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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