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Heme / Onc > SM_244b: Intro to CBC > Flashcards

SM_244b: Intro to CBC Flashcards

1
Q

Blood is composed of ___, ___, and ___

A

Blood is composed of plasma (55%), RBC (45%), and WBC / platelet

  • Plasma: water (93%), protein, others
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2
Q

If CBC shows abnormal WBC count, ___ is done

A

If CBC shows abnormal WBC count, WBC differential is done

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3
Q

Mean corpuscular volume (MCV) is ___

A

Mean corpuscular volume (MCV) is average red cell size / volume

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4
Q

Hematocrit (HCt) is ___

A

Hematocrit (HCt) is volume of RBCs over blood volume

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5
Q

Mean corpuscular hemoglobin (MCH) is ___

A

Mean corpuscular hemoglobin (MCH) is hemoglobin content in an RBC

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6
Q

Mean corpuscular hemoglobin concentration is ___

A

Mean corpuscular hemoglobin concentration is average hemoglobin concentration in total RBCs

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7
Q

Red cell distribution width (RDW) is ___

A

Red cell distribution width (RDW) is degree of variation in size of RBCs

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8
Q

Falsely high RBC count may occur when there is ___ or ___

A

Falsely high RBC count may occur when there is marked leukocytosis (> 100 K/UL) or giant platelets

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9
Q

Falsely low RBC count may occur when there is ___ or ___

A

Falsely low RBC count may occur when there is RBC agglutination (cold agglutinin) or microcytosis

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10
Q

Hemoglobin may be falsely high if there is ____ due to ____, ____, ____, or ____

A

Hemoglobin may be falsely high if there is increased sample turbidity due to HLD, hyperbilirubinemia, high protein, or marked leukocytosis

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11
Q

Low MCV indicates ____ that may occur due to ____

A

Low MCV indicates microcytosis that may occur due to iron deficiency anemia

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12
Q

High MCV indicates ____ that may occur due to ____

A

High MCV indicates macrocytosis that may occur due to B12 / folate deficiency

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13
Q

Falsely high MCV may occur due to ____, ____, or ____

A

Falsely high MCV may occur due to

  • RBC agglutination
  • Osmotic abnormalities (hyperglycemia, hypernatremia)
  • Significantly increased young RBCs: larger than older RBCs
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14
Q

Red cell agglutination and hyperglycemia may lead to a ____ MCV

A

Red cell agglutination and hyperglycemia may lead to a falsely elevated MCV

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15
Q

Falsely low platelet count may occur when ____, ____, or ____

A

Falsely low platelet count may occur when

  • Clotted sample: platelets trapped in blood clots
  • Platelet clumping: cannot be counted as an individual platelet
  • Frequent giant platelets: may be counted as WBC or RBC because of large size
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16
Q

Describe CBC interference

A

CBC interference

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17
Q

Describe cells of a normal peripheral blood smear

A

Normal peripheral blood smear

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18
Q

Describe morphologic evaluation of RBC

A

Morphologic evaluation of RBC

  • Distribution: Rouleaux formation, agglutination
  • Size and shape: microcytic / normocytic / macrocytic, RBC morphology associated with hemolysis, others
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19
Q

Rouleaux formation is when RBCs look like a ____ due to ____

A

Rouleaux formation is when RBCs look like a stack of coins due to increased plasma proteins

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20
Q

In lymphoplasmacytic lymphoma, RBC rouleaux formation results from ____

A

In lymphoplasmacytic lymphoma, RBC rouleaux formation results from a high level of monoclonal IgM produced by lymphoma cells

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21
Q

_____, _____, _____, and _____ are associated with RBC rouleaux formation

A

Multiple myeloma, some lymphomas, chronic inflammation / infection, and other are associated with RBC rouleaux formation

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22
Q

RBC aggultination is when ____

A

RBC aggultination is when RBCs form clumps

23
Q

RBC aggultination is associated with ____ resulting from ____

A

RBC aggultination is associated with cold agglutinin disease resulting from antibodies (IgM) against RBCs

24
Q

Describe cold agglutinin disease

A

Cold agglutinin disease

  • Clinical symptoms related to exposure to cold, hemolytic, and antibodies (most commonly IgM) directed against polysaccharide antigens on the RBC surface that cause agglutination of RBCs at low temperatures
25
Q

Cold agglutinin disease may present with ___, ___, or ___

A

Cold agglutinin disease may present with anemia, acrocyanosis, and hemoglobinuria

26
Q

Cold agglutinin disease may result from ____, ____, or ____

A

Cold agglutinin disease may result from infection, lymphoma, or non-lymphoid malignancy

