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Quiz QA- Week % Flashcards

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1
Q

five things to learn in hematology

A

RBC function/formation, reticulocytes, counting, size/shape variation and erytrhocite sedimentation rater

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2
Q

what is CBC

A

Complete blood count the most routinely run panel in the health care system

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3
Q

what does CBC include 8

A

RBC, WBC, platelet, nutrition, inflammation, disease states, hydration and occult blood loss

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4
Q

what makes of 99% of blood cells?

A

RBC

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5
Q

How big is RBC

A

2 x 7.5 um but can squeeze to 3um

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6
Q

what is unique about RBC

A

no nucleus so can carry more hemoglobin.

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7
Q

what is RBC function

A

contain for hemogobin, gas exchange and buffering of blood and clotting mechasim via hemostatic plug.

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8
Q

what enzyme in RBC helps buffer blood

A

carbonic anhydrase

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9
Q

what gasses does RBC exchange

A

Oxygen to cells, CO2 to lungs

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10
Q

How is CO2 trasported

A

disolved, in hemoglobin, bicarbonate

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11
Q

what acts on bone marrow to increse RBC production

A

erythropoietin EPO from the kidnelys

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12
Q

How is EPO regulated?

A

Oxygen levels in kidneys

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13
Q

Why would we test serum for EPO levels?

A

for reason of increased RBC, polycythemia or anemia

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14
Q

What can elevate EPO

A

Decreased oxygen states or improper excretion

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15
Q

Example of decreased oxygen

A

hypoxia, smoking, COPD altitude

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16
Q

Example of improper excretion

A

renal carcinoma, hepatic tumor, adrenal tumor

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17
Q

what 3 things could cause Depressed EPO?

A

Renal failure, severe malnutrion, hypothyroidism, malignancy. Increased TNF=a

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18
Q

Where does drythropoiesis happen in adults?

A

in the bone marrow of long or flat bones

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19
Q

what is erythropoiesis

A

production and maturation of RBC

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20
Q

Generations of erythropoiesis

A

mesenchyme, liver, spleen, bone marrow

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21
Q

how long does mature RBC, erythrocyte last

A

120 days

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22
Q

undifferentiate stem cell is what?

