PNCB Prep:Hematologic/Immunology/Rheumatology/Oncology, Hematological Disorders

MCV (Mean Corpuscular Volume)
-Definition
-Level (normal) (3)
-Low level / Indicates (3)
-High level / Indicates – correct answer Definition:
-Measures average RBC volume (actual size of the cell) (of individual erythrocyte)
-Determines the volume of the average RBC in femtoliters
Lab Values:
–Normocytic: 80-100
Anemias:

1. Anemia of chronic disease
2. Early IDA
3. Acute blood loss
   –Microcytic: < 80 (most in peds anemias – new production is small RBCs)
4. Lead poisoning
5. Iron deficiency
6. Thalassemia
   –Macrocytic: >100 (most adult anemias; virtually nonexistent in peds)
7. Hypothyroid
   
8. B12 or folate deficiency
9. Bone marrow failure syndromes
10. Fanconi anemia (Constitutional Aplastic Anemia)
11. Sickle cell
    MCHC (Mean Corpuscular Hemoglobin Concentration)
    -Definition
    -Importance of Value
    -Level (normal) (3)
    -Low level / Indicates (3)
    -High level / Indicates – correct answer Definition:
    -Average concentration of hemoglobin in each RBC
    –color More accurate measure than MCH (Mean Corpuscular hemoglobin)
    Importance of Value:
    -Used in determining type and severity of anemia
    -Mirrors MCV
    Lab Values:
    –Normochromic: 32%-36%
    Anemias:
12. Anemia of chronic disease
13. Early IDA
14. Acute blood loss
    –Hypochromic: <32% (anemias) (Pediatric)
15. Lead poisoning
16. Iron deficiency
17. Thalassemia
    
    –Hyperchromic: >36% (most texts deny the existence of this state – impossible for RBC to be too red)
    MCH
    -Definition – correct answer -Expression of the average amount and weight of Hgb contained in single
    erythrocyte (not useful) uses the WBC count anemia RBC count decrease not as useful it moves Normal
    26 to 36 pgs
    Red (blood cell) distribution width (RDW) /
    Red cell distribution width (RCDW)
    -Definition
    -Importance of Value
    -Level (normal) / Indicates (1-2)
    -High level / Indicates (1-2) – correct answer Definition:
    -A measure of the range of variation of red blood cell (RBC) volume/size
    -Red cell size and shape variation: Anisocytosis Decrease response with increase and new RBC quickly
    making different sizes and shapes
    -Increased level: indicates mixed population of RBCs
    -Immature RBCs are larger or smaller than mature RBCs, so an increase is associated with anemias
    -Differentiates between iron deficiency anemia (IDA), thalassemia, and anemia of chronic disease (ACD)
18. IDA: RDW is increased
19. Thalassemia: RDW is normal or slightly increased
20. ACD: RDW is normal
    How does the MCV and MCHC affect the RDW level? – correct answer -If MCV and MCHC are ↓, the
    RDW is usually ↑.
    3 / 4
    -If MCV and MCHC are low, the body is quickly making more RBCs and spitting them out into the system
    causing them to be immature (AKA different sizes between mature and immature – causing RDW to go
    ↑)
    Definition:
    -RDW: A measure of the range of variation of red blood cell (RBC) volume/size
    What anemic disorders use folic acid as part of their management method? – correct answer 1. Sickle
    Cell Anemia
21. Thalassemia
    What diagnosis relates to these findings?
22. Nucleated RBCs
23. H/H: Low
24. RBC: Low
25. Reticulocytes: High
26. WBC: elevated
27. Indirect Bili: elevated
28. Platelet: elevated – correct answer Sickle Cell Anemia
    Reticulocyte count
    -Definition
    -Importance of Value
    -Level (normal)
    -Low level / Indicates (1)
    -High level / Indicates (3) – correct answer Definition:
    –Number of new RBCs in circulation