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Heme / Onc > SM_244b: Intro to CBC > Flashcards

SM_244b: Intro to CBC Flashcards

1
Q

Blood is composed of ___, ___, and ___

A

Blood is composed of plasma (55%), RBC (45%), and WBC / platelet

  • Plasma: water (93%), protein, others
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2
Q

If CBC shows abnormal WBC count, ___ is done

A

If CBC shows abnormal WBC count, WBC differential is done

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3
Q

Mean corpuscular volume (MCV) is ___

A

Mean corpuscular volume (MCV) is average red cell size / volume

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4
Q

Hematocrit (HCt) is ___

A

Hematocrit (HCt) is volume of RBCs over blood volume

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5
Q

Mean corpuscular hemoglobin (MCH) is ___

A

Mean corpuscular hemoglobin (MCH) is hemoglobin content in an RBC

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6
Q

Mean corpuscular hemoglobin concentration is ___

A

Mean corpuscular hemoglobin concentration is average hemoglobin concentration in total RBCs

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7
Q

Red cell distribution width (RDW) is ___

A

Red cell distribution width (RDW) is degree of variation in size of RBCs

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8
Q

Falsely high RBC count may occur when there is ___ or ___

A

Falsely high RBC count may occur when there is marked leukocytosis (> 100 K/UL) or giant platelets

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9
Q

Falsely low RBC count may occur when there is ___ or ___

A

Falsely low RBC count may occur when there is RBC agglutination (cold agglutinin) or microcytosis

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10
Q

Hemoglobin may be falsely high if there is ____ due to ____, ____, ____, or ____

A

Hemoglobin may be falsely high if there is increased sample turbidity due to HLD, hyperbilirubinemia, high protein, or marked leukocytosis

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11
Q

Low MCV indicates ____ that may occur due to ____

A

Low MCV indicates microcytosis that may occur due to iron deficiency anemia

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12
Q

High MCV indicates ____ that may occur due to ____

A

High MCV indicates macrocytosis that may occur due to B12 / folate deficiency

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13
Q

Falsely high MCV may occur due to ____, ____, or ____

A

Falsely high MCV may occur due to

  • RBC agglutination
  • Osmotic abnormalities (hyperglycemia, hypernatremia)
  • Significantly increased young RBCs: larger than older RBCs
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14
Q

Red cell agglutination and hyperglycemia may lead to a ____ MCV

A

Red cell agglutination and hyperglycemia may lead to a falsely elevated MCV

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15
Q

Falsely low platelet count may occur when ____, ____, or ____

A

Falsely low platelet count may occur when

  • Clotted sample: platelets trapped in blood clots
  • Platelet clumping: cannot be counted as an individual platelet
  • Frequent giant platelets: may be counted as WBC or RBC because of large size
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16
Q

Describe CBC interference

A

CBC interference

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17
Q

Describe cells of a normal peripheral blood smear

A

Normal peripheral blood smear

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18
Q

Describe morphologic evaluation of RBC

A

Morphologic evaluation of RBC

  • Distribution: Rouleaux formation, agglutination
  • Size and shape: microcytic / normocytic / macrocytic, RBC morphology associated with hemolysis, others
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19
Q

Rouleaux formation is when RBCs look like a ____ due to ____

A

Rouleaux formation is when RBCs look like a stack of coins due to increased plasma proteins

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20
Q

In lymphoplasmacytic lymphoma, RBC rouleaux formation results from ____

A

In lymphoplasmacytic lymphoma, RBC rouleaux formation results from a high level of monoclonal IgM produced by lymphoma cells

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21
Q

_____, _____, _____, and _____ are associated with RBC rouleaux formation

A

Multiple myeloma, some lymphomas, chronic inflammation / infection, and other are associated with RBC rouleaux formation

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22
Q

RBC aggultination is when ____

A

RBC aggultination is when RBCs form clumps

23
Q

RBC aggultination is associated with ____ resulting from ____

A

RBC aggultination is associated with cold agglutinin disease resulting from antibodies (IgM) against RBCs

