Question | Answer |
Male RBC | 4.3-5.9 |
Female RBC | 3.5-5.5 |
Birth RBC | 5-6.3 |
Hemorrhage | Low RBC |
Hemolysis | Low RBC |
Dietary deficiency (Iron or B12) | Low RBC |
Sickle Cell | Low RBC |
Medications | Low RBC |
Chronic disease (Cancer, sepsis) | Low RBC |
Renal Disease | Low RBC |
Pregnancy | Low RBC |
Prosthetic Valves | Low RBC |
Dehydration | High RBC |
Hypoxia | High RBC |
Polycythemia Vera | High RBC |
High Altitude | High RBC |
Medications | High RBC |
Smoking | High RBC |
MCV | 80-100 |
MCH | 27-32 |
MCV | tells cell size |
MCH | tells amount or weight of Hb |
MCHC | tells percent of Hg within a single RBC; color - hyper or hypochromic |
Chronic illness | normocytic, normochromic anemia |
acute blood loss | normocytic, normochromic anemia |
aquired hemolytic anemia (heart valve) | normocytic, normochromic anemia |
iron deficiency | microcytic, hypochromic |
thalassemia | microcytic, hypochromic |
lead poisioning | microcytic, hypochromic |
renal disease | microcytic, normochromic |
B12 deficiency | macrocytic, normochromic |
folate deficiency | macrocytic, normochromic |
liver disease | macrocytic, normochromic |
alcoholics | macrocytic |
iron deficiency | decreased MCHC |
lead poisoning | decreased MCHC |
thalassemia | decreased MCHC |
spherocytosis | increased MCHC |
RDW | red blood cell distribution width |
Increased RDW | large variation in RBC size |
Iron deficiency | increased RDW |
folate deficiency | increased RDW |
B12 deficiency | increased RDW |
hemolytic anemia | increased RDW |
transfusion | increased RDW |
alcohol abuse | increased RDW |
Male Hb | 14-17 |
Female HB | 12-15 |
anemia | low Hb |
erythropoietin deficiency | low Hb |
Transfusion reaction | low Hb |
bleeding | low Hb |
lead poisoning | low Hb |
malnutrition | low Hb |
nutritional deficiencies (iron, folate, b12, b6) | low Hb |
overhydration | low Hb |
congenital heart disease | high Hb |
cor pulmonale | high hb |
pulmonary fibrosis | high Hb |
polycythemia vera | high Hb |
excess erythropoietin | high Hb |
anabolic steroids | high Hb |
Hematocrit | percent of whole blood that is RBC |
male Hct | 40-50 |
female Hct | 36-44 |
1 unit of blood raises Hct | 1.5-2 |
anemia | low Hct |
blood loss | low Hct |
bone marrow failure | low Hct |
destruction of RBC | low Hct |
malignancies | low Hct |
malnutrition | low Hct |
rheumatoid arthritis | low Hct |
Anemia of chronic diseases | low Hct |
dehydration | high Hct |
erythrocytosis | high Hct |
polycythemia vera | high Hct |
WBC | 4,500-11,000 |
Neutrophils | fighting cells |
emotional disturbances | high neutrophils |
nausea/vomiting | high neutrophils |
physical exercise | high neutrophils |
acute infections | high neutrophils |
bacterial, mycotic, rickettsial, spirochetal (strep) infection | high neutrophils |
acute inflammatory disorders | high neutrophils |
rheumatoid arthritis, rheumatic fever, vasculitis, myositis | high neutrophils |
uremia, diabetes acidosis, thyroid storm, eclampsia | high neutrophils |
post hemorrhage | high neutrophils |
leukemia | high neutrophils |
myeloproliferative disorders | high neutrophils |
tissue necrosis, MI, burns, malignant neoplasia | high neutrophils |
smoking | high neutrophils |
allergy | high neutrophils |
appendicitis WBC | 10,000-12,000 |
bacterial infections (typhoid fever, sepsis) | low neutrophils |
hepatitis | low neutrophils |
mono | low neutrophils |
measles, rubella, flu, HIV | low neutrophils |
radiation/chemo | low neutrophils |
lupus, rheumatoid arthritis, alcohol | low neutrophils |
lymphocytes | increased with mostly viral diseases |
hepatitis | high lymphocytes |
mono, CMV, zoster | high lymphocytes |
mumps, measles, viral pneumonia | high lymphocytes |
pertussis | high lymphocytes |
IBD, ulcerative colitis, chrons disease | high lymphocytes |
ALL, CML leukemia, multiple myeloma | high lymphocytes |
acute infections | low lymphocytes |
increased corticosteroids with tx or Cushings | low lymphocytes |
immunodeficiencies | low lymphocytes |
defects in lymphatic drainage | low lymphocytes |
debilitating disease (cancer, lupus, TB, renal failure) | low lymphocytes |
monocytes | increase with everything! |
TB, lupus, syphilis | high monocytes |
hepatitis, mumps | high monocytes |
malaria | high monocytes |
leukemia, lymphomas | high monocytes |
polycystemia vera | high monocytes |
collagen vascular disease | high monocytes |
Main causes of increased eosinophils | parasitic diseases, allergies, fungal infections |
parasitic diseases (trichinosis, intestinal) | high eosinophils |
allergic diseases (asthma, urticaria) | high eosinophils |
skin disorders (eczema, pemphigus, TENS) | high eosinophils |
drugs | high eosinophils |
fungal infections (aspergillius, histo) | high eosinophils |
malignancy (hodgkins, ovarian, lung cancer) | high eosinophils |
platelets | 150,000-400,000 |
safe platelet count to operate for emergent procedures | 30,000 |
aplastic anemia | low platelets |
radiation/chemo | low platelets |
