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Hematology > Episode 2 - Common Hematologic Tests > Flashcards

Episode 2 - Common Hematologic Tests Flashcards

1
Q

What tests are included in a CBC?

A
  1. White Blood Cell Count 2. WBC Differential Count 3. Red Blood Cell Count 4. Hematocrit (Hct) 5. Hemoglobin 6. Mean Corpuscular Volume (MCV) 6. Mean Corpuscular Hemoglobin (MCH) 7. Mean Corpuscular Hemoglobin Concentration (MCHC) 8. Red Cell Distribution Width (RCW) 9. Platelet Count 10. Mean Platelet Volume (MPV)
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2
Q

CBC Test

A

A broad screening test (panel of tests) to check for disorders.

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3
Q

White Blood Cell Count

A

Count the # of WBC per volume of blood.

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4
Q

When would a WBC increase?

A

Increases with infections, inflammation, cancer and leukemia

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5
Q

When would a WBC decrease?

A

Decreases with medications, bone marrow failure, chemotherapy and congenital marrow aplasia.

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6
Q

WBC Differential Count

A

% of each of the 5 major types of leukocytes including immature (band neutrophils)Variance in the percentage can be indicative of the type of infection, and the stage (acute/chronic) conditions. EX. Acute or Chronic Lymphocytic Leukemia

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7
Q

RBC Count

A

of RBC per volume of blood

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8
Q

When would RBC Count be decreased?

A

Anemia

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9
Q

When would RBC Count be increased?

A

Too many are made and with loss of fluids (diarrhea, dehydration, burns)

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10
Q

Hemoglobin Test

A

The amount of oxygen0carrying protein in the bloodShould mirror RBC count results

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11
Q

Hematocrit aka “the Crit” Test

A

% of RBCs in a given volume of whole blood. Should mirror RBC count results

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12
Q

Anemia cause and symptoms

A

Can be caused by a lack of iron due to poor diet or chronic blood loss.Less hemoglobin = less oxygen delivery = increased weakness and tiredness

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13
Q

Mean Corpuscular Volume (MCV)

A

Average size of the RBCs

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14
Q

Macrocytic

A

MCV is elevated meaning RBCs are larger than normal. Caused by B12 deficiency

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15
Q

Microcytic

A

MCV is decreased meaning RBCs are smaller than normal. Caused by iron deficient anemia or thalassemias

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16
Q

Mean Corpuscular Hemoglobin (MCH)

A

Calculation of average amount of oxygen-carrying hemoglobin inside an RBCs.

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17
Q

How does MCH look in Macrocytic or Micocrytic RBCs?

A

High MCH in Macrocytic.Low MCH in Microcytic

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18
Q

Mean Corpuscular Hemoglobin Concentration (MCHC)

A

Calculation of average concentration of hemoglobin inside a red cell

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19
Q

Hypochromia

A

Decreased MCHC values Seen when hemoglobin is abnormally diluted inside RBCs such as iron deficient anemia or thalassemia

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20
Q

Hyperchromia

A

Increased MCHC values.Seen when hemoglobin is abnormally concentrated inside RBCs such as burn patients or hereditary spherocytosis

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21
Q

Red Cell Distribution Width (RDW)

A

Calculation of variation in the size of RBCsIn some anemias (pernicious anemia), anisocytosis and poikilocytosis increase RDW

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22
Q

Anisocytosis

A

Amount of variation in RBC size

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23
Q

Poikilocytosis

A

Variation in shape

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24
Q

Platelet Count

A

of platelets in given volume of bloodIncreases and decreases are indicative of abnormal conditions (excess bleeding or clotting)

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25
Q

Mean Platelet Volume (MPV)

A

Machine-calculated measurement of the average size of platelets.

26
Q

New platelet effect on MPV?

A

New platelets are larger = increased MPV when increased numbers of platelets are produced.

27
Q

Thrombocytopenia

A

Body produces abnormally low levels of platelets. Patients bleed easier and more excessively.

28
Q

Thrombocytosis

A

Body produces abnormally high levels of platelets.

29
Q

CMP Test

A
  1. Ordered as part of a history/physical examination2. It is a panel of 14 tests3. Patients fast for 10-12 hours prior to blood draw4. Can be used to monitor disease progress/ effectiveness of treatment.
30
Q

Components of CMP

A
  1. Sodium 2. Potassium 3. Calcium 4. Chloride 5. Carbon dioxide 6. Glucose 7. Albumin 8. Total Protein 9. Total Bilirubin10. Creatinine 11. Blood Urea Nitrogen (BUN) 12. Alkaline Phosphate (ALP) 13. Alananine Aminotransferase (ALT)14. Aspartate Aminotransferase (AST)
31
Q

Sodium Fx in body

A
  1. Regulation of plasma volume2. Generation of nerve impulses3. Generation of muscle contractions4. Facilitation of glucose absorption in the small intestine
32
Q

Calcium Fx in body

A
  1. Muscle contraction2. Cardiac function3. Enzyme activation4. Exocytosis of neurotransmitters5. Blood clotting6. Normal bone/ tooth architecture
33
Q

Potassium Fx in body

A
  1. Generation of nerve impulses2. Generation of muscle contractions3. Acid base balance
34
Q

