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Lab diagnosis > Quiz QA- Week % > Flashcards

Quiz QA- Week % Flashcards

1
Q

five things to learn in hematology

A

RBC function/formation, reticulocytes, counting, size/shape variation and erytrhocite sedimentation rater

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2
Q

what is CBC

A

Complete blood count the most routinely run panel in the health care system

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3
Q

what does CBC include 8

A

RBC, WBC, platelet, nutrition, inflammation, disease states, hydration and occult blood loss

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4
Q

what makes of 99% of blood cells?

A

RBC

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5
Q

How big is RBC

A

2 x 7.5 um but can squeeze to 3um

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6
Q

what is unique about RBC

A

no nucleus so can carry more hemoglobin.

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7
Q

what is RBC function

A

contain for hemogobin, gas exchange and buffering of blood and clotting mechasim via hemostatic plug.

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8
Q

what enzyme in RBC helps buffer blood

A

carbonic anhydrase

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9
Q

what gasses does RBC exchange

A

Oxygen to cells, CO2 to lungs

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10
Q

How is CO2 trasported

A

disolved, in hemoglobin, bicarbonate

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11
Q

what acts on bone marrow to increse RBC production

A

erythropoietin EPO from the kidnelys

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12
Q

How is EPO regulated?

A

Oxygen levels in kidneys

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13
Q

Why would we test serum for EPO levels?

A

for reason of increased RBC, polycythemia or anemia

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14
Q

What can elevate EPO

A

Decreased oxygen states or improper excretion

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15
Q

Example of decreased oxygen

A

hypoxia, smoking, COPD altitude

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16
Q

Example of improper excretion

A

renal carcinoma, hepatic tumor, adrenal tumor

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17
Q

what 3 things could cause Depressed EPO?

A

Renal failure, severe malnutrion, hypothyroidism, malignancy. Increased TNF=a

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18
Q

Where does drythropoiesis happen in adults?

A

in the bone marrow of long or flat bones

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19
Q

what is erythropoiesis

A

production and maturation of RBC

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20
Q

Generations of erythropoiesis

A

mesenchyme, liver, spleen, bone marrow

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21
Q

how long does mature RBC, erythrocyte last

A

120 days

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22
Q

undifferentiate stem cell is what?

A

rubriblast, it is what gets released from marro,

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23
Q

what is reticulocyte

A

immiture rBC that has already lost nucleus

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24
Q

who nurses young RBCs untill they lose nucleus

A

the nurse macrophage, they recycle nucleuse to grow new RBCs

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25
Q

how long does it take for a reticulocyte to mature

A

24 hours

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26
Q

how is a reticulocyte identified?

A

mesh like appearance, bluish with wright stain larger than RBC. About 1%

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27
Q

what happens in and anemic person blood?

A

RETIC maturition time increases from 24 hours up to 2.5 days according to severity.

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28
Q

why do anemic peoples reticulocytes take longer to mature?

A

They are kicked out of marrow super early before maturing enough inside, have to make up time on outside.

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29
Q

when shoud we see increased reticulocyte count?

A

responding to anemia or hemorrhage.

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30
Q

what would anemia eith low reticulocytes mean? 4

A

Failure of bone marrow, EPO deficiency, Bone marrow malignancy, anemia of chronic disease

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31
Q

Failure of bone marrow

A

aplastic anemia

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32
Q

EPO deficiency

A

Renal failure

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33
Q

bone marrow malignancy

A

leukemia

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34
Q

What can interfere with reticulocyte counts

A

Pregnancy, increased cound with increased fluid volume, hypoxia, or Howell jolly bodies

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35
Q

Howell-jolly bodies are what

A

nuclear remnant that may be mistaken for teticulocyte

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36
Q

How is the RI adjusted to comared to normal hematocrit

A

Reticulocyte index, its recommended for anemia.

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37
Q

What is normal hematocrit?

A

.45(L/L)

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38
Q

what should the RI in patients with good marrow responses be

A

2-3% to indicate increased RBC production

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39
Q

what if the RI in patients in response to anemia is <2%

A

Hypoproliferative, response is not good enough.

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40
Q

in what conditons would you have increased reticulocytosis?

A

Hemolytic anemia, hemorrhage, HND, deficiency anemias that have been treated. Pushing out Reticulocytes faster

41
Q

In what conditions would you see reticulocytopenia

A

Pernicious anemia, Nutrient deficiencies, aplastic anemai, radiation therapy, chronic disease

42
Q

reticulocytopenia

A

decreased reticulocyte countes

43
Q

How were RBC,s counted?

A

diluted blood sample over slide with grid,

44
Q

RBC count under what magnification

A

High powered field

45
Q

What is coulter counter

A

1st commercially available machine to automate RBC counting, more accurate and takes 1/3 the time.

46
Q

How does coulter counter work

A

measures voltage variation as cells pass aperature

47
Q

how are RBC counts reported?

