Diagnostic Laboratory Medicine 2 Flashcards
(135 cards)
1
Q
What does CBC stand for?
A
Complete Blood Count
2
Q
What is the average amount of circulating blood?
A
5 liters
3
Q
What is the average amount of plasma circulating at any given time?
A
3 liters
4
Q
What is the average amount of cells circulating at any given time?
A
2 liters
5
Q
Where is plasma derived from? What does it do?
A
Intestines and lymphatic system, vehicle for movement
6
Q
Give examples of the composition of blood
A
Red Blood Cells, White Blood Cells, Platelets
7
Q
The “normal range” in adults refers to the lower and upper limits observed in ____% of the normal population
A
95%
8
Q
T/F - Outlying values are always abnormal
A
False - 2.5% of the normal population have values that exceed the 95% confidence interval limits
9
Q
Normal values for children are based on ___ and ___
A
age and sex
10
Q
Name the 5 types of white blood cells
A
neutrophils, eosinophils, basophils, monocytes, and lymphocytes
11
Q
What is the name for white blood cells
A
Leukocytes
12
Q
What is the function of leukocytes?
A
Fight infection and defend the body
13
Q
What is the process called where leukocytes fight infection and defend the body?
A
Phagocytosis
14
Q
White blood cells produce, transport, and distribute _____ as part of the immune response to a foreign substance (____)
A
antibodies in response to foreign antigens
15
Q
Where are the cells in blood produced?
A
Bone marrow
16
Q
T/F - Leukocyte and differential counts by themselves can diagnose
A
False, they are of little value unless the results are related to the clinical condition of the patient
17
Q
T/F - Specific patterns of leukocyte response can be expected in various types of diseases
A
True
18
Q
Give examples of agranulocytes (no granules)
A
Lymphocytes, Monocytes
19
Q
What is another name for agranulocytes
A
Mononuclear leukocytes
20
Q
Name the granulocytes
A
Neutrophils “segs”, eosinophils, basophils
21
Q
Name the 2 broad categories of white blood cells
A
Agranulocytes and granulocytes
22
Q
Which WBC is also known as SEG
A
Neutrophils
22
Q
What is another name for granulocytes
A
polymorphonuclear leukocytes or polys or PMNs
23
Q
(Agranulocytes/granulocytes) have a multi lobed nucleus
A
Granulocytes (Neutrophils/Basophils/Eosinophils)
24
Which leukocytes make up 45-65% of WBC count?
Neutrophils
25
Which leukocytes make up 20-40% of WBC count?
Lymphocytes
26
Which leukocytes make up 3.0-9.0% of WBC count?
Monocytes
27
What is the name for High total WBC count?
Leukocytosis
28
What is the name for Low total WBC count?
Leukopenia
29
Give examples for Leukocytosis
**Acute bacterial infections, **Leukemia, Myeloproliferative disorders, Certain Meds (Steroids), Sun or UV light, stress, exercise, pain, cold/heat, anesthesia
30
Give examples for Leukopenia
**Viral infections, **Overwhelming bacterial infections "Degenerative LEFT SHIFT," Leukemia, Hodgkin's lymphoma, Malignancies, Certain meds, hypersplenism, bone marrow disorders, pernicious anemia, pancytopenia (all cells are low)
31
Name the four conditions of myeloproliferative disorders
Essential thrombocythemia, polycythemia vera, chronic myelocytic leukemia, and agnogenic myeloid metaplasia
32
Increase in total WBC count
leukocytosis
33
Most common cause of leukocytosis? Followed By?
NEUTROPHILIA, followed by lymphocytosis
It is uncommon to see increased eosinophils or monocytes
34
Leukocytosis is most frequently due to a normal ____ ____ response to relatively benign causes such as ?
bone marrow, Inflammation, Infection, Smokers, Normal variations, Drugs!
35
Inflammatory conditions like ? cause an increase in WBC
Crohn's disease, ulcerative colitis, arthritis, many others
36
Infectious conditions like ? cause an increase in WBC
UTI, skin infections, pharyngitis, STDs, appendicitis, pancreatitis, colitis
37
It has been estimated that the WBC count in smokers is raised by ____% with a doubling of absolute ____ count in pts who smoke two packs per day
25%, neutrophil
38
T/F - Study followed pts for 20 years with WBC elevations ranging from 11,000-25,000 who were perfectly healthy
True
39
Inhalation (snorting/smoking) or Injecting any foreign substance causes (elevated/decreased) WBC count
elevated
40
An extreme WBC count should cause you to think of what dx?
