click below
click below
Normal Size Small Size show me how
LabMedicine Heme
LabMedicine Test 1
| 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 |