CBC

Question 1

What are some examples of H/H abnormalities?

Answer 1

Anemia (low Hb)

Polycythemia (high Hb/Hct) —> dehydration? COPD?

Question 2

Hemoglobin is usually _______ compared to Hematocrit

Answer 2

1:3

Hb RR is 13.5-17.5 g/dL
Hct RR is 38.8-50%

Question 3

The molecule that binds and transports O2

Answer 3

Hemoglobin

Question 4

The volume of packed RBCs

Answer 4

Hematocrit

Question 5

Life span of RBC

Answer 5

120 days

Question 6

DDx for elevated H/H

Answer 6

Dehydration
COPD
Polycythemia vera
High altitude

Question 7

DDx for decreased H/H

Answer 7

Anemia
• AOCD
• Iron deficiency
• Acute blood loss
• Folate deficiency
• Vit B12 deficiency
• Hemolytic anemia
• Aplastic anemia

Question 8

If the patient is anemia, what’s the next value you look at?

Answer 8

Mean Corpuscular Volume (MCV)

Calculated value to determine average size of RBCs

MCV = Hct/RBC count

Question 9

Reference ranges for MCV

Answer 9

Microcytic = <80 fL
Normocytic = 80-100 fL
Macrocytic = >100 fL

Question 10

MCH and MCHC usually ________ MCV

Answer 10

“Follow” - if MCV is high, so will these be (usually)

Question 11

What are MCH and MCHC?

Answer 11

Mean Cell Hemoglobin and Mean Cell Hgb Concentration

Reflect the amount of hemoglobin in RBC

MCH = Hb/RBC
MCHC = Hb/Hct

Question 12

Reference ranges for MCH

Answer 12

Hypochromic = <26
Normochromic = 26-34
Hyperchromic = >34

Question 13

Reference range for MCHC

Answer 13

Normal = 31-36

Question 14

What is RDW?

Answer 14

Red Cell Distribution

An indicator of the degree of variation in the size of RBCs

Question 15

Varied sizes in RBCs on a peripheral smear

Answer 15

Anisocytosis

Question 16

WBC count > 10K is called…

Answer 16

Leukocytosis

DDx:
Bacterial infection
Inflammation
Neoplasm
Leukemoid response
Steroid use

Question 17

WBC count < 5K is called…

Answer 17

Leukopenia

DDx:
Viral infection
Overwhelming bacterial infection
Bone marrow failure
Drug toxicity
Autoimmune disease

Question 18

What does leukocytosis with a left shift mean?

Answer 18

Increased WBC count due to an increase in neutrophils and bands (baby neutrophils)

Bands enter circulation when neutrophil production is highly stimulated

Question 19

Why would you see a left shift?

Answer 19

Acute bacterial infection

Question 20

The most common type of granulocyte

Answer 20

Neutrophil

Question 21

What are granulocytes?

Answer 21

Have granules in their cytoplasm and multilobed nuclei

Neutrophils (most common)
Eosinophils
Basophils

Question 22

Another name for granulocytes

Answer 22

PMNs or polymorphonuclear leukocytes

Question 23

Neutrophilia DDx

Answer 23

Bacterial infections
Inflammation
Medications (steroids)
Stress
Trauma, tissue damage

Question 24

DDx for Neutropenia

Answer 24

Medications (esp Chemotherapy)
Viral infection
Aplastic anemia
Overwhelming bacterial infection
Radiation

Question 25

__________ do not respond to bacterial or viral infections

Answer 25

Eosinophils

Question 26

In Arizona, if you see eosinophilia (increased eosinophils), think...

Answer 26

Valley Fever

Question 27

DDx for Eosinophilia

Answer 27

``` Coccidiomycosis Leukemia/lymphoma ALLERGIC reactions Autoimmune disease PARASITES Medications (DRESS syndrome - allopurinol, NSAIDs, Abx) ```

Question 28

DDx for Eosinopenia

Answer 28

Corticosteroids Acute inflammation or stress Note - won’t really see this

Question 29

DDx for Basophilia

Answer 29

Myeloproliferative disease Leukemia CML!!!!!!!

Question 30

DDx for Basopenia

Answer 30

Acute ALLERGIC reactions | Stress reactions

Question 31

What are the non granulocytes/agranulocytes?

Answer 31

Do not have granules in their cytoplasm 1. Lymphocytes (T-cells and B-cells) Fight acute VIRAL infections 2. Monocytes Phagocytic cells capable of fighting bacteria

Question 32

DDx for lymphocytosis

Answer 32

``` VIRAL infections (EBV, Hepatitis) Lymphocytic leukemia ```

Question 33

DDx for lymphocytopenia

Answer 33

``` Infections Corticosteroids Immunodeficiency Lymphoma Chemo Radiation ```

Question 34

Malaria would result in what WBC diff abnormality?

Answer 34

Monocytosis

Question 35

DDx for Monocytosis

Answer 35

Chronic inflammatory disorders Viral infections Parasites (ie MALARIA) TB

Question 36

What might cause monocytopenia?

Answer 36

Corticosteroid therapy

Question 37

The cliff notes of what the different WBCs do...

Answer 37

Neutophils - Bacterial infections Eosinophils - Fungal or parasitic infections and allergic disorders Basophils - Allergic disorders Lymphocytes - Viral infections Monocytes - Severe infections

Question 38

What are some causes of thrombocytosis?

Answer 38

Reactive (acute blood loss, malignancy, inflammatory conditions, trauma, infections) Essential thrombocytosis Polycythemia vera CML, AML, MDS, myelofibrosis

Question 39

What are some causes of thrombocytopenia?

Answer 39

Primary immune thrombocytopenia (ITP) Thrombotic thrombocytopenic purpura (TTP) Drug-induced immune thrombocytopenia (incl Heparin induced) Cancer with bone marrow suppression or infiltration Infections Chronic liver disease Disseminated intravascular coagulation Aplastic anemia Inherited thrombocytopenia

Question 40

Chronic Myeloproliferative neoplasm characterized by colonial proliferation of myeloid cells and an elevated red blood cell mass

Answer 40

Polycythemia vera

Question 41

What CBC abnormality would you expect in mononucleosis patients?

Answer 41

Lymphocytosis (increased lymphocytes)

Question 42

What CBC abnormality would you expect in a CML patient?

Answer 42

Basophilia

Question 43

What abnormality would you expect in Valley Fever?

Answer 43

Eosinophilia