Complete Blood Count Quiz

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Questions and Answers

Which of the following represents the correct order of information typically provided in a Complete Blood Count (CBC)?

  • RBC, Hemoglobin, Hematocrit, Platelets (correct)
  • Hemoglobin, Hematocrit, RBC Indices, WBC count
  • WBC count, RBC Indices, Hematocrit, Platelets
  • Platelets, WBC count, RBC, Hemoglobin

If a patient's Mean Corpuscular Volume (MCV) is elevated, which of the following conditions is least likely to be a primary cause?

  • Vitamin B12 deficiency
  • Folate deficiency
  • Iron deficiency (correct)
  • Alcohol abuse

Which of the following is NOT directly assessed by a standard CBC?

  • The volume of individual red blood cells
  • The oxygen-carrying capacity of red blood cells
  • The number of circulating white blood cells
  • The capacity of the blood to bind iron (correct)

Which white blood cell type is primarily responsible for releasing histamine during an allergic reaction?

<p>Basophil (B)</p> Signup and view all the answers

What is the most likely reason for an elevated reticulocyte count?

<p>Increase red blood cell destruction (C)</p> Signup and view all the answers

Which condition is characterized by an increase in the number of erythrocytes that is often physiologically induced due to increased oxygen requirements?

<p>Polycythemia (D)</p> Signup and view all the answers

A patient's blood smear reveals the presence of larger than normal red blood cells. Which of these nutritional deficiencies is most likely to be the cause?

<p>Vitamin B12 or Folate (B)</p> Signup and view all the answers

Which of the following conditions results in a decrease in all blood cell types, including red blood cells?

<p>Aplastic anemia (B)</p> Signup and view all the answers

A patient with chronic renal disease is found to have a low erythrocyte count. Which of the following best explains the cause of this?

<p>Decreased production by bone marrow (C)</p> Signup and view all the answers

A female patient presents with an erythrocyte count of 3.9 x $10^{12}$/L. Which of the following conditions is most likely contributing to this result?

<p>Pregnancy (C)</p> Signup and view all the answers

Which condition is least likely to be associated with an increased white blood cell count (leukocytosis)?

<p>Bone marrow failure (A)</p> Signup and view all the answers

A patient's red blood cell indices show an elevated MCV and normal MCHC. Which of the following conditions is most likely?

<p>Folic acid deficiency (C)</p> Signup and view all the answers

Which of the following statements is most accurate regarding mean corpuscular hemoglobin concentration (MCHC)?

<p>MCHC measures the average concentration of hemoglobin in a red blood cell relative to its size. (B)</p> Signup and view all the answers

A patient's lab results show a significantly decreased RDW in a CBC sample. Which of the following interpretations is the most likely?

<p>The sample has uniform, or consistent sizes of red blood cells. (A)</p> Signup and view all the answers

Following emotional distress, a patient’s lab results showed an elevated WBC count. Which of the following should be the most accurate interpretation?

<p>These results could be transient and related to the patient's emotional state. (B)</p> Signup and view all the answers

What does a 'left shift' in a white blood cell differential typically indicate?

<p>An ongoing bacterial infection (D)</p> Signup and view all the answers

Which type of white blood cell is known to remain in circulation longer and is produced more rapidly in response to bacterial infection?

<p>Monocytes (C)</p> Signup and view all the answers

Hypersegmented neutrophils, characterized by having 6 or more lobes, are highly suggestive of what condition?

<p>Megaloblastic anemias (C)</p> Signup and view all the answers

Which of the following cellular inclusions observed in a blood smear is associated with acute myeloid leukemia?

<p>Auer rods (C)</p> Signup and view all the answers

In the context of leukemia, what is the primary distinguishing factor between acute and chronic forms?

<p>The presence of blast cells and their effect on bone marrow function (A)</p> Signup and view all the answers

A patient presents with severely elevated white blood cell counts but is otherwise asymptomatic. The white blood cell differential reveals a high number of mature granulocytes. What condition should be strongly suspected?

<p>Chronic myeloid leukemia (CML) (A)</p> Signup and view all the answers

Which of the following is true regarding acute leukemias?

