Barrons Heme/Anemia Indicies

What is the gold-standard laboratory value for identifying and monitoring anemia?

Hemoglobin (Hgb)

What is the gold-standard RBC index for classifying anemia?

Mean corpuscular volume (MCV)

What is the normal MCV range?

80-96 fL

What does an MCV

Microcytic anemia

What does an MCV >96 fL indicate?

Macrocytic anemia

What does MCH measure, and what is its normal range?

RBC color/hemoglobin content; 27-33 pg

What does an MCH

Hypochromia; commonly associated with iron-deficiency anemia

What does RDW measure, and what is its normal range?

Variation in RBC size; 11.5-14.5%

What does an elevated RDW indicate?

Anisocytosis (increased variation in RBC size)

What is the normal reticulocyte range?

0.5-2.5%

In normocytic anemia, what does a reticulocyte count >2.5% suggest?

The marrow is responding; think acute blood loss or hemolysis

In normocytic anemia, what does a normal reticulocyte count

Anemia of chronic disease

What laboratory finding in addition to reticulocytosis supports hemolytic anemia?

Decreased haptoglobin

What test is positive in immunologic hemolytic anemia according to the notes?

Coombs test

What is the classic iron-study pattern for iron-deficiency anemia?

Decreased ferritin, decreased serum iron, increased TIBC, decreased TSAT

What is the classic iron-study pattern for anemia of chronic disease?

Normal ferritin, decreased serum iron, decreased TIBC, decreased TSAT

Why can ferritin be misleading during infection or inflammation?

Ferritin is an acute-phase reactant and may be falsely elevated

What is the normal platelet range?

150,000-450,000/µL

At what platelet count does bleeding risk with trauma become important?

At what platelet count is spontaneous bleeding a major risk?

What platelet count defines thrombocytosis?

>450,000/µL

What platelet count defines thrombocythemia in Barrons' lecture?

>800,000/µL

What are the risks associated with thrombocythemia?

Both clotting and bleeding

What is the normal MPV range?

7-11 fL

Thrombocytopenia with a high MPV suggests what mechanism?

Hyperdestructive thrombocytopenia; marrow is responding with larger/newer platelets

Thrombocytopenia with a low MPV suggests what mechanism?

Hypoproductive thrombocytopenia; impaired platelet production

Which test monitors warfarin, and what is the usual therapeutic range in the notes?

INR; therapeutic range 2-3 for most indications

What is the preferred test for monitoring UFH, and when should aPTT be used instead?

Anti-factor Xa is preferred; use aPTT when a patient is on a DOAC and the baseline anti-Xa is >0.5 U/mL

Does LMWH routinely require monitoring, and when might anti-Xa monitoring be needed?

No; anti-Xa may be needed with BMI >40 or weight >120 kg, weight

What does D-dimer measure, what is normal, and how should it be interpreted?

A fibrin degradation product from plasmin digestion of cross-linked fibrin; normal