Lab Midterm Flashcards by Mikayla Cleary

What does MCV mean and what does it reflect? What is the formula? What is the normal range?

Mean red blood cell volume reflects RBC diameter (volume)
Hematocrit/rbc count x 10
80-100fL

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What does MCH mean and what does it reflect? What is the formula? What is the normal range?

Mean corpuscular hemoglobin reflects weight of hemoglobin in the average red blood cell
Hemoglobin/RBC count x 10
26-34 pg

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What does MCHC mean? What is the formula? What is the normal range?

Mean cell hemoglobin concentration
Hemoglobin/hematocrit x 100
32-36 g/dL

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What does RDW mean and what does it reflect? What is the normal range?

RBC distribution width reflects the degree of volume variation
12-14.5

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What is the normal range of hematocrit and how is it calculated

Normal range: 40-52% for males and 35-47% for females
RBC/total volume x 100

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Formula for calculating % retics

Number of retics/1000 RBC x 100

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Formula for calculating retic index corrected? When does it get used/corrected?

% Retics x hematocrit/hematocrit of 45 (M) or 42 (F)
Gets used to adjust for the level of anemia to obtain a more accurate reflection of erythropoiesis

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Calculation for reticulocyte production index (RPI)

Retic index (corrected)/maturation time (aka how old the sample is)

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What is the RPI when bone marrow is not responding

RPI < 3

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What is the RPI when bone marrow is responding

RPI > 3

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How to calculate hemocytometer

Cell count x dilution factor/volume (1x1x0.1) = cells/mL

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How to do a WBC estimation

Count WBCs for 10 fields at 40x
Divide by 10 to find average
Multiply by 2,000
ex: 2.5 x 2000 = 5.0x10^3/microliter

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How to do a platelet estimation

Count platelets in 10 fields at 100x
Divide by 10 to find average
Multiply by 20,000
Ex: 10 x 20,000 = 200x10^3/microliter

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What is the mentzer index and how is it calculated

A calculation used to differentiate between IDA and thalassemia
MCV/RBC

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What does it mean if your mentzer index is greater than 13

Low RBC = IDA

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What does it mean if your mentzer index is less than 13

High/increase RBC = thalassemia

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How do you do a manual diff

Count 100 WBCs differentiating each kind

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Name the disease and what to look for

G6PD deficiency
Degmacytes “bite cell”
Polychromasia
Heinz bodies (supravital stain)
Normocytic, normochromic

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Name the disease and what to look for

Iron deficiency anemia (IDA)
Microcytic, hypochromic
Low ferritin
High transferrin
High TIBC
Low transferrin saturation %
High thrombocytosis

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Name the disease and what to look for

Anemia of chronic disease
Microcytic, hypochromic
High ferritin
Low transferrin
Low TIBC
Low transferrin saturation %
Common in lupus, renal disease, etc.

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Name the disease and what to look for

Sideroblastic anemia
Microcytic, hypochromic
Iron satellites
Pappenheimer bodies
Basophilic stippling
Acquired: lead poisoning
High ferritin
Low transferrin
Low TIBC
High transferrin saturation %

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Name the disease and what to look for

Megaloblastic anemia
Hypersegmented neutrophils
Ovalocytes
Macrocytic
High/normal iron, ferritin, transferrin saturation %
Elevated homocysteine (B12 breaks down homocysteine)
Could also have poikilocytosis or anisocytosis
Pancytopenia observed
B-12 = elevated methylmalonic acid (MMA)
Can’t absorb B12

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Name the disease and what to look for

Aplastic anemia
Pancytopenia (decreased all cells)
70% idiopathic
Hypocellular BM
Liver enzymes elevated
Increase serum iron
Increase transferrin saturation
Acquired: pregnancy, drug therapy, viruses (parvovirus b19/HIV)

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Name the disease and what to look for

Myelophthistic anemia
Usually caused by cancer
Dacryocytes! And nRBCS

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Name the 3 types of and what to look for for erythrocytopenia anemias

Low RBC Normocytic, normochromic Pure Red cell aphasia Congenital dyserythropoietic anemia Anemia of chronic renal insufficiency (echinocytes)

Name the disease and what to look for

Hemoglobin S (sickle cell anemia) Normal beta 6 glutamic acid replaced by valine High/increase retics - Polychromasia - nRBCs Sickle cells Target cells Poikilocytosis Normal MCV Increase in RDW, WBC, platelets Low RBC HJ bodies, basophilic stippling, schistocytes, pappenheimer bodies

Name the disease and what to look for

Hemoglobin C Normal beta 6 glutamic acid replaced by lysine Crystals - looks like rods Normal MCV Increase in MCHC and retics Target cells and nRBC

Name the disease and what to look for

Hemoglobin SC Normal beta 6 glutamic acid replaced by valine Amorphous crystals Target cells and nRBCs Some sickles may be present

Name the disease and what to look for

Hemoglobin E Normal beta 26 glutamic acid replaced by lysine Extremely low MCV (~55) Microcytic, hypochromic Target cells and nRBC

Name the disease and what to look for

B-thalassemia Microcytic, hypochromic Target cells, nRBC, basophilic stippling Poikilocytosis Major = 100x worse than minor + anisocytosis Decrease in retics Increase in ferritin; decrease in transferrin Minor = normal RDW

Name the disease and what to look for

Alpha - thalassemia Hemoglobin H Microcytic, hypochromic Poikilocytosis Target cells, nRBC Increase in ferritin; decrease in transferrin Minor = normal RDW Beta tetramere Missing 3 alpha genes Can be seen with supravital stain

Name the disease and what to look for

Alpha-thalassemia (major) Bart's hemoglobin Missing all 4 alpha genes Won't survive (still born)

