Hematology PPT (serum complete blood count & basic blood cell info)

where are RBCs formed?

in the bone marrow (pelvis, ribs, and sternum)

what is the lifespan if a RBC?

120 days

what 5 materials are required for the formation of RBCs (mental answer girrllll)?

iron, protein, vitamin B12, vitamin B6, folic acid

what hormone stimulates the formation of RBCs (going from a reticulocyte → erythrocyte)?

erythropoietin

what is an immature erythrocyte (RBC)?

reticulocyte

where is the important hormone erythropoietin produced?

90% in the kidneys, 10% in the liver

what 2 things are recycled when a RBC is destroyed/days (after 120 days)?

globulin & iron

when an RBC is destroyed, what happens to the heme portion?

it’s broken down into biliruben

what is the relationship between B12 and B6?

B6 helps the body absorb B12

as you know, the kidneys produce the majority of the hormone that triggers RBC production. how are the kidneys themselves stimulated to release this hormone?

by hypoxemia OR anemia

recall that during RBC destruction the heme portion is broken down into bilirubin. what is important to remember about bilirubin?

there are 2 different types of biliruben: conjugated and unconjugated

what type of bilirubin is FAT soluble and is responsible for causing jaundice when in abundance?

unconjugated bilirubin

what type of bilirubin is WATER soluble and is thus easily excreted from the body?

conjugated bilirubin

what is the normal range for WBCs in the body?

4,500 - 10,000

what are WBCs/leukocytes important for within the body?

fighting infections

what is a WBC count less that 4,500 referred to as?

leukocytopenia

what is a WBC count more than 10,000 referred to as?

leukocytosis

what is a WBC count less that 4,500 indicate?

that the pt is immunocompromised (leukocytopenia)

what is a WBC count more than 10,000 indicate?

that they have an infection or there is inflammation (leukocytosis)

what are neutrophils and are there different types of neutrophils?

they’re a type of WBC/leukocyte — segs and bands?

what is a mature neutrophil referred to as?

segs

what is an immature neutrophil referred to as?

bands

what are the different types of WBCs/leukocytes?

neutrophils (MOST COMMON), thrombocytes(platelets), granulocytes, lymphocytes, monocytes, eosinophils, basophils

what is the normal range of segs in the body?

3,000-5,800

what is the normal range of bands in the body?

150-400

a pt presents with a segs count greater than 5,800. what does this indicate?

that there is an increased presence and there might be bacterial or a fungal infection

a pt presents with a bands count greater than 400. what does this indicate?

that there is an increased presence and the pt is experiencing severe/widespread infection

what are some causes of leukocytosis?

infection & SIRS

what is a trademark clinical manifestation associated with thrombocytopenia?

purpura and/or petechiae (bc this type of pt is prone to bleeding)

what is a trademark clinical manifestation associated with thrombocythemia?

erythromelalgia (a burning sensation)

what does a term ending with -penia mean?

a deficiency of

what does a term ending in -ctosis / -cythemia mean?

an excess of

what do basophils release and what do they do?

they are involved in allergic and hypersensitive reaction — they release histamines (vasodilators) and heparin (antocoag / blood thinner)

what is the normal range for Hgb?

12-16

what is Hgb important for?

for their oxygen carrying capacity (and CO2)

what is the following associated with:

• long term hypoxia (so the body is making for RBCs to compensate)

• high altitude

• flush skin, dizziness

increased Hgb levels

what is the following associated with:

• anemic/hemorrhage

• hemolysis (so there’s a release of bilirubin…)

• jaundice

decreased Hgb levels

what is the normal percentage range for HCT (the percent of RBCs in 100 mL of plasma)?

36-50

what foes an increased HCT percentage indicate?

they’re dehydrated

what foes an decreased HCT percentage indicate?

they’re in fluid overload

a pt presents with the follow:

• HCT percentage that went from 49 to 53%

• they’ve lost some blood & are dehydrated

• they’re sweating a lot, and complain of being too hot when the window curtains are opened

what would this tell you abt their HCT levels?

they’re too high

a pt presents with the follow:

• HCT percentage that went from 37 to 33%

• they’re pregnant

• they’re experiencing SOB, headaches, and palor

what would this tell you abt their HCT levels?

they’re too low

what is the normal Plt range?

150k - 400k

what is a Plt count less than 150 k referred to as?

thrombocytopenia (too low)

what is a Plt count more than 400 k referred to as?

thrombocythemia

if a pt has an elevated Plt count (greater than 400k), what would you suspect is going ON?

there’s a suspicion for cancer AND clot formation

what key clinical manifestation is associated with thrombocythemia?

erythromelalgia → a burning sensation

if a pt has an decreased Plt count (less than 150k), what would you suspect could happen?

they’re at a risk for bleeding

a pts Plt is less than 20k. what are they at a risk for?

spontaneous bleeding

for thrombocytopenia, how would you treat this?

you’d replace platelets with platelets (this is a low amount of Plts in the body)

what should you be immediately thinking about when a pt is thrombocytopenic?

stopping the bleed

what type of Plt levels are associated with petechia/purpura, ecchymosis (bruising), hematoma, hemarthrosis & hematuria?

thrombocytopenia

what are the different types of thrombocytopenia (LIST MENTALLY)?

• Immune Thrombocytopenia (ITP)

• Thrombotic Thrombocytopenia Purpurea (TTP)

• Drug Induced Thrombocytopenia

• Impaired Platelet Fxn

describe immune thrombocytopenia purpurea (ITP)?

it’s an idiopathic autoimmune disorder

describe thrombotic thrombocytopenia purpurea (TTP)?

is associated with renal failure and will present with a fever that increases Plt destruction

low Plt count = dengue fever & heatstroke

low Plt aggreg. = hemorrhagic fever

what can quinidine & sulfa containing drugs cause?

drug induced thrombocytopenia

what is a big cause for impaired platelet function (a type of thrombocytopenia)?

inherited disorders like von Willbrand disease (factor 8 problem)

what are the different coagulation tests (LIST MENTALLY)?

• partial prothrombin time (PTT)

• prothrombin time (PT)

• international normalized ratio (INR)

what is the normal range for a partial prothrombin time (PTT) test?

25 - 35 seconds

what is the normal range for a prothrombin time (PT) test?

12.7 - 15.4 seconds

what is the normal range for a international normalized ratio (INR) test?

0.8 -1

what does the prothrombin time (PT) AND international normalized ratio (INR) panel measure?

warfarin levels

what does the partial prothrombin time (PTT) panel measure?

heparin levels

what disease will have a LONGER partial prothrombin time (PTT) panel?

hemophilia & von willebrand’s

what is the heparin THERAPEUTIC range (where you want to keep this range for therapeutic tx)?

1.5-2 * the normal partial prothrombin time (PTT) panel