NURS660 Exam
A patient is experiencing shortness of breath, pallor, and dizziness. Do you suspect
an acute or chronic anemia? - ANSWER Acute blood loss
Chronic is often asymptomatic until very severe
What does an MCV value tell you? What is a normal value? What would a low and
high value be called? - ANSWER the size of the RBC
normal: 80-100
>100: macrocytic (large RBC)
<80: microcyctic (small RBC)
What does an MCHC value tell you? What is a normal value? What would a low and
high value be called? - ANSWER the "color" of the RBC or how saturated it is with
HGB
Normal: 32-37
high value not a thing
<32: hypochromic (lacking HGB)
What does an RDW value tell you? What is a normal value? What would a low and
high value be called? - ANSWER essentially how far apart the RBCs are from each
other - the further apart, the less RBCs, otherwise they would be closer just based
on the sheer volume
ranges about 11-15% but for testing purposes I think it will just say elevated or low
Describe in what types of infections/scenarios the types of WBCs would be elevated.
Neutrophil
Lymphocyte
Eosinophils
Monocytes
Basophils - ANSWER Neutrophil: first line for bacterial infection
Lymphocyte: first line for viral infection
Eosinophils: allergies, parasitic infections
Monocytes: share function with neutrophils, only elevated in SEVERE infections
Basophils: parasitic, allergic, inflammation
If your CBC comes back abnormal, what is something you can do next? - ANSWER
add on a peripheral smear if you didn't get one already
Anisocytosis on your peripheral smear is/is not concerning - ANSWER not
concerning
normal size variant
Blasts on your peripheral smear is/is not concerning - ANSWER Very concerning
blasts = red flag for leukemia, requires an oncology referral
blasts should remain in bone marrow until mature and ready to be released
, Smudge cells on peripheral smear are seen with - ANSWER CLL
What are the two smear cells you may see on a patient with IDA? - ANSWER
ovalcyte/elliptocyte OR teardrop cells
Target cells and basophilic stippling on smears are indicative of... - ANSWER
thalassemia
Spherocytes on smear may indicate - ANSWER hemolytic anemia
What is the most common trigger for the bone marrow to produce more RBCs? -
ANSWER decrease in o2
Name the normal lab values for these labs
RBC
Hemoglobin
Hematocrit - ANSWER RBC: 4.1-5.8
Hgb: 12-16 in women
14-17.5 in men
Hct: should be roughly 3x hgb
33-45% in women
38-51% in men
What hemoglobin value requires an immediate ED referral? - ANSWER <7
In a macrocytic, normochromic anemia, you would expect what labs? - ANSWER
Decreased RBC/Hgb/HCT (Hgb most commonly used)
Increased MCV (>100)
Normal MCHC (32-37)
Name some causes for macrocytic normochromic anemia. - ANSWER B12
deficiency
Folate deficiency
Alcohol induced
Liver disease
Multiple myeloma
In a normochromic, normocytic anemia, you would expect what labs? - ANSWER
Decreased RBC/Hgb/HCT (Hgb most commonly used)
Normal MCV (80-100)
Normal MCHC (32-37)
RDW often normal as well
not an abnormal cell, just less of them
Causes of normochromic, normocytic anemia - ANSWER Anemia of chronic disease
Acute blood loss/bleeding
Hemolytic anemia
Early IDA
A patient is experiencing shortness of breath, pallor, and dizziness. Do you suspect
an acute or chronic anemia? - ANSWER Acute blood loss
Chronic is often asymptomatic until very severe
What does an MCV value tell you? What is a normal value? What would a low and
high value be called? - ANSWER the size of the RBC
normal: 80-100
>100: macrocytic (large RBC)
<80: microcyctic (small RBC)
What does an MCHC value tell you? What is a normal value? What would a low and
high value be called? - ANSWER the "color" of the RBC or how saturated it is with
HGB
Normal: 32-37
high value not a thing
<32: hypochromic (lacking HGB)
What does an RDW value tell you? What is a normal value? What would a low and
high value be called? - ANSWER essentially how far apart the RBCs are from each
other - the further apart, the less RBCs, otherwise they would be closer just based
on the sheer volume
ranges about 11-15% but for testing purposes I think it will just say elevated or low
Describe in what types of infections/scenarios the types of WBCs would be elevated.
Neutrophil
Lymphocyte
Eosinophils
Monocytes
Basophils - ANSWER Neutrophil: first line for bacterial infection
Lymphocyte: first line for viral infection
Eosinophils: allergies, parasitic infections
Monocytes: share function with neutrophils, only elevated in SEVERE infections
Basophils: parasitic, allergic, inflammation
If your CBC comes back abnormal, what is something you can do next? - ANSWER
add on a peripheral smear if you didn't get one already
Anisocytosis on your peripheral smear is/is not concerning - ANSWER not
concerning
normal size variant
Blasts on your peripheral smear is/is not concerning - ANSWER Very concerning
blasts = red flag for leukemia, requires an oncology referral
blasts should remain in bone marrow until mature and ready to be released
, Smudge cells on peripheral smear are seen with - ANSWER CLL
What are the two smear cells you may see on a patient with IDA? - ANSWER
ovalcyte/elliptocyte OR teardrop cells
Target cells and basophilic stippling on smears are indicative of... - ANSWER
thalassemia
Spherocytes on smear may indicate - ANSWER hemolytic anemia
What is the most common trigger for the bone marrow to produce more RBCs? -
ANSWER decrease in o2
Name the normal lab values for these labs
RBC
Hemoglobin
Hematocrit - ANSWER RBC: 4.1-5.8
Hgb: 12-16 in women
14-17.5 in men
Hct: should be roughly 3x hgb
33-45% in women
38-51% in men
What hemoglobin value requires an immediate ED referral? - ANSWER <7
In a macrocytic, normochromic anemia, you would expect what labs? - ANSWER
Decreased RBC/Hgb/HCT (Hgb most commonly used)
Increased MCV (>100)
Normal MCHC (32-37)
Name some causes for macrocytic normochromic anemia. - ANSWER B12
deficiency
Folate deficiency
Alcohol induced
Liver disease
Multiple myeloma
In a normochromic, normocytic anemia, you would expect what labs? - ANSWER
Decreased RBC/Hgb/HCT (Hgb most commonly used)
Normal MCV (80-100)
Normal MCHC (32-37)
RDW often normal as well
not an abnormal cell, just less of them
Causes of normochromic, normocytic anemia - ANSWER Anemia of chronic disease
Acute blood loss/bleeding
Hemolytic anemia
Early IDA
