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Hematology > RBC > Flashcards

RBC Flashcards

1
Q

What is a RBC morphology?

A
  • Bi-concave
  • central pallor (hemoglobin)
  • anucleated
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2
Q

how long do RBC survive?

A

120 days

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3
Q

What are the three RBC indices

A

MCV
MCH
MCHC

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4
Q

what does MCV mean?

A

Mean corpuscular volume

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5
Q

What is the MCV?

A

Size of the RBC

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6
Q

What does MCH mean ?

A

Mean corpuscle hemoglobin

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7
Q

What does MCHC mean?

A

Mean corpuscular hemoglobin concentration?

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8
Q

What is the MCH represent?

A

How much hemoglobin in one RBC

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9
Q

what does the MCHC represent?

A

The overall concentration of hemoglobin

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10
Q

Where is RBC production?

A

bone marrow

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11
Q

What is the process of RBC formation called?

A

erythropoiesis

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12
Q

When is hemoglobin synthesized during RBC formation?

A

pro-normoblastic stage
polychromatophilic stage

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13
Q

What can you expect to happen to the MCH + MCHC if agglutination occurs?

A

they both increase

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14
Q

What is the normal range for MCV?

A

80 -100 fL

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15
Q

what is the average size of the central pallor when normal levels of hemoglobin are present?

A

3 mcm

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16
Q

How long does a megakaryocyte survive?

A

10 days

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17
Q

What do you call the formation of megakaryocytes?

A

megakaryocytopoiesis

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18
Q

what is the main function of megakaryocytes?

A

production of platelets from fragements of their cytoplasm

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19
Q

what is the normal range of hemoglobin?

A

Males: 140 -180 g/L
Females: 120 - 160 g/L

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20
Q

what is the normal range of hematocrit?

A

Males: 0.42 - 0.52
Females: 0.37 - 0.47

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21
Q

what is the normal range of RBC?

A

males: 4.7 - 6.1
females: 4.3 - 5.4

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22
Q

What is the normal range of MCH?

A

27 - 31 pg

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23
Q

What is the normal range of MCHC?

A

320 - 360

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24
Q

what is the normal range of platelets count?

A

150 - 450 x 10^9/L

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25
Q

when are platelet counts decreased?

A

ITP
TTP

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26
Q

what does RDW mean?

A

Red cell distribution width

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27
Q

what is the normal range of RDW?

A

11.5 - 14.5 %

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28
Q

What is the first indicator of anemia?

A

RDW

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29
Q

what is RDW?

A

measure of average volume and size of RBC

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30
Q

what can cause a high RDW?

A

dual population

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31
Q

what does MPV mean?

A

Mean platelet volume

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32
Q

what is MPV?

A

average size of platelets

33
Q

Who is most at risk of iron deficiency?

A

women in childbearing age

34
Q

what does ESR mean?

A

Erythrocyte sedimentation rate

35
Q

what is the purpose of an ESR?

A

Non specific screening test for inflammation

36
Q

how is ESR reported?

A

mm/hr

37
Q

what is ESR directly proportional to?

A

RBC mass

38
Q

what is ESR inversely proportional to?

A

plasma viscosity

39
Q

what factors effect ESR

A
  • Size + shape
  • Plasma fibrinogen
  • Globulin levels
  • Mechanical factors
  • Improperly anti-coagulated
  • Rouleaux
40
Q

what is the normal range for ESR?

A

male: 15 mm/h
female: 0-20 mm/h

41
Q

what can cause false positives to the ESR test?

A
  • Vibrations
  • cold agglutinin disease
  • rouleau
42
Q

What characteristic would a EDTA ESR test sample be rejected for?

A
  • Hemolyzed
  • older than 24 hours
  • clotted
43
Q

What are 3 reasons for an increase ESR?

A
  • Kidney disease
  • Pregnancy
  • Rheumatic fever
44
Q

What are 3 conditions related to lowered ESR?

A
  • Congestive heart failure
  • hyper viscosity
  • Decreased fibrinogen levels
45
Q

when should blood smears be made?

A

within 3 hours

46
Q

how should blood smears be labelled?