  • Mycoplasma pneumoniae, infectious mononucleosis
27
Q

Microcytic hypochromic RBC and low iron indicate ____

A

Microcytic hypochromic RBC and low iron indicate iron deficiency anemia

28
Q

Hypochromic cell is ___

A

Hypochromic cell is iron deficiency anemia

29
Q

Ovalocyte (elliptocyte) is ___

A

Ovalocyte (elliptocyte) is hereditary elliptocytosis

30
Q

Target cell is ____

A

Target cell is liver disease

31
Q

Burr cell (symmetric short sharp projections) is ___

A

Burr cell (symmetric short sharp projections) is kidney disease

32
Q

Acanthocyte (asymmetric, unequal long projections) is ____

A

Acanthocyte (asymmetric, unequal long projections) is chronic liver disease

33
Q

Teardrop cell is ____

A

Teardrop cell is myelofibrosis

34
Q

Sickle cell (curved RBC with sharp ends) is ___

A

Sickle cell (curved RBC with sharp ends) is sickle cell disease

35
Q

Spherocyte (dark RBC with no central pallor) is ____

A

Spherocyte (dark RBC with no central pallor) is autoimmune hemolysis

36
Q

Bite cell (bites in RBC) is ____ which may occur in ____

A

Bite cell (bites in RBC) is Heinz body hemolysis which may occur in G6PD deficiency

37
Q

Schistocyte (irregularly shaped RBC fragments) occurs in ___ such as ___, ___, or ___

A

Schistocyte (irregularly shaped RBC fragments) occurs in microangiopathic hemolytic anemia such as disseminated intravascular coagulation, hemolytic uremic syndrome, and thrombotic thrombocytopenia purpura

38
Q

____ are red cell fragments that occur in ____

A

Schistocytes are red cell fragments that occur in microangiopathic hemolytic anemia

  • DIC, TTP, HUS, HELLP
  • Artificial heart valve
39
Q

Microangiopathic hemolytic anemia results from ____, ____, ____, and ____

A

Microangiopathic hemolytic anemia results from

  • Disseminated intravascular coagulation (DIC)
  • Thrombotic thrombocytopenia purpura (TTP)
  • Hemolytic uremic syndrome (HUS)
  • Hemolysis, elevated liver enzymes, low platelet count (HELLP) syndrome
40
Q

Describe disseminated intravascular coagulation

A

Disseminated intravascular coagulation

  • Schistocytes
  • Intravascular activation of coagulation cascade leading to intravascular deposition of fibrin thrombi
  • Abnormal coagulation tests: prolonged PT and PTT, elevated D-dimer, decreased haptoglobin, and decreased fibrinogen
41
Q

Describe thrombotic thrombocytopenia purpura

A

Thrombotic thrombocytopenia purpura

  • Schistocyte
  • Hemolytic anemia, thrombocytopenia, neurologic symptoms, renal failure, fever
  • Decreased activity of ADAMTS13 (normally cleaves vWF) -> high mollecular vWF
  • Diagnosis: thrombocytopenia and microangiopathic hemolytic anemia without another clinically apparent etiology
42
Q

Describe hemolytic uremic syndrome

A

Hemolytic uremic syndrome

  • Schistocytes
  • Caused by E. coli O157:H7 infection
  • Hemolytic anemia, acute renal failure, thrombocytopenia
  • Shiga-toxin binds to glomerular endothelium -> platelet activation, also inactivates ADAMTS13 -> microthrombi formation
43
Q

____ are small RBCs without central pallor

A

Spherocytes are small RBCs without central pallor

44
Q

Spherocytes are associated with ____ and ____

A

Spherocytes are associated with hereditary spherocytosis and immune hemolytic anemia

45
Q

Chronic lymphocytic leukemia patients may develop ___

A

Chronic lymphocytic leukemia patients may develop autoimmune hemolytic anemia

46
Q

Describe causes of autoimmune hemolysis

A

Autoimmune hemolysis causes

  • Viral infections
  • Autoimmune and connective tissue diseases (e.g. lupus)
  • Immune deficiency diseases (e.g. common variable immunodeficiency)
  • Malignancies (e.g. lymphoma, particularly CLL)
  • Drugs
  • Others
47
Q

____ look like they have had bites taken out of them

A

Bite cells look like they have had bites taken out of them

48
Q

Bite cells indicate ____ that may occur with ____, ____, or ____

A

Bite cells indicate Heinz body hemolysis that may occur with G6PD deficiency, unstable hemoglobin, or oxidant drugs

49
Q

Rasburicase is ___

A

Rasburicase is a recombinant urate oxidase used to protect renal function by promoting uric acid degradation to a more water-soluble compound

  • Used to prevent tumor lysis syndrome in CLL
  • An oxidative byproduct of uric acid breakdown (H2O2) can cause hemolytic potential in patients with G6PD deficiency
50
Q

Describe abnormal RBC morphology associated with hemolysis

A

Abnormal RBC morphology associated with hemolysis

  • Schistocytes
  • Spherocytes
  • Bite / blister cells
51
Q

RBCs are ____

Most likely diagnosis is ____

A

RBCs are microcytic hypochromic RBC

Most likely diagnosis is iron deficiency anemia

52
Q

CBC results indicate ___

A

CBC results indicate possible thalassemia

53
Q

Peripheral blood smear from newborn girl who has jaundice and increased bilirubin. Possible cause is ___

A

Peripheral blood smear from newborn girl who has jaundice and increased bilirubin. Possible cause is immune-mediated hemolysis

54
Q

Next step to evaluate thrombocytopenia is ____

A

Next step to evaluate thrombocytopenia is review of peripheral blood smear

Heme / Onc (41 decks)

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