Vocabulary And Tests

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Anisocytosis

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* considerable variation in the size of cells that are usually uniform

* seen in anemias and liver disease

* used to differentiate between iron-deficiency anemia from Thalassemia

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Bands

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immature form of neutrophils with a crescent shaped nucleus

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Hemoglobinemia

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the presence of free hgb in the blood plasma, as when intravascular hemolysis occurs

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Hemoglobinuria

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presence of hgb in the urine

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Hemosiderosis

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transfusional iron overload

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Howell Jolly bodies

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* dense cicular blue inclusions that represent nuclear remants.

* Presence suggests defects in splenic function, megaloblasts, hemolytic anemias, celiac disease.

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Poikilocytosis

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Presence of irregularly shaped RBCs in the peripheral blood

*schistocytes, sickle cell
* target cell (indicate thalassemia, iron deficiency, hemoglobinopahties, abnormally thin)

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Segs

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* segmented neutrophils

* Phagocytic cell that exists to ingest/digest foreign proteins.

* Serves as first line of defense against infection

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Target cells

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* Cells that have a bulls-eye appearance

* classic finding for Thalassemia

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Hemoglobin (Hgb)

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Serves as direct indication of O2 – carrying capacity of the blood.

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Hematocrit

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Percentage volume of blood composed of erythrocytes

AKA- Packed cell volume

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MCV (Mean Corpuscular Volume)

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Estimate of average volume of RBCs

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MCH

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Amount of hemoglobin (weight) per RBC

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MCHC

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Measure of the average concentration or percentage of hgb within a single RBC

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Platelets

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Function in clotting mechanism by forming temporary plug that helps seal breaks in blood vessels.

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Red Blood Cells (RBCs)

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Number of RBCs in a given amount of blood

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White Blood Cells (WBCs)

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WBC count - number of leukocytes in a given amount of blood.

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Bilirubin

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* product of hemoglobin breakdown.

* Goes to liver and it then secreted into intestine as bile, metabolized to stercobilin and excreted into feces

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Unconjugated bilirubin

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is high when the problem is occurring before the liver, so in the breakdown of RBC and Hgb

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Conjugated bilirubin

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would be a problem in the liver or after.

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Coombs test

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* Negative direct when testing for hereditary spherocytosis

Indirect: screening for antibodies to transfused blood cells, looking more at the serum

Direct: looks at RBC, is this person having an autoimmune rxn to their own blood cells or to a transfused blood

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Spherocytosis

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* auto-hemolytic anemia characterized by the production of red blood cells that are sphere-shaped, rather than bi-concave

* Spherocytes are found in hereditary spherocytosis and autoimmune hemolytic anemia.

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Erythrocyte Sedimentation Rate

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* Non specific= Not diagnostic

* Acute phase reactant so increases in inflammatory states so useful for monitoring those conditions

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Erythrocyte Sedimentation Rate - increased/decreased in?

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Increased: infection, malignancy, inflammation, severe anemia, chronic renal failure, temporal arterits

Decreased: PV, corticosteroids, spherocytosis, sickle cell anemia

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Ferritin

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* major iron storage protein

* Normally present in serum in concentrations directly related to iron storage

* Positive acute phase reactant so may be elevated in inflammatory states

* Low in iron deficiency anemia

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Folic acid

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* needed for RBC and WBC formation

* Indicated folic acid deficiency

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Hemoglobin electrophoresis

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* Screen to detect and differentiate variant and abnormal hemoglobin

* Diagnostic for sickle cell anemia

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Serum Iron

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* iron bound to transferring

* Indicates: Iron deficiency

* Need to take in 10-15 mg/day for menstruating women and 30 mg/day if pregnant

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Prothrombin time

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* time it takes for clot formation to occur after the addition of thromboplastin and calcium chloride.