<p>They are characterized by the presence of blast cells, which impair bone marrow function. (A)</p> Signup and view all the answers

If a blood smear indicates a high proportion of lymphocytes containing Auer rods, what should the next step be?

<p>Proceed to bone marrow biopsy for further analysis (B)</p> Signup and view all the answers

What characterizes Hodgkin’s lymphoma?

<p>Presence of Reed-Sternberg cells (B)</p> Signup and view all the answers

What does a high Total Iron Binding Capacity (TIBC) indicate?

<p>Iron deficiency (C)</p> Signup and view all the answers

Which statement accurately reflects the relationship between ferritin and iron in the body?

<p>Decreased ferritin signifies iron deficiency anemia (B)</p> Signup and view all the answers

How does ESR (Erythrocyte Sedimentation Rate) relate to inflammation?

<p>Increased sedimentation rate signifies inflammation (C)</p> Signup and view all the answers

Which of the following is NOT a component of the Iron Panel?

<p>C-reactive protein (D)</p> Signup and view all the answers

What does an elevated C-reactive protein (CRP) level indicate?

<p>Presence of inflammation or bacterial infections (D)</p> Signup and view all the answers

What is indicated by increased levels of ferritin?

<p>Hemochromatosis or iron overload (D)</p> Signup and view all the answers

What is the primary function of transferrin in the body?

<p>To transport iron in the bloodstream (B)</p> Signup and view all the answers

What does the Coagulation Panel help assess?

<p>Broad understanding of hemostatic mechanisms (D)</p> Signup and view all the answers

What condition does NOT lead to elevated ferritin levels?

<p>Iron deficiency anemia (D)</p> Signup and view all the answers

A patient presents with prolonged prothrombin time (PT) and a normal partial thromboplastin time (PTT). Which of the following factors is most likely deficient?

<p>Factor VII (A)</p> Signup and view all the answers

A patient is diagnosed with a deep vein thrombosis (DVT). Which of the following tests would be most useful in monitoring the patient's response to anticoagulant therapy?

<p>D-dimer (D)</p> Signup and view all the answers

A patient presents with a prolonged PT and a prolonged PTT. The patient is also experiencing significant bleeding. Which of the following conditions is most likely the cause?

<p>Disseminated intravascular coagulation (DIC) (C)</p> Signup and view all the answers

A patient with a history of atrial fibrillation is prescribed warfarin therapy. What is the primary goal of monitoring the patient's INR?

<p>To ensure adequate anticoagulation (D)</p> Signup and view all the answers

A patient presents with prolonged PTT, normal PT, and a family history of bleeding disorders. Which of the following clotting factors is most likely affected?

<p>Factor VIII (D)</p> Signup and view all the answers

A patient with severe liver disease is likely to have which of the following coagulation abnormalities?

<p>Prolonged PT and normal PTT (C)</p> Signup and view all the answers

A patient admitted to the hospital with sepsis has an elevated D-dimer. Which of the following is the best interpretation of this finding?

<p>The patient is at high risk of developing a pulmonary embolism (PE) (A)</p> Signup and view all the answers

A patient presents with a prolonged PT and prolonged PTT. Which of the following laboratory tests is most useful in differentiating between a deficiency in Factor I (fibrinogen) and a deficiency in Factor V?

<p>Fibrinogen assay (D)</p> Signup and view all the answers

Flashcards

Mean Corpuscular Volume (MCV)

Measure of the average size of RBCs; helps classify anemias.

Megaloblastic Anemia

Type of anemia characterized by high MCV; caused by B12 or folic acid deficiency.

Red Blood Cell Distribution Width (RDW)

Indicates variation in size of RBCs; useful in anemia classification.

White Blood Cell Count (WBC)

Total number of leukocytes in blood; normal range 5,000-10,000/mm3.

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Neutrophils

Type of WBC; make up 55-70% of count; increased in bacterial infections.

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Erythrocyte count (RBCs)

Measures the number of red blood cells in 1mm³ of blood.

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Anemia

A condition marked by decreased RBC count.

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Macrocytic anemia

Characterized by larger, fewer RBCs due to DNA synthesis impairment.

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Microcytic anemia

Condition with small RBCs, usually caused by iron deficiency.

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Pancytopenia

Deficiency of all blood cell types, often due to aplastic anemia.