Name the disease and what to look for

Hereditary spherocytosis Spherocytes predominate Increase in reticulocytes Mutation in vertical protein

What is the most common inherited aplastic anemia and what does it look like

Fanconi anemia Maltese crossed chromosomes Short stature, deformed fingers, mental retardation, microsephaly Can't repair DNA properly

Name the disease and what to look for

Hereditary elliptocytosis Elliptocytes predominate (100%) No poikilocytosis Mutation in horizontal

Name the disease and what to look for

Pyropoikilocytosis Poikilocytosis where elliptocytes predominate

Name the disease and what to look for

Hereditary stomatocytosis >50% Ion imbalance

Name the disease and what to look for

Microangiopathic hemolytic anemia (MAHA) Thrombocytopenia - platelet clots throughout body Schistocytes, nRBC Intravascular Anisocytosis, polychromasia Petechiae indicates internal bleeding/clotting

Name the disease and what to look for

Thermal injury (burn patients) Spherocytes and poikilocytes

Name the disease and what to look for

Malaria Ring, throphozoite, schizont, gametocyte Spread via mosquito

Name the disease and what to look for

Babesia microti Maltese crosses Spread via tick

Name the disease and what to look for

Trypanosoma brucei From Africa Transmitted via fly Causes African sleeping sickness

Name the disease and what to look for

Trypanosoma cruzi From central /south America Transmitted via kissing bug Dense chromatin tip Causes chagas disease

Study

Name the disease/condition: Degmacytes "bite cell' Polychromasia Heinz bodies (supravital) Normocytic, normochromic

G6PD deficiency

Name the disease/condition: Microcytic, hypochromic Low ferritin High transferrin High TIBC Low transferrin saturation % High thrombocytosis

Iron deficiency anemia (IDA)

Name the disease/condition: Microcytic, hypochromic High ferritin Low transferrin Low TIBC Low transferrin saturation % Common in lupus, renal disease, etc.

Anemia of chronic disease

Name the disease/condition: Microcytic, hypochromic Iron satellites Pappenheimer bodies Basophilic stippling Acquired: lead poisoning High ferritin Low transferrin Low TIBC High transferrin saturation %

Sideroblastic anemia

Name the disease/condition: Hypersegmented neutrophils Ovalocytes Macrocytic High/normal iron, ferritin, transferrin saturation % Elevated homocysteine (B12 breaks down homocysteine) Could also have poikilocytosis or anisocytosis Pancytopenia observed B-12 = elevated methylmalonic acid (MMA) Can't absorb B12

Megaloblastic anemia

Name the disease/conditions: Pancytopenia (decreased all cells) 70% idiopathic Hypocellular BM Liver enzymes elevated Increase serum iron Increase transferrin saturation Acquired: pregnancy, drug therapy, viruses (parvovirus b19/HIV

Aplastic anemia

Name the disease/condition: Usually caused by cancer Dacryocytes! And nRBCS

Myelophthistic anemia

Name the disease/condition: Normal beta 6 glutamic acid replaced by valine High/increase retics - Polychromasia - nRBCs Sickle cells Target cells Poikilocytosis Normal MCV Increase in RDW, WBC, platelets Low RBC HJ bodies, basophilic stippling, schistocytes, pappenheimer bodies

Hemoglobin S (sickle cell anemia)

Name the disease/condition: Normal beta 6 glutamic acid replaced by lysine Crystals - looks like rods Normal MCV Increase in MCHC and retics Target cells and nRBC

Hemoglobin C

Name the disease/condition: Normal beta 6 glutamic acid replaced by valine Amorphous crystals Target cells and nRBCs Some sickles may be present

Hemoglobin SC

Name the disease/condition: Normal beta 26 glutamic acid replaced by lysine Extremely low MCV (~55) Microcytic, hypochromic Target cells and nRBC

Hemoglobin E

Name the disease/condition: Microcytic, hypochromic Target cells, nRBC, basophilic stippling Poikilocytosis Major = 100x worse than minor + anisocytosis Decrease in retics Increase in ferritin; decrease in transferrin Minor = normal RDW

B-thalassemia

Name the disease/condition: Microcytic, hypochromic Poikilocytosis Target cells, nRBC Increase in ferritin; decrease in transferrin Minor = normal RDW Beta tetramere Missing 3 alpha genes Can be seen with supravital stain

Alpha-thalassemia Hemoglobin H

Name the disease/condition: Missing all 4 alpha genes Won't survive (still born)

Alpha - thalassemia Bart's hemoglobin

Name the disease/condition: Spherocytes predominate Increase in reticulocytes Mutation in vertical protein

Hereditary spherocytosis

Name the disease/condition: Elliptocytes predominate (100%) No poikilocytosis Mutation in horizontal

Hereditary elliptocytosis

Name the disease/condition: Poikilocytosis where elliptocytes predominate

Pyropoikilocytosis

Name the disease/condition: Stomatocytes >50% Ion imbalance

Hereditary stomatocytosis

Name the disease/condition: Thrombocytopenia - platelet clots throughout body Schistocytes, nRBC Intravascular Anisocytosis, polychromasia Petechiae indicates internal bleeding/clotting

Microangiopathic hemolytic anemia (MAHA)

Name the disease/condition: Burn patient Spherocytes and poikilocytes

Thermal injury

Name the disease/condition: Ring, throphozoite, schizont, gametocyte Spread via mosquito

Malaria

Name the disease/condition: Maltese crosses Spread via tick

Babesia microti

Name the disease/condition: From Africa Transmitted via fly Causes African sleeping sickness

Trypanosoma brucei

Name the disease/condition: From central /south America Transmitted via kissing bug Dense chromatin tip Causes chagas disease

Trypanosoma cruzi

How do you calculate dilution factor

Volume of specimen/total volume