Laboratory Evaluation Of Hematologic Parameters

Front 1

What are the tests in a CBC?

Back 1

RBC
Hgb
Hct
MCV
MCH
MCHC
RDW

Front 2

What is the RBC?

Back 2

Red Blood Count
Red cells are highest at birth (RBC, Hb, Hct)
30% are Hb F
At 3 months Hb F decreases to normal level (2%)
Number of red cells remains stable until puberty, then male values exceed female
Nubmer of red cells does not decrease as part of aging

Front 3

What is the hemoglobin?

Back 3

Hemoglobin
Value is measured in grams per deciliter
Tells you how much hemoglobin (in grams) is in one deciliter of blood

Front 4

What is the hematocrit?

Back 4

Value is a percentage
Tells you the volume of packed red blood cells in a given volume of whole blood

Front 5

What is the MCV?

Back 5

Mean cell volume
Tells size of red blood cell

Front 6

What is the MCH?

Back 6

Mean Corpuscular Hemoglobin

Tells average weight of hemoglobin per cell

Front 7

What is the MCHC?

Back 7

Mean Corpuscular Hemoglobin Concentration

Tells average concentration of hemoglobin per cell

Front 8

What is the MCV?

Back 8

Mean Corpuscular Volume
Tells us the size of the red blood cell

Normal between 80-100

Front 9

What is the RDW?

Back 9

Red cell distribution width
Tells us the how varied the sizes of the red cells are
If RDW is normal, all cells are similar size (whether they’re all big or all small)
If RDW is increased, cell size is NOT known

Front 10

What is the reticulocyte count?

Back 10

Measures the percentage of reticulocytes circulating in the blood
Methylene blue stain identifies precipitated RNA in young cells
Larger than mature RBC; with less central pallor
Not part of CBC; need to order separately

Front 11

What cells are found in a white cell count differential?

Back 11

Segs
Bands
Lymphs
Monos
Eos
Basos
Other

"Never let men eat bologna"

Front 12

How are platelets counted?

Back 12

Platelets are counted off of a peripheral smear.

Front 13

What lab findings do you find in microcytosis and hypochromia?

Back 13

Low MCV
Low MCH

Front 14

What pathologies will cause microcytosis?

Back 14

Iron deficiency anemia
Hemoglobinopathies (sickle cell, thalassemias, etc)
Anemia of chronic disease
Copper deficiency
Lead poisoning (decreased heme synthesis)

Front 15

What is basophilic stipling?

Back 15

Punctate basophilic precipitation of undegraded RNA
A sign of ineffective hematopoiesis

Front 16

What pathology do you find basophilic stipling?

Back 16

Lead toxicity

Front 17

What are target cells?

Back 17

Result of redundant red cell membrane/ decreased cell volume

Front 18

What pathologies do you find target cells?

Back 18

Hemoglobinopathies/thalassemias
Iron deficiency anemia
Drug-induced hemolytic anemia
Liver disease

Front 19

What pathologies do you find schistocytes?

Back 19

disseminated intravascular coagulation, TTP

Front 20

What patholgies do you find an acanthocyte?

Back 20

liver disease, artifact

Front 21

What are rouleaux cells?

Back 21

French for “rolls” as in rolls or stacks of coins
RBCs abnormally adhere to each other due to increased immunoglobulin production

Front 22

What pathologies do you find roleaux cells?

Back 22

Multiple myeloma, plasma cell leukemia, infection
Artifact

Front 23

What are howell jolly bodies?

Back 23

Remants of nuclear chromatin normally removed by the spleen

Front 24

What conditions do you find howell holly bodies?

Back 24

Seen in surgically or functionally asplenic patients and patients on dialysis

Front 25

How do you distinguish spherocytes from normal RBC?

Back 25

No central pallor

Front 26

What conditions do you see spherocytes?

Back 26

hereditary spherocytosis

Front 27

What happens to bone marrow aspirate?

Back 27

Flow Cytometry
This helps us determine lineage
FISH (fluroscscent in situ hybridization)

Front 28

What is electrophoresis?

Back 28

Use to separate and quantitate serum protein including hemoglobin
Separates different proteins based upon their phsical and chemical properties
Mobility of protein depends on molecular weight and charge

Front 29

What tests are done in a BMP?

Back 29

Sodium
Potassium
Chloride
CO2
BUN
Creatinine
Glucose
Calcium

run on serum

Front 30

What tests are performed in a Comprehensive metabolic panel?

Back 30

Sodium
Potassium
Chloride
CO2
BUN
Creatinine
Glucose
Calcium
Total Protein
Albumin
AST
ALT
Alkaline Phosphatase
Total Bilirubin

run on serum

Front 31

What is a SPEP?

Back 31

Blood is separated into cells and serum
Serum is applied to a gel, current is applied, and different proteins move at different rates/distances along the gel

Front 32

What proteins are found in SPEP?

Back 32

Serum Proteins: Albumin (main component)

Microglobulins:
Alpha 1 (alpha 1 antitrypsin), Alpha 2
Beta 1, Beta 2 (predicts change in immunoglobulin production; used to assess disease activity of multiple myeloma)
Immunoglobulins: IgG, M, A, >>>E, D

Front 33

How is eletrophoresis performed on hemoglobin?

Back 33

Red cells are lysed, Hb is separated and applied to a gel. A current is applied.
Different hemoglobins migrate at different speeds across the gel

Front 34

What is a sickle cell screen?

Back 34

RBC mixed with reducing agent and observed under microscope for characteristic change in shape (sickle).