Anemia and RBC Characteristics

RBC Size and Hemoglobin

• MCH: Represents the amount of hemoglobin per red blood cell.
• MCHC: Indicates hemoglobin concentration relative to red blood cell size, important in classifying anemias.

Anemia

• Characterized by a reduction in overall red blood cell mass.
• Common causes include blood loss, deficiencies in cell formation, abnormal cell formation, chronic diseases, and aging.
• Results in decreased oxygen-carrying capacity.
• Iron deficiency anemia is a notable type.

Carboxyhemoglobin

• Formed when carbon monoxide binds with hemoglobin.
• Carbon monoxide has a binding affinity 210 times greater than oxygen.
• Smoking increases COHb levels to 5-7%.

Methemoglobinemia

• Occurs when hemoglobin is converted to methemoglobin, impairing oxygen binding.
• Characterized by high oxygen saturation but low partial pressure of oxygen (PaO2).

Sulfhemoglobinemia

• Sulfur binds with hemoglobin.
• Associated with the use of certain medications (e.g., Imetrex for migraines).
• Symptoms may include bluish or greenish discoloration of blood and skin, without detectable blood abnormalities.

Polycythemia

• Primary Polycythemia: Relatively uncommon.
• Secondary Polycythemia: More common; often a response to chronic hypoxemia (e.g., COPD, heavy smoking).

Reticulocyte Count

• Normal refers to about 1% of total red blood cells.
• Increased levels indicate stress on bone marrow to produce more red blood cells and help evaluate anemias.

Hemostasis

• Ability to prevent hemorrhage; plasma must form a fibrin clot in under 1 minute.
• Assessed through tests: platelet count, APTT, PT/INR.

Platelet Count

• Critical for blood clot formation and defense against pathogens.

White Blood Cell (WBC) Count

• Normal range: 4.0 to 11.0 x 10^9/L.
• Different types include neutrophils, eosinophils, basophils, lymphocytes, and monocytes.

WBC Abnormalities

• Leukocytosis: Increase in white blood cells.
• Leukopenia: Decrease in white blood cells.
• Specific cell types may indicate various conditions, such as neutrophilia or eosinophilia.

Neutrophilia

• Indicates a response to infection and inflammation, often seen with immature neutrophils (bands) being released.

Neutropenia

• Characterized by low neutrophil counts, can result from bone marrow failure or increased peripheral destruction.

Eosinophilia

• Marked increase in eosinophils, often related to parasitic infections, allergies, or allergic asthma.

Basophilia

• Associated with myeloproliferative neoplasms (MPNs), with some genetic predispositions.

Lymphocytosis

• Increase in lymphocytes, commonly seen in viral infections.
• Lymphocytopenia signifies a decrease in lymphocytes, frequently associated with HIV and trauma.

Monocytosis

• An increase in monocytes seen with infections like TB, syphilis, or fungal infections.

Red Blood Cells

• Produced in the bone marrow with a lifespan of about 120 days.
• Main function: oxygen transport, carrying CO2 to the lungs.

Hemoglobin (Hb)

• Major oxygen carrier protein within red blood cells, containing 200-300 million molecules per RBC.
• Acts as a buffer to maintain blood pH.

Hematocrit (Hct)

• Ratio of packed red blood cell volume to total blood volume.
• Normal values: Men 40-54%, Women 35-49%.

Complete Blood Count (CBC)

• Includes measurements for both RBCs and WBCs, along with indices for hemoglobin levels and size/shape of cells.

Normal Blood Values

• WBC Count: 4.0 - 11.0 x 10^9/L
• RBC Count: Males 4.20 - 6.00 x 10^12/L, Females 3.80 - 5.20 x 10^12/L
• Hemoglobin: Males 13.5 - 18.0 g/dL, Females 12.0 - 15.0 g/dL
• Hematocrit: Males 40 - 54%, Females 35 - 49%
• Platelet Count: 150 - 450 x 10^9/L

Brain Natriuretic Peptide (BNP)

• Hormone released by ventricles in response to myocardial stretching.
• Differentiates between dyspnea due to cardiac vs. pulmonary causes.

Glucose Metabolism

• Normal fasting plasma glucose levels range from 70-105 mg/dL.
• Type I Diabetes: Results from insufficient insulin production.
• Type II Diabetes: Characterized by insulin resistance and high blood sugar.
• Gestational Diabetes: Develops during pregnancy and usually resolves post-birth.

Protein in Blood

• Primary serum protein is albumin (60%).
• Critical for drug transport and maintaining oncotic pressure in blood.
• Decreased total protein levels indicate liver disease and malnutrition.

