Hematology Quiz: Blood Counts and Anemias

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Questions and Answers

Which of the following is NOT included in a complete blood count (CBC)?

White blood cell count

Electrolyte levels (correct)

Red blood cell count

Platelet count

What is the function of a reticulocyte count?

To assess the bone marrow's ability to produce red blood cells (correct)

To measure the number of mature red blood cells in the blood

To check for the presence of infections

To determine the level of iron in the blood

Which of the following conditions can increase the number of red blood cells (RBCs) in the blood?

Living at high altitudes (correct)

Hemolysis

Myelofibrosis

Hemorrhage

Which of these is a red blood cell index?

MCHC (C) Signup and view all the answers

Which of the following is NOT a type of white blood cell included in a differential count?

Erythrocyte (A) Signup and view all the answers

What is a common feature observed in patients with both macrocytic anemia and microcytic anemia?

Decreased levels of hemoglobin in red blood cells (A) Signup and view all the answers

What is the most common cause of aplastic anemia?

Exposure to toxins (C) Signup and view all the answers

Which of the following is a difference between Hodgkin's and non-Hodgkin's lymphoma?

Hodgkin's lymphoma is characterized by the presence of Reed-Sternberg cells, while non-Hodgkin's lymphoma is not (D) Signup and view all the answers

In which scenario would you expect to see an increase in RBC count due to a physiological response?

A patient living at high altitude (C) Signup and view all the answers

What is a distinguishing characteristic of macrocytic anemia?

Larger than normal red blood cells (B) Signup and view all the answers

What is the most likely explanation for a patient presenting with neutrophilia without bands?

Inflammation without infection (C) Signup and view all the answers

What does a 'left shift' indicate?

Increased production of immature neutrophils (D) Signup and view all the answers

Which of the following is NOT a characteristic of chronic myeloid leukemia (CML)?

Presence of blast cells (D) Signup and view all the answers

What type of leukemia is characterized by the presence of Auer rods?

Acute myeloid leukemia (AML) (A) Signup and view all the answers

A patient presents with hypersegmented neutrophils. What is the most likely cause?

Megaloblastic anemia (B) Signup and view all the answers

Which of the following conditions is MOST associated with Dohle bodies?

Severe stress (C) Signup and view all the answers

Which type of white blood cell is primarily responsible for fighting bacteria?

Neutrophils (A) Signup and view all the answers

What is the primary difference between acute and chronic leukemia?

The rate of disease progression (D) Signup and view all the answers

Which of these conditions would most likely result in a decreased MCV?

Iron deficiency anemia (D) Signup and view all the answers

A patient with a low reticulocyte count and anemia is most likely experiencing which of the following?

Inadequate bone marrow response to anemia (A) Signup and view all the answers

Which of the following conditions could potentially lead to a decreased platelet count (thrombocytopenia)?

Aplastic anemia (B) Signup and view all the answers

What does an increased MPV (Mean Platelet Volume) typically indicate?

Presence of larger, immature platelets (B) Signup and view all the answers

What is the primary function of hemoglobin in red blood cells?

Carrying oxygen and carbon dioxide (B) Signup and view all the answers

Which of the following conditions could lead to an increased reticulocyte count?

Hemolytic anemia (B) Signup and view all the answers

Which statement best describes the relationship between hematocrit (Hct) and hemoglobin (Hgb) values?

Hct is typically about 3 times the Hgb value (D) Signup and view all the answers

Which of these indices provides information about the average size of red blood cells?

MCV (D) Signup and view all the answers

What is the primary difference between Hodgkin's lymphoma (HL) and non-Hodgkin's lymphoma (NHL)?

HL is characterized by the presence of Reed-Sternberg cells, while NHL is not. (D) Signup and view all the answers

Which of the following is NOT a component of the iron panel?

Erythrocyte Sedimentation Rate (B) Signup and view all the answers

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

Iron deficiency (B) Signup and view all the answers

Which of the following conditions can cause a falsely elevated ferritin level?

Chronic inflammation (B) Signup and view all the answers

Which of the following statements is TRUE regarding the erythrocyte sedimentation rate (ESR)?

ESR is a nonspecific test that can be elevated in various inflammatory conditions. (B) Signup and view all the answers

Which of the following is a disadvantage of using C-reactive protein (CRP) as a marker for inflammation?

