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88 Cards in this Set
- Front
- Back
Screening tests are
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highly sensitive
(might test other dx) |
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Diagnostic tests are
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highly specific
ie troponin, blood cultures |
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Instead of normal range, use
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reference range
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A value when you need to take action
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critical/panic value
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Sensitivity screening
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ability of test to identify positive results in patients WITH the disease
true positive rate |
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the higher the sensitivity...
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the lower the chance of a false --
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specificity-confirmatory
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% of NEG results in people WITHOUT the disease
true negative rate |
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the higher the specificity,
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the lower the chance of a false positive
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close to true value
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accuracy
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reproducability of a value
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precision
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blue top collection tube
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sodium citrate
used for most coagulation studies |
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lavendar top collection tube
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EDTA
binds calcium used for CBC, ESR, reticulocyte, HgA1 |
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Orange/Tiger Top collection tube
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serum separator tube
forms barrier between serum and cells during centrifugation |
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Red top collection tube
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no anticoagulants!!
provides serum for testing |
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gray top collection tube
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sodium flouride oxalate
prevents glycolysis glucose tolerance testing |
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yellow top collection tube
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blood culture
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green top collection tube
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heparin
inhibits action of thrombin |
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2 tubes that contain antigoagulants to keep blood in liquid form
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lavendar (EDTA) and blue
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fibrinogen and clotting factors are found in
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plasma NOT serum
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blood consists of
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55% plasma
40-50% RBCs 1% WBCs |
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where does hematopoeisis take place in
1) earliest stage 2) 2-7 months gestation 3) 7 months throughout life |
1) yolk sac, until 2-3 months gestation
2) liver and spleen EXTRAMEDULLARY 3) bone marrow (primary site) MEDULLARY |
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lymphocytes and monocytes
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agranular leukocytes
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basophils, neutrophils, eosinophils
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granular leukocytes
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T cell, B cell, NK cell
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lymphocytes
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distribution of leukocytes
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neutrophils 60-70%
lymphocytes 20-25% monocytes 3-8% eosinophils 2-4% basophils <1% |
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phagocytic
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neutrophils and monocytes
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allergic/parasitive infextions
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eosinophils
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histamine/heparin
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basophils
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antibody production
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B lymphocyte
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targets viral/cancer cells
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T lymphocyte
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production of neutrophils, eosinophils, basophils, and monocytes
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myelopoeisis (7-10 days)
maturation pool-->functional pool |
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blood smear contains what type of cells
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mature
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RBC production is controlled by
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erythropoietin
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120 day lifespan
recycled by spleen biconcave disk-->central pallor no nucleus size of lymphocyte nucleus |
RBC characteristics
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form right before the mature RBC
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reticulocyte
stains bluish because it has more RNA |
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WBC, RBC, Hg, Hct, RBC indices (MCV, MCH, MCHC, RDW), platelet, differential
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contained in CBC
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uses lasers to measure forward and side scatter
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flow cytometry
forward scatter=size side scatter=granularity |
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inadequate mixing of specimen
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interfering factor in specimen collection
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millions per 1 cubic mm
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how RBCs are measured measured
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4.7-6.1
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normal RBC range in MEN
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4.2-5.4
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normal RBC range in females
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distribution of RBC count
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infants>men>women
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adults contain 97% of this hemoglobin
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Hemo A
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Hemoglobin (RBC and Hct) panic values
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<8
>20 g/dl |
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erythroctosis
hypoxia polycythemia vera dehydration |
increased hemoglobin
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anemia
hemoglobinopathy diet deficiency cirrhosis pregnancy |
decreased hemoglobin
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hemoglobin x 3
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hematocrit %
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Hct/RBC
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MCV (mean cell volume)
average volume of red cells |
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average volume of red cells
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Mean cell volume
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Hgb/RBC
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MCH (mean cell hemoglobin)
weight of hemoglobin per RBC |
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Hgb/Hct
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MCHC (Mean cell hemoglobin concentration)
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weight of hemoglobin of average RBC
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Mean cell hemoglobin
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measure of degree of anisocytosis (variation in RBC size)
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RDW (red cell distribution width)
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low MCV
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thalassemia and Fe def anemia
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low MCV/normal RDW
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thalassemia
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low MCV, high RDW
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iron deficiency anemia
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segmented or polysegmented
45-73% |
mature neutrophil (PMNs)
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bands or stabs
3-5% |
young neutrophil
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increase in neutrophil number in response to invading organisml higher in children
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neutrophilia
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decrease production of neutrophils, excess stored in BVs
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neutropenia
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hypersegmented neutrophils can be seen in megaloblastic anemia and liver disease
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right shift of neutrophils
(more mature) |
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marrow release of less mature neutrophils
more than 10-12% bands |
left shift of neutrophils
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more lymphocutes than neutrophils
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inverted/reverse diff
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atypical lymphocytes seen in
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mono, viral hep, CMV, toxoplasmosis
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become macrophages in tissue
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monocytes (horseshoe shape and often contain vaculoles)
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Neoplasm
Allergy Addisons Collagen vasc disease Parasites (NAACP) PIE (pulm infiltrate eosin) |
eosionophilia
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phagocytic, are called mast cells when found in tissue
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basophil
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infective/inflammatory states
burns, chemo, pregnancy, TB |
Dohle bodies
(light blue line) |
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variation in RBC size
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anisocytosis
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variation in RBC shape
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poikilocytosis
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MCV <80 with ansicocytosis
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Iron def anemia
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MCV>101 with anisocytosis
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B12/folate deficiency
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may be due to mechanical trauma of RBCs (aortic stenosis)
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schistocytes
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spikes on perimeter of cell (not uniform)
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acanthocytes
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regularly spaced spikes on RBC
seen in uremia |
Burr cell (echinocytes)
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teardrop RBCs
may be liver/bone marrow problem |
dacrocytes
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RNA granules in RBC seen with lead or heavy metal poisoning
may also have blue/black gums (Burton's lines) |
basiphilic stippling
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denatured or precipitated protein seen in G6PD def
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Heinz bodies (blue dot on RBC)
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drug-induced hemolytic anemia with Heinz bodies
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G6PD def
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purple dot near RBC periphery that resembles DNA (chromatin remnant) seen after splenectomy
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Howell-Jolly bodies
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iron particles seen in
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Prussian blue reaction
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pappenheimer bodies (blue, purple granules) characteristic of
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Siderocytes
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stack of coins formation seen in multiple myeloma
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rouleaux formation
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use methylene blue (supravital stain) for
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reticulocyte count
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inflammation will have what effect on ESR
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increase
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microcytic, polycythemia vera, spherocytosis, sickle cell will have what effect on ESR
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decrease
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inflammation, multiple myeloma, macrocytic disorders, pregnancy, polymyalgia rheumatica and temporal arteritis will cause what to ESR
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increased rate
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produced by liver and increased with inflammation
disappears with salicylated or steroids |
C-reactive protein
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