24
Q

Describe cold agglutinin disease

A

Cold agglutinin disease

  • Clinical symptoms related to exposure to cold, hemolytic, and antibodies (most commonly IgM) directed against polysaccharide antigens on the RBC surface that cause agglutination of RBCs at low temperatures
25
Cold agglutinin disease may present with \_\_\_, \_\_\_, or \_\_\_
Cold agglutinin disease may present with anemia, acrocyanosis, and hemoglobinuria
26
Cold agglutinin disease may result from \_\_\_\_, \_\_\_\_, or \_\_\_\_
Cold agglutinin disease may result from infection, lymphoma, or non-lymphoid malignancy * Mycoplasma pneumoniae, infectious mononucleosis
27
Microcytic hypochromic RBC and low iron indicate \_\_\_\_
Microcytic hypochromic RBC and low iron indicate iron deficiency anemia
28
Hypochromic cell is \_\_\_
Hypochromic cell is iron deficiency anemia
29
Ovalocyte (elliptocyte) is \_\_\_
Ovalocyte (elliptocyte) is hereditary elliptocytosis
30
Target cell is \_\_\_\_
Target cell is liver disease
31
Burr cell (symmetric short sharp projections) is \_\_\_
Burr cell (symmetric short sharp projections) is kidney disease
32
Acanthocyte (asymmetric, unequal long projections) is \_\_\_\_
Acanthocyte (asymmetric, unequal long projections) is chronic liver disease
33
Teardrop cell is \_\_\_\_
Teardrop cell is myelofibrosis
34
Sickle cell (curved RBC with sharp ends) is \_\_\_
Sickle cell (curved RBC with sharp ends) is sickle cell disease
35
Spherocyte (dark RBC with no central pallor) is \_\_\_\_
Spherocyte (dark RBC with no central pallor) is autoimmune hemolysis
36
Bite cell (bites in RBC) is ____ which may occur in \_\_\_\_
Bite cell (bites in RBC) is Heinz body hemolysis which may occur in G6PD deficiency
37
Schistocyte (irregularly shaped RBC fragments) occurs in ___ such as \_\_\_, \_\_\_, or \_\_\_
Schistocyte (irregularly shaped RBC fragments) occurs in microangiopathic hemolytic anemia such as disseminated intravascular coagulation, hemolytic uremic syndrome, and thrombotic thrombocytopenia purpura
38
\_\_\_\_ are red cell fragments that occur in \_\_\_\_
Schistocytes are red cell fragments that occur in microangiopathic hemolytic anemia * DIC, TTP, HUS, HELLP * Artificial heart valve
39
Microangiopathic hemolytic anemia results from \_\_\_\_, \_\_\_\_, \_\_\_\_, and \_\_\_\_
Microangiopathic hemolytic anemia results from * Disseminated intravascular coagulation (DIC) * Thrombotic thrombocytopenia purpura (TTP) * Hemolytic uremic syndrome (HUS) * Hemolysis, elevated liver enzymes, low platelet count (HELLP) syndrome
40
Describe disseminated intravascular coagulation
Disseminated intravascular coagulation * Schistocytes * Intravascular activation of coagulation cascade leading to intravascular deposition of fibrin thrombi * Abnormal coagulation tests: prolonged PT and PTT, elevated D-dimer, decreased haptoglobin, and decreased fibrinogen
41
Describe thrombotic thrombocytopenia purpura
Thrombotic thrombocytopenia purpura * Schistocyte * Hemolytic anemia, thrombocytopenia, neurologic symptoms, renal failure, fever * Decreased activity of ADAMTS13 (normally cleaves vWF) -\> high mollecular vWF * Diagnosis: thrombocytopenia and microangiopathic hemolytic anemia without another clinically apparent etiology
42
Describe hemolytic uremic syndrome
Hemolytic uremic syndrome * Schistocytes * Caused by E. coli O157:H7 infection * Hemolytic anemia, acute renal failure, thrombocytopenia * Shiga-toxin binds to glomerular endothelium -\> platelet activation, also inactivates ADAMTS13 -\> microthrombi formation
43
\_\_\_\_ are small RBCs without central pallor
Spherocytes are small RBCs without central pallor
44
Spherocytes are associated with ____ and \_\_\_\_
Spherocytes are associated with hereditary spherocytosis and immune hemolytic anemia
45
Chronic lymphocytic leukemia patients may develop \_\_\_
Chronic lymphocytic leukemia patients may develop autoimmune hemolytic anemia
46
Describe causes of autoimmune hemolysis
Autoimmune hemolysis causes * Viral infections * Autoimmune and connective tissue diseases (e.g. lupus) * Immune deficiency diseases (e.g. common variable immunodeficiency) * Malignancies (e.g. lymphoma, particularly CLL) * Drugs * Others
47
\_\_\_\_ look like they have had bites taken out of them
Bite cells look like they have had bites taken out of them
48
Bite cells indicate ____ that may occur with \_\_\_\_, \_\_\_\_, or \_\_\_\_
Bite cells indicate Heinz body hemolysis that may occur with G6PD deficiency, unstable hemoglobin, or oxidant drugs
49
Rasburicase is \_\_\_
Rasburicase is a recombinant urate oxidase used to protect renal function by promoting uric acid degradation to a more water-soluble compound * Used to prevent tumor lysis syndrome in CLL * An oxidative byproduct of uric acid breakdown (H2O2) can cause hemolytic potential in patients with G6PD deficiency
50
Describe abnormal RBC morphology associated with hemolysis
Abnormal RBC morphology associated with hemolysis * Schistocytes * Spherocytes * Bite / blister cells
51
RBCs are \_\_\_\_ Most likely diagnosis is \_\_\_\_
RBCs are microcytic hypochromic RBC Most likely diagnosis is iron deficiency anemia
52
CBC results indicate \_\_\_
CBC results indicate possible thalassemia
53
Peripheral blood smear from newborn girl who has jaundice and increased bilirubin. Possible cause is \_\_\_
Peripheral blood smear from newborn girl who has jaundice and increased bilirubin. Possible cause is immune-mediated hemolysis
54
Next step to evaluate thrombocytopenia is \_\_\_\_
Next step to evaluate thrombocytopenia is review of peripheral blood smear

Heme / Onc (41 decks)

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