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Components of a CBC

Includes RBC, hemoglobin, hematocrit, platelets, and RBC indices like MCV, MCH, MCHC.

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RBC Indices

Measures mean corpuscular volume (MCV), mean corpuscular hemoglobin (MCH), and mean corpuscular hemoglobin concentration (MCHC).

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Reticulocyte Count

A measure of young red blood cells to assess bone marrow activity.

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Hodgkin’s vs Non-Hodgkin’s Lymphoma

Hodgkin’s lymphoma is characterized by Reed-Sternberg cells; Non-Hodgkin’s does not have these cells.

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Left Shift

Increase in immature neutrophils indicating bacterial infection.

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Right Shift

Return towards normal neutrophil values after an infection.

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Hypersegmented Neutrophils

Neutrophils with 6 or more lobes; sign of megaloblastic anemia.

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Leukemia

Cancer of white blood cells, can be acute or chronic.

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Acute Lymphoblastic Leukemia (ALL)

A type of leukemia with blast cells, common in children.

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Chronic Myeloid Leukemia (CML)

Chronic type of leukemia; many mature leukocytes present.

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Blood Smear

Microscopic examination to assess blood cell types and abnormalities.

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Prothrombin time (PT)

Test measuring the time for blood to clot via the extrinsic pathway.

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International normalized ratio (INR)

A standardized measure derived from PT indicating bleeding risks.

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Partial thromboplastin time (PTT)

Test measuring the speed of blood clotting via the intrinsic pathway.

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Fibrinogen assay

Test measuring fibrinogen levels, important for clot formation.

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D-dimer

Product of fibrin degradation, elevated levels suggest clot presence.

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Elevated PT

Indicates deficiencies in extrinsic and common pathway factors.

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Elevated PTT

Indicates deficiencies in intrinsic pathway factors.

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Common pathway factors

Factors involved in both PT and PTT assessments, include I, II, V, and X.

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Types of Lymphoma

Non-Hodgkin’s lymphoma (NHL) 90%, Hodgkin’s lymphoma (HL) 10%; HL has Reed-Sternberg cells.

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Reed-Sternberg Cells

Mutated B-cells with a distinct appearance; key indicator for Hodgkin’s lymphoma.

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Iron Panel Components

Includes serum iron, TIBC, transferrin saturation, and ferritin.

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Serum Iron

70% located in Hgb of RBCs; 30% stored as ferritin and hemosiderin.

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TIBC/Transferrin

Measurement of proteins that bind iron; high indicates iron deficiency.

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Ferritin

Major protein storing iron; low levels indicate deficiency.

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Erythrocyte Sedimentation Rate (ESR)

Rate at which RBCs settle; increases with inflammation.

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C-reactive Protein (CRP)

Protein secreted by liver in response to inflammation; more sensitive than ESR.

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Coagulation Panel

Tests to understand hemostatic mechanisms; includes PT/INR, PTT, bleeding time, fibrinogen.

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Bleeding Time

Measures how long it takes for a superficial wound to stop bleeding.