CRP can be elevated by a wide range of factors, not just inflammation. (C) Signup and view all the answers

Which of the following tests is NOT typically included in a coagulation panel?

Erythrocyte Sedimentation Rate (ESR) (C) Signup and view all the answers

What does a prolonged bleeding time indicate?

A potential problem with platelet function. (C) Signup and view all the answers

Which of the following is a TRUE statement about the relationship between iron intake and iron stores?

Ferritin levels can be influenced by factors other than iron intake, such as inflammation. (D) Signup and view all the answers

What is the primary purpose of ordering a coagulation panel?

To provide a broad understanding of the hemostatic mechanisms involved in blood clotting. (D) Signup and view all the answers

If a patient has a decreased MCV, what could be a possible underlying condition?

Iron deficiency anemia (C), Thalassemia (D) Signup and view all the answers

What does an elevated red blood cell distribution width (RDW) typically suggest?

A wide range of red blood cell sizes (D) Signup and view all the answers

In a white blood cell differential, which type of leukocyte is typically increased in a bacterial infection?

Neutrophils (C) Signup and view all the answers

A patient presents with a low white blood cell count (leukopenia). What conditions might be considered?

Bone marrow failure, cancer treatment, autoimmune diseases (C) Signup and view all the answers

What is the primary function of the white blood cell differential?

To identify the proportion of each type of white blood cell in the blood (C) Signup and view all the answers

Study Notes

Hematology Week 3

This week's hematology course covers blood components, common causes of anemia and polycythemia, and blood cell types and functions.
The course also covers the relationship between B12, folate, and megaloblastic anemia.
The instructional objectives outline key learning points for each topic, such as understanding the components of a complete blood count (CBC), including indices (MCV, MCH, MCHC), comparing anemia and polycythemia causes, and evaluating the reticulocyte count.
Another objective is comparing and contrasting different blood cell types (neutrophils, lymphocytes, monocytes, eosinophils, basophils, thrombocytes) and their functions.
Understanding white blood cell inclusions, comparing Hodgkin's and non-Hodgkin's lymphoma, and differentiating CLL, ALL, CML, and AML lab findings are also important elements of the course.

Complete Blood Count (CBC)

A series of blood tests providing information about red blood cells (RBCs), platelets, and white blood cells (WBCs).
Easy, quick, and inexpensive.
Includes RBC, hemoglobin, hematocrit, platelets, and RBC indices (MCV, MCH, MCHC).
WBC count and differential are also included, detailing the five white blood cell types (neutrophils, lymphocytes, monocytes, eosinophils, and basophils). A blood smear is not part of the routine CBC.

Erythrocyte Count (RBCs)

Measures the number of RBCs per cubic millimeter of blood.
Reference ranges: male (4.7–6.1 x10¹²/L), female (4.2–5.4 x10¹²/L).
Lower values in females than males, and count decreases with age.
Decreased RBC count indicates anemia.
Conditions causing decreased RBC production include myelofibrosis, leukemia, renal disease, dietary deficiencies.
Conditions leading to increased loss include hemorrhage, hemolysis, and blood dilution (e.g., pregnancy).

Increased Erythrocyte Count (RBCs) = Polycythemia

Physiologically induced by increased oxygen requirements (e.g., high altitudes).
Chronic hypoxia.
Dehydration can also artificially increase RBC count.

Anemias

Macrocytic Anemia: Megaloblastic anemia occurs due to impaired DNA synthesis during RBC production. RBCs grow bigger but are fewer. Many causes; often vitamin B12 or folate deficiency.
Microcytic Anemia: Small RBCs; iron intake is the most common cause. Insufficient iron intake, increased iron demand, or issues with iron absorption can lead to hemoglobin decrease (lower Hgb). Pancytopenia is also a cause. Causes include aplastic anemia, toxin exposure, hereditary causes, and autoimmune diseases.

Reticulocytes

Immature red blood cells.
Reference range in adults: 0.5%–2.0%.
Increased reticulocyte count indicates the bone marrow is producing more red blood cells in response to a loss. Low or normal reticulocyte count in an anemic patient suggests ineffective bone marrow response.