Composition of Blood

• Blood consists of formed elements (cells) and plasma (liquid component).
• Formed elements include white blood cells (WBCs), red blood cells (RBCs), and platelets.
• Plasma contains electrolytes, clotting factors, immunologic factors, proteins, lipids, and hormones.
• Serum is the liquid portion of blood after clotting factors have been removed.

Complete Blood Count (CBC)

• CBC measures RBCs and WBCs along with various indices.
• Normal WBC count: 4.0 – 11.0 x 10^9/L.
• Normal RBC counts: Males: 4.20 – 6.00, Females: 3.80 – 5.20.
• Normal hemoglobin: Males: 13.5 – 18.0 g/dL, Females: 12.0 – 15.0 g/dL.
• Hematocrit levels: Males: 40 – 54%, Females: 35 – 49%.
• Normal platelet count: 150 - 450 x 10^9/L.

White Blood Cells (WBCs)

• WBCs primarily function to combat infections.
• Types of WBCs: Neutrophils, Eosinophils, Basophils, Lymphocytes, Monocytes.
• Differential count determines the percentage of each WBC type present.

Neutrophils

• Comprise 50% to 70% of WBCs, known as polymorphonuclear leukocytes.
• Short lifespan, produced in bone marrow.
• Play a key role in fighting inflammation and infections through phagocytosis.

Eosinophils

• Make up 1% to 3% of WBCs, characterized by large red-staining granules.
• Involved in immune regulation and accumulate at sites of allergic reactions.

Basophils

• Represent 0-1% of WBCs with large dark blue or purple granules.
• Contain heparin to prevent coagulation at inflammation sites and participate in allergic reactions.

Lymphocytes

• Comprise 20% to 45% of WBCs and are important for adaptive immunity.
• Types include large granular lymphocytes (NK cells) and small lymphocytes (T and B cells).
• T cells are involved in cell-mediated immunity; B cells produce antibodies.

Monocytes

• Account for 2-11% of WBCs, and transform into macrophages in tissues.
• Function mainly in phagocytosis; increase occurs in stress and chronic inflammation.

Abnormal WBC Counts

• Leukocytosis: Increased WBC count.
• Leukopenia: Decreased WBC count; includes neutrophilia, neutropenia, eosinophilia, basophilia, lymphocytosis, and monocytosis.

Red Blood Cells (RBCs)

• Produced in bone marrow; primary function is to transport oxygen.
• Each RBC contains 200-300 million hemoglobin (Hb) molecules.
• Lifespan is approximately 120 days.

Hemoglobin (Hb)

• Vital for oxygen transport; also functions in CO2 transport and blood pH buffering.
• Normal Hematocrit (Hct): Men: 40 to 54%, Women: 35 to 49%.

Platelets

• Involved in hemostasis; low and high platelet counts indicate thrombocytopenia and thrombocytosis, respectively.
• Normal function involves clot formation to prevent blood loss.

Electrolytes

• Vital for fluid balance and electrical current conduction in the body.
• Key electrolytes: Sodium (Na+), Potassium (K+), Chloride (Cl-), Bicarbonate (HCO3-).

Sodium (Na+)

• Major extracellular cation; normal levels: 135 - 145 mmol/L.
• Regulated by hormones like aldosterone and ADH.

Hypernatremia and Hyponatremia

• Hypernatremia: >147 mEq/L; caused by water loss without salt. Symptoms include excessive thirst and dry mouth.
• Hyponatremia: <137 mEq/L; results from increased sodium loss. Severe cases can affect cardiac and muscle functions.

Other Electrolytes

• Calcium (Ca2+), Phosphorus (PO4-), Magnesium (Mg2+).

Anion Gap

• Represents the balance between cations and anions; normal range: 8-16 mEq/L.
• Useful in diagnosing metabolic acidosis.

Brain Natriuretic Peptide (BNP)

• Secreted by heart ventricles in response to myocyte stretching.
• Normal levels: < 100 pg/mL indicate no heart failure; higher levels signal varying degrees of heart failure.

Glucose

• Normal fasting plasma concentration: 70-105 mg/dL.
• Insulin is essential for glucose utilization in cells.

Diabetes

• Type I: Insulin-dependent, glucose builds up in the blood due to lack of insulin.
• Type II: Insulin resistance leads to high blood glucose levels.
• Gestational diabetes occurs during pregnancy but typically resolves post-birth.

Protein Levels

• Albumin makes up 60% of serum protein; maintains oncotic pressure and transports substances.
• Total protein levels decrease in conditions such as liver disease and malnutrition.

This quiz covers the characteristics of red blood cells (RBCs), including MCH and MCHC, and their relevance in classifying anemias. It explores the causes of anemia, including blood loss and deficiencies, as well as the impact on oxygen transport in the body. Additionally, it touches on carboxyhemoglobin and its formation.