Week 13 Blog #1

Blog #1:

Week 13 March 28 – April 3

Monday, March 28, 2016

4p-8p 4 Hours Interned

Objective #2:

2. Will verbally demonstrate knowledge of tests included in a CMP and CBC/diff including abnormalities, what disease process they might indicate and possible signs and symptoms that a patient might demonstrate given these values.

Signs and symptoms a patient may demonstrate to have these tests ordered in relation to abnormal values:

Red Blood Cell Test

Test is ordered as part of the CBC test as part of a routine/annual check up, when an individual has recently received a new diagnosis, or is on a new drug treatment that could affect these levels. The test is also ordered when an individual shows any signs or symptoms that may be related to disorders that affect blood cells. Signs and symptoms to indicate so would include fatigue or weakness, has an infection, inflammation, bruising, and bleeding. Signs, symptoms, and disease processes related to red blood cells are anemia, hemolytic anemia, nutritional deficiency, bone marrow disease, chronic inflammatory disease, chronic kidney disease, lung disease, kidney or other tumors that produces excess erythropoiten, smoking, dehydration, living at a high altitude, genetic causes, and a rare disease known as polycrythemia.

Week 12 Blog #2

Blog #2:

Week 12 March 21-27

Friday, March 25, 2016
4p-8p 4 Hours Interned
Saturday, March 26, 2016
2p-10p 8 Hours Interned
Sunday, March 27, 2016
2p-10p 8 Hours Interned

Objective #2:
2. Will verbally demonstrate knowledge of tests included in a CMP and CBC/diff including abnormalities, what disease process they might indicate and possible signs and symptoms that a patient might demonstrate given these values.

Platelets Normal Range: 150-450 x 10³/microliter

Low platelet levels signify- AKA thrombocytopenia. Low levels of platelets are due to viral infections, rocky mountain spotted fever, platelet autoantibody, drugs such as Tylenol, quinidine, and sulfa drugs, cirrhosis, autoimmune disorders, sepsis, leukemia, lymphoma, myelodysplasia, and chemo or radiation.

High platelet levels signify- AKA thrombocytosis. High levels of platelets are due to cancer, rheumatoid arthritis, lupus, inflammatory bowel disease (IBM), iron deficiency anemia, hemolytic anemia, and myeloproliferative disorder.

Platelet Count (Plt) Normal Range: 150-450 x 10³/microliter

Mean Platelet Volume (MPV): No normal value range because this test evaluates the average size of the platelets.

Low Mean Platelet Volume levels signify- Indicates the average size of platelets is small. Older platelets are generally smaller than younger ones and a low MPV may mean that a condition is affecting the production of platelets in the bone marrow.

High Mean Platelet Volume levels Signify- Indicates a high number of larger, younger platelets in the blood. This may be due to the bone marrow producing ad releasing too many platelets and too fast into circulation.

Platelet Distribution Width (PDW): No normal value range because this test evaluates the uniformity in size of platelets.

Low Platelet Distribution Width signify- Indicates uniformity in size of platelets.

High Platelet Distribution Width signify- Indicates increased variation in the size of the platelets, which may mean that a condition is present that is affecting the platelets.

Week 12 Blog #1

Blog #1:

Week 12 March 21-27

Monday, March 21 2016
4p-8p 4 Hours Interned
Tuesday, March 22, 2016
5p-9p 4 Hours Interned

Objective #2:
2. Will verbally demonstrate knowledge of tests included in a CMP and CBC/diff including abnormalities, what disease process they might indicate and possible signs and symptoms that a patient might demonstrate given these values.

White Blood Cells Normal Range: 4,500-11,000 White Blood Cells per microliter (mcL)
As stated white blood cells are broken up into a variety of groups and become elevated when a pathogen has invaded the body. There is always a normal range of white blood cell and not common to be low unless a particular disease is present. Typically, WBCs are measured to see an increase in a particular type to indicate what kind of pathogen has invaded the body but can also be high due to particular diseases.
High Levels of WBCs Signify- AKA Leukocytosis. Due to infection or disease.
Low Levels of WBCs Signify- AKA Leukopenia. Due to disease.

White Blood Cell Differential (Diff)
No normal range because this test is just done as part of the CBC and determines the different types of WBCs in the blood. White blood cell differential consists of the 5 white blood cells listed below:

Absolute Neutrophil Count (Neu, PMN, polys) Normal Range: 1800-7800 mcL

Low Neutrophil levels signify- AKA neutropenia. Low levels of neutrophils due to overwhelming infection known as sepsis, dietary deficiencies, reaction to chemotherapy, autoimmune disorders, immunodeficiency, and bone marrow damage.

