Midterm Refresher: WBC and RBCs

what is a direct indication of o2 transport capacity

HgB

What is the relationship between HcT and HgB

HcT is a % and should be 3x bigger than HgB

MCV range

80-96 fl/cell

What RBC indices is used to classify anemia?

MCV

What are reticulocytes

immature, non nucleated RBC’s released into peripheral blood from bone marrow

Precursor to RBC

An increased production indicated blood loss of hemolysis

Patient has a MCV of 90. What is the interpretation

Patient has a normal MCV count

Range is 80-96 Fl

A patient has a MCV of >100. What is the intepretation

The patient could have a B12 or Folate deficiency. Further testing of MMA would be needed to distinguish the 2. Positive MMA would be B12

Patient has MCV <80. What is the interpretation

The patient has microcytic anemia. The patient could have iron deficiency anemia or anemia of chronic disease

Which of the following types of anemia would be used to describe a patient with a mean corpuscular volume (MCV) of 70 fL/cell?

a. microcytic

b. normocytic

c. macrocytic

d. normochromic

microcytic

Hemolytic anemia would most accurately be described as:

a. normocytic anemia

b. microcytic anemia

c. microcytic anemia

d. multifactorial anemia

a. normocytic anemia

Order of WBC

Never Let Monkeys Eat Bananas

Neutrophils, Lymphocytes, Monocytes, Eosinophils, Basophils

What does a left shift indicate

increase in bands = immature neutrophils

Can indicate infection

when do neutrophil levels increase

in bacterial infections, glucocorticoids, trauma

when do neutrophil levels decrease

immunosuppressive therapy (like chemo)

Eosinophils increase in

parasitic infections, allergies, asthma, medications like ACE inhibitors and antimicrobial drugs

eosinophils decrease in

acute infections

lymphocytes increase in

bacterial and viral infections, malignancies

lymphocytes decrease in

burns, trauma, HIV, lymphoma, glucocorticoids, aplastic anemia

leukopenia is

<4000 cells/uL

Can be caused by HIV, Autoimmune disease, bone marrow disorders, lymphoma, bacterial infections (severe), lupus

leukocytosis is

>11000 cells/uL

Can be caused by

Infections, leukemia, inflammatory conditions, stress, exercise, splenectomy, allergies, asthma

T/F fluctuations in WBC and temperature are specific and but not sensitive

Fluctuations in WBC and temperature are sensitive but not specific

A patient has a macrocytic megaloblastic anemia, (High MCV) which of the following would distinguish the cause of their anemia?

1. A MCV count

2. A high MMA count, which would signify a folate deficiency 

3. A high MMA count, which would signify a B12 deficiency 

4. None of the above

A high MMA count, which would signify a B12 deficiency

Which of the following incorrectly matches the potential cause of anemia to its cause

1. Macrocytic anemia: B12 or Folate deficiency 

2. Normocytic anemia: Hemolytic Anemia, Blood loss

3. Microcytic anemia: Iron deficiency anemia 

4. Macrocytic anemia: B12 or Folate excess

Macrocytic anemia: B12 or Folate excess is INCORRECT; it is a deficiency that causes the anemia

Which of the following would result in neutropenia?

1. 19 year old college student who is stressed out

2. A patient undergoing chemotherapy 

3. A patient taking glucocorticoids

4. A patient with a bacterial infection

Answer: B) Chemotherapy lowers neutrophils 

↑ in bacterial infections, glucocorticoids, trauma

↓ in chemotherapy, immunosuppressive therapy

What is the most important factor for temperature? 

1. Method

2. Trend of Temperature 

3. The number 

4. Something else

TREND!

Which of the following is the normal reference range for Leukocytes? 

1. 4.4-11.3 x 10^3

2. 81-99 fl

3. 4.5-4.9 x 10^6

4. None of the above 

4.4 - 11.3 × 10³

When is leukopenia determined? 

1.  <80,000 cells/uL

2. > 100,000 cells /uL

3. < 4000 cells/uL

4. <11,000 cells/uL

< 4000 cells/uL

What is the typical lifespan for a platelet? 

7-10 days

Which of the following patients are at risk for leukocytosis? (Select all) 

1. A patient experiencing leukemia

2. A patient with a splenectomy 

3. A patient with lymphoma 

4. A patient with HIV

Leukocytosis is high WBC

A patient experiencing leukemia and splenectomy would have high wbc

What is the most abundant white blood cell?

Neutrophils

What is a normal platelet count

150,000 - 450,000

Is adaptive immunity sensitive or specific?

Adaptive immunity is specific