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- author "me"
- fileName "Rbc indices and abnormalities "
- tags ""
- description ""
- Put these in order: Proerythroblast, Pluropotential stem cell, CFU-E, Erythrocyte, Erythroblast, Reticulocyte
- Pluripotential stem cell --> CFU-E --> Proerythroblast --> Erythroblast --> Reticulocyte --> Erythrocyte
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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
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What surpresses erythropoiesis?
Inflammatory Cytokines (IL1, TNF-y, TGF-B), Drugs, HIV, Increased suppressor T lymphocytes
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Where does EPO bind?
It binds on committed eythroid cells in the bone marrow
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How long does it take for EPO to result in an increased reticulocyte count?
4-5 days
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How long does it take for EPO to increase hematocrit?
1 week or more
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What percent of RBCs are replaced daily?
10%
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How is the shape of the RBC maintained?
By the membrane skeleton (actin, spectrin, anykrin and protein 4.1)
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How much of the diameter of a RBC is pallor (pail)?
1/3 of diameter
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What provides RBC with energy and do they have mitochondria?
Glycolysis and NO! Not even a nucleus
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Do RBCs have inclusions (Build up of nonliving matter inside a cell) ?
No
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What percent of RBC mass is Hb?
33%
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Normal adult Hb - Match: (HbA, HbA2, HbF) and (2%, 1%, 97%)
HbA - 97%, HbA2 - 2%, HbF - 1%
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What are qualitative Hb disorders?
The quality of Hb is affected; Hemoglobinopathies (ie, sickle cell disease)
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What are quantitative Hb disorders?
Decreased amt of Hb (anemias, thalassemias), Increased amt of Hb (smoking, EPO, high altitude)
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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
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What are normal Hb levels (g/L)?
Adult male: 140-180 g/L; Adult female: 120-160 g/L
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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)
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What can cause false high hematocrit?
Sun stroke, shock, severe burns, dehydration and fever
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What can cause false low hematocrit values?
Pregnancy, heart failure, fluid overload
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How is hematocrit calculated?
HCT = RBCs x MCV
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How is MCV calculated?
It is measured by the instruments or MCV = HCT/RBCs x 1000
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What is Mean Corpuscular Hemoglobin (MCH)?
Amount of hemoglobin per RBC; MCH = Hb (g/L)/RBCs (x10^12) [picograms of Hb/cell]
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What is Mean Corpuscular Hb Concentration?
Hb concetration within circulating RBC; MCHC = Hb/HCT
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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%
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RBC Parameter: Decreased number
Decreased production, Increased destruction/consumption, Loss (acute or chronic)
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RBC Parameter: Increased number
Benign conditions, neoplasms
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RBC parameter: Size Classifications
Microcytic, Normocytic, Macrocytic
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RBC Parameter: Color
Normochromic, Hypochromic, Polychromasia
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What does high RDW represent? Anisocytosis or Poikolocytosis
Anisocytosis
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What does polychromasia indicate?
Increase number of reticulocytes in peripheral blood
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What does poikilocytosis mean?
Variable shape of RBCs
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What does ansiocytosis mean?
Variable size of RBCs
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What is rouleaux?
Stacks of RBCs
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When is anisocytosis found?
Deficiency anemias, post transfusion, reticulocytosis
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When is poikilocytosis found?
Hemolytic anemias, myeloproliferative neoplasms?
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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
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What is an elliptocyte? When are they seen?
Pencil shaped RBC; Hereditary, thalassemia, severe iron deficiency
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When are random abnormal shapes seen?
Mechanical destruction and hemolytic anemias; Fragmented cells (schistocyte/helmet cells)
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Three abnormal Hb disorders:
HbS (glu6 --> val), HbC (glu6-->lys), HbE (glu26-->lys)
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What are the effects of decreased Hb on colour and size?
Microcytosis and Hypochromasia (TAILS)
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What is a tear drop RBC caused by?
Myelofibrosis, infiltration of marrow by neoplastic cells, hemolytic anemia
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What is an aganthocyte?
Irregulary spiculated cells; Spur cell; Altered cell membrane lipids
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What is an echinocyte?
Regulary spaced spicules; Burr cell; Artifact, Uremia/chronic renal disease, liver disease
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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
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When are macrocytes mostly seen?
B12/folate def, alcoholism, drugs/chemo, MDS, liver disease
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What is a Howell-Jolly body?
A remnant of DNA in an RBC; common in hemolysis, splenectomy, hyposplenism, megaloblastic anemia
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What is a Heinz body?
Denatured and precipitated Hb in RBC; common in G6PD def, Unstable hemoglobinopathies, oxidant drugs, severre alcoholic liver diseases
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What is basophilic stippling?
Aggregation of ribosomes RNA in RBC; common in thalassemia, lead poisoning, sideroblastic anemia
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When is polychromasia common?
Increased reticulocytes, acute blood loss, recovery of BM, new born
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When can we find nucleated RBCs?
Myelofibrosis, MPN, MDS, Leukoerythroblastic conditions
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