Chloride Fx in body

A
  1. Acid base balance2. Facilitates actions of certain neurotransmitters (GABA, glycine)
35
Q

Albumin is synthesized in __________

A

Liver

36
Q

Albumin Fx in body (Albumin/Total Protein test)

A
  1. Maintain oncotic pressure2. Bind Ca ions3. Maintenace of pH (acts as buffer)4. Transports thyroid hormones, fat-soluble hormones, free FAs, unconjugated bilirubin and many drugs
37
Q

Creatinine

A

Waste product made in skeletal muscle and filtered by kidneys Kidney failure = higher levels of creatinine in blood

38
Q

Blood Urea Nitrogen (BUN)

A

Amount of urea in blood. Urea is a (toxic) waste product from amino acid metabolism. Filtered in kidneys.BUN/Creatininine tests ordered when kidney disorders are suspected.

39
Q

BUN/ Creatinine

A

Not exclusively indicative of kidney function. Other conditions can cause increase or decrease of creatinine/ urea in blood.

40
Q

Alanine aminotransferase (ALT)

A

Enzyme mainly found in liver. Involved in amino acid catablolism

41
Q

Aspartate aminotransferase (AST)

A

Enzyme mainly found in liver (some in heart/ skeletal muscle). Involved in amino acid catabolism.

42
Q

Alkaline phosphatase (ALP)

A

Enzyme related to bile ducts. Spills into blood when ducts are blocked or inflamed. Also can be indicative of liver necrosis.

43
Q

Total bilirubin/ sites of RBC degradation

A

Bilirubin is hydrophobic waste from metabolism of hemoglobin.RBCs degraded in liver, spleen and bone marrow to produce bilirubin that is sent to the liver

44
Q

Carbon dioxide

A

Waste product of aerobic metabolism

45
Q

Lipid panel/ lipid profile

A
  1. LDL-C (LDL-cholesterol)2. HDL-C3. Triglycerides4. Total cholesterolAssesses patient’s risk of CVD or vascular disease in other parts of body
46
Q

Sources of cholesterol

A
  1. Liver (endogenous cholesterol)2. Diet (exogenous cholesterol)
47
Q

LDL-C

A

High LDL-C has been linked to accumulation of fatty deposits (plaques) in the arteries (atherosclerosis) reducing blood flow.Plaques can rupture and cause major heart/vascular problems

48
Q

HDL-C

A

“Good” cholesterol because it carries excess cholesterol back to liver. Liver turns excess cholesterol into bileHDL looks like a “deflated beach ball”

49
Q

Triglycerides

A

High triglyceride levels are linked to plaque formation and cardiovascular disease. LESS of correlation than LDL-C

50
Q

Erythrocyte Sedimentation Rate (ESR)

A

Easy, inexpensive, non-specific test to detect conditions associated with acute/chronic inflammation:1. Infections 2. Cancers3. Autoimmune diseases

51
Q

ESR Procedure

A

The rate which RBC/s precipitate (settle) in a tube in one hour.The rouleaux of RBCs (caused by inflammatory mediators) will cause RBCs to settle faster. ( => more precipitation= greater inflammation)Test is nonspecific only testing for the presence of inflammation not the cause or location of inflammation. Not solely definitive of inflammation, ordered in conjunction with other tests.

52
Q

Inflammatory conditions often associated with elevated ESR

A
  1. Temporal Arteritis (chronic inflammation of large arteries of head)2. Polymyalgia Rheumatica (shoulder and pelvic joint stiffness)3. Rheumatoid Arthritis4. SLE
53
Q

A1C

A

Indicative of average blood glucose levels over the last 3-4 months. (<6.5% is normal)

54
Q

Long-term implications of Diabetes (chronic hyperglycemia)

A

Long-term damage, dysfunction or failure of:1. Eyes 2. Kidneys3. Nerves 4. Heart5. Blood vessels

55
Q

Diagnostic stats for diabetes

A
  1. A1C >6.5%2. Fasting Plasma Glucose >1263. 2hr Plasma Glucose or random Glucose >200
56
Q

C-reactive protein (CRP; hs-CRP)

A

Protein produced in liver & secreted into blood. It is a “marker” of inflammation. It is a predictor (as predictive as cholesterol) of cardiac risk>1 = low risk of CVD1-2.9= moderate risk<3= high risk

57
Q

Effect of arterial inflammation

A

Linked to:1. Increased risk of heart disease (CVD)2. Myocardial Infaction,3. Sudden death4. Stroke5. PAD (peripheral arterial disease)

58
Q

Periodontal disease

A

Chronic bacterial infection of tissues that support the teeth and is a MAJOR cause of tooth loss. Can affect:1. Gingiva 2. Cementum3. Periodontal ligament 4. Alveolar bone.

59
Q

Periodontal disease & systemic disease

A
  1. Periodontal disease is more severe/prevalent in patients with Type 1 & 2 diabetes2. Associatioin between Periodontal disease and atherosclerotic cardiovascular disease
60
Q

What tests do you order for someone with periodontal disease?

A
  1. Lipid panel2. Blood glucose measurements (fasting and A1C)3 Consider plasma hsCRP (CRP)

Hematology (8 decks)

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