Case 1: CBC/HPD Lab Values

Question 1

HPD

Answer 1

Heme Profile with Differential

Question 2

% of total blood volume made up by RBCs

Answer 2

hematocrit

Question 3

Why does pregnancy usually cause slightly decreased values of Hct?

Answer 3

because of chronic hemodilution

Question 4

When RBCs contain normal amounts of Hgb and are of normal size, the Hct % is usually ___ times the Hgb concentration.

Answer 4

3 times

Question 5

Hgb determines the ____-carrying capacity of blood and also acts as an important ____-_____ _____ system

Answer 5

oxygen; acid-base buffer system

Question 6

Dehydration causes artificially ______ values in a CBC.

Answer 6

high

Question 7

What can cause high Hgb and Hct?

Answer 7

Erythrocytosis (due to physiological response to illness or high altitude)

Question 8

Which two RBC indices give info about RBC size?

Answer 8

MCV and RDW (RBC Distribution Width)

Question 9

The ____ _______ _____ is an indication of variation in RBC size.

Answer 9

RBC Distribution Width

Question 10

RDW is an essential indicator of the degree of __________, or variability RBC size

Answer 10

anisocytosis

Question 11

RBCs are of unequal size

Answer 11

anisocytosis

Question 12

The _____ is the measure of the average amount of Hgb within an RBC.

Answer 12

MCH

Question 13

The MCH value adds very little information to what we learn from a ____ concentration value.

Answer 13

Hgb

Question 14

The MCHC is the (___ x 100) divided by ___.

Answer 14

Hgb; Hct

Question 15

The MCHC tells us the average concentration of _____ per ____.

Answer 15

hemoglobin; RBC

Question 16

If the MCHC is decreased, RBCs are __________.

Answer 16

hypochromic (low Hgb)

Question 17

Hypochromicity is associated with _______ deficiency, _________, and anemia of _____ ______.

Answer 17

Iron deficiency, thalassemia, and anemia of chronic illness.

Question 18

Two most common causes of macrocytic anemia (high MCV).

Answer 18

Low B12 or low folic acid

Question 19

Anemia caused by low B12

Answer 19

pernicious anemia

Question 20

_____ patients commonly fail to respond to severe bacterial infection with leukocytosis (increased WBC count).

Answer 20

Elderly

Question 21

The CBC differential measures what?

Answer 21

The percentages of each type of each type of leukocyte present in a specimen.

Question 22

What do increased WBCs generally indicate?

Answer 22

Infection, inflammation, tissue necrosis, or leukemic neoplasia. (Trauma or stress can also cause elevated WBCs)

Question 23

Decreased WBC count is caused by?

Answer 23

Some type of bone marrow failure (caused by chemotherapy, radiation, marrow infiltrative diseases, overwhelming infection, dietary deficiency, autoimmune diseases)

Question 24

Primary function of neutrophils

Answer 24

Killing and digesting bacterial organisms

Question 25

Neutrophils are produced in ____ days and exist in circulation for only ___ hours.

Answer 25

7 to 14 days; 6 hours

Question 26

Increased bands in a CBC is called a ____ ____, and it is indicative of __________ infection.

Answer 26

a left shift; bacterial

Question 27

True of false: Basophils and eosinophils respond to viral and bacterial infections.

Answer 27

False

Question 28

_____ and ______ WBCs respond to allergic reactions.

Answer 28

Basophils and eosinophils

Question 29

The cytoplasm of basophil cells contains ____, _____, and _____.

Answer 29

Heparin, histamine, and serotonin

Question 30

Which WBC is the primary responder to parasitic infections?

Answer 30

eosinophils

Question 31

_________ primarily function to fight chronic bacterial infection and acute viral infections.

Answer 31

Lymphocytes (T and T cells)

Question 32

What two types of WBCs would you expect to see elevated in chronic inflammatory disorders?

Answer 32

Neutrophils and monocytes

Question 33

What type of anemia is typically associated with anisocytosis?

Answer 33

iron deficient anemia

Question 34

Formula for absolute neutrophil count

Answer 34

ANC = WBC x (%neutrophils + % bands) x 10

Question 35

ANC less than ____ is considered mild neutropenia, a count of less than ____ is considered moderate neutropenia, and an ANC less than ____ is considered severe neutropenia.

Answer 35

1500; 1000; 500

Question 36

If a patient's ANC is less than ____, the patient should be placed under neutropenic precautions.

Answer 36

1000

Question 37

What does MPV tell you?

Answer 37

Average size of platelets (mean platelet volume)

Question 38

What would a low platelet count and a high MPV suggest?

Answer 38

That bone marrow is rapidly producing platelets (newer platelets are bigger).

Question 39

What would a low platelet count and a low MPV suggest?

Answer 39

That bone marrow isn't producing enough platelets to replenish supply being used up (small platelets--i.e., a low mean platelet volume-- are older).

Question 40

What does RDW tell us?

Answer 40

The amount of variation in volume and size of RBCs

Question 41

What conditions are associated with high RDW and high MCV?

Answer 41

Macrocytic anemias due to nutrient deficiencies (iron, folate, or B-12).

Question 42

Can microcytic anemia have a high RDW?

Answer 42

Yes (will often see a low MCV and a high RDW in macrocytic anemia, such as iron deficiency anemia).