A
  • 2 unique identifiers
  • date specimen collected
  • initial of technologist making smear
47
Q

what are causes for poor blood smears?

A
  • prolonged storage
  • delayed prep
  • dirty slides
    drying artifacts
48
Q

what are the three main components of RBC survival?

A
  • RBC membrane
  • hemoglobin structure + function
  • Metabolic pathway
49
Q

What replaces RBC each day?

A

RES reticuloendothelial system
MPS mononuclear phagocytic system

50
Q

What will replace RBC?

A

reticulocytes

51
Q

What happens as RBC age?

A

decrease deformability + function

52
Q

What is the composition of RBC membrane?

A
  • 40% lipids
  • 52% proteins
  • 8% carbohydrates
53
Q

what are the two most important proteins in RBC?

A
  • glycophorin
  • spectrin
54
Q

what is deformability?

A
  • cells ability to be flexible.
55
Q

what is the purpose of a cell being deformable?

A
  • oxygen delivery
56
Q

What are characteristics of the RBC membrane?

A
  • permeable to water
  • impermeable to cation
  • elastic / flexible
57
Q

How often is extravascular hemolysis?

A

90%

58
Q

What happens during extra vascular hemolysis?

A
  • Hemoglobin is disassembled
  • iron is recycled by transferrin
  • Globin is broken down + stored
  • protoporphyrin ring broken down
  • Biliverdin is converted to bilirubin
59
Q

How is bilirubin excreted?

A
  • Into the intestine as stercobilinogen (stool)
  • Urobilinogen is excreted in urine
60
Q

How often is intravascular hemolysis?

A

5-10%

61
Q

where is intravascular hemolysis happening?

A

within the lumen of blood vessels

62
Q

what is the function of hemoglobin?

A
  • deliver + release oxygen
  • Pick up CO2
63
Q

what is the structure of hemoglobin?

A
  • 4 heme groups
  • protoporphorin ring + ferrous
64
Q

what do you call the change in hemoglobin shape when loading and unloading O2?

A

respiratory movement

65
Q

What three things does the production of hemoglobin rely on?

A
  • iron
  • protoporphyrin
  • globin
66
Q

What are the three abnormal hemoglobin?

A

Carboxyhemoglobin (CO)
Methemoglobin (iron = ferric)
Sulfhemoglobin (sulfure)

67
Q

How is iron delivered to the RBC?

A

in the body as ferric (bone), transported by transferrin into cytoplasm where mitochondria reduce it to ferrous where it is then inserted into the protoporphyrin ring.

68
Q

what happens when there is an access of iron in the body?

A

aggregates as ferritin in cytoplasm

69
Q

How is protoporphyrin synthesized?

A
  1. Delta aminolaevulinic acid by mitochondria
  2. Porphyrinogen intermediate to heme
  3. porphyrin (oxidization of Porphyrinogen)
70
Q

What is required in the first step of protoporphyrin synthesis?

A

B6 (pyridoxal phosphate)

71
Q

What happens when heme synthesis is blocked?

A

formation of porphyrias instead of porphyrins.

72
Q

What is the main form of hemoglobin in fetuses?

A

Hb F = alpha + gamma chains

73
Q

What is the main form of hemoglobin in adults?

A

HbA - alpha + beta chains
HbA2 - Alpha + delta chains

74
Q

what is the main function of littoral cells?

A

sensitive detectors of the spleen for RBC abnormalities

75
Q

what is the function of the spleen?

A
  • storage
  • filtration
  • immunogenic
  • hematopoiesis
76
Q

what is hemoglobinuria

A
  • depletion of haptoglobin
  • auto-oxidation of hemoglobin in the urinary tract
77
Q

what is the result of auto-oxidation?

A

oxyhemoglobin - alkaline
methemoglobin - acidic

78
Q

What happens to free hemoglobin?

A
  1. oxidizes to methemoglobin
  2. disassemble metheme groups
  3. bind to hemopexin which carries to liver
79
Q

what happen if hemoglobin is in excess of hemopexin ?

A

Hemoglobin will bind to albumin and remain in circulation till more hemopexin is available.

Hematology (3 decks)

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