Hematology Chapter Quiz

Hematology Overview

• Hematology is the study of blood and blood related diseases.
• This week's focus is on blood tests, including CBC, RBC indices (MCV, MCH, MCHC), and the reticulocyte count.
• Important blood components include: Red Blood Cells (RBCs), platelets, and White Blood Cells (WBCs).
• Hematology also covers various blood disorders, including anemia, polycythemia, and different types of leukemias (acute/chronic, lymphoid/myeloid).

Instructional Objectives

• Learn the components of a Complete Blood Count (CBC) and RBC indices (MCV, MCH, MCHC).
• Identify common causes of anemia and polycythemia.
• Understand the significance of the reticulocyte count.
• Compare and contrast ferritin, iron, total iron-binding capacity, and transferrin, and associated indications.
• Explain the relationship between B12, folate, and megaloblastic anemia.
• Identify the functions of white blood cell types and causes for their increases or decreases (neutrophils, lymphocytes, monocytes, eosinophils, basophils, thrombocytes).
• Describe white blood cell inclusions and their indications.
• Compare and contrast Hodgkin's and non-Hodgkin's lymphoma.
• Distinguish between Chronic Lymphocytic Leukemia (CLL), Acute Lymphocytic Leukemia (ALL), Chronic Myelogenous Leukemia (CML), and Acute Myelogenous Leukemia (AML), focusing on lab findings.

Blood Components and Tests

• CBC (Complete Blood Count): A series of blood tests providing information on RBCs, platelets, and WBCs; it's quick, cheap, and easy. Includes RBC, hemoglobin, hematocrit, platelets, and RBC indices (MCV, MCH, MCHC, RDW).
• WBC differential: Examines the five types of white blood cells (neutrophils, lymphocytes, monocytes, eosinophils, basophils).
• RBC indices (MCV, MCH, MCHC): Reveal the size and hemoglobin content of red blood cells.
• Reticulocyte count: Measures immature red blood cells; increased count suggests rapid production of new blood cells usually triggered by blood loss.

Specific Blood Values and Conditions

• Erythrocyte (RBC) count: The number of red blood cells per cubic millimeter of blood. Normal ranges vary by sex and age. A decreased count indicates anemia.
• Anemia: A condition where the blood has insufficient red blood cells or hemoglobin, leading to insufficient oxygen delivery.
• Polycythemia: An abnormally high number of red blood cells, often due to high altitudes or chronic hypoxia.

Fishbone Diagram

• Lists common laboratory tests (Hgb, WBC, Pit, Hct, Na, Cl, K, BUN, CO₂, Creat) to help identify and analyze information from a patient.

Red Blood Cell Indices

• MCV (Mean Corpuscular Volume): Average size of a red blood cell.
• RDW (Red Blood Cell Distribution Width): Variation in RBC size in a sample.
• MCH (Mean Corpuscular Hemoglobin): Average amount of hemoglobin in a red blood cell.
• MCHC (Mean Corpuscular Hemoglobin Concentration): Average concentration of hemoglobin in a red blood cell

Platelet Count

• Platelet count: The number of platelets in a given volume of blood.
• Platelet Dysfunction: A significant decrease in platelet count indicates possible issues with clotting mechanisms.

Specific Hematologic Diseases

• Leukemia: A type of cancer affecting white blood cells, often categorized as acute or chronic, lymphoid or myeloid.
• Lymphomas: Cancers arising from lymphocytes, primarily categorized as Hodgkin's or Non-Hodgkin's.
• Anemia: Conditions like iron deficiency, megaloblastic, and microcytic anemia are explained, along with causes including dietary deficiencies, internal bleeding, or bone marrow problems.
• Polycythemia: Increased RBC production, typically due to high oxygen requirements.

Iron Panel

• Ferritin: Storage protein for iron within the body. Low ferritin suggests depleted iron stores. High ferritin indicates excess iron storage; there are many causes.
• Serum Iron, TIBC (Transferrin): Measurements of serum iron and total iron-binding capacity, important for assessing iron metabolism and potential deficiencies.

Erythrocyte Sedimentation Rate (ESR)

• Measure of how quickly red blood cells settle in a test tube; elevated ESR typically indicates inflammation, infection, and some cancers

C-reactive Protein (CRP)

• A marker of inflammation, often measured alongside ESR; rises more quickly than ESR in response to inflammatory conditions

Coagulation Panel

• Assesses the body's ability to form blood clots. Common tests include: Bleeding time, Prothrombin Time (PT), International Normalized Ratio (INR), Activated Partial Thromboplastin Time (aPTT), Fibrinogen.
• Elevated PT and/or INR: May indicate decreased production of clotting factors or liver problems.
• Elevated PTT: May point to deficiencies in clotting factors of the intrinsic pathway.

D-dimer

• A fibrin degradation product; an elevated D-dimer often suggests blood clot formation or breakdown. Useful in DVT/PE considerations