Wk 2 Hematology Labs and Diagnostics Flashcards
What four tests are part of a CBC?
1) RBC
2) Hemoglobin & Hematocrit
3) WBC
4) Platelets
What is the normal platelet count?
150-300/400K
What is the order of leukocytes shown on a differential
Neutrophils Lymphocytes Monocytes Eosinophils Basophils
What is the normal percentage range for neutrophils?
40-70%
What is the normal percentage range for lymphocytes?
20-25%
What is the normal percentage range for monocytes?
3-8%
What is the normal percentage range for eosinophils?
2-4%
What is the normal percentage range for basophils?
Less than 1%
What is would a raise in neutrophils indicate?
Actue bacterial infection
What are the seg neutrophils?
mature neutrophils
What are the immature neutrophils called?
Bands
Which type of neutrophil raises with an actue bacterial infection?
Bands
What is a raise in the percentage of band neutrophils called?
shift to the left
What does a CBC count show specifically for red blood cells? (three things)
1) total number of RBCs
2) Hemoglobin and hematocrit
3) morphology
What are the two tests for RBC morphology called?
MCV and MCHC
What does morphology refer to?
Color, size, and shape of cell
What does RBC morphology help a provider do?
Determine the cause of the anemia of a patient
What does MCV stand for?
Mean corpuscular volume
What does the MCV test for?
The size of the red blood cells
What does normocytic mean?
Normal cell size
What does microcytic mean?
Small cell size
What is an example of a microcytic anemia?
Iron deficiency anemia
What does macrocytic mean?
Large cell size
What is an example of a macrocytic anemia?
B12 and folate deficiency anemias
What type of anemias are folate and b12 deficiency?
megaloblastic anemias
What does MCHC stand for?
Mean concentration of hemoglobin
What does MCHC test for?
How concentrated the RBC is with hemoglobin
If the RBC has a normal amount of hemoglobin, what is it called?
Normochromic
If the RBC does not have enough hemoglobin, what is it called?
Hypochromic
Hypochromic red blood cells look __ in color
pale
Why do hypochromic red blood cells look pale in color?
The hemoglobin is what gives it it’s red color
When looking at H&H, what is most important?
Trends, not stand alone values!
What is hemoglobin?
Iron containing pigment of the RBC
What is normal hemoglobin range for a woman?
12-16g/dL
What is a normal hemoglobin range for a man?
14-18 g/dL
What is hematocrit?
Percentage of total blood volume that is made up off red blood cells
What is the normal range of hematocrit for males?
42-52%
What is the normal range of hematocrit for females?
37-47%
What happens if a patient has a low hematocrit?
They are anemic
What are some causes of anemia? (4)
Bleeding
Bone marrow failure
Dietary deficiency
Renal disease
What happens if someone has a high hematocrit?
Polycythemia
What can happen if a patient has fluid retention (in relation to their hematocrit)?
The hematocrit will be lower
What can happen if a patient has dehydration (in relation to their hematocrit)?
The hematocrit will be higher
Iron serum is low with __ __ __
iron deficiency anemia
What percentage of the body’s iron is found on the RBCs?
about 70%
How is the rest of the iron in the body stored?
In the form of ferritin and hemosiderin
Iron is bound to a protein called __
transferrin
What is transferrin?
A protein that transports iron
What will also be decreased with iron deficiency anemia besides iron?
transferrin
What three blood tests will show iron deficiency anemias?
Serum iron, serum transferrin, serum ferritin
What is ferritin?
A protein that stores iron
What serum blood test is the most sensitive to test for iron deficiency anemia?
Serum ferritin
What is a test you can do to see if someone has pernicious anemia?
antibodies to intrinsic factor
What type of cells produce intrinsic factor?
parietal cells in the stomach
Without intrinsic factor your body can’t do what?
Breakdown and digest vitamin b12
Why is it called pernicious anemia?
It due to the autoimmune disease
Not every b12 deficiency anemia is…
pernicious anemia
What else might be the cause of vitamin b12 deficiency?
Poor intake, like someone who is vegan
How might you test for someone who has poor intake of vitamin b12?
Serum folate and serum vitamin b12
What is a stool for guaiac test?
Occult blood test
Blood in the stool that you can see with your eyes
frank blood
What is melena?
Blood in the stool that is dark, tarry, and malodorous (digested blood)
6 additional tests for anemia
1) positive antibodies to intrinsic factor
2) serum b12 and serum folate
3) Coombs test
4) bone marrow exam
5) stool for guaiac
6) esophagogastroduodenoscopy (EGD) or colonoscopy
What is a Coombs test?
A serum blood test used to differentiate between the types of hemolytic anemia
What does a direct coombs test, test for?
Indicated whether the body is attacking it’s own red blood cells
What causes the body to attack it’s own RBCs?
Drugs, immunity, incompatible blood transfusion
What is an indirect Coombs test used for?
Screen for antibodies prior to a blood transfusion
What is a “type & screen” test?
An indirect Coombs test, they will use at the blood bank to test for the type of blood and screen for antibodies for blood compatibility
What is a bone marrow biopsy?
Removal of bone marrow to evaluate blood forming tissues
What does a bone marrow biopsy indicate?
Unexplained anemias, thrombocytopenia, leukopenia
Do you need informed consent from the patient for a bone marrow biopsy?
Yes
What is typically done before a bone marrow biopsy for comfort of the patient?
Premedicate
What should be done after a bone marrow biopsy?
Apply gentle pressure and assess bleeding post-procedure
What type of anemia will a bone marrow biopsy diagnose?
Aplastic anemia
Where are blood cells made the body?
The red bone marrow
Where is a good site for aspirating red bone marrow for a biopsy?
Iliac crest (lower back)
