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80 Cards in this Set
- Front
- Back
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4 types of microcytic anemias:
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iron deficiency anemia (IDA) sideroblastic anemia thalassemias anemia of inflammation |
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normal MCV range:
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80-100fL
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normal MCH range:
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21-37pg
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normal MCHC range:
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32-36%
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factors affecting iron levels:
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iron ingested iron absorbed recycled hemoglobin iron stores iron loss |
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iron absorption enhancers:
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orange juice vitamin C pickles soy sauce vinager alcohol |
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iron absorption inhibitors:
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tea coffee oregano milk |
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what daily intake of iron is needed to maintain RBCs:
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daily intake 5% iron
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what does serum iron test for?
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total iron in serum
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what is serum ferittin?
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acute phase reactant MOST SENSITIVE indicators of iron storage storage of iron in tissues |
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what is tranferrin/
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iron form during transport
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TIBC: Total-iron binding capacity
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availability of binding to transferrin
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transferrin saturation formula:
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% (serum iron/TIBC)x100
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normal serum iron range:
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50-150 micrograms/dl
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normal serum ferritin ranges:
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male: 15-250 female 10-120 |
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normal TIBC range:
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250-400
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normal transferrin saturation:
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20%-55%
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how many stages of iron deficiency?
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3
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1st stage iron deficiency:
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iron depletion from marrow prussian blue sain will show deficiency |
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2nd stageiron deficiency:
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iron deficient erythropoiesis
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stage 3 iron deficiency:
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a frank case of IDA in the peripheral circulation
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symptoms of iron deficiency anemia:
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fatigue pallor vertigo dyspnea cold intolerance lethargy pica cheilitis koiloncychia developmental delays behavioral disturbances pre-term delivery low birth weight |
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what percent of of population has IDA?
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50%
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causes of iron deficiency anemia:
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increased demands lack of intake blood loss |
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what percent of iron is recycled in children and adults?
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adults- 95% infants: 70% |
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another name for iron overload conditions;
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sideroblastic anemias
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causes of sideroblastic anemia:
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accumulation of iron in mitochondria aquired through transfusion, alcoholism, lead poisening, hereditary |
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how is sideroblasic anemias diagnosed?
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dimorphism pappenheimer bodies increased serum ferritin increased serum iron ringed sideroblasts in bone marrow |
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siderotic granules
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ONLY when prussian blue stain is utilized
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pappenheimer bodies:
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ONLY in wrights stain
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hereditary hemochromatosis:
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inherited iron overloading
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what chromosome is this inherited gene found on?
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chromosome 6
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what is the abnormal gene?
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HFE gene
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what are the two mutations?
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C282Y and H63D
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the gene is found in what persent of HH patients?
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80-95%
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what serum ferritin and transferrin levels are indicative of HH?
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serum ferritin- >300 micrograms/L transferrin- >60% |
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what is thalassemia the result of?
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diminished or absent globin chain synthesis (alpha or beta) |
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what clinical results may appear due to this?
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increased RBC production with decreased Hgb
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Barts hydrops fetalis
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no alpha chains leads to spontaneous abortion and stillbirth incompatable with life |
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Hgb disease
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1 functional chain Hgb H inclusion looks like a pitted golf ball |
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alpha thalassemia trait:
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two functional chains mild anemia some hemoglobin barts |
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silen carrier:
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3 functional alpha chains hematologically normal |
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3 types of Beta thalassemias:
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thalassemia major thalassemia intermedia thalasssemia minor (trait) |
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thalassemia major:
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little to no beta chain synthesis coolys anemia or mediterranean anemia |
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thalassemia minor (trait)
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one abnormal gene inherited mimics IDA not an iron problem increased RBC due to bone marrow compensation |
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thalassemia intermedia
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develope problems later in life little to no need for tansfusions larger spleens minor bone changes
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major hemoglobin in alpha thalassemia (two or three gene deletion)
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Hgb H 5-40% in 3 gene deletion condition
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major hemoglobin in silent carrier alpha thalassemia:
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lower amounts or normal Hgb
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major hemoglobin in Beta thalassemia Major:
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Hgb F
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major hemoglobin in beta thalassemia minor:
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elevated Hgb A2
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what is the percentage of total blood volume occupied by erythrocytes
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microhematocrit
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what is microhematocrit also known as?
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packed red blood cell volume
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purpose of microhematocrit test:
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screen for anemia ofton used in conjuntion with hemoglobin determination test H&H test |
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what method is used to determine micromehatocrit?
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centrifugal microhematocrit method( spun crit)
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centrifugal microhematocrit method
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seperates blood into 3 layers by using a capillary tube, the hematocrit is calculated by measuring the lengths of the layers |
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normal reference ranges of microhematocrit:
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male- 42-52% female- 37-47% newborn- 53-65% |
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increased hematocrit signifies:
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polycythemia (increased RBCs) dehydration |
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decreased hematocrit signifies:
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anemias acute blood loss |
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rule of 3's |
hematocrit= 3x Hgb +3
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erythrocyte sedimentation rate:
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distance at which the red blood cells fall/ settle per hour directionally preportional to red cell masss inversely proportional to red cell surface area |
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what is ESR used for?
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nonspecific test for inflammation follow up testing to monitor pregression or remission of a disease |
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what can ESR be diagnostic for?
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multiple myeloma temoral arteritis polymyalgia rheumatica |
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what is the method of choice for ESR? |
westergren method
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westergren method testing principle:
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a solution of sodium citrate is mixed with fresh anticoagulated blood and used to determine the ESR measures the distance that RBCs will fall in a vertical tube in a given time period |
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3 stages of sedimentation:
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first stage- (lag phase) 10mins second stage- (decantation phase) 40mins- large aggregates of red cells settle out rapidly third phase- 10 minutes- slow compacting of red cells |
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specimen requirements for testing:
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EDTA may be used, tube must be 1/2 full at least, well mixed, free of clots or fibrin, at room temp up to 4 hrs old or refrigerated up to 24hrs specimen MUST be hemolyzed |
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how soon should the test be preformed?
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1-2hrs after collection
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factors affecting ESR:
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technical and mechanical factors RBC size and shape plasma fibrinogen and globulin levels will cause increased setling and increase ESR specimens not properly anitcoagulated |
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normal ESR reference ranges:
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males- 0-15mm/hr females- 0-20mm/hr |
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what percentage of circulating red blood cells are reticulocytes?
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0.5-2.0%
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what does a reticulocyte count measure?
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the number and percentage of reticulocytes in the blood indicator of the bone marrows ability to produce RBCs |
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what stain is used to differentiate reticulocytes?
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supervital new methlyene blue method
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reticulocyte percentage formula;
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#of reticulocytes / 1000 RBCs x 100=% reticulocytes
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how do you find a Absolute reticulocyte count (ARC)
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reticulocytes% x RBCs count/ 100
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normal ARC reference value:
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50x10^9 retics/L
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increased retic count:
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hemolytic anemias patients with hemorrhage IDA undergoing iron therapy uremia |
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decreased retic count:
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aplastic anemia ineffective arythropoiesis |
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MCV:
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indicator of size HCT/RBCx10 |
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MCH:
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average weight of hemoglobin in an RBC Hgb/RBCx10 |
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MCHC:
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aaverage concentration of hemoglobin per RBC Hgb/HCTx100 |
