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26 Cards in this Set
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Red Blood Cell Count
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Normal Values
Male = 4.7-6.1mill/cu mm Female = 4.2-5.4mill/cu mm General = 4.5-6.2mill/cu mm Critical Value 10% Decrease = Anemia |
Increase
- High Altitude - Smoking - Congenital Heart Disease - Dehydration - Polycythemia Vera Decrease (Anemia) - Hemorrhage - Hemolysis - Dietary Deficiency - Genetic Aberration - Pregnancy - Drug Ingestion - Marrow Failure - Chronic Illness |
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Hemorrhaging Anemia
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1. GI Bleeding
- Gastritis (Excess Aspirin) - Peptic Ulcer Disease 2. Trauma |
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Hemolysis Anemia
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Shortened RBC Lifespan
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Intrinsic (hereditary)
- Hereditary spherocytosis Extrinsic - Snake Venom - Mechanical Heart Valve - Hemoglobinopathy - A+ and B+ blood - Penicillin - Antibiotic induced Antibodies - Hemolytic Disease of the Newborn |
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Dietary Deficiency Anemia
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1. Iron Deficiency
2. B12 Anemia 3. Folate Anemia |
**Intrinsic Factor in the GI must be present in order to convert B12 into usable substance. If you do not have adequate intrinsic factor resulting in anemia = Pernicious Anemia
**You get your folate from your leafy greens. Alcoholics and pregnant women frequently have decreased RBC counts due to folate. |
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Genetic Anemia
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1. Sickle Cell Anemia
2. Thalassemia |
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Drug Ingestion Anemia
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1. Chloramphenicol
2. Hydantoins 3. Quinidine |
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Marrow Failure Anemia
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1. Myelofibrosis
2. Leukemia 3. Antineoplastic Chemotherapy |
**Leukemia produces a lot of dysfunctional WBC that displace good RBC in the marrow. Marrow becomes packed with malignant WBC.
** Chemotherapy attacks rapidly growing cells and thus in addition to killing cancerous cells, it will kill good cells such as hair, RBC, & marrow. |
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Chronic Illness Anemia
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1. Tumor
2. Sepsis 3. Chronic Kidney Disease 4. CT 5. RA Disease 6. Problems with RE Cells |
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Over-Hydration Anemia
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1. Decreased Concentration
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Hemoglobin Blood Count
(Hgb, Hb) |
Normal Values
Male = 14-18 g/dL Female = 12-16 g/dL General = 13-17.7 g/dL Critical Value = <5.0 g/dL Betathalacemia - Will increase A2 production and hang on to fetal Hb Alphathalacemia - Less common, requires three genetic changes |
Increase
- Congenital Heart Disease - Polycythemia Vera - Dehydration - COPD - CHF - High Altitude - Severe Burns Decrease - Anemia - Severe hemorrhage - Hemolysis - Cancer - Nutritional Deficincies - Kidney Disease - Chronic Disease - Hemoglobinopathies |
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Hematocrit (Hct)
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*Measure of the percentage of RBC in the total blood volume
Normal Values Male = 42-52% Female = 37-47% General = 39-54% Critical Value = <15% |
Increase
- Congenital Heart Disease - Polycythemia Vera - Severe Dehydration - Shock/Burns - Trauma/Surgery Decrease - Anemia - Hyperthyroidism - Hemorrhage - Hemolytic Reaction - Dietary Deficiency - Bone Marrow Failure - Normal Pregnancy - Leukemia |
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Rule of 3's
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RBC x 3 = Hemoglobin (Hgb)
Hgb x 3 = Hematocrit (Hct) |
**If the RBCs are of normal size and contain normal amounts of hemoglobin
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Mean Corpuscular Volume (MCV)
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Reasonable estimate of the average size/volume of a single red blood cell
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Normal Values = 80-100 cu microns
Critical Values >110 = Megaloblastic <80 = Microcytic Anemia MCV = Hct/RBC count x 10 Increase - Liver Disease - Anti-Neoplastic Chemo - Alcoholism - B12/Folate Deficiency Decrease - Iron Deficiency - Thalassemia |
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mean Corpuscular Hemoglobin (MCH)
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Reasonable estimate of the average weight of hemoglobin within a single RBC
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Normal Values = 27-31 pg
MCH = Hgb/RBC count x 10 Increase - Macrocytic Anemia Decrease - Microcytic Anemia - Hypochromic Anemia |
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Mean Corpuscular Hemoglobin Concentration (MCHC)
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Measure of average concentration of hemoglobin within a single RBC
**Decrease MCHC = Hypochromic Cells |
Normal Values = 30-36 g/dL
MCHC = Hgb/Hct x 100 Increase - Spherocytosis Decrease - Iron Deficiency Anemia - Thalassemia |
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Red Cell Distribution Width (RDW)
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Indicates whether there is a lot of variances in cell size.
**In connection with the MCV, will give you an idea of RBC size. |
Normal Values = 11.5-14.5%
**Is an indicator of the degree of anisocytosis (RBC of variable and abnormal size) |
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Left Shift
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**Immature WBC being produced in bone marrow.
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Blood Viscosity Factors
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1. RBC concentration
2. Protein concentration 3. Size of cells 4. Speed of blood within vessel |
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Erythropoietin (EPO)
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**A hormone produced in the kidneys that accelerates the production, differentiation, and maturation of RBC. It reduces the time for RBC to enter circulation and facilities iron incorporation into RBC.
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- Increased EPO = Increased RBC production
- Testosteron = Increased EPO Activity - Estrogen = Decreased EPO Activity **Someone with bad kidneys or liver (Anemia of the Chronic Disease) will be unable to produce adequate amounts of EPO |
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Reticulocyte
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An immature RBC that has lost it's nucleus but has retained aggregates of RNA
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**A "Retic" count is the best test to monitor a patient's ability to naturally replenish their blood supply by increasing erythropoiesis.
Normal Value = .5-1.5% *Major Hemorrhage = Up to 9% *Elderly Retic will be lower *Iron Deficiency = Will not retic unless provided with iron. |
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Anisocytosis
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The variation in size of RBC
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Normal = Normocytic
Small = Microcytic Large = Macrocytic |
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Poikilocytosis
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The variation in the shape of and RBC
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- Burr Cells
- Acanthocytes - Schistocytes - Teardrops - Target Cells - Spherocytes - Ovalocytes - Stomatocytes - Sickle Cells |
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Target Cells
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Has a central area of hemoglobin pigment surrounded by a relatively clear area and a peripheral rim of hemoglobin
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**Common in thalassemia, sickle-cell, and other types of hemoglobinopathies.
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Sickle Cells
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*Lose their elasticity
*Thin, elongated, and pointed on either side. *May have crescent, L, V, or S shape *Darker than normal RBC |
**Observed in Hb-S Thalassemia and Sickle-Cell Anemia
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Ovalocyte
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Elongated cell with blunt ends.
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**Small numbers found in iron deficiency, thalassemia, sickled hemoglobinopathies, and other anemias
**Increased numbers found in hereditary ovalcytosis **Macrocytic ovalocytes are typical of megaloblastic anemia |
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Spherocytes
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Densely stained red cells lacking central pallor and smaller than normal RBC
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**Characteristic of hereditary spherocytosis.
**May be seen in acquired immune hemolytic anemias, patients who have had transfusions, drug induced hemolytic anemia, increased hemolysis secondary to enlarged spleen. |