* Measure the extrinsic pathway

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Partial thromboplastin time

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* clotting time in seconds after addition of partial thromboplastin, calcium chloride and an activator to patient’s plasma

* screen for intrinsic pathway problems

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D-dimer

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* Formed when thrombin causes fibrinogen to fibrin and factor XIII links with fibrin

* Used to diagnose and R/O thrombosis

* Elevated in DVT, PE, sickle cell and thrombosis

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Reticulocyte count

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* Immature RBC

* persist in circulation for 1-2 days before maturing

* Identifying drug induced bone marrow suppression or monitor anemic pt response to Fe or vitamin therapy

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Total binding iron capacity

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* Measurement of all proteins available for binding mobile iron

*Elevated TBIC= iron deficiency anemia

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Forward type

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testing for the antigens on RBC

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Reverse type

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testing for the antibodies in the serum

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Thrombocytopenia

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relative decrease of platelets in blood.

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petechia

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pinpoint hemorrhages on skin and mucous membranes

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Purpura

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appearance of red or purple discolorations on the skin that do not blanch on applying pressure. They are caused by bleeding underneath the skin usually secondary to vasculitis or dietary deficiency of vitamin C (scurvy)

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Schilling test

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* medical investigation used for patients with vitamin B12 (cobalamin) deficiency.

* purpose to determine pernicious anemia.

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Low HgB may be found in?

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• Anemia
• Pregnancy
• Hemolysis

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High HgB may be found in?

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• Chronic hypoxic states
• Hyperlipidemia- false high because of turbidity
• High altitudes
• Polycythemia vera (PV)

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Disproportionate results can occur in a hematocrit due to?

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conditions where cells are abnormal in shape or size

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Conditions that cause macrocytic (large cell) MVC?

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• B12 and folate deficiencies
• Liver disease
• Chemotherapy

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Conditions that cause microcytic (small cell) MVC?

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• Iron deficiency
• Thalassemias
• Lead poisoning

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False MVC results may be due to?

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* Increases in reticulocytes, which are larger in size than mature erythrocytes

* false increase in hyperglycemia.

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MCH (Amount of hemoglobin (weight) per RBC) is elevated in?

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macrocytosis (B12 defeceny)

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MCH (Amount of hemoglobin (weight) per RBC) is decreased in?

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microcytosis

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Abnormal MCHC (Measure of the average concentration or percentage of hgb within a single RBC) may be due to?

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Hypochromic – deficiency of Hgb causing RBC to appear pale
• Iron deficiency anemia
• Overhydration
• Thalassemia

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RBC may be low in what conditions?

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o Menstruating females
o Anemia
o Hemolysis
o Bone marrow suppression

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RBC may be high in what conditions?

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• Chronic hypoxic states
• High altitudes
• PV

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Acute Lymphoblastic Leukemia (ALL)

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fast-growing cancer of a type of white blood cells called lymphocytes.

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Acute Myeloid Leukemia (AML)

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cancer that starts inside bone marrow. Cancer grows from cells that normally turn into white blood cells.

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Chronic Lymphocytic Leukemia

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* “Small Cleaved Lymphoma” same disease at different stages.

* Clonal malignancy of B cells

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Chronic Myeloid Leukemia

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* myeloproliferative disorder that starts inside bone marrow.

* Overproduction of myeloid cells

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Hodgkin’s Disease

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Lymphoma-cancer of lymph tissue found in the lymph nodes, spleen, liver, and bone marrow

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Non-Hodgkin’s Lymphoma

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* Heterogenous group of cancers of lymphocytes

* Malignancies that range from a very slow disease to an extremely aggressive but curable condition

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Lymphoma

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cancer of lymph tissue found in the lymph nodes, spleen, liver, and bone marrow

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Polycythemia Vera

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Acquired myeloproliferative disorder that causes overproduction of erythroid cells

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Multiple Myeloma

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Neoplastic Proliferation of malignant plasma cells in the bone marrow producing monoclonal IG. Malignant cells replace the cells of the bone marrow leading to bone destruction