Clin Lab Med Hematology Oncology Wk 2

hematology

The study of blood, blood-forming organs, and blood diseases.

complete blood count

a series of tests that provides information about RBCs, platelets, and WBCs.

RBC indices

Measures including MCV, MCH, and MCHC that provide information about the size and hemoglobin content of RBCs.

MCV

Mean corpuscular volume, average size of a single RBC, useful in classifying anemias.

MCH

Mean corpuscular hemoglobin, average amount of hemoglobin in an RBC.

MCHC

Mean corpuscular hemoglobin concentration, average concentration of hemoglobin in 1 RBC relative to cell volume.

RDW

Red blood cell distribution width, variation of RBC sizes in the sample.

ESR

Erythrocyte sedimentation rate, the rate at which RBCs settle, used to detect inflammation.

CRP

C-reactive protein, an acute phase reactant protein secreted by the liver in response to inflammation.

anemia

A condition characterized by a deficiency of red blood cells or hemoglobin.

polycythemia

An increase in the number of red blood cells.

reticulocyte count

Percentage of immature RBCs, indicates bone marrow response to anemia.

Hemostasis

The process of blood clotting and maintaining blood in a fluid state.

Vitamin K

A vitamin essential for the synthesis of proteins required for blood coagulation.

Thrombocyte

Another term for platelets, which are involved in blood clotting.

Megaloblastic anemia

A type of anemia caused by impaired DNA synthesis, often due to B12 or folate deficiency.

Microcytic anemia

Anemia characterized by small RBCs, often due to iron deficiency.

Normocytic anemia

Anemia with normal cell size, often due to chronic disease.

Ferritin

A protein that stores iron in the body.

Total Iron Binding Capacity (TIBC)

A measure of all proteins available for binding iron.

Transferrin

A protein that transports iron in the blood.

Transferrin saturation

Percentage of TIBC that is saturated with iron.

Hemoglobin (HGB)

A protein in RBCs that carries oxygen and carbon dioxide.

Hematocrit (HCT)

The percentage of total blood volume made up of RBCs.

Erythrocyte Count (RBC)

Measures the number of RBCs in 1mm3 of peripheral blood.

Bone Marrow

The tissue in which blood cells are produced.

Peripheral Blood

Blood that circulates throughout the body.

White Blood Cell Inclusions

Abnormalities found in WBCs, indicating various conditions.

Hodgkin's lymphoma

A type of cancer that affects the lymphatic system.

Non-Hodgkin's lymphoma

A diverse group of blood cancers that includes any lymphoma except Hodgkin's lymphoma.

Chronic disease

A long-term health condition that may affect RBC production.

M = 13.5-17.5 F = 12.0-160 critical = < 5 and > 20

What is the hemoglobin reference range

M = 41-53% F = 36-46%

What is the hematocrit reference range?

total iron binding capacity

measurement of all proteins available for binding iron

Increased Ferritin

Represents iron excess.

Recent blood transfusion, hemosiderosis, hemochromatosis, anemias, hepatitis.

Iron overload causes?

Factitiously elevated ferritin

Occurs in chronic disease states.

Positive acute phase reactant

Serum concentration and stores rise significantly with inflammation.

Cancer, infection, liver disease, alcoholism.

Conditions causing elevated ferritin

Hypersplenism

Sequestration; platelets trapped in spleen.

thrombocytosis

Increased Platelet Count

thrombocytopenia

decreased platelet count causing decrease production and increased destruction

stress,excercise

Physiologic causes of increased PLT

Reactive causes of increased PLT

Blood loss, hemolysis, infection, inflammatory disease, malignancy, post-splenectomy.

Mean Platelet Volume (MPV)

Measurement of the average size of platelets.

Massive hemorrhage, leukemia.

Causes of increased MPV

Chemotherapy, myelosuppression, aplastic anemia.

Causes of decreased MPV

Critical WBC Count values

Less than 2,500 or greater than 30,000.

Increased WBC Count

Leukocytosis; caused by infection, inflammation, cancer, leukemia, necrosis.

Decreased WBC Count

Leukopenia; caused by bone marrow failure, cancer treatment, autoimmune diseases, overwhelming infections.

WBC Differential

Percent of each type of leukocyte.

Neutrophils percentage

54-62%; phagocytize bacteria and can lead to immature neutrophils

Lymphocytes percentage

25-33%; involved in chronic bacterial or acute viral infections.

Monocytes percentage

3-7%; fight bacteria like neutrophils remaining in circulation

Basophils and eosinophil percentage

represent a response to parasite or allergens and do not respond to bacterial or viral infections

blood smear

Manual microscopic examination of RBCs, platelets, and WBCs.

How is malaria an RBC inclusion?

leads to hemolysis

Heinz bodies show:

oxidative damage- G6PD drug defieicny

Malaria, Heinz bodies, Howell Jolly bodies, basophilic stippling, Pappenheimer bodies.

what are the RBC inclusions

Hypersegmented neutrophils, Dohle bodies, Auer rods, basophilic stippling

What are the WBC inclusions?

Leukemia

WBC cancer in the marrow/blood; divided into acute and chronic.

Acute Myeloid Leukemia (AML)

Affects PMNs; >20% peripheral blasts; Auer rods present.

Chronic Myeloid Leukemia (CML)

PMNs; WBC median 150,000; Philadelphia chromosome.

lymphomas

cancers arising from lymphocytes, mostly tissue based, on proliferation of B,T or NK cells

Non-Hodgkin's Lymphoma (NHL)

90% of lymphomas; neoplastic proliferation of B, T, or NK cells.

Hodgkin's Lymphoma (HL)

10% of lymphomas; marked by Reed-Sternberg cells.

Evaluate abnormal cell counts, diagnose malignancy, document abnormal iron stores.

What are the bone marrow biopsy indications?

Coagulation Panel

Combination of tests used to provide broad understanding of hemostatic mechanisms commonly ordered with CBC

bleeding time

causing superficial puncture wounds and blotting skin every 30 sec until it stops bleeding

11-15 seconds

What is the Prothrombin Time (PT) Reference Range

prothrombin

the inactive form of thrombin which tuns fibrinogen into fibrin

What are decreased factors that can cause < PT?

liver disease, obstructive biliary disease, anticoagulant administration

International Normalized Ratio (INR)

Calculated from PT to assess risk of bleeding/coagulation.

partial thromboplastin time (PTT

measures speed of blood clotting via factors VIII, IX, XI, Xii, monitoring heparin, prolonged autoimmune with a normal range of 25-40 seconds

< 400 NG/ML or 0.0-0.4 UG/ML.

What is the D Dimer reference range

when a clot is degrading

When do D-dimer levels increase?

DIC

Disseminated Intravascular Coagulation; consumption coagulopathy.

Factor V Leiden

Genetic issue with protein C.

protein C deficiency

regulates factor Va and VIIIa

hemophilia

genetic issues with Factor 8, factor 9, and factor Xi

Vitamin K Deficiency

Important for clotting; dietary, GI, newborns.