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Diagnositcs > CBC > Flashcards

CBC Flashcards

1
Q

WBC differential reference range %s

A 
Neutrophils				40-85%
Lymphocytes				10-45%
Monocytes				3-15%
Eosinophils				0-7%
Basophils				0-2%
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2
Q

Describe the 3 granulocytes

A

“BEN”

Basophils- allergic rxn, parasitic infections
Eosinophils- allergic rxn
Neutrophils- most abundant, phagocytosis of bacteria

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3
Q

Describe the 2 nongranulocytes

A

Lymphocytes (T cells and B cells)

  • fight viral infections
  • chronic bacterial infections

Monocytes
-phagocytic against bacteria

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4
Q

General causes of Leukocytosis > 10,000/mm³

A 
Bacterial infection
Inflammation
Neoplasm
Leukemoid response
Glucocorticosteroid use
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5
Q

General causes of Leukopenia < 5000/mm³

A 
Viral infection
HIV
Overwhelming bacterial infection (esp in elderly)
Bone marrow failure
Drug toxicity
Autoimmune disease
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6
Q

“Left shift” =

A

bacterial infection

an elevated WBC count due to an increase in neutrophils

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7
Q

What is a leukemoid response?

A

Markedly elevated WBC >50,000/mm3

Development of early neutrophilic cells called metamyelocytes.

Associated with infection, benign, and resolves as condition resolves.

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8
Q

Common causes of Neutrophilia

A 
Bacterial Infections
Leukemia
Inflammation (RA)
Medications
Stress
Steroids (Cushing’s or meds), epinephrine (short duration ~20-30 minutes)
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9
Q

Common causes of Neutropenia

A
  • Viral infection (# of lymphocytes up, # of neutrophils down)
  • Aplastic anemia
  • Overwhelming bacterial infection (esp in elderly)
  • Drugs
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10
Q

Conditions associated with Lymphocytosis

A

Viral infections

  • Mononucleosis
  • Viral Hepatitis

Lymphocytic leukemia

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11
Q

Conditions associated with Lymphocytopenia

A

Corticosteroids*
Immunodeficiency diseases* (late stage HIV)

Leukemia
Radiation therapy
Sepsis

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12
Q

Associated conditions with Eosinophilia

A 
"NAACP"
Neoplasms 
Allergic reactions 
Addison's disease 
Collagen vascular disease (autoimmune dz like Lupus) 
..and Coccidiomycosis
Parasites
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13
Q

What is the allergy triad?

A

Asthma
Rhinorrhea (hay fever rhinitis)
Eczema (atopic dermatitis)

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14
Q

Causes of Eosinopenia

A

Corticosteroids (the opposite of Addison’s disease)*

Acute stress or inflammatory conditions

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15
Q

Describe pt histories to consider when evaluating WBC abnormalities

A
  • acute infection or inflammatory condition
  • medications
  • pregnancy or recent delivery
  • hematologic disease (e.g leukemia, myelodysplastic disease, sickle cell dz)
  • recent surgery/trauma (snake, insect bites)
  • splenectomy
  • recent vaccine
  • smoking
  • family hx
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16
Q

Cigarette smoking is associated with what WBC abnormality?

A

neutrophilia

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17
Q

Atypical lymphocytes, seen on a peripheral smear, is associated with what infection?

A

mononucleosis

18
Q

How can you tell apart a leukemoid reaction from leukemia?

A

Elevated WBC >50,000/microL

Leukemoid response
Blood smear may show metamyelocytes and bands but rarely myeloblasts (the very immature forms) and bone marrow shows more cells but is otherwise typical.

vs

Leukemia
Bone marrow shows predominance of the most immature elements (eg, myeloblasts)

Also with leukemia will see a persistent elevation of WBCs vs in leukemoid response it will be decrease as infection resolves.

19
Q

What are metamyelocytes?

A

early neutrophilic cells

associated with Leukemoid response

20
Q

Describe the reference range for platelets, critical values, and when you would transfuse?