Bone marrow pathologies like leukemia, cancer, autoimmune diseases
41
When looking at leukocytosis, it is important to also look at ____ and other components like ?
lineage, hemoglobin, platelets
42
History + Clinical findings such as ? may increase suspicion for an underlying bone marrow disorder in leukocytosis
weight loss and enlarged lymph nodes, liver, and spleen
43
T/F - Some pts have absolute increase in one WBC element but not elevation in total WBC so you should employ specific terms which describe the actual state of affairs in a given pt
True
44
A decrease in total WBC is due to a decrease in ____ and/or ____
neutrophils and/or lymphocytes
45
Low WBC (often neutrophils) indicates ____
immunosuppression
46
T/F - Chronic use of alcohol, benzodiazepines, and Z-drugs can lower WBC but sobriety can improve numbers
True
47
Chronic use of ? lowers WBC
ALCOHOL, benzodiazepines, Z-drugs
48
What is the most numerous and important type of leukocyte in body's reaction to inflammation?
NEUTROPHILS
49
Which cells are the primary defense against microbial invasion through phagocytosis
Neutrophils
50
T/F - Neutrophils can cause some tissue damage by release of enzymes and endogenous pyogens
True
51
If you see BANDS, you know there is an immature state of development of ?
Neutrophils
52
Increase in absolute number of neutrophils in response to invaders or tumor cells
Neutrophilia
53
Lower neutrophils are found in which population
African Americans
54
? respond to acute, localized, and general bacterial infections as well as some fungal, spirochetes, parasitic, and rickettsial infections
Neutrophils
55
is a response to inflammation such as vasculitis, rheumatoid arthritis, gout, and pancreatitis
Neutrophilia
56
Neutrophilia is a hallmark of ???
Chronic Myelogenous Leukemia
57
BLASTS in ____ suggest ??
Neutrophilia, Acute Leukemia
58
? is a response to tissue necrosis (MI, burns, tumors)
Neutrophilia
59
A dx of Polycythemia Vera means the bloodwork shows ?
Neutrophilia
60
When _____ is discovered during the evaluation of a febrile pt, propensity to infection dominates
neutropenia
61
Low WBC indicates ?, so pts are likely to have rapidly worsening infections
immunosuppression
62
Name some causes of neutropenia
stem cell disorders, drugs, chemicals, hematopoietic diseases (anemia), autoimmune diseases, splenic sequestration, NSAIDS, Chronic illnesses (HIV, Hepatitis, Autoimmune), B12 deficiency, folate deficiency, nutritional deficiencies
63
T/F - neutrophilia is a natural response to pregnancy
False, neutroPENIA is normal until labor
64
_____ contain one third of all histamine in the body
Eosinophils
65
Neutrophils + ____ are capable of phagocytosis
Eosinophils
66
____ are used to dx allergic infections, assess severity of infestations with worms, other large parasites
Eosinophils
67
Causes of eosinophilia
ALLERGIES, HAY FEVER, ASTHMA, Autoimmune conditions (Lupus, RA), parasitic infection, chronic skin disease (eczema/pemphigus), SPIDER BITES, BEE STINGS, VENOMS, Endocrine disorders like Addisons, Hodgkins, CML
68
Eosinopenia is caused by ____ ____ production, like Cushings Syndrome
Adrenal Steroid Production - Cushings syndrome (acute adrenal failure)
69
Eosinopenia can also indicate that the pt is on ?
Drugs - ACTH, epinephrine, thyroxine, prostaglandins
70
What cells are found only in leukemia or leukomoid blood pictures?
Eosinophilic myelocytes
71
Basophilia can be indicative of ?
Granulocytic (myelocytic) and acute basophilic leukemia, myeloproliferative disorders, Hodgkins disease
72
Basopenia can be indicative of ?
Acute phase of infection, thyroid disorders, stress reactions like pregnancy, MI, prolonged steroid use
73
Monocytes are (granulocytes/agranulocytes)
Agranulocytes
74
What is the body's second line of defense?
monocytes
75
Which cells perform a scavenger function clearing the body of debris?
monocytes
76
These cells remove injured and dead cells, microorganisms, insoluble particles from blood from respiratory, GI, and GU organs
monocytes
77
Short term monocytosis can be due to ?
recovery from chemotherapy or drug-induced neutropenia, infectious (fungal) or inflammatory conditions
78
Persistent monocytosis should be considered to be due to ?
Myeloproliferative disorder, such as CML (chronic myelomonocytic leukemia)
79
___ migrate to areas of inflammation in both early and late stages of process
Lymphocytes
80
___ are the source of serum immunoglobulins and cellular immune response
Lymphocytes
81
T/F - All lymphocytes are made In bone marrow
True
82
Where do B cells mature?
bone marrow
83
Where do T cells mature?
thymus
84
_____ cells control the antigen-antibody response that is specific to the offending antigen. have 'memory'
B cells
85
Give examples of T cells
CD4 helper T cells, killer cells, cytotoxic cells, CD8 suppressor T cells
86
T/F - Plasma cells are normally in blood
False
87
Plasma cells are fully differentiated ___ cells
B
88
Lymphocytosis is prominent in ____ infections
viral
89
What could be causes of lymphocytosis
CMV, ****Mononucleosis, HIV, hepatitis, Toxoplasmosis, bacterial infections like TB or pertussis
90
Mononucleosis is characterized by what
ATYPICAL LYMPHOCYTES
91
T/F - You can dx pt with mono just from atypical lymphocytes
True
92
reasons for lymphopenia
chemo, radiation, Hodgkins, AIDS, malignancies, severe debilitating illness
93
total number of erythrocytes in a ____ of blood is RBC count
microliter
94
High RBC count is suspicious of ?
