EXAM #1: CLINICAL INTERPRETATION OF LAB EXAMS Flashcards Preview

Hematology and Oncology > EXAM #1: CLINICAL INTERPRETATION OF LAB EXAMS > Flashcards

Flashcards in EXAM #1: CLINICAL INTERPRETATION OF LAB EXAMS Deck (47):
1

What is the definition of normocytic?

Normal MCV/ size

2

What is the definition of normochromic?

Normal concentration of Hb

3

What is the definition of anisocytosis?

Blood cells are of UNEQUAL size

4

What is the definition of poikilocytosis?

Abnormally shaped RBCs

5

What is the normal MCV of a RBC?

80-100 FL

6

What is the definition of macrocytic?

MCV greater than 100 FL

7

What is the definition of microcytic?

MCV than 80 FL

8

How are anemias classified?

1) Etiology
2) Mean Corpuscular Volume (MCV)

9

What are the three classifications of anemia based on MCV?

1) Microcytic
2) Macrocytic
3) Normocytic

10

What are the three classifications of anemia based on etiology?

1) Impaired RBC production
2) Increased RBC destruction
3) Blood loss*****

11

What is the first lab test to order in a patient with suspected anemia?

CBC, Complete Blood Count

12

What are the elements of a CBC?

1) Hb= Hemoglobin
2) Hct= Hematocrit
3) PCV= Packed Cell Volume
4) RBC count
5) RBC indices
6) RDW= Red Cell Distribution Width
7) WBC count
- TLC= Total Leukocyte Count
- Diff= differential leukocyte count
8) Platelet count
9) PBS= Peripheral Blood Smear

13

What are the three RBC indices?

1) MCV= Mean Corpuscular Volume*****
2) MCH= Mean Corpusular Hemoglobin
3) MCHC= Mean Corupusuclar Hemoglobin COncentration

*****This is the most important value in differentiating anemias*****

14

What additional lab values would help to differentiate anemias secondary to a CBC?

1) Reticulocyte count
2) ESR= erythrocyte sedimentation rate
3) Bone marrow exam

15

What is the normal leukocyte differentiation?

Neutrophil= 50% - 74%
Lymphocyte= 26% - 46%
Monocyte= 2 - 12%
Eosinophil= 0.0 - 5.0%
Basophil= 0.0 - 2.0%

16

What is a reticulocyte count?

- Reticulocytes are precursors to RBCs --this is a count of reticulocytes
- Used to determine the efficacy of erythropoiesis

17

What is the utility of the ESR?

Elevation indicates an underlying inflammation/ organic disease

18

What does an elevated reticulocyte count indicate? What is a normal retic count?

Anemia

****Note that normal is 0.5-1.5%*****

19

What do you need to remember about retic. counts in anemia?

These values need to be CORRECTED for the degree of anemia.

20

How is a retic. count corrected?

(patient Hct/45) x retic count

21

How are reticulocytes identified?

- Retics have RNA while mature RBCs do NOT
- Stain with RNA stain to id. retics

22

What are the four common causes of microcytic anemia? What is the most common?

1) Iron deficiency*****
2) Anemia of chronic disease --esp. renal failure
3) Thalassemia
4) Siderblastic anemia

*****This is the most common cause of microcytic anemia****

Recall, microcytic anemia= MCV less than 80 FL

23

What are the important lab values used to specifically evaluate microcytic anemia?

1) Serum iron
2) TIBC
3) % saturation
4) Serum ferritin****

24

How do you tell the difference between IDA and ACD?

See ppt.

25

What is hemolytic anemia?

Anemia caused by the destruction of blood cells

26

What are the causes of immune hemolytic anemia?

1) Drugs
2) Auto-immune disease e.g. SLE
3) Allo-immune
- Hemolytic transfusion rxn
- Hemolytic disease of newborn

27

What is the most common cause of autoimmune hemolytic anemia?

Systemic Lupus Erythematosus

28

What is the difference between the direct and indirect Coombs test?

DCT=
- Direct Antiglobulin Test (DAT)
- RBC

ICT=
- INdirect Antiglobulin Test
- Patient serum i.e. antibodies

29

Explain the DCT.

1) RBC sample from patient
2) Add anti-human antibodies (Coombs reagent)
3) Aggregation/ agglutination occurs indicating a positive test

30

Explain the ICT.

1) Obtain patient serum
2) Add donor (control) RBC
3) Patient Ig attack RBC
4) Add Coombs reagent
5) Agglutination indicates positive test

31

What is the difference between lymphoma and leukemia?

Lymphoma= lymphoid masses arising in discrete masses i.e. in a solid organ

Leukemia= lymphoid neoplasm with involvement of blood and bone marrow
- DOES NOT form a MASS

32

What cells are typically present in the germinal center of a lymph node?

asdf

33

What are the lab tests for diagnosing lymphoma?

1) Hematoxylin and Eosin (H&E)
2) Immunophenotyping= determining cell type via protein expression
- Immunohistochemistry
- Flow cytometry
3) Cytogenetics/ FISH= chromosomal abberations
4) Molecular diagnostics i.e. PCR

34

What is the key part of diagnosing lymphoma?

- Immunohistochemistry
- Flow cytometry

*****This is done to tell the difference between T and B cells*****

35

What are the symptoms of lymphoma?

1) PAINLESS, non-tender mass
2) Lymhadenopathy
3) Fatigue
4) Malaise
5) Night sweats
6) Fever
7) Weight loss

36

What is the difference between a diffuse and nodular lymphoma?

This is just the difference between the gross structure of a mass

37

What does polymorphic mean?

Cells are not of the same type

38

What is the origin of an immature lymphoid cell?

Lymphoblast

39

What is the origin of mature lymphoid cells?

Peripheral cells

40

What is the key marker for B-cells?

CD20

- CD19
- Lambda positive light chain

41

What is the key marker for T-cells?

CD3

42

What are the WHO characteristics for lymphoma classification?

- Clinical features
- Morphology
- Immunophenotype*****
- Cytogenetics
- Molecular analysis

43

What are the five main categories of lymphoma?

1) Precursor B-cell/ immature B-cell
2) Peripheral B-cell/ mature
3) Precursor T-cell/ immature T
4) Peripheral T-cell and NK cell/ mature T and NK
5) Hodgkin

44

Outline the staging of lymphoma.

I= single node, region, or extralymphatic site

II= 2+ regions on same side of diaphragm

III= BOTH sides of diaphragm

IV= Disseminated or diffuse involved

45

What is the difference between A and B stages of lymphoma?

Asymptomatic= A

Symptomatic= B

46

PET Scan example from powerpoint.

Stage III

47

What are the defining characteristics of Hodgkin Lymphoma?

Reed-Sternberg cells and variants