A

rubriblast, it is what gets released from marro,

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23
Q

what is reticulocyte

A

immiture rBC that has already lost nucleus

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24
Q

who nurses young RBCs untill they lose nucleus

A

the nurse macrophage, they recycle nucleuse to grow new RBCs

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25
how long does it take for a reticulocyte to mature
24 hours
26
how is a reticulocyte identified?
mesh like appearance, bluish with wright stain larger than RBC. About 1%
27
what happens in and anemic person blood?
RETIC maturition time increases from 24 hours up to 2.5 days according to severity.
28
why do anemic peoples reticulocytes take longer to mature?
They are kicked out of marrow super early before maturing enough inside, have to make up time on outside.
29
when shoud we see increased reticulocyte count?
responding to anemia or hemorrhage.
30
what would anemia eith low reticulocytes mean? 4
Failure of bone marrow, EPO deficiency, Bone marrow malignancy, anemia of chronic disease
31
Failure of bone marrow
aplastic anemia
32
EPO deficiency
Renal failure
33
bone marrow malignancy
leukemia
34
What can interfere with reticulocyte counts
Pregnancy, increased cound with increased fluid volume, hypoxia, or Howell jolly bodies
35
Howell-jolly bodies are what
nuclear remnant that may be mistaken for teticulocyte
36
How is the RI adjusted to comared to normal hematocrit
Reticulocyte index, its recommended for anemia.
37
What is normal hematocrit?
.45(L/L)
38
what should the RI in patients with good marrow responses be
2-3% to indicate increased RBC production
39
what if the RI in patients in response to anemia is <2%
Hypoproliferative, response is not good enough.
40
in what conditons would you have increased reticulocytosis?
Hemolytic anemia, hemorrhage, HND, deficiency anemias that have been treated. Pushing out Reticulocytes faster
41
In what conditions would you see reticulocytopenia
Pernicious anemia, Nutrient deficiencies, aplastic anemai, radiation therapy, chronic disease
42
reticulocytopenia
decreased reticulocyte countes
43
How were RBC,s counted?
diluted blood sample over slide with grid,
44
RBC count under what magnification
High powered field
45
What is coulter counter
1st commercially available machine to automate RBC counting, more accurate and takes 1/3 the time.
46
How does coulter counter work
measures voltage variation as cells pass aperature
47
how are RBC counts reported?
million/mm3
48
RBC counting with culter counter is independent of what?
cell shape, color and density
49
what type of RBC counts allow Hematocrit calculation
automated RBC
50
who has the most RBC
men or 16-18 year olds
51
who has the least RBC
women, less even than babies
52
what does dehydration do?
looks like Erythrocytosis but its really reduced plasma to RBC ration
53
what erythrocytosis has normal EPO
dehydration and bone marrow proliferation disorder like leukemia
54
what would cause erythrocytosis with elevated EPO
renal proliverative disorder and secondary polycythemia like high altitude
55
what would cause erythrocytosis with low EPO
Primary polycythemia like a genetic disorder
56
what can cause anemia
malnutriton, mal absorbtion, inflammation, hemorrage, BM failure and renal disease
57
what can interfere wit RBC counts
Pregnancy shows decreased, High altitued is increased, Hydration and drugs
58
what is hematocrit?
the portion of blood composed of erythrocytes
59
how is hematocrit expressed
percentage of total blood volume.
60
how is hematocrit determined
centerfuge then dividing height of RBC by total height and multiply by 100
61
what is hemacrit an indirect measure of?
Indirect measure of # of RBCs and their total blood volume
62
reference for female hemocrit
37-47%
63
reference for male hemocrit
42-52%
64
anisocytosis
signifigant variation of RBC size
65
where is most anisocytosis found
most anemias and leukemias
66
what often causes anisocytosis
deficiency in raw material
67
how is anisocytosis graded
scale 1+ to 4+
68
What is red blood cell distrobution witdth, RDW
statistical measure of variation of RBC size and it indicated degree of anisocytosis.
69
what does an indreased RDW, Red Blood cell Distribution width mean?
iron def anemia, B12 or folic adic def, hemoglobinpathies, hemolytic anemias, post hemorrhagic anemia.
70
what RDW is clinically signifigant?
increased RDW, not decreased RDW,
71
normal RDW is what
11.5 to 14.5
72
what does a round macrocyte indicate
liver disease
73
what does an oval macrocyte indicate
B12/folic acid deficiency or pernicious anemia
74
what is a macrocyte
greater than 8um without the central paleness
75
what is a microcyte
small than 6um with increased central palor
76
what can cause microcytes
iron deficiency, blood loss and diseroblastic, lead poisioning
77
What does a periperal smear evaluatio help with?
to diagnose range of deficiencies, diseases and disorders by determine if cells are normal size
78
poikilocytosis
excessive RBC shape variation,
79
Target cells- dark spot in middle
Thalassemia, splenectomy, LIVER disease,
80
if someone had target cells what labs to follow
CBC, iron studies, liver profile testing
81
spherocytes with no central palor
autoimmune hemolytic anemia and hereditary sperocytosis.
82
signs of sperocytes
splenomegaly, jaundice and anemia because RBCs burst easily
83
schistocytes
fragmented cells that result from trauma to membrane, HUS, TTP
84
Helmet cells
Pulmonay emboli
85
echinocytes
multiple tiny spikes that are enenly distributed,
86
what causes echinocytes
exposure of certain substances to cell, burr cells
87
acanthocytes/spurr cells
sphere shaped with large irregular thornes,
88
where is acanthocytes seen
post splenectomy, alcholics, chirrhosis, hemolytic anemias
89
dacrocytes
teardrop shaped, pathologic and indicate bone marrow failure
90
when are darocytes seen
megoblastic anemia, renal failue, Fe deficiency
91
elliptocytes, or ovalcytes
thalassemia, fe or folate deficiency, or heredity elliptocytosis.
92
sickel cells
abnormal hemoglobin, prone to tension when o2 is low, that then get stuck in capillariesl
93
signs of sickel cell
splenic enlargment then size reduction
94
what are inclusions
weired stuff in RBC like Howell-olly bodies
95
when are inclusions most often seen
after splenectomy because normally spleen would remove these
96
Heinz bodies
damage to hemoglobin by oxidative stress, irreservable hemichrom oxidation
97
where are heinz bodies seen
congenital hemolytic anemai, alpha thalassemia
98
Basophilic stippling
toxic injury to bone marrow, sever megoblastic anema, lead poisoning.
99
few more slides to go
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Lab diagnosis (4 decks)

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