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HIID > L27: Complete Blood Count (CBC) > Flashcards

L27: Complete Blood Count (CBC) Flashcards

1
Q

What are the major components of a CBC?

A

Red blood cell count (RBC)

Hemoglobin (HGB)

Hematocrit (HCT)

RBC indices - Mean cell volume (MCV)

Red cell distrubution width (RDW)

Reticulocyte count (RETIC)

White blood cell count (WBC)

WBC differential count (DIFF)

Platelet count (PLT)

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2
Q

How is WBC, RBC, and PLT measured?

A

Number of cells per unit volume (µL or L)

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3
Q

What is HGB?

A

Hemoglobin

The concentration of hemoglobin in the RBCs (g/dL)

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4
Q

What is HCT?

A

Hematocrit

% of packed RBCs per packed volume of whole blood

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5
Q

What is the rule of three?

A

When RBCs are normal

HGB x 3 = HCT +/- 3

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6
Q

What is the reference range for WBCs?

A

Male and female: 4.5 - 11.5 x 10^3/µL

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7
Q

What is the reference range for HGB?

A

Male: 13.5 - 18.0 g/dL

Female: 12.0 - 15.0 g/dL

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8
Q

What is the reference range for HCT?

A

Male: 40 - 54%

Female: 35 - 49%

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9
Q

What is the reference range for RETIC?

A

< 2.5%

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10
Q

What is the reference range for PLT?

A

Male and female: 150 - 450 x 10^3/µL

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11
Q

What is commonly called H & H?

A

HGB and HCT

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12
Q

What counts are higher in newborns and fetuses? Why?

A

Fetus and newborn have higher HGB, HCT, RETIC bc Hb F (the major hemoglobin in fetus) shifts the O2 dissociation to left resulting in hypoxia

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13
Q

What does decreased HGB, HCT, RBC count indicate?

A

Anemia

Decreased production, increased destruction (hemolysis), blood loss, dilutional (increased plasma volume)

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14
Q

What does increased HGB, HCT, RBC count indicate?

A

Polycythemia

Benign and malignant causes, severe hydration (decreased plasma volume)

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15
Q

What is MCV?

A

Average volume of RBCs (fL)

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16
Q

What is MCHC?

A

Hemoglobin concentration in a cell

Average weight of hemoglobin per RBC in pg

Correlates w/ MCV

<30 g/dL is hypochromic

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17
Q

What is the most important RBC indice?

A

MCV

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18
Q

What are RBCs with a normal MCV called? How do they appear on blood film?

A

Normocytic, normochromic

RBC diameter is normal

Central pallor 1/3 of cell

19
Q

What are RBCs w/ increased MCV called? How do they appear on blood film?
What are the causes?

A

Macrocytic

RBC diameter is increased

Found in megaloblastic anemia, myelodysplastic syndrome, bone marrow failure, liver disease

20
Q

What are RBCs w/ decreased MCV called? How do they appear on blood film?What are the causes?

A

Microcytic, hypochromic

MCV, MCHC decreased

RBC diameter is decreased

Central pallor > 1/3 of cell

21
Q

What is RDW?

A

Red cell distribution width

Measures variation in red cell volume

22
Q

What does increased RDW correlate with?

A

Anisocytosis (variation in RBC diameter on a blood smear)

Seen in: Deficiency of iron, vitamin B12, and/or foltate

Hemolytic anemias

23
Q

Why is it important to look at MCV and RDW together?

A

MCV can be the same but distribution can indicate abnormalities

24
Q

What is increased RWD called?

A

Anisocytosis

25
Q

How might a bimodal histogram of RDW and RBC occur?

A

If you have a pt with microcytic anemia and you give them iron and they start producing normal cells

26
Q

What are retics?

A

Last immature RBC stage

27
Q

What is the clinical sue or retics?

A

Estimate of erythropoietic activity of BM in anemia (or BM’s ability to replace RBCs)

28
Q

What does increased retic count indicate?

A

Bone marrow responding to anemia

Hemolytic anemias, acute hemorrhage, after successful therapy for iron, vitamin B12, or folate deficiency

29
Q

What does decreased retic count indicate?

A

Bone marrow NOT responding to anemia

Bone marrow failure

30
Q

What does interpreation of WBC count depend on?

A

Type of cell affected

31
Q

What is increased WBC count called? What does it indicate?

A

Leukocytosis

Infections, inflammation, some leukemias

32
Q

What is decreased WBC count called? What does it indicate?

A

Leukopenia

Some hematologic malignancies, bone marrow failure, megaloblastic anemia

33
Q

What is WBC differential count?

A

Proportion of each type of WBC

Relative (%)
Absolute (# per µL or L)

34
Q

Is relative or absolute WBC count more reliable?

A

Absolute

35
Q

How is absolute count measured?

A

Absolute count = Total WBC count x % cell

36
Q

How is absolute neutrophil count (ANC) measured?

A

ANC = Total WBC x (% Neut + % Bands)

37
Q

What occurs if instrument differential is abnormal?

A

Slide is viewed under microscope or w/ digital technology

Slide review includes morphology assessment of RBCs, WBCs, PLTs (including inclusions); looking for abnormal or immature blood cells or other abnormal findings

38
Q

What is left shift?

A

Shift to the left, band shift

Increase in bands and presence of immature neutrophils in PB

39
Q

What is the clinical correlation of left shift?

A

Bacterial infections usually present with neutrophilia and a left shift

Immature neutrophils also found in PB in myeloid malignancies

40
Q

What are NRBCs?

A

Nucleated RBCs

41
Q

When are NRBCs normally present?

A

Present in PB of neonates in small #s

42
Q

What does presence of NRBCs in PB after 4 days of life indicate?

A

Indicates BM response to severe anemia or disruption of BM (leukemias, other malignancies)

43
Q

What is increased PLT count called? What does it indicate?

A

Thrombocytosis

Various benign and malignant causes

44
Q

What is decreased PLT count called? What does it indicate?

A

Thrombocytopenia

Excessive loss, consumption, or destruction

Decreased production in bone marrow

Maldistribution

HIID (27 decks)

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