RBC, WBC, and Anemia Flashcards

1
Q

sensitivity rules __ disease

A

out

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2
Q

specificity rules __ disease

A

in

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3
Q

hb equation

A

hb = rbc x 3

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4
Q

hematocrit equation

A

hct = hb x 3
or
hct = rbc x 9

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5
Q

rbcs are indirect measure of what

A

hemoglobin

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6
Q

hematocrit is indirect measure of what

A

rbcs in volume of blood

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7
Q

what tells you average size of rbc

A

MCV

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8
Q

what tells you quantity of hemoglobin in rbc

A

MCH

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9
Q

what tells you concentration or color of rbc

A

MCHC

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10
Q

increase in RDW suggests what

what conditions

A

increase in different types of cell sizes

factor deficiency, homozygous globinpathy

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11
Q

normal RDW suggests what conditions

A

thalassemia minor
heterozygous globinpathy
chronic disease anemia

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12
Q

what is a spherocyte

A

type of microcyte

round and lacks center clear area

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13
Q

what are polychromatophile RBCs

A

reticulocytes

immature RBCs

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14
Q

what is rouleaux

A

rbcs partially adhering to each other like stack of coins

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15
Q

what is anemia defined as

A

decrease in hemoglobin concentration

may result from loss of RBCs which contain hb

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16
Q

what are the causes of pseudoanemia

A
overhydration 
fluid retention 
pregnancy 
athletics 
hypoalbuminemia 
lab error 
posture
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17
Q

what are causes of anemia

A
hemorrhage 
bone marrow failure 
renal disease  
dietary deficit 
hemolytic disease
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18
Q

anemia is classified by what

A

cell morphology

  • macrocytic, micro, normo
  • hypochromic, normo

pathogenesis

  • factor deficiency
  • production deficit
  • depletion
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19
Q

