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### 46 Cards in this Set

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 RBC Red Blood Count 4.7-6.1 (M) 4.2-5.4 (F) millions/uL HgB hemoglobin 14-18 (M) 12-16 (F) g/dL HCT hematocrit 42-52 (M) 37-47 (F) % MCV mean cell volume 80-96 fL (1X10^-15 L) MCH mean cell hemoglobin (average weight of Hb/cell) 27-31 picograms MCHC mean cell Hb concentration 33-37 g/dL RDW red cell distribution width 11.5-14.5 % How do RBC vary based on age? 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 Hemoglobin how much hemoglobin (in grams) is in one deciliter of blood Hematocrit Tells you the volume of packed red blood cells in a given volume of whole blood what is the numerical relationship between hemoglobin and hematocrit? hematocrit = 3 x hemoglobin RDW -Red cell distribution width -how varied the sizes of the red cells are -cv of mcv reticulocyte count percentage of reticulocytes circuling in the blood does a reticulocyte count come with CBC? NO Why is methylene blue used in reticulocyte count? methylene blue identifies the precipitated RNA How do you recognize lead toxicity be looking at RBCs? basophilic stippling Low MCV 1. Iron deficiency anemia 2. Hemoglobinopathies (sickle cell, thalassemias, etc) 3. Anemia of chronic disease 4. Copper deficiency 5. Lead poisoning (decreased heme synthesis) schistocyte helmet cell - DIC - TTP Acanthocyte thorn cell - liver disease - atrifact (from poor preparation of the slide) Target Cells 1. Result of redundant red cell membrane/ decreased cell volume 2. Hemoglobinopathies/thalassemias 3. Iron deficiency anemia 4. Drug-induced hemolytic anemia 5. Liver disease Rouleaux RBCs abnormally adhere to each other due to increased immunoglobulin production -Multiple myeloma, plasma cell leukemia, infection -Artifact Howell Jolly Bodies -Remants of nuclear chromatin normally removed by the spleen -Seen in surgically or functionally asplenic patients and patients on dialysis Spherocytes no central pallor seen in hereditary spherocytosis What are the 2 most common sites of bone marrow production in adults? Hip pelvic bone Sternum What are the steps to electrophoresis of hemoglobin? 1. lyse red cells 2. separate out Hb 3. apply it to the gel 4. apply a current What proteins are in serum? 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 Electrophoresis -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 Basic panel Sodium Potassium Chloride CO2 BUN Creatinine Glucose Calcium Comprehensive Panel Sodium Potassium Chloride CO2 BUN Creatinine Glucose Calcium Total Protein Albumin AST ALT Alkaline Phosphatase Total Bilirubin What do we do with the core? use it to determine cellularity What do we do with the bone marrow aspirate? Flow Cytometery (to help with cell lineage) Cytogenetics (must be when cells are in metaphase) Fish Blast Cells Bone Marrow Aspirate <5 Promyelocytes Bone Marrow Aspirate 3.6 - 13.0 Neutrophil Myelocytes Bone Marrow Aspirate 4.0 - 20.0 Metamyelocytes Bone Marrow Aspirate 1.0 - 7.0 Neutrophils Bone Marrow Aspirate Male: 20.0 - 46.0 Female: 30.0 - 47.0 Eosinophils Bone Marrow Aspirate 0.4 - 4.0 Basophils Bone Marrow Aspirate <1.0 Monocytes Bone Marrow Aspirate 0.0 - 3.2 Erythroblasts Bone Marrow Aspirate Male: 18.0 - 40.0 Female: 14.0 - 30.0 Lymphocytes Bone Marrow Aspirate 5.0 - 20.0 Plasma Cells Bone Marrow Aspirate 0.0 - 1.4 What is in a white cell differential Neutrophils Bands Lymphs Monos Eos Basos Other What is the mnemonic for a differential (largest percentage to smallest)? Never let men eat bologna. Neutrophils, Lymphs, Monos, Eos, Basos Basophilic Stippling Punctate basophilic precipitation of undegraded RNA A sign of ineffective hematopoiesis Seen in lead toxicity PICC Peripherally Inserted Central Catheter inserted in the basophilic vein tip is in the superior vena cava/right atrium border DONT PUT IN RIGHT ATRIUM --> could trigger arrythmia