Lecture 27 - CBC and anemia

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Lecture 27
Lesley Howard
Fichas por Lesley Howard, actualizado hace más de 1 año
Lesley Howard
Creado por Lesley Howard hace más de 8 años
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HGB Hemoglobin concentration Concentration per deciliter of whole blood Average = 15g/dL
RBC Red blood cell count Number of RBCs in whole blood Average = 5*10^6 Use 5 in calculation
HCT Hematocrit Packed cell volume % of whole blood occupied by RBCs Average = 45% Use 45 in calculation not .45
MCV Mean corpuscular volume The average volume of circulating RBCs MCV = HCT/RBC (10)
Microcytic MCV < 80 fL
Normocytic MCV 80-100 fL
Macrocytic MCV > 100 fL
MCH Maan corpuscular hemoglobin Amount of Hb in the average circulating RBC MCH = HGB/RBC (10) Average = 26-32 pG/RBC
MCHC Mean corpuscular hemoglobin concentration Concentration of Hb in the average circulating RBC MCHC = HGB/HCT (100) MCHC = MCH/MCV (100)
Normochromic MCHC = 31-37%
Hypochromic MCHC < 31%
RDW Red blood cell distribution width Measure of the variation in RBC volume Normal = 11-15% Elevated = anisocytosis Elevated in nutritional deficiencies
Rule of 3 RBC in million * 3 = HGB in g/dL HGB in g/dL * 3 = HCT %
Order of RBC formation Stem cell > pro erythroblast > early erythroblast > intermediate erythroblast > late erythroblast > reticulocyte > RBC
Nucleus is removed from Late erythroblast
Erythropoiesis Production of RBCs in bone marrow Stimulated by erythropoietin
Erythropoietin Stimulated by hypoxia or increased demand by tissue for oxygen Released from kidney, acts on red marrow Increases BFUE/CFUE cells, the rate of erythroid differentiation, production and release of reticulocytes, iron absorption, and Hb synthesis
Recombinant EPO Administered to patients with kidneys that are too damaged to produce sufficient EPO
Reticulocytes 72 hours to mature 48 in marrow 24 in circulation Contain ribosomes and mRNA
Anemia Most common blood disorder Reduction in O2 to tissues Sign of a disease
Impaired anemia Impaired DNA synthesis Iron deficiency Lack of hemoglobin
Destruction anemia Excessive hemolysis due to defective RBCs Acute bleeding
Corrected reticulocyte Used to determine pathological cause of anemia Calculated value based on the proportion of reticulocytes as compared to total RBCs Low to normal: Insufficient erythropoiesis Elevated: Increased RBC destruction or loss
Flowchart Q1 Is HGB within normal limits? If yes, no anemia If no, move to Q2
Flowchart Q2 What are the CR levels? Low or within range: Decreased erythropoiesis, so check MCV Elevated: Increased RBC destruction or blood loss
Flowchart Q3 Check MCV if CR levels are low or within range Low: Microcytic cells with impaired Hb synthesis and possible iron deficiency Elevated: Increased RBC destruction or blood loss
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