what are the steps to determine if patient is anemic

A

ask question - are they anemia
morphology classification
pathogenesis

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20
Q

factor deficiency results from what

A

lack of raw materials necessary for hematopoesis

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21
Q

what are factors necessary for hb synthesis

A

iron
b12
folic acid
pyridioxine

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22
Q

microcytosis results from hb molecule lacking __ or __

A

iron - IDA

pyridoxine - sideroblastic anemia

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23
Q

most common cause of microcytosis

A

IDA

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24
Q

MCV and MCHC decrease

A

IDA

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25
microcytosis is a process that evolves over time what happens to serum ferritin? si? and tibc?
ferritin decreases si decerases tibc increases
26
IDA morphology and pathogenesis
microcytosis | hypochromic
27
what is necessary for the development of heme
pyridoxine
28
what is pyridoxine decreased by
alcohol stress diet
29
in pyridoxine deficiency, the si is __ and tibc is __
si increases | tibc decreases
30
macrocytosis results from what
b12 or folic acid deficit
31
b12 and folic acid cause macrocytosis how
affect DNA synthesis of precursor cells in marrow
32
what is found in foods of animal origin
cyanocobalamin
33
deficiency of b12 and folic acid result from what
``` absorption issues - intrinsic factor autoimmune antibodies on parietal and chief cells lack of gastric acid terminal ileum malabsorption distal bowel surgery ```
34
b12 dietary deficiency is __ found in who
rare vegetarians
35
MCV is increased over __ in b12 deficiency MCHC is ___
100 normal
36
MCV increase and MCHC normal
b12 deficiency macrocytosis and normochromic
37
b12 deficiency anemia morphology and pathogenesis
macrocytosis and normochromic
38
what is schillings test used for
b12 anemia pernicious anemia malabsorption
39
what is used to determine if clinically borderline levels of b12 deficit is present does this increase or decrease
MMA assay increases
40
what is the most common cause of folic acid deficiency common in who
diet alcoholics
41
what will confirm folic acid anemia
serum foliate and rbc foliate
42
production defect anemia results from what
inadequate erythropoiesis (hypoplastic bone marrow/aplastic anemia/systemic disease in bone marrow) with or without factor deficiency
43
production defect anemia results in what cell morphology and pathogenesis
normocytic and normochromic sometimes hypochromic
44
production defect anemia is due to what
hypoplastic bone marrow aplastic anemia systemic disease on bone marrow
45
what directly replaces or depressed the cellular elements of bone barrow --> hypoplastic marrow
fibrosis causing myelofibrosis | mets causing myelophthisic anemia
46
what is a peripheral pancytopenia and platelets due to deficiency of bone marrow cell precursors without cell abnormality or replacement of tumor or fibrosis
aplastic anemia
47
hypoplastic marrow and aplastic anemia are caused by what
damage to bone marrow meds autoimmune condition
48
systemic and chronic disease do what to si and tibc why
decrease si and tibc renal disease (damage and decrease epo), azotemia, neoplasia, infection, RA, liver disease, hypothyroid all associated with decrease RBC life span, not enough progenitor cells, decrease epo, or impaired iron metabolism
49
what are two main types of depletion anemia
abnormal loss of rbc - hemorrhage | abnormal destruction of rbc - hemolytic anemia
50
hemolytic anemias are classified as what
intracorpuscular and extracorpuscular defects
51
what results in free hemoglobin in circulation
hemolysis
52
free hb will damage what
renal tissue
53
what binds with hb to eliminate it once it is saturated it binds with ___ to form ___ if free hb is still found in serum it will result in
haptoglobulin + albumin = methemalbumin hemoglobulinuria
54
what are extrinsic agents that cause depletion anemia
imha - immune mediated hemolytic anemia maha - microangiopathic hemolytic anemia tranfusion reaction fetal rh incompatibility lead, bacteria, benzene, parasites - malaria
55
what are the intrinsic agents that cause depletion anemia
hb structural abnormalities - sickle cell
56
normal hb is 98% what the other 2% is what
hb A hbF
57
newborns have __% of hb _ bit it is normally replaced by what time period
> 50% hbF 6 months of age
58
hbA is comprised of what
95-98% hbA1 | 1-2% of hbA2
59
sickle cell disease mostly occurs in what population
african americans
60
sickle cell disease what percent of people have the trait what percent of people have the disease
trait - 8% disease - 1%
61
what is the hemoglobin and the percent in sickle cell disease what is the hemoglobin and percent in sickle cell trait
disease -- hbS - 80% trait -- hbS 20-40% and hbA 60-80%
62
sickle cell prep screens pick up small amounts of hbS so it is only reliable at what age
after 6 months of age
63
what is the definitive screen for sickle cell disease
hb electrophoresis
64
what does sickle cell trait cause
no anemia! except under certain conditions
65
what is a structural abnormality of hemoglobin what is a abnormality of hemoglobin synthesis
structural - sickle cell synthesis - thalassemia
66
no thalassemia hb, so what causes thalassemia to occur
genetic abnormality of globin chain synthesis
67
globin portion of hb contains what