acute leukemia, myelofibrosis, multiple myeloma | low platelets |
most common cause of low platelets | thrombocytopenia |
excessive pooling (hypersplenism) | low platelets |
post transfusion purpura | low platelets |
Idiopathicothrompocytopenic purpura | low platelets |
mono | low platelets |
drugs | low platelets |
Disseminated Intravascular coagulation (DIC) | low platelets |
sepsis | low platelets |
hemolytic uremic syndrome | low platelets |
heart valves | low platelets |
heparin | low platelets |
HIV | low platelets |
Causes of low platelets by | decreased production, excessive pooling, increased destruction |
Causes of high platelets by | reactive or primary diseases |
infection | high platelets |
acute blood loss | high platelets |
cancer | high platelets |
splenectomy | high platelets |
polycythemia vera | high platelets |
chronic leukemia | high platelets |
Normal Pt Hemoglobin differences | High HbA1, low Hg A2, low Hg F, No Hb S or C |
Newborn HgF | 50-80% |
6 month old HgF | 8% |
>6month old HgF | 1-2% |
Beta Thalassemia Major | Increased HgF |
Sickle Cell | Increased HgF |
Reticulocyte count | measures percent of immature RBC |
erythroblastosis fetalis | high reticulocytes |
most common cause of high reticulocytes | hemolytic anemia |
acute blood loss/post hemorrhage | high reticulocytes |
kidney disease (increased erythropoietin) | high reticulocyte |
infiltrative marrow disorders | high reticulocytes |
bone marrow failure (due to toxicity, tumor, fibrosis, infection) | low reticulocytes |
cirrhosis | low reticulocytes |
folate, iron, vit B12 deficiency | low reticulocytes |
drugs | low reticulocytes |
kidney disease (decreased erythropoietin) | low reticulocytes |
Factor V Leiden | hypercoagulable state |
malignancy | hypercoagulable state |
PT | prothrombin time |
Normal PT | 11-12.5 seconds |
If pt is anticoagulated, PT should be | 1.5-2 times faster than the normal PT |
PT | extrinsic pathways |
Vitamin K dependent factors | II, VII, IX, X |
Extrinsic pathway factors | I, II, V, VII, IX, X |
coumadin | prolonged PT |
heparin | prolonged PT |
vit K deficiency | prolonged PT |
liver disease | prolonged PT |
decreased fibrinogen | prolonged PT |
VWF deficiency | prolonged PT |
DIC | prolonged PT |
DIC | disseminated intravascular coagulation |
factor deficiency | prolonged PT |
coumadin | increased INR |
Vit K | decreased PT |
Normal INR | 2-3 |
INR | international normalizing ratio |
INR for mechanical prosthetic valves | 2.5-3.5 |
If INR is 1.8 | increase coumadin dose |
if INR really high (10 or 11) | give Vit K |
ETOH | prolong PT/INR |
high fat or leafy veg | decrease PT/INR |
diarrhea/malabsorption | prolonged PT/INR |
allopurinol, b-lactams, quinolones, thorazine, cimetidine | prolong PT/INR |
anabolic steroids, digoxin, benadryl, BC | decrease PT/INR |
PTT | intrinsic |
Coumadin | extrinsic |
heparin | intrinsic |
PTT | partial thromboplastin time |
Normal PTT | 60-70 seconds |
APTT or anticoagulated pt PTT | want to be 2x faster than normal so 30-40 seconds |
heparin | increased PTT |
vit k deficiency | increased PTT |
liver disease | increased PTT |
DIC | increased PTT |
lupus anticoagulant | increased PTT |
factor deficiencies | increased PTT |
thrombin time | TT |
normal TT | 12-18 seconds |
TT | used to detect hypofibrinogenemia and presence of heparin |
heparin | prolonged TT |
severe hypofibrinogenemia | <80 mg/dL fibrinogen |
severe hypofibrinogenemia | prolonged TT |
DIC | prolonged TT |
normal fibrinogen level | 200-400 mg/dL |
critical fibrinogen levels | <100 mg/dL |
liver disease | decreased fibrinogen |
DIC | decreased fibrinogen |
large volume blood transfusion | decreased fibrinogen |
estrogens and BC | increased fibrinogen |
FSP | fibrin split producs |
FSP Normal value | <10 mcg/mL |
DIC | increased FSP |
therapeutic throbolysis | TPA |
TPA | increased FSP |
thrombosis | increased FSP |
thrombotic thrombocytopenic purpura | increased FSP |
hemolytic uremic syndrome | increased FSP |
D-dimer normal values | <250mg/mL |
DVT | increased D-dimer |
PE | increased D-dimer |
sickle cell | increased D-dimer |
malignant thrombosis | increased D-dimer |
major surgeries | increased D-dimer |
Direct Coomb normal values | negative |
direct coomb normal values | trace - 4 |
positive coomb normal values | >4 |
erythroblastosis fetalis | elevated direct coombs |
incompatible blood transfusion reaction | elevated direct coombs |
lymphoma | elevated direct coombs |
autoimmune hemolytic anemia | elevated direct coombs |
infectious mono | elevated direct coombs |
mycoplasma infections | elevated direct coombs |
hemolytic anemia after CABG | elevated direct coombs |
drugs - ampicillin, captopril, cephalosporins, thorazine | false positive elevated direct coombs |
direct coombs | checks for antibodies on RBC surface |
indirect coombs | checkes for antibodies in blood serum |
good glucose control | <5.9% HbA1C |
fair glucose control | 6-8% HbA1C |
poor glucose control | >8% HbA1C |