A

million/mm3

48
Q

RBC counting with culter counter is independent of what?

A

cell shape, color and density

49
Q

what type of RBC counts allow Hematocrit calculation

A

automated RBC

50
Q

who has the most RBC

A

men or 16-18 year olds

51
Q

who has the least RBC

A

women, less even than babies

52
Q

what does dehydration do?

A

looks like Erythrocytosis but its really reduced plasma to RBC ration

53
Q

what erythrocytosis has normal EPO

A

dehydration and bone marrow proliferation disorder like leukemia

54
Q

what would cause erythrocytosis with elevated EPO

A

renal proliverative disorder and secondary polycythemia like high altitude

55
Q

what would cause erythrocytosis with low EPO

A

Primary polycythemia like a genetic disorder

56
Q

what can cause anemia

A

malnutriton, mal absorbtion, inflammation, hemorrage, BM failure and renal disease

57
Q

what can interfere wit RBC counts

A

Pregnancy shows decreased, High altitued is increased, Hydration and drugs

58
Q

what is hematocrit?

A

the portion of blood composed of erythrocytes

59
Q

how is hematocrit expressed

A

percentage of total blood volume.

60
Q

how is hematocrit determined

A

centerfuge then dividing height of RBC by total height and multiply by 100

61
Q

what is hemacrit an indirect measure of?

A

Indirect measure of # of RBCs and their total blood volume

62
Q

reference for female hemocrit

A

37-47%

63
Q

reference for male hemocrit

A

42-52%

64
Q

anisocytosis

A

signifigant variation of RBC size

65
Q

where is most anisocytosis found

A

most anemias and leukemias

66
Q

what often causes anisocytosis

A

deficiency in raw material

67
Q

how is anisocytosis graded

A

scale 1+ to 4+

68
Q

What is red blood cell distrobution witdth, RDW

A

statistical measure of variation of RBC size and it indicated degree of anisocytosis.

69
Q

what does an indreased RDW, Red Blood cell Distribution width mean?

A

iron def anemia, B12 or folic adic def, hemoglobinpathies, hemolytic anemias, post hemorrhagic anemia.

70
Q

what RDW is clinically signifigant?

A

increased RDW, not decreased RDW,

71
Q

normal RDW is what

A

11.5 to 14.5

72
Q

what does a round macrocyte indicate

A

liver disease

73
Q

what does an oval macrocyte indicate

A

B12/folic acid deficiency or pernicious anemia

74
Q

what is a macrocyte

A

greater than 8um without the central paleness

75
Q

what is a microcyte

A

small than 6um with increased central palor

76
Q

what can cause microcytes

A

iron deficiency, blood loss and diseroblastic, lead poisioning

77
Q

What does a periperal smear evaluatio help with?

A

to diagnose range of deficiencies, diseases and disorders by determine if cells are normal size

78
Q

poikilocytosis

A

excessive RBC shape variation,

79
Q

Target cells- dark spot in middle

A

Thalassemia, splenectomy, LIVER disease,

80
Q

if someone had target cells what labs to follow

A

CBC, iron studies, liver profile testing

81
Q

spherocytes with no central palor

A

autoimmune hemolytic anemia and hereditary sperocytosis.

82
Q

signs of sperocytes

A

splenomegaly, jaundice and anemia because RBCs burst easily

83
Q

schistocytes

A

fragmented cells that result from trauma to membrane, HUS, TTP

84
Q

Helmet cells

A

Pulmonay emboli

85
Q

echinocytes

A

multiple tiny spikes that are enenly distributed,

86
Q

what causes echinocytes

A

exposure of certain substances to cell, burr cells

87
Q

acanthocytes/spurr cells

A

sphere shaped with large irregular thornes,

88
Q

where is acanthocytes seen

A

post splenectomy, alcholics, chirrhosis, hemolytic anemias

89
Q

dacrocytes

A

teardrop shaped, pathologic and indicate bone marrow failure

90
Q

when are darocytes seen

A

megoblastic anemia, renal failue, Fe deficiency

91
Q

elliptocytes, or ovalcytes

A

thalassemia, fe or folate deficiency, or heredity elliptocytosis.

92
Q

sickel cells

A

abnormal hemoglobin, prone to tension when o2 is low, that then get stuck in capillariesl

93
Q

signs of sickel cell

A

splenic enlargment then size reduction

94
Q

what are inclusions

A

weired stuff in RBC like Howell-olly bodies

95
Q

when are inclusions most often seen

A

after splenectomy because normally spleen would remove these

96
Q

Heinz bodies

A

damage to hemoglobin by oxidative stress, irreservable hemichrom oxidation

97
Q

where are heinz bodies seen

A

congenital hemolytic anemai, alpha thalassemia

98
Q

Basophilic stippling

A

toxic injury to bone marrow, sever megoblastic anema, lead poisoning.

99
Q

few more slides to go

A

ok

Lab diagnosis (4 decks)

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