroids or immunosuppressant medication

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57
Q

Monocyte is the precursor of the:

A

macrophage

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58
Q

The function of the monocyte

A

help removed dead or damaged tissue by evolving into macrophages and removing cellular debris

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59
Q

What do macrophages secrete?

A

over 100 proteins that contribute to host defense and immunity

60
Q

Normal monocyte %:

A

2-8% of WBCs

61
Q

Absolute monocyte count

A

0.0-0.8 x 10^3/uL

62
Q

Causes of increased monocytes:

A

bacterial infection, viral infection, parasitic infection, hematologic or myeloproliferative disorder, hemolytic anemia, autoimmune disorders

63
Q

What do eosinophils do?

A

Who knows

64
Q

Normal % Eosinophils?

A

0-7% of WBCs

65
Q

Aboslute Eosinophil count:

A

0.00-0.45 x 10^3

66
Q

Eosinophilia causes:

A

parasites, allergic disorders

67
Q

Eosinopenia causes:

A

most acute or bacterial infections are associated with a decreased eosinophil count

68
Q

Basophils are involved in?

A

parasitic infections and allergy related illnesses

69
Q

Normal % basophils

A

0-3% of WBCs

70
Q

Absolute basophil count

A

0.00-0.20 x 10^3/uL

71
Q

Platelets are the x and the most x

A

smallest and most numerous

72
Q

Normal platelet value:

A

150-450 x 10^3/uL

73
Q

Thrombocytosis conditions:

A

infection, post surgery, malignancy, postsplenectomy, acute blood loss or iron deficiency, malignancy

74
Q

Thrombocytopenia conditions:

A

lab error, drug induced, infection (HIV, Hepatitis C, Epstein Barr virus, sepsis, parasites)

75
Q

RBC normal male

A

4.6-6.0 x 10^6/uL

76
Q

RBC normal female

A

3.9-5.5 x 10^6/uL

77
Q

Increased RBC count

A

cigarette smoking, dehydration, increase production of EPO by kidneys, bone marrow malignancy or disase, polycythemia

78
Q

What’s polycythemia?

A

abnormally high RBC count and corresponding high hemoglobin count

79
Q

Decreased RBC count

A

anemia, bleeding, hematopoetic failure (radiation, toxins, tumors), poor nutrition (B6, B12, folate, iron), drug induced (antibiotics, NSAIDs)

80
Q

Hemoglobin is naturally increased in:

A

newborns

81
Q

Normal HGB value males:

A

13.6-17.2 g/dL

82
Q

Normal HGB value women:

A

12.0-15.0 g/dL

83
Q

Increased hemoglobin levels:

A

tobacco use and advanced COPD, alcohol use, dehydration (false elevation), living in high altitudes, EPO abuse

84
Q

Decreased hemoglobin

A

acute blood loss anemia, malnutrition, renal failure, disorders of hemoglobin structure (thalassemia, sickle cell anemia)

85
Q

Hematocrit normal values male:

A

41-50%

86
Q

Female hematocrit normal values:

A

35-45%

87
Q

What is hematocrit?

A

percentage of whole blood that is made up of RBCs

88
Q

Hematocrit aka

A

Packed Cell Volume (PCV)

89
Q

Hematocrit is increased in:

A

newborns and young

90
Q

MCV =

A

mean corpuscular volume

91
Q

MCHC =

A

mean corpuscular hemoglobin concentration

92
Q

MCH =

A

mean corpuscular hemoglobin

93
Q

RDW =

A

red blood cell distribution width

94
Q

RDW refers to the variation of the RBC:

A

volume (not the diameter) of the erythrocyte from the standard deviation

95
Q

RDW =

A

(SD of MCV / mean MCV) x 100

96
Q

Higher RDW indicates

A

larger variation in RBC volume

97
Q

Cells of varying size (word)

A

anisocytosis

98
Q

What is the earliest manifestation of iron deficiency anemia?

