Anemia and the CBC

Question 1

anemia

Answer 1

is a symptom, not a disease

decrease in RBC mass or Hg - decreased O2 carrying capacity

Question 2

anemia measure

Answer 2

<2.5 percentile value of reference range

Question 3

anemia lab values

Answer 3

2 standard deviations away

95% of population within 2 SDs

Question 4

erythrocytosis polycythemia

Answer 4

high RBC count

Question 5

severe anemia

Answer 5

fainting
chest pain
angina
heart attack

Question 6

conjunctiva

Answer 6

is pale in anemic patients

Question 7

jaundice

Answer 7

seen in anemia

hemolytic process occuring

Question 8

3 reasons to be anemic

Answer 8

blood loss
hemolysis
decreased RBC production

Question 9

blood loss

Answer 9

acute

chronic - menstruation, GI bleed

Question 10

hemolysis

Answer 10

genetic defects - inherited or acquired

Ab- mediated destruction

microangiopathic hemolytic anemia

infection

toxic/chemical injury

Question 11

deficient DNA synthesis

Answer 11

B12 and folate deficiency

Question 12

deficient hemoglobin synthesis

Answer 12

iron deficient anemia

Question 13

parvovirus B19

Answer 13

infection of RBC progenitors

Question 14

MCV

Answer 14

mean cell volume

80-100

microcytic 100

Question 15

microcytic anemia

Answer 15

iron deficient
thalassemias
sideroblastic

Question 16

normocytic anemia

Answer 16

anemia of chronic disease
blood loss
BM suppression

Question 17

macrocytic anemia

Answer 17

B12 folate deficiency

ethanol consumption

Question 18

anemia of chronic disease

Answer 18

normocytic anemia

Question 19

ethanol abuse

Answer 19

macrocytic anemia

Question 20

MCHC

Answer 20

mean cell Hg concentration

chromaticity

33-37

Question 21

range of MCHC

Answer 21

33-37

Question 22

reticulocytes

Answer 22

immature RBCs

has rough ER - form net in cytoplasm

remnant RNA stains blue with methylene blue**

Question 23

macrocytic

Answer 23

MCHC values are invariably low

relative Hg production not increased at greater rate than cell increase in size

Question 24

normal reticulocyte

Answer 24

larger than mature RBC

circulate 2-3 days

usually 2% of cell population

Question 25

rate of production and release of RBCs by marrow into peripheral blood

Answer 25

retic count

Question 26

pediatric retic count

Answer 26

3-7%

Question 27

adult retic count

Answer 27

0.5-1.5%

Question 28

reticulocytosis

Answer 28

increase in retic count 3-4 days after episode of acute hemorrhage peak 6-10 days - 6-8%

Question 29

corrected retic count

Answer 29

to adjust for decreased existing number of red cells in peripheral blood retic index = retic count x patient Hct / 45%

Question 30

common causes of reticulocytosis

Answer 30

acute blood loss acute hemolysis hemolytic anemia response to therapy

Question 31

impaired globin synthesis

Answer 31

alpha and beta thalassemia microcytic anemia

Question 32

decreased/abnormal synthesis protoporphyrin-heme

Answer 32

lead intox anemia sideroblastic anemia microcytic anemia

Question 33

abnormal Hg

Answer 33

hemoglobin C disease microcytic anemia

Question 34

microcytic anemia with low ferritin

Answer 34

iron deficient

Question 35

Hg electrophoresis

Answer 35

assess for thalassemia

Question 36

acquired microcytosis with microcytic anemia

Answer 36

anemia of chronic disease

Question 37

``` microcytic anemia low ferritin high TIBC low serum iron high sTfR ```

Answer 37

iron deficiency anemia

Question 38

serum ferritin

Answer 38

50-170

Question 39

TIBC

Answer 39

250-400

Question 40

soluble transferrin receptor

Answer 40

2-5

Question 41

ferritin

Answer 41

20-250

Question 42

``` microcytic or normocytic anemia high ferritin low TIBC low serum iron sTfR normal ```

Answer 42

anemia of chronic disease

Question 43

``` microcytic anemia high ferritin low TIBC high serum iron low sTfR ```

Answer 43

sideroblastic anemia

Question 44

first check with normocytic anemias

Answer 44

retic count | -if high - hemolysis or blood loss

Question 45

high retic count

Answer 45

hemolytic anemia

Question 46

positive coombs test

Answer 46

hemolytic anemia IgG coating RBCs

Question 47

low haptoglobin

Answer 47

hemolytic anemia binds free Hg - so less of it

Question 48

HgB A2 and F

Answer 48

hemolytic anemia - thalassemia

Question 49

Hgb S

Answer 49

hemolytic anemia - sickle cell

Question 50

elevated bilirubin

Answer 50

with hemolytic anemia

Question 51

high RDW

Answer 51

variation in size of RBC - anisocytosis hemolytic anemias

Question 52

measure of variable size of RBCs

Answer 52

RDW

Question 53

direct coombs test

Answer 53

patient RBCs are washed and incubated with antihuman Abs (coombs reagant)

Question 54

ethanol abuse

Answer 54

folic acid deficiency

Question 55

macrocytic anemia with high retic count

Answer 55

bleeding recent tx with B12 or folate hemolytic anemia

Question 56

labs for macrocytic anemia

Answer 56

retics peripheral smear B12/folate level