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Study Notes

Hematology Overview

  • Hematology is the study of blood and blood disorders.
  • A complete blood count (CBC) is a series of blood tests evaluating red blood cells (RBCs), platelets, and white blood cells (WBCs).
  • CBCs are quick, easy, and inexpensive.
  • RBCs include hemoglobin, hematocrit, and RBC indices (MCV, MCH, MCHC, RDW).
  • WBCs consist of five white blood cell types: neutrophils, lymphocytes, monocytes, eosinophils, and basophils.
  • A blood smear is a microscopic examination of RBCs, platelets, and WBCs, checking size, shape, and color, mainly used when abnormal values are detected.
  • RBC indices provide data on RBC size, hemoglobin content, and hemoglobin concentration.
  • MCV, MCH, MCHC, and RDW are RBC indices.
  • Common blood disorders covered include anemia and polycythemia.
  • Reticulocyte counts are important for diagnosing and monitoring anemias and other blood disorders.
  • The relationship between vitamin B12, folate, and megaloblastic anemia is crucial for diagnosis and treatment.
  • Important aspects of the function and variations in segmented neutrophils, lymphocytes, monocytes, eosinophils, basophils, and thrombocytes are crucial in diagnosis.
  • White blood cell inclusions are categorized and diagnosed based on their indications.
  • Hodgkin's lymphoma and non-Hodgkin's lymphoma are contrasted.
  • Types of leukemia, including CLL, ALL, and CML, and their distinguishing lab findings are discussed.
  • Erythrocyte counts (RBCs) are measured in millions per cubic millimeter (mm³)
  • Male reference range for RBCs is 4.7-6.1; female 4.2-5.4 (x10¹²/L).
  • Decreased RBC count suggests anemia.
  • Conditions leading to decreased RBC production by bone marrow include myelofibrosis, leukemia, renal disease, dietary deficiencies, and increased loss of RBCs.
  • Increased RBC count (polycythemia) is categorized as physiological (higher altitudes) or dehydration.
  • Various types of anemias (macrocytic and microcytic) and their causes are described.
  • Reticulocytes (immature RBCs) are elevated when the bone marrow compensates for blood loss or hemolysis.
  • Hemoglobin (Hgb) is the protein in RBCs that carries oxygen and has a normal range: male 14-18 g/dL; female 12-16 g/dL.
  • Hematocrit (Hct) measures the percentage of blood volume occupied by RBCs (normal range: male 42-52%; female 37-47%).
  • Platelet count (Plt) is vital for blood clotting (normal range 150,000-400,000 / mm³).
  • Mean platelet volume (MPV) measures the average size of platelets.
  • Increased MPV suggests immature platelets are being released.
  • Decreased MPV suggests bone marrow underproduction or suppression.
  • Leukocytes include WBCs.
  • WBC count (reference range: 5,000-10,000/mm³) is routinely used for diagnosing issues with bacteria and infections.
  • Increased WBC count (leukocytosis)indicates infection, inflammation, or cancer.
  • Decreased WBC count (leukopenia)indicates bone marrow failure, cancer, or overwhelming infections.
  • A WBC differential assesses the percentage of each type of leukocyte (neutrophils, lymphocytes, monocytes, eosinophils, basophils).
  • Hypersegmented neutrophils are associated with megaloblastic anemias (B12 or folate deficiency).
  • Dohle bodies, Auer rods, and other cell inclusions are also diagnostically helpful.
  • Leukemia (WBC cancer) is categorized as acute or chronic.
  • Lymphomas are cancers arising from lymphocytes. Non-Hodgkin's lymphoma (NHL) and Hodgkin's lymphoma (HL) are the main categories.
  • Hodgkin's lymphoma is marked by Reed-Sternberg cells.
  • An iron panel measures serum iron, TIBC/transferrin, transferrin saturation, and ferritin levels for iron-related issues.
  • ESR (Erythrocyte Sedimentation Rate) measures RBC settling rate. High values suggest inflammation.
  • CRP (C-reactive protein) increases with inflammation and can be used to detect cardiac risk.
  • A coagulation panel assesses clotting mechanisms that includes bleeding time, protime/prothrombin time (PT), partial thromboplastin time (PTT), and others.
  • D-dimer levels are elevated in the presence of clots and fibrin degradation.

Important Terms

  • CBC: Complete Blood Count
  • RBC: Red Blood Cell
  • WBC: White Blood Cell
  • MCV: Mean Corpuscular Volume
  • MCH: Mean Corpuscular Hemoglobin
  • MCHC: Mean Corpuscular Hemoglobin Concentration
  • RDW: Red Blood Cell Distribution Width
  • Hgb: Hemoglobin
  • Hct: Hematocrit
  • Plt: Platelet
  • MPV: Mean Platelet Volume
  • ESR: Erythrocyte Sedimentation Rate
  • CRP: C-reactive Protein

Different Types of Blood Cell Disorders

  • Anemia: A condition characterized by a decrease in the number of red blood cells or a decrease in hemoglobin levels.
  • Polycythemia: An increase in the number of red blood cells in the blood.
  • Leukemia: A type of cancer that affects the blood and bone marrow.
  • Lymphoma: A type of cancer that affects the lymphatic system.
  • Thrombocytopenia: A condition characterized by a decrease in the number of platelets in the blood.
  • Other: Numerous other conditions are mentioned through the slides, including infections, inflammation, and various specific diseases.

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