CBC Exam Review Flip Cards

H shaped vertebra are associated with?

Sickle cell anemia

Hair on end calvarium is most likely associated with

Thalassemia

List the microcytic hypochromic anemias

IDA, CBL (really and IDA), ACD/ARD, and Thalassemia

What would be the expected TIBC associated with an IDA?

Increased

Describe secondary polycythemia

An erythropoietin mediated increase of RBC’s and hemoglobin due to hypoxia, often associated with pulmonary, cardiac or kidney disorders

Relative polycythemia

Cause of RBC increase: Decreased plasma volume

Erythropoietin levels: ???

Normal

Secondary polycythemia

Cause of RBC increase: Hypoxia

Erythropoietin levels: ????

Decreased

Primary polycythemia

Cause of RBC increase: Overproduction by bone marrow

Erythropoietin levels: ????

Decreased

Your patient had as CBC and they have been told they have a microcytic anemia. What follow up testing would be helpful?

History, clinical presentation, iron parameters, fecal occult blood test

What are the iron parameter levels in thalassemia?

Normal iron, ferritin and TIBC

Your pt has signs and symptoms of a pneumonia. The pt’s CBC result show 14.4 WBCs, 80 neutrophils, 12 bands and 8 lymphocytes. The diagnosis is most likely an/ a

Bacterial pneumonia

Your patient has normal WBC’s numbers and a normal differential. Although the CBC reveals normal RBC’s low hemoglobin and Hematocrit. The RCB indices were all decreased. What is the most likely dx and what is the ddx?

IDA, CBL, ACD/ARD and thalassemia

Most likely IDA caused by CBL bc it is the MC

What is the expected TIBC for thalassemia

Normal

Increased TIBC can be seen in which microcytic anemias?

IDA and CBL

Which microcytic anemias have decreased TIBC levels?

ACD and ARD

Chronic blood loss can result in which cell sized anemia?

Microcytic anemia

Your patient is anemic with a normal MVC, they also have 43.5 WBC's, 10 segs, 10 lymphs and 80 blasts. What are the diagnoses and which is most significant?

They have a normocytic anemia and acute myelocytic anemia. Of course the AML is more significant than the anemia. The differential for the normocytic anemia is: ABL, ACD, aplastic anemia and a hemolytic anemia

Your patient has 105 WBC's with 20 segs, 10 lymphocytes, 5 monocytes, 20 L Pros and 45 L Blasts.

ALL

Acute lymphocytic leukemia the most likely diagnosis.

Your patient has 44.7 WBC's with an inverted ratio and negative biopsy findings. What is the most likely diagnosis?

Lymphocytic leukemoid reaction

Your patient has 44.7 WBC's with an inverted ratio and negative biopsy findings. The most likely diagnosis is a lymphocytic leukemoid reaction.

Your patient has 110 WBC with 15 neutrophils, 5 bands, 75 lymphocytes, and 5 monocytes. The likely diagnosis is

CLL

Your patient has 43 WBC's with 45 segs, 35 bands and 20 lymphs. What is the diagnosis or differential diagnosis?

Neutrophilic leukemoid Rx or CML

Your patient has 42.5 WBC's with 30 segs, 5 bands, 60 lymphs, 5 monocytes. What is the diagnosis or differential diagnosis?

Lymphocytic leukemoid Rx or CLL

Your patient has 47 WBC's with 20 segs, 20 bands, 20 lymphs, 5 metas, 5 myelos, 10 pros, 20 blasts. What is the diagnosis or differential diagnosis?

The most likely diagnosis is acute myelocytic leukemia. The blasts and pros makes this AML and not a leukemoid reaction.

What is the differential diagnosis for an ivory vertebra?

Blastic mets, Paget's and lymphoma

Your 23 year old patient has an ivory vertebra at L3. What is the most likely diagnosis?

Lymphoma is the most likely because they are 23 years old.

The "CRAB" mnemonic as it relates to Multiple Myeloma refers to what findings?

The "CRAB" mnemonic relates to full blown Multiple Myeloma and refers to elevated calcium, renal dysfunction, anemia and bone lesions.

Your patient had lab work accomplished and it revealed suspected multiple myeloma. What diagnostic procedure would be helpful to further help confirm Multiple Myeloma?

Protein electrophoresis

Bence Jones proteinuria would suggest what diagnosis?

Multiple Myeloma

What are thrombocytes?

Platelets

On a CBC what would an inverted ratio mean?

