Rbc indices and abnormalities .txt
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Rbc indices and abnormalities .txt
fileName "Rbc indices and abnormalities "
Put these in order
: Proerythroblast, Pluropotential stem cell, CFU-E, Erythrocyte, Erythroblast, Reticulocyte
Pluripotential stem cell --> CFU-E --> Proerythroblast --> Erythroblast --> Reticulocyte --> Erythrocyte
What organ detects oxygen levels to release EPO? What other proteins stimulate erythropoiesis?
Kidney (in the case of pulmonary dysfunction, shift in O-Hb dissociation curve, Low atm. O2); Insulin and ILGF1 also increase erythropoiesis
What surpresses erythropoiesis?
Inflammatory Cytokines (IL1, TNF-y, TGF-B), Drugs, HIV, Increased suppressor T lymphocytes
Where does EPO bind?
It binds on committed eythroid cells in the bone marrow
How long does it take for EPO to result in an increased reticulocyte count?
How long does it take for EPO to increase hematocrit?
1 week or more
What percent of RBCs are replaced daily?
How is the shape of the RBC maintained?
By the membrane skeleton (actin, spectrin, anykrin and protein 4.1)
How much of the diameter of a RBC is pallor (pail)?
1/3 of diameter
What provides RBC with energy and do they have mitochondria?
Glycolysis and NO! Not even a nucleus
Do RBCs have inclusions (Build up of nonliving matter inside a cell) ?
What percent of RBC mass is Hb?
Normal adult Hb - Match: (HbA, HbA2, HbF) and (2%, 1%, 97%)
HbA - 97%, HbA2 - 2%, HbF - 1%
What are qualitative Hb disorders?
The quality of Hb is affected; Hemoglobinopathies (ie, sickle cell disease)
What are quantitative Hb disorders?
Decreased amt of Hb (anemias, thalassemias), Increased amt of Hb (smoking, EPO, high altitude)
What type of Hb can all other types be converted to? What is it used for?
Cyanmethemoglobin; it is stable and can be accurately measured by spectrophometer
What are normal Hb levels (g/L)?
Adult male: 140-180 g/L; Adult female: 120-160 g/L
What does hematocrit represent? What is a way of estimating it?
Proportion of the volume of a blood sample that is occupied by RBCs; Centrifuge it, pack the RBCs into small volume (may trap some plasma)
What can cause false high hematocrit?
Sun stroke, shock, severe burns, dehydration and fever
What can cause false low hematocrit values?
Pregnancy, heart failure, fluid overload
How is hematocrit calculated?
HCT = RBCs x MCV
How is MCV calculated?
It is measured by the instruments or MCV = HCT/RBCs x 1000
What is Mean Corpuscular Hemoglobin (MCH)?
Amount of hemoglobin per RBC; MCH = Hb (g/L)/RBCs (x10^12) [picograms of Hb/cell]
What is Mean Corpuscular Hb Concentration?
Hb concetration within circulating RBC; MCHC = Hb/HCT
What is the Red Cell Distribution Width (RDW)?
A measurement of the amount that RBCs vary in size (reflects variability in cell size and not cell width itself); Normal range is 11-15%
RBC Parameter: Decreased number
Decreased production, Increased destruction/consumption, Loss (acute or chronic)
RBC Parameter: Increased number
Benign conditions, neoplasms
RBC parameter: Size Classifications
Microcytic, Normocytic, Macrocytic
RBC Parameter: Color
Normochromic, Hypochromic, Polychromasia
What does high RDW represent? Anisocytosis or Poikolocytosis
What does polychromasia indicate?
Increase number of reticulocytes in peripheral blood
What does poikilocytosis mean?
Variable shape of RBCs
What does ansiocytosis mean?
Variable size of RBCs
What is rouleaux?
Stacks of RBCs
When is anisocytosis found?
Deficiency anemias, post transfusion, reticulocytosis
When is poikilocytosis found?
Hemolytic anemias, myeloproliferative neoplasms?
What is a spherocyte? What is the clinical significance? When are they seen?
Spherical RBC; Decreased membrance redundancy; Hereditary, immune related, thermal injury, Microangiopathic hemolytic anemias
What is an elliptocyte? When are they seen?
Pencil shaped RBC; Hereditary, thalassemia, severe iron deficiency
When are random abnormal shapes seen?
Mechanical destruction and hemolytic anemias; Fragmented cells (schistocyte/helmet cells)
Three abnormal Hb disorders:
HbS (glu6 --> val), HbC (glu6-->lys), HbE (glu26-->lys)
What are the effects of decreased Hb on colour and size?
Microcytosis and Hypochromasia (TAILS)
What is a tear drop RBC caused by?
Myelofibrosis, infiltration of marrow by neoplastic cells, hemolytic anemia
What is an aganthocyte?
Irregulary spiculated cells; Spur cell; Altered cell membrane lipids
What is an echinocyte?
Regulary spaced spicules; Burr cell; Artifact, Uremia/chronic renal disease, liver disease
What is a target cell and when do we see them?
RBC that has the appearance of a bulls eye target; thalassemia, iron defiency, liver disease, hemoglobinopathy, post splenectomy, artifact
When are macrocytes mostly seen?
B12/folate def, alcoholism, drugs/chemo, MDS, liver disease
What is a Howell-Jolly body?
A remnant of DNA in an RBC; common in hemolysis, splenectomy, hyposplenism, megaloblastic anemia
What is a Heinz body?
Denatured and precipitated Hb in RBC; common in G6PD def, Unstable hemoglobinopathies, oxidant drugs, severre alcoholic liver diseases
What is basophilic stippling?
Aggregation of ribosomes RNA in RBC; common in thalassemia, lead poisoning, sideroblastic anemia
When is polychromasia common?
Increased reticulocytes, acute blood loss, recovery of BM, new born
When can we find nucleated RBCs?
Myelofibrosis, MPN, MDS, Leukoerythroblastic conditions