High Neutrophil levels signify- Aka neutrophillia. High levels of neutrophils due to minor bacterial infections, inflammation, stress from rigorous exercise, and trauma, heart attack, or burns.

Absolute Lymphocyte Count (Lymph) Normal Range: 1000-4800 mcL

Low Lymphocyte levels signify- Aka lymphocytopenia. Low levels of lymphocytes due to autoimmune disorders, infections such as HIV, viral hepatitis, typhoid fever, and influenza, corticosteroids, and bone marrow damage.

High lymphocyte levels signify- AKA lymphocytoss. High levels of lymphocytes due to acute viral infections, certain bacterial infections, toxoplasmosis, chronic inflammatory disorders, lymphoma, and acute stress.

Absolute Monocyte Count (Mono) Normal Range: 0-800- mcL

Low monocyte levels signify- A low monocyte count is usually insignificant but can be due to bone marrow damage or failure, hairy cell leukemia, and aplastic anemia.

High monocyte levels signify- High levels of monocytes are due to chronic infections, infections of the heart, collagen vascular disease, and monocytic or myelomonocytic leukemia.

Absolute Eosinophil Count (Eos) Normal Range: 0-450 mcL

Low eosinophil levels signify- A low eosinophil count is a good thing and not significant. Don’t want a high eosinophil level because it usually indicates a parasitic infection or an allergic reaction.

High Eosinophil levels signify- A high eosinophil count is due to asthma, allergies, drug reaction, parasitic infection, inflammatory disorder, some cancers such as leukemias or lymphomas, and Addison disease.

Absolute Basophil Count (Baso) Normal Range: 0-200 mcL

Low Basophil levels signify- A low basophil count is similar to a low eosinophil count. A low count is a good thing and not significant. Don’t want high levels of basophils because they usually indicate a severe allergic reaction.

High Basophil levels signify- A high basophil count is due to rare and severe allergic reactions such as hives, food allergies, etc., chronic inflammation, some leukemias, and uremia.

Week 11 Blog #2

Blog #2:
Week 11 March 14-20

Friday, March 18, 2016
4p-8p 4 Hours Interned
Saturday, March 19, 2016
10p-6a 8 Hours Interned

Objective #2:
2. Will verbally demonstrate knowledge of tests included in a CMP and CBC/diff including abnormalities, what disease process they might indicate and possible signs and symptoms that a patient might demonstrate given these values.

So like before with the CMP, this part of the blog is going to start getting kind of dry. I am now going to explain the abnormal tests values from the list above and what the abnormal values can potentially signify in relation to the disease process. I am going to break up the 16 tests over the next two to three blogs to keep on track with the timeframe of my biweekly blog requirements.

Red Blood Cells Normal Range:
Male: 4.5-5.9 x 10⁶/microliter
Female: 4.5-5.1 x 10⁶ microliter
Low red blood cell count levels signify- Known as anemia. Results from acute or chronic bleeding, RBC destruction, nutritional deficiency, bone marrow disoders or damage, chronic inflammatory disease, and chronic kidney disease.
High red blood count levels signify- Known as polycythemia. Results from dehydration, lung disease, kidney or other tumor that produces excess erythropoietin, smoking, living at a high level altitude, altered oxygen sensing, or polycythemia vera (a rare disease).

Hemoglobin (Hb) Normal Range:
Male: 14-17.5 g/d
Female: 12.3 - 15.3 g/dL
Low hemoglobin levels signify- Usually mirrors RBC results, provides additional info in regards to the total amount of the oxygen-carrying protein in the blood.
High hemoglobin levels signify- Usually mirrors RBC results as above.

Hematocrit (Hct) Normal Range:
Male: 41.5-50.4%
Female: 36.9-44.6%
Low hematocrit levels signify- Like hemoglobin, mirrors the RBC results in determining the proportion of your blood that is made up of RBCs.
High hematocrit levels signify- Mirrors the RBC results. Most common cause is because of dehydration.

Mean Corpuscular Volume (MCV) Normal Range: 80-96 micrometer³
Low MCV levels signify- Indicates that RBCs are smaller than normal. Caused by iron deficiency anemia or thalassemias.
High MCV levels signify- Indicates that RBCs are larger than normal. Caused by anemia caused by vitamin B12 or folate deficiency, myelodysplasia, liver disease, and hypothyroidism.

Mean Corpuscular Hemoglobin (MCH) Normal Range: 27.5-33.2 pg
Low MCH levels signify- Mirrors MCV results indicated smaller RBCs would have a lower hemoglobin value.
High MCH levels signify- Mirrors MCV results indicate larger RBCs would have a higher hemoglobin value.