A

RDW

99
Q

MCV measures:

A

the average volume of the RBC by dividing the Hct/Hgb

100
Q

MCV categorizes the size of RBC into three categories:

A

microcytic, normocytic, macrocytic

101
Q

Word for decreased MCV

A

microcytic

102
Q

Word for normal MCV

A

normocytic

103
Q

Word for increased MCV

A

macrocytic

104
Q

MCH measures:

A

the average weight of hemoglobin within the RBC by dividing the Hgb/RBC

105
Q

MCH rises and falls with:

A

MCV

106
Q

MCHC measures

A

the proportion of each RBC that is taken up by hemoglobin

107
Q

Word for decreased concentration of hemoglobin

A

hypochromic (decrease MCH or MCHC)

108
Q

Word for normal concentration of hemoglobin

A

normochromic (normal MCH/MCHC)

109
Q

Word for increased concentration of hemoglobin

A

hyperchromic (increase MCH or MCHC)

110
Q

Increased hemoglobin (increased iron) does what to color of RBC

A

increased red

111
Q

What is the most frequently encountered anemia?

A

normocytic anemia

112
Q

In normocytic anemia what is decreased and what is normal

A

Hgb/Hct decreased, but MCV normal

113
Q

Normocytic anemia reflects:

A

decreased RBC production or increased RBC destruction

114
Q

Normocytic anemia conditions:

A

acute blood loss, anemia of chronic diseases (75% of time), hemolytic anemia

115
Q

In microcytic anemias, what is decreased?

A

MCV

116
Q

The most common cause of microcytic anemia is:

A

iron deficiency anemia (usually hypochromic too)

117
Q

Microcytic anemia conditions:

A

iron deficiency anemia, alpha-thalassemia, beta-thalassemia, anemia of chronic diseases (25% of time), lead poisoning

118
Q

In macrocytic anemia what is increased?

A

MCV

119
Q

Conditions of macrocytic anemia:

A

alcoholism, B12 or folate deficiency, liver disease

120
Q

When do you order a reticulocyte count?

A

to follow up abnormal CBC results or to investigate for bone marrow disorders

121
Q

What are reticulocytes?

A

immature red blood cells that are visible due to the presence of ribosomal RNA that turns blue when stained

122
Q

Reticulocytes approximate about x% of RBCS

A

1%

123
Q

Reticulocytes circulate about x days as reticulocytes then mature

A

1-2 days

124
Q

Average lifespan of RBC:

A

100-120 days

125
Q

When are reticulocytes released?

A

In cases of severe anemia (higher count)

126
Q

When does low reticulocyte count occur?

A

bone marrow failure (EPO fails inf ace of anemia)

127
Q

Increased reticulocyte count represents:

A

recent or ongoing RBC production and activity

128
Q

Reticulocytes are increased in:

A

hemolysis or hemolytic anemia, actute blood losss

129
Q

Decreased reticulocyte count represents:

A

decrease in RBC production

130
Q

Reticulocytes are decreased in:

A

vitamin deficiency anemia, iron deficiency anemia, bone marrow failure, decreased EPO production (renal disease/failure)

131
Q

Hemoglobin A:

A

composed of 2 alpha and 2 beta chains

132
Q

Hemoglobin A2:

A

composed of 2 alpha and 2 delta chains

133
Q

Hemoglobin F

A

composed of two alpha and 2 gamma chains

134
Q

Adult hemoglobin:

A

two alpha and two beta

135
Q

Fetal hemoglobin:

A

two alpha and two gamma chains

136
Q

What’s special about fetal hemoglobin?

A

higher oxygen affinity in utero

137
Q

Alpha thalassemia

A

impaired production of alpha chains

138
Q

Beta thalassemia

A

impaired or very reduced beta hemoglobin chains

139
Q

Beta thalassemia is common in

A

mediterranean, asian, and african descent

140
Q

Hemoglobin S

A

sickle cell trait or disase

141
Q

Hemoglobin C

A

mild anemia

142
Q

Hemoglobin E

A

mild anemia, common in Asian descent

143
Q

Hemoglobin S, C, E, D result from variations in what hemoglobin chain?

A

beta

144
Q

When is hemoglobin electrophoresis indicated?

A

evaluation of suspected hemoglobinopathies, following an abnormal CBC or finding of anemia, family studies

145
Q

Increased hemoglobin A2

A

beta thalassemia or heterozygous for trait

146
Q

Decreased hemoglobin A2

A

alpha thalassemia or heterozygous for trait