Labs & Anemias of Deficiency Flashcards
List some things that can cause leukopenia
- viral infection
- sepsis
- leukemia
- meds that suppress bone marrow (chemo)
List some things that can cause leukocytosis
- infection/inflammation
- bacterial infection (with left shift)
- leukemia
- meds (steroids)
List some things that can affect basophil absolute count
- increased in leukemia
- stippling seen in anemias
List some things that can cause lymphocytosis
- infection
- leukemia/lymphoma
List some things that can affect monocyte absolute count
- infection & recovery
- hematologic cancers
List some things that can cause thrombocytosis
- leukemia
- acute infection
- iron deficiency anemia
List some things that can cause thrombocytopenia
- hematologic disorders
- some infections
- liver disease/cirrhosis
- clotting of the sample
What kinds of things can cause erythrocytosis
- polycythemia vera
- chronic lung disease
- living at high altitude
- EPO use (doping)
List the important elements of hemoglobin production
- Transferrin
- Dietary iron, B12, Folate
- Hepcidin hormone
- erythropoietin
Describe the role of transferrin in hemoglobin production
carries iron from intestines to site of use and storage (bone marrow & muscle)
(high in iron deficiency)
Describe hepcidin’s role in hemoglobin production
- iron regulatory hormone produced by the liver
(increases with inflammation and decreases with erythropoiesis)
Describe the role of erythropoietin in hemoglobin production
hormone produced by the kidneys in response to cellular hypoxia which stimulates bone marrow to make RBC & inhibit apoptosis
What test can describe how much hemoglobin is present, what the RBC looks like, and how many immature cells are present
CBC
(directly measures: MCV, Hgb, RBC count, RDW) (Calculates: Hct, MCH, MCHC)
What is a normal hemoglobin for a female
12-15.5 g/dL
What is a normal hemoglobin for a male
13.5-17.5
Describe what mean corpuscular volume is assessing (MCV)
- size of average RBC
- looked at in anemia
- low: microcytic (<80)
- normal: normocytic (80-100)
- high: macrocytic (>100)
List some causes of microcytosis
- chronic blood loss
- iron deficiency
- thalassemia
- lead tox
- anemia of chronic disease
Which conditions are typically normocytic
- acute blood loss
- kidney disease
- anemia of chronic disease
- most forms of mild anemia
Which conditions cause macrocytosis
- B12 deficiency
- folate deficiency
- liver dz/alc overuse
- meds
- obesity
- HoThyroidism
What does Mean corpuscular hemoglobin (MCH) measure
amount of Hgb per RBC & color
(If MVC is low, MCH is low. if MVC is high, MCH is high)
What does MCHC measure (mean corpuscular hemoglobin concentration)
average concentration of Hgb inside a single RBC (Hgb divided by Hct)
What does red cell distribution width measure (RDW)
measure of degree of variation in RBC size
- if high (Anisocytosis), greater variation
- usually high in iron/B12/folate deficiency anemias
What does anisocytosis mean
variation in RBC size, high RDW
What does Poikilocytosis mean
variation in RBC shape (on peripheral smear)
Describe a reticulocyte count
measures immature RBCs in circulation
- normal/decreased if there is a production problem
- elevated in accelerated loss if RBCs are being replaced (like when we start treating iron/B12/folate deficiency anemias)
What may cause a low-normal retic count
- iron/B12/folate deficiency anemias
- anemia of chronic disease
- cancers
- bone marrow failure/sarcoidosis
What may cause a high retic count
- blood loss
- hypersplenism
- malaria
- C. perfringens
- liver disease
- hemolysis (sickle cell, hemolytic-uremic syndrome, mechanical cardiac valve)
Describe what a serum ferritin is measuring
water soluble protein complex that stores iron
- low in iron deficiency anemia
- high in iron overload, inflammation