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19 Cards in this Set
- Front
- Back
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What are the red cell indices you get in a CBC?
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MCV, MCH, MCHC, RDW
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Which values in a CBC are measured, and which are calculated?
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Measured: hemoglobin, RBC, MCV.
Calculated: hematocrit (MCVxRBC), MCH, MCHC, RDW |
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What is the most accurate and reproducible way to monitor anemia?
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Hemoglobin (grams/deciliter.)
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What does RDW measure?
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RDW (RBC Distribution Width) measures variation in MCV. The smaller the coefficient, the more uniform the cells are in size.
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What is anemia?
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Anemia is decreased hemoglobin/hematocrit below normal range for gender and age.
It is a manifestation of disease, not a final diagnosis. |
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What are the symptoms of blood loss related to hypovolemia (decrease in blood volume)?
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Hypotension (low BP),
orthostasis (low BP and high HR when patient stands), Syncope (fainting), and Shock (lack of organ perfusion.) |
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What are the symptoms of tissue hypoxia?
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Fatigue, SOB, cognitive difficulties, ischemic pain (angina, claudication, intestinal claudication.)
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What is the body's response to anemia?
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Increased heart rate,
vasoconstriction, retention of salt and water, right shifting O2 dissociation curve (increased O2 delivery to tissues), and increased erythropoietin synthesis. |
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What three mechanisms can cause anemia?
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1. Hemorrhage
2. Decreased red cell survival (hemolysis.) 3. Decreased red cell production. |
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What are two ways to classify anemia?
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You can classify anemia by
1. the erythropoietic response or 2. the size of the red cells. |
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What color are reticulocytes on a Wright-Giemsa stain?
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Polychromatophilic (grayish blue.)
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How do you calculate retic index and absolute retic count?
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Retic index = retic count x Hct/ideal Hct x .5
Absolute retic count = retic % x RBC. The idea behind this is that reticulocyte percentage increases as anemia worsens. |
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What does the retic index/absolute retic count tell you?
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If retic index is <2% or absolute retic count is <75,000, this suggests a problem with the marrow reponse, i.e. hypoproliferative anemia.
If retic index is >2% or absolute retic count is >100,000, then the marrow response is adequate, i.e. blood loss or hemolysis. |
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What is microcytic anemia and what are some examples?
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Microcytic anemia reflects a problem with hemoglobin synthesis.
Examples: iron deficiency, thalassemia, lead poisoning, anemia of chronic disease, sideroblastic anemia. |
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What is macrocytic anemia and what are some examples?
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Macrocytic anemia can be either:
Megaloblastic anemia (problem with DNA synthesis as with B12/folate deficiency or some meds), or Non-megaloblastic anemia (elevated reticulocyte counts, liver disease, alcohol, hypothyroidism, myelodysplasia.) |
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Why are normocytic anemias hard to diagnose?
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Normocytic anemias are hard to diagnose because in many cases the causes are multifactorial (i.e., combination of iron deficiency and B12 deficiency.) It could also be that the body hasn't had time to respond to the anemia yet.
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What two approaches can you take to treat anemia?
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1. Treat the underlying cause.
2. Transfusion |
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What three questions must you ask yourself when deciding whether or not to transfuse?
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1. How symptomatic is the patient?
2. Can we reverse the underlying cause? 3. Do we have enough time to treat the underlying cause? |
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What are the general indications for a transfusion?
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1. Cardiovascular compromise (congestive heart failure, shock, angina),
2. Hypoproliferative anemia with a prolonged recovery period, or 3. Surgery |