Lymphs greater than Segs

On a CBC an inverted ratio is associated with

Viral inf, lymphocytic leukemia, lymphocytic leukemoid Rx or maybe normal

Which type of lymphocyte is involved with humoral immunity?

B cell

A malignant proliferation of plasma cells is called

Multiple Myeloma

Plasma cells produce

Antibodies

Atypical lymphocytes are usually associated with what type of infection?

Mono

Mononucleosis is due to what organism?

Epstein-Barr virus

15 year old patient presents with fatigue, sore throat, swollen lymph nodes in their neck. Their CBC reveals a decreased segs, increased lymphocytes, presence of atypical lymphocytes. And a total WBC count of 14,387 and a positive monospot test. What is the most likely Dx?

Late Mono

Mononucleosis and because of the elevated WBC count it is later Mono

A 15 year old patient presents with fatigue, sore throat, swollen lymph nodes in their neck. Their CBC reveals a decreased segs, increased lymphocytes, presence of atypical lymphocytes. And a total WBC count of 4,233. What is the most likely Dx?

Early Mono

Mononucleosis and because of the decreased lymphocytes early mononucleosis would be suspected.

Your patient has the following CBC results: normal RBC, low Hgb, low Hct, low MCV and a biochemical profile reveals elevated TIBC. What is the most likely diagnosis?

IDA or CBL anemia

They have a microcytic anemia with an elevated TIBC which reflects either an IDA or a chronic blood loss anemia. A CBL anemia is really an IDA.

Your patient has a microcytic anemia with normal iron parameters. The likely diagnosis is ___________.

Thalassemia

A malignant increase of WBC's above 50,000 with a proliferation of myeloblasts and promyelocytes would indicate what diagnosis?

AML

A malignant increase of WBC's above 50,000 with a proliferation of myeloblasts and promyelocytes would indicate acute myelocytic leukemia.

A malignant increase of WBC's above 50,000 with a proliferation of lymphoblasts and prolymphocytes would indicate what diagnosis?

ALL

A malignant increase of WBC's above 50,000 with a proliferation of lymphoblasts and prolymphocytes would indicate acute lymphocytic leukemia.

A malignant increase of WBC's above 50,000 with a proliferation of E blasts and E pros would indicate what diagnosis?

AEL

A malignant increase of WBC's above 50,000 with a proliferation of E blasts and E pros would indicate acute eosinophilic leukemia

A total WBC count below 5000 WBC's per cubic millimeter is called

Leukopenia

A total WBC count above 10,000 WBC's per cubic millimeter is called

Leukocytosis

A total WBC count above 50,000 WBC's per cubic millimeter is usually due to

Leukemia

What is the WBC range for a typical infection.

10-18k

A total WBC count in the 30,000 to 50,000 range usually indicates

Leukemoid Rx or leukemia

A neutrophilic leukocytosis of 16,285 WBC in a patient with a sore throat would likely indicate

Bacterial pharyngitis

A lymphocytic leukocytosis of 16,285 WBC in a patient with a sore throat would likely indicate

Viral pharyngitis

Eosinophils primarily combat

Allergy and parasites

In an infection, lymphocytes primarily combat

Viral

In a potential infection neutrophils function to combat

Bacteria

A malignant increase of WBC's above 50,000 with a proliferation of B blasts and B pros would indicate what diagnosis?

ABL

A malignant increase of WBC's above 50,000 with a proliferation of Mo blasts and MO pros would indicate what diagnosis?

AMoL

What age of patients are most likely to get acute lymphocytic leukemia?

less than 20

A 10 year old patient has 85,000 WBC with 20 neutrophils and 15 lymphocytes, 10 prolymphocytes and 55 lymphoblasts. What is the most likely diagnosis?

ALL

A Philadelphia chromosome is usually identified with

CML

Your 63 year old patient has 75 WBC's, 20 segs, 30 bands, 10 lymphs, 30 metas, 8 myelos, 1 pro and 1 blast. According to the WHO what would be the most likely diagnosis?

CML

An increase in immature WBC's on a CBC is termed

shift to the left

An increase in the number of bands on a WBC differential is termed

shift to the left

Your patient is anemic and they have a normal MCV, 46.4 WBC, 55 segs, 30 bands and 15 lymphs. What is the DX or DDx?

They have a normocytic anemia and either chronic myelocytic leukemia or a neutrophil leukemoid reaction

What is the most likely diagnosis?

Thalassemia

What is the diagnosis and what test may help ensure the diagnosis?

Sickle Cell anemia. A CBC would be helpful to see if they have a normocytic anemia.