Hematopoietic and Lymphoid System Pt 1_SV_2024.pdf

HEMATOPOIETIC AND LYMPHOID SYSTEM Learning Objectives Define complete blood count with indices Be able to classify anemias based on CBC and indices List the general causes of microcytic anemia, giving examples of each Outline the clinical and laboratory features of thalassemia G...

HEMATOPOIETIC AND LYMPHOID SYSTEM Learning Objectives Define complete blood count with indices Be able to classify anemias based on CBC and indices List the general causes of microcytic anemia, giving examples of each Outline the clinical and laboratory features of thalassemia Give the classification of the normocytic anemias; include examples Classify and describe the clinical and laboratory features of the macrocytic anemias Compare and contrast polycythemia vera and secondary polycythemia Describe sickle cell disease including its underlying abnormality and clinical features Describe glucose-6-phosphate deficiency with its clinical laboratory features List 4 causes of thrombocytopenia Describe the clinical and laboratory features of idiopathic thrombocytopenic purpura and thrombotic thrombocytopenic purpura and their treatment Complete Blood Count (CBC) – the basics Hemoglobin protein molecule in red blood cells that carries oxygen from lungs to tissues and carries carbon dioxide from tissues to lungs Hematocrit Percentage of the volume of whole blood that is made up of red blood cells White blood cell count and differential Platelet Count There’s more – but we will get to that later Big take homes “cytosis” → ex: leukocytosis → too many/extra white blood cells “penia” → ex: leukopenia → we have a lack of those white blood cells Red blood cell indices – what do the cells look like? Mean corpuscular volume (MCV) Average red blood cell size Normal range 80 -100 femtoliter Microcytic 100 Mean concentration of hemoglobin (MCH) Amount of hemoglobin per red blood cell Normal range 27-31 picograms/cell Hypochromic 31  Anemia Anemia - reduction in the number of RBCs, hemoglobin, or hematocrit How to classify → by looking at the red cells/morphology and the retic count Retic count: measure of immature RBCs being produced by bone marrow Pathophysiology: Decreased RBC production Bone marrow (hypoproliferative) Increased RBC destruction or Accelerated RBC loss Acute/excessive blood loss, hemolysis, or recent replacement of missing erythropoietic nutrient, excessive destruction Microcytic Anemia Mnemonic: TICS or TAILS Etiologies: Iron deficiency → most common Thalassemia Lead toxicity Iron deficiency Anemia (aka IDA) Hypochromic, microcytic *CAN be normocytic normochromic early on Symptoms Fatigue Restless leg syndrome Not conclusive, but warrants measurement or trial of iron Shortness of breath Exercise intolerance Weakness Pica  Iron deficiency Ferritin – BEST TEST Storage form of iron (money in the BANK) ALSO → an Acute phase reactant (goes up in stress/illness) If >50 ng/mL, they definitely do not have IDA If