Visceral Disorders- RBC Quiz- CBC notes- Part 3

Everything is increased

Polycythemia

3 types of polycythemia

1. Polycythemia Vera (primary)

2. Absolute polycythemia (secondary)

3. Relative polycythemia

Polycythemia physical symptoms

Red face

High BP

Low exercise tolerance

Joint pain s

In polycythemia rebar Vera, erythrocytosis ( IS or IS NOT) dependent o nerythropoeitein

Not dependent

Polycythemia rubes vera the bone marrow is

Hyperplastic

Chronic myeloproliferative disorder overproduction of erythrocytes (red blood cells)

Polycythemia rubra Vera

Absolutely increase in all cell types

Polycythemia rubra Vera

MCV and MCH/MCHC levels with polycythemia rubra Vera

Normal or may be elevated

RBC, WBC, Hgb, Hct and platelets levels with polycythemia rubra Vera

Normal or elevated

Blood is _______ with polycythemia rubra Vera

Thick and clogs vessels

Erythropoietin mediated increase of RBCs and hemoglobin due to hypoxia

Secondary polycythemia

Physiologic response to the need for more RBC production due to an increased need for oxygen, pulmonary disorder or increased erythropoietin

Seen in areas of high elevation

Secondary polycythemia

RBC, Hgb, Hct MCV and MCH/MCHC levels with secondary polycythemia

Increased

WBCs and platelets count with secondary polycythemia

Normal

Due to a decrease in plasm volume and the RBC mass remains unchanged

Relative polycythemia

Relative polycythemia is most often associated with

Dehydration

RBC, Hgb Hct count with relative polycythemia

Increased

WBC and platelets count with relative polycythemia

Normal

Primary polycythemia is really a malignancy of

Bone marrow (low erythropoietin)

Secondary polycythemia is related to

Hypoxia (high erythropoietin)

Cause of RBC increase in relative polycythemia

Declared plasma volume (dehydrate)

Erythropoietin levels in relative polycythemia

Normal

Cause of RBC increase in secondary polycythemia

Hypoxia (cardiac, pulmonary, liver problems etc causing hypoxia)

Erythropoietin levels in secondary polycythemia

increased and dependent on erythropoietin

Cause of RBC increase in primary polycythemia

Overproduction of bone marrow

Erythropoietin levels in primary polycythemia

Decreased and not dependent on erythropoietin

Measurement of the rate RBC settle in saline or plasma over a specific time

Erythrocyte sedimentation rate

ESR is

Sensitive but non specific (tells you something is wrong but doesn't tell you what it os)

ESR can be used to

Monitor disease progress (disease worsen ESR increase)

ESR increase with

Inflammation, infection, neoplasm, tissue necrosis, infarction, etc

What is stacking of the RBC similar to a stack of coins as they stack they drop more rapidly during the ESR

Rouleaux formation (multiple myeloma classically has these)

ESR increase with

Age

TRUE or FALSE

ESR is not part of the CBC and must be ordered separately

TRUE

ESRS parallels

C reactive protein

C reactive protein levels (DO or DO NOT) consistently rise with virus infection

DO NOT consistently rise

What is more sensitive, C reactive protein or ESR

C reactive protein

What disappears sooner during recovery, c relative protein or ESR

C reactive protein

Larger than normal size RBC found in accelerated erythropoiesis, chronic liver disease, B12 and folate deficiency (megaloblastic anemia)

Macrocytes

Smaller than normal RBC often found in IDA, ACD, thalassemia, CBL

Microcytic

RBC that vary in size, frequently found in hemolytic anemia

Anisocytes

Lower then normal Hgb concentration and indicate decreased Hgb production found in IDA, thalassemia, ACD

Hypochromia

Increased numbers of reticulocytes seen in folate and B12 deficiency as well as polycythemia

Polychromasia

Oval shaped, normally only small number are present, may be seen in IDA and megaloblastic anemia

Ovalocytes

Teardrop shape and may be seen in thalassemia

Teardrop cells

Hgb found in peripheral rim and central core and are seen with thalassemia, SS anemia and chronic liver disease

Target cells

Crescent shape and are characteristic of SS anemia

Sickle cells

Abnormal variations in shape seen in the anemias, and leukemias

Poikilocytes

Seen in lead poisoning and are remnants or RNA found in the RBC cause stippling appearance, seen in thalassemia and hemolytic anemia`s

Basophilic stippling

Young immature non-nuclear RBCs increased levels seen with increased RBC production, decreased amounts seen if bone marrow is not keeping up production

Reticulocyte