2 pairs of chains alpha and beta
68
in thalassemia disease, what are the hemoglobin present which contains the most
hbF 60% hbA1 20% hbA2 3%
69
in thalassemia trait, what are the hemoglobin present which contains the most
hbA1 50% hbA2 4-6% hbF 3%
70
what is thalassemia disease called what is thalassemia trait called
disease - thalassemia major trait - thalassemia minor
71
thalassemia major presents as anemia with ___ and ___ what cells are present in thalassemia disease/major
microcytosis and hypochromic target cells
72
what thalassemia is from a history of mediterranean origin
thalassemia major - disease
73
what thalassemia looks like IDA
thalassemia major
74
how does thalassemia minor differ from IDA
normal RDW | anemia is unlikely - RBC > 5x10 to the 6th power
75
in thalassemia minor, what is going on with TIBC and ferrtin what is going on in IDA
thalassemia minor - TIBC decreased and normal ferritin IDA - TIBC increased and ferritin decreased
76
what is the only rbc enzyme deficiency how is it genetic affects what gender more brought on by what factors
glucose 6 phosphate dehydrogenase x sex linked men more than women drugs - asa, phenacetin, sulfas, nitrofurntoin
77
what are the rbc membrane abnormalities due to what what happens to MCHC symptoms
hereditary spherocytosis and eliptocytosis lack of protein spectrin - part of cytoskeleton mchc increased hemolysis, juandice, splenomegaly
78
is it anemia what values do you check what is the ratio? explain
rbc, hb, hct 3:1 1 is low - ehh 2 is low - suspicious 3 is low - yes its anemia
79
slow or chronic bleeds usually result in what
factor deficiency anemia
80
under 45 years old males cause of factor deficiency female cause of factor deficiency over 45 years old
under 45 males - peptic disease females - menstrual disorder over 45 both - occult cancer
81
hypersegmented neutrophils are seen in what condition
b12 deficiency
82
sideroblasts are seen in what condition
pyrdoxine deficiency
83
production deficit produces normocytic normochromic cells that is caused by what
chronic disease
84
depletion anemia produces normocytic normochromic cells that is caused by what
acute bleeds or hemolytic disease
85
if the patient is anemic and you rule out microcytic and macrocytic, what do you look for
elevated reticulocyte count - indicates bone marrow activity or production of new rbcs
86
elevated reticulocyte count is seen in what situations
acute blood loss hemolysis treatment of anemia
87
what are the percentages of WBC found in a adult
never let my engine blow ``` neutrophils - 60 lymphocytes - 30 monocytes - 8 eosinophils - 3 basophils - 0 ```
88
WBCs are used to diagnose or evaluate what
inflammation infection neoplasia immunosuprresion
89
lymphocytes predominate in what years of life
age 4-5
90
what is the predominate WBC if the patient is less than 5 years old
lymphocytes
91
what is the predominate WBC if the patient is greater than 5 years old
neutrophils
92
neutrophils predominate in what years of life
> 5 years old
93
what is -osis or -philia mean
increase in WBC
94
what is -penia mean
decrease in WBC
95
what does a shift to the left represent in WBCs
increase in number of immature forms of cells
96
leukocytosis indicates what
inflammation or bacterial infection
97
leukopenia indicates what
marrow suppression overwheming infection autoimmune viral syndromes
98
neutrophilia indicates what
bacterial infection | inflammation
99
relative lymphocytosis indicates what true lymphocytosis indicates what
RELATIVE LYMPHOCYTOSIS - viral infection (absolute lymph count normal, WBC count shows leukopenia because of decrease granulocytes) TRUE LYMPHOCYTOSIS - pertussis, infectious lymphocytosis, lymphocytic leukemia (absolute lymph count and WBC count elevate)
100
monocytosis is indicates what
``` SBE TB lymphoma leukemia typhoid ```
101
eosinophilia indicates what
acute allergic reaction skin conditions - pemphagus and psoriasis scarlet fever brucelliosis
102
basophilia indicates what
CML | myoproliferative diseases
103
leukemoid reaction indicates what
non leukemic WBC count >50,000 OR differential count of >5% metamyelocytes
104
leukemia can develop at what stage of cell maturation
any stage of maturation and is named accordingly
105
in leukemia, the more immature the predominant cell means what
worse the prognosis blast cells (acute) = worse prognosis mature cells (chronic) = better prognosis
106
"leukemia" means what total count of WBCs are ?
malignancy of white blood cells elevated
107
acute leukemia has __% of __ forms where are these forms present chronic leukemia has __ forms
>25% blast forms peripheral blood mature forms
108
ALL occurs when
before the age of 10
109
AML occurs when
over the age of 50
110
what do you see in acute leukemia types
1/2 WBCs counts elevated 1/2 WBCs normal anemia is moderate to severe in 80% of people
111
what type of leukemia makes up 30% of all leukemias
CLL
112
CLL makes up what % of all leukemias
30%
113
CLL occurs when
over the age of 50
114
CML occurs when
ages 20-50
115
CML makes up what % of all leukemias
20%
116
what type of leukemia makes up 20% of all leukemias
CML
117
what cell types are present in CML
myelocytes and metamyelocytes
118
what leukemia is associated with philadelphia chromosome
CML
119
what is an increase in the blood cell mass called
polycythemia
120
what are the 3 types of polycythemia
vera - all cells increasd (WBC, RBC, platelets) relative - dehydration secondary - hypoxia