Hemoglobin (Hgb)

Protein in RBCs carrying oxygen and carbon dioxide.
Reference ranges: male (14–18 g/dL), female (12–16 g/dL).
Low hemoglobin levels indicate anemia.

Hematocrit (Hct)

Percentage of total blood volume made up of RBCs.
Reference ranges: male (42–52%), female (37–47%).
Closely reflects hemoglobin levels.
Elevated WBC counts can decrease hematocrit.

Platelet Count (Plt)

Measures the number of thrombocytes (platelets) per cubic millimeter of blood.
Reference range: 150,000–400,000/mm³.
Essential for blood clotting.
Decreased platelet count (thrombocytopenia) can result from reduced production (e.g., bone marrow failure, cancer) , increased destruction, or sequestration (e.g., in the spleen)

Mean Platelet Volume (MPV)

Measures the average size of platelets.
Increased MPV typically indicates immature platelets.
Decreased MPV indicates decreased platelet production or destruction.

Red Blood Cell Indices

Provide information about RBC size and hemoglobin content.
Include cell size (normocytic, microcytic, macrocytic), hemoglobin content (normochromic, hypochromic, hyperchromic), and RBC indices (MCV, MCH, MCHC, RDW).

White Blood Cell Count (WBC)

Measures the number of white blood cells per cubic millimeter of blood.
Reference range: 5,000–10,000/mm³.
Routinely used to diagnose and track infections.
Increased (leukocytosis) or decreased (leukopenia) counts may indicate infections, inflammation, cancer, or other medical conditions.

WBC Differential

Determines the percentage of each type of white blood cell.
Key cell types include neutrophils, lymphocytes, monocytes, eosinophils, and basophils, each associated with various conditions. Increased values in neutrophils often suggest bacterial infections, while low values might signal bone marrow failure or other serious issues.

Blood Smear

Manual microscopic examination of RBCs, platelets, and WBCs.
Used when automated cell counters detect abnormal values.

WBC Inclusions

Abnormalities observed within white blood cells, often indicative of specific conditions, such as hypersegmented neutrophils (seen in megaloblastic anemia) or Dohle bodies (seen in stress). Auer rods are characteristic of acute myeloid leukemia.

Leukemia

Cancer affecting white blood cells, divided into acute and chronic.
Symptoms are often nonspecific, with many potential causes. Characteristic symptoms may include infections, fever, etc.

Lymphomas

Cancers arising from lymphocytes.
Two main categories: Hodgkin's lymphoma (around 10%), and Non-Hodgkin's lymphoma (around 90%).
Differences in treatment and prognosis are based on identifying which category the lymphoma belongs to.

Iron Panel

Measures serum iron, TIBC/transferrin, transferrin saturation, and ferritin (often done separately).
Ferritin is a key iron storage protein; lower ferritin values indicate iron deficiency.
TIBC and transferrin saturation relate to iron absorption and transport; high values often indicate iron deficiency, while decreased values can be related to an excess of iron.

Erythrocyte Sedimentation Rate (ESR)

Measures the rate at which red blood cells (RBCs) settle in a blood sample.
Used to detect inflammation and infections.
Increased ESR often indicates inflammation.

C-reactive Protein (CRP)

Acute-phase reactant protein.
Increased CRP suggests inflammation, such as infections, but also other conditions.
Often ordered with ESR, it is sensitive to inflammation and can be useful for monitoring.

Coagulation Panel

Includes tests measuring components of blood clotting.
Common tests include bleeding time, protime (PT), partial thromboplastin time (PTT), and international normalized ratio (INR), Fibrinogen. Each test focuses on specific aspects of the coagulation and clotting processes.
PT is linked to the extrinsic pathway; PTT is associated with the intrinsic pathway; and INR assesses the overall clotting ability in relation to normal values.

D-dimer

Protein fragment resulting from fibrin degradation.
Elevated levels suggest the presence of blood clots, such as Deep Vein Thrombosis (DVTs) or pulmonary embolisms (PEs).

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Description

Test your knowledge on hematology with this quiz focusing on blood counts, types of anemia, and related conditions. You'll explore questions about complete blood counts (CBC), red and white blood cell indices, and various hematological disorders. Ideal for students studying medicine or healthcare professionals refreshing their knowledge.