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25 Cards in this Set
- Front
- Back
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What tests should you run for a suspected hematological disorder?
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Complete blood count that includes:
HB, HCT/PCV, RBC, RBC indicies, WBC, Platelet count, Peripheral blood smear eval |
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HB
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Hemoglobin-best indicator for blood oxygen carrying capacity
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HCT/PCV
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accurate simple screening for anemia
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RBC
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Red blood cell count:
decreased=anemia increased=primary/secondary polycythemia (erythrocytosis), and hemoconcentration dehydration |
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RBC indicies
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MCV=most imp, avg volume of RBC
MCH=avg mass of hemoglobin in an individual RBC MCHC=avg Hb con'c in a given vol of PCV RDW=reflects size variations of RBC in peripheral blood |
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Anisocytosis
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reflects variations in size of packed red cells in peripheral blood
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How is the MCV classified?
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microcytic < 80um
normocytic = 80-100um macrocytic > 100um |
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WBC
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TLC= (normal) 4,500-11,000
DLC= differential white cell count (100 cell diff. subdivides into %'s) |
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Platelet count
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automated cell counters are used normal=150,000-400,000mm3
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Peripheral blood smear eval
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-check RBC (size, shape, Hb, inclusion bodies)
-WBC (diff count, morphology) -platelets (presence, size) anything abnormal |
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How would you identify reticulocytes in the blood?
What is the normal amt? |
with supra-vital stains
< 3%, but falsely high in anemia |
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ESR
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measures acute phase response (useful to monitor)
-fibrinogen and other acute phase proteins bind RBC and increases ESR |
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TIBC
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Total iron binding capacity
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Specific confirmatory tests
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sickling, G6PD assay, vit B12/folic acid levels, AB's against intrinsic factor
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MCH/MCHC is reflected by what?
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central pallor
-hypochromic -hyperchromic -polychromasia |
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poikilocytosis
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abnormal shape
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microspherocyte
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(hyperchromic- inc MCHC)
-hereditary spherocytosis -auto-immune hemolytic anemia |
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Sickle cell
-mutation with what AA? |
(depranocyte)
-sickle cell anemia glutamine - valine |
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Tear drop cell
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(dacrocyte)
-myelofibrosis -marrow infliltration BONE MARROW disorders!!!! |
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Schistocyte
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fragmented RBC's
-hemolytic anemia (can be broken down going through a clot) |
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Target Cells (bull's eye)
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(periphery contains a band of Hb)
-Thalassemia -Fe deficiency anemia -Alcoholic liver disease |
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RBC inclusion bodies:
Punctuate basophilia |
(altered reticulocyte ribosomes aggregate)
-lead poisoning -Thalassemia -megaloblastic anemia -severe infection -drug exposure -alcoholism |
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RBC inclusion bodies:
Howell-Jolly bodies |
(purple large DNA remnants)
-absent spleen (splenectomy) -non-functioning spleen (sickle cell anemia) |
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RBC inclusion bodies:
Heinz bodies |
particles of denatured Hb on inner face of RBC membrane
(seen with supra vital stain) -G6PD deficiency |
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RBC inclusion bodies:
siderocytes |
Fe granules not bound to HB (seen with prussian blue staining)
-iron overload |