thalassemia trait
95
Low RBC count is suspicious of ?
blood loss or anemia
96
H&H means
Hemoglobin and Hematocrit
97
general indicator of anemia or polycythemia
Hemoglobin and Hematocrit
98
O2 carrying capacity of blood (Hgb, Hb)
Hemoglobin
99
packed cell volume (Hct)
Hematocrit
100
MCV meaning and what does it indicate
Mean Corpuscular Volume , SIZE OF RBC
101
MCH meaning and what does it indicate
Mean Corpuscular Hemoglobin,, WEIGHT OF RBC
102
MCHC meaning and what does it indicate
mean corpuscular hemoglobin content, CONCENTRATION of HEMOGLOBIN IN RBC
103
Key diagnosis for anemias is ?
RBC size variation
104
What is used to differentiate anemias and bone marrow abnormalities, contains material from newly released blood cells for 1-2 days before cell matures
Reticulocyte count
105
RBC distribution width (RDW) measures variation in ____ of RBCs
size
106
Dropping H&H can indicate ?. ESSENTIAL to address Hgb levels under ___ with follow up tests and ROS for bleeding
BLOOD LOSS, 9***
107
____ may possibly cause elevated H&H results
OPIOIDS
108
What users commonly have anemias and may see improving H&H over 6 week with sobriety?
Chronic alcohol, Z drug, amp/meth, benzodiazepines
109
Serum folate levels will (rise/fall) after rapid alcohol intake
Fall, so do not drink alcohol while pregnant
110
abnormal variation in size
anisocytosis
111
abnormal variation in shape
poikilocytosis
112
abnormal variation in color
polychromasia
113
a condition where blood has lower than normal number of RBC and can happen if cells don't contain enough Hgb
anemia
114
a group of disorders passed down through families where there is abnormal production or structure of the hemoglobin molecule. Ex. sickle cell anemia
Hemoglobinopathies
115
isolated decreased in plasma volume can elevate the hemoglobin, hematocrit, and RBC count
relative polycythemia
116
cells with dark center and periphery and clear ring in between, seen in liver disease, thalassemia, iron deficiency anemia
target cells
117
crescent shaped RBC
sickle cells
118
spherical purple bodies in or on RBCs. seen with hyposplenism, sickle cell, thalassemia
Howell-jolly bodies
119
where are platelets made
bone marrow
120
2/3 of platelets are found ?, 1/3 found in ?
circulating blood, spleen
121
? are necessary for blood clotting, vascular integrity, vasoconstriction, and adhesion activity
platelet activity
122
MPV = ? - ordered at times in conjunction with a platelet count. What does it indicate?
Mean Platelet Volume, indicates the uniformity of size of platelet population
123
Lab value of platelets assesses for ?
bleeding disorders, AKA Coagulopathies or Coagulation disorders
124
____ of PTS WITH UNEXPECTED PLATELET INCREASES WILL HAVE A MALIGNANCY
50%
125
Thrombocytosis = ?, what does it indicate
Thrombocythemia, or ABNORMALLY HIGH PLATELET count. Indicates leukemia, lymphoma, SPLENECTOMY
126
Pts with thrombocytosis have attributed it to ?
Substance abuse
127
REACTIVE THROMBOCYTOSIS is a rebound effect that lasts up to ___ weeks without treatment needed other Than to abstain from substance abuse. Platelets may seen as high as ____-____
6 weeks, 600-900
128
Reactive thrombocytosis is most commonly seen with ?
alcohol, opioids, meth, cocaine, stimulants
129
Name the categories that you should be able to put results into
Infection (Viral, Bacterial), Anemia, Bleeding Disorder, Allergic Rxn, Leukemia
130
What does thrombocytopenia indicate
ITP idiopathic thrombocytopenic purport, HIV, HEPARIN INDUCED THROMBOCYTOPENIA, CHF, alcohol toxicity, bacterial infections, renal insufficiency
131
when medicine or drug causes body to produce antibodies that seek to destroy platelets
drug induced thrombocytopenia *ITP = Immune Thrombocytopenia
132
chronic alcohol consumption causes bone marrow suppression and defective platelet formation, LOW PLATELETS
alcohol induced thrombocytopenia
133
Studies show that low platelet count with alcoholic is a good indicator of development of ___ and ____
DTs and cirrhosis
134
Give schematic number clockwise from L to R, 1 2(on top) 3 (on right), 4 (on bottom below 2)
WBC, Hgb, PLT, HCT