A

RR is 150,000-400,000/mm³
Critical Values: <50,000 or >1 million
<10k severely increased bleed risk - transfuse

21
Q

Describe possible causes of thrombocytosis

A

Platelets >400,000/mm³

Malignancy*
Polycythemia vera
Postsplenectomy syndrome
Drugs
Testosterone
Estrogens
Oral contraceptives
22
Q

What is the term for a platelet count >400,000/mm³ ?

A

thrombocytosis

23
Q

Conditions that may be assoc. with thrombocytopenia

A

Leukemia
Cirrhosis
DIC (disseminated intravascular coagulation)
Anemia (ex: hemolytic, pernicious)

24
Q

What platelet disorder is most common in children and AIDS pts?

A

ITP (Idiopathic Thrombocytopenic Purpura)

25
Q

Describe ITP (Idiopathic Thrombocytopenic Purpura)

A

Platelet count markedly low, usu. < 10,000.
Other blood counts & peripheral smear normal

Etiology - autoimmune

More common in children and AIDS pts. Better prognosis and usually self limited in children.

PE findings:
Petechiae, purpura, epistaxis, menorrhagia

26
Q

Where is erythropoietin made?

A

kidneys

EPO triggers stem cell hematopoiesis to ↑ erythrocyte production

27
Q

RBCs have no mitochondria. How do they produce energy?

A

Glycolysis

28
Q

Define anisocytosis and poiliocytosis?

A

Anisocytosis - varying RBC size

Poiliocytosis- varying RBC shape

29
Q

Target cells are assoc. with what conditions?

A

Thalasemia or liver disease

30
Q

Why might you see fragmented cells on a peripheral blood smear?

A

Foreign bodies in blood like from heart valve and thermal injury

31
Q

Describe the etiology of polycythemia vera

A

Bone marrow disorder characterized by overproduction of erythroid cells

Elevated Hgb/Hct = characteristic initial finding
Increased RBC mass*

32
Q

What conditions are assoc with secondary polycythemia?

A

Tissue hypoxia such as COPD & living at high altitude

Due to increased EPO production.

33
Q

How would you differentiate relative vs absolute polycythemia?

A

Relative - increases Hct but normal RBC mass

Absolute - increased Hct and increased RBC mass

34
Q

Pruritus following warm shower or bath is a complaint seen in what hematological condition?

A

Polycythemia vera

Other possible sxs
HA, dizziness, tinnitus, blurred vision, fatigue

35
Q

Describe possible causes of microcytic anemia

A
  • Iron deficiency (usually secondary to chronic blood loss)
  • Lead poisoning (would also see basophilic stippling)
  • Thalasemia (target cells + basophilic stippling on peripheral blood smear)
36
Q

Causes of normocytic anemia

A

Anemia of chronic disease
e.g, autoimmune diseases, malignancy
Renal failure
Acute blood loss

37
Q

Causes of macrocytic anemia

A

Vitamin B12 deficiency
Folate deficiency

Also ETOH can cause a macrocytosis with or without anemia

38
Q

Transferrin is also a negative acute-phase reactant protein, what does this mean?

A

In various acute inflammatory reactions, levels decrease

May also decreased w/ chronic illness and liver disease (transferrin is a protein produced in liver)

39
Q

What is the BEST iron test for hemochromatosis?

A

Transferrin saturation (would be increased)

Transferrin sat (%) = serum iron level/TIBC x 100%

40
Q

In iron deficiency anemia, would you expect TIBC to increase or decrease?

A

increase

Less iron = less protein binding of iron = increase in the protein available to bind iron = increase in TIBC

41
Q

Describe ferritin

A

Marker of iron storage
Can be most sensitive test to detect iron deficiency
↓ ferritin = decrease iron storage = iron deficiency
↑ ferritin = iron excess (e.g. hemochromatosis)

Diagnositcs (2 decks)

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