Mean Corpuscular Hemoglobin Concentration (MCHC) Normal Value:  33.4-35.5 g/dL
Low MCHC levels signify- May be low when MCV is low. Decreased MCHC values, AKA hypochromia, are seen in conditions such as iron deficiency anemia and thalassemia.
High MCHC levels Signify- AKA hyperchromia. Increased MCHC values are seen in conditions where the hemoglobin levels are more concentrated inside the RBCs such as autoimmune hemolytic anemia, in burn patients, and hereditary spherocytosis (a rare congenital disorder)

Red Blood Cell Distribution Width (RDW)
No normal value range because this tests evaluates the uniformity in size of the red blood cells.
Low Distribution Width Red Blood Cells signify- Uniformity in size of RBCs.
High Distribution Width Red Blood Cells signify- Indicates a mixed population of small and large RBC's. Young RBCs tend to be larger.

Reticulocytes Normal Range: 0.5 - 1.5% 
Low levels of reticulocytes signify- In the setting of anemia, a low reticulocyte count indicates a condition is affecting the production of RBCs such as bone marrow disorder or damage, or a nutritional deficiency (iron, B12, Folate)
High levels of reticulocytes signify- In a setting of anemia, a high reticulocyte count generally indicates peripheral cause such as bleeding or hemolysis, or response to treatment such as iron deficiency anemia.

Week 11 Blog #1

Blog #1:

Week 11 March 14-20

Monday, March 14, 2016

4p-8p 4 Hours Interned

Objective #2:

2. Will verbally demonstrate knowledge of tests included in a CMP and CBC/diff including abnormalities, what disease process they might indicate and possible signs and symptoms that a patient might demonstrate given these values.

So here are the lab normal lab values for the components of the CBC test.

Red Blood Cells

- Low red blood cell count known as anemia

- High red blood count known as polycythemia

- Normal Range: 

Male: 4.5-5.9 x 10⁶/microliter

Female: 4.5-5.1 x 10⁶ microliter

1. Hemoglobin (Hb)

Male: 14-17.5 g/d

Female: 12.3 - 15.3 g/dL

2. Hematocrit (Hct)

Male: 41.5-50.4%

Female: 36.9-44.6%

3. Mean Corpuscular Volume (MCV)

Normal Range: 80-96 micrometer³

4. Mean Corpuscular Hemoglobin (MCH)

Normal Range: 27.5-33.2 pg

5. Mean Corpuscular Hemoglobin Concentration (MCHC)

Normal Value:  33.4-35.5 g/dL

6. Red Blood Cell Distribution Width (RDW)

No normal value range because this tests evaluates the uniformity in size of the red blood cells.

7. Reticulocytes

Normal Range: 0.5 - 1.5% 

2. White Blood Cells

- Low white blood cell count known as leukopenia

- High white blood cell count known as leukocytosis

- Normal Range: 4,500-11,000 White Blood Cells per microliter (mcL)

8. White Blood Cell Differential (Diff)

White blood cell differential consists of the 5 white blood cells listed below:

9. Absolute Neutrophil Count (Neu, PMN, polys)

Normal Range: 1800-7800 mcL

10. Absolute Lymphocyte Count (Lymph)

Normal Range: 1000-4800 mcL

11. Absolute Monocyte Count (Mono)

Normal Range: 0-800- mcL

12. Absolute Eosinophil Count (Eos)

Normal Range: 0-450 mcL

13. Absolute Basophil Count (Baso)

Normal Range: 0-200 mcL

3. Platelets

- Low platelet count known as thrombocytopenia

- High platelet count known as thrombocytosis

- Normal Range: 150-450 x 10³/microliter

14. Platelet Count (Plt)

Normal Range: 150-450 x 10³/microliter
15. Mean Platelet Volume (MPV)

No normal value range because this test evaluates the average size of the platelets.

16. Platelet Distribution Width (PDW)

No normal value range because this test evaluates the uniformity in size of platelets.

**Note that there arent specific names for low or high values of the subsections to the RBCs, WBCs, and platelets, because they "subgroups" are all the types of blood cells of their category. Thus, the names reflect those to their category of blood cell they are to.

Week 10 Blog #2

Blog #2:
Week 10 March 7-13

Sunday, March 13, 2016
2p-10p 8 Hours Interned

Objective #2:
2. Will verbally demonstrate knowledge of tests included in a CMP and CBC/diff including abnormalities, what disease process they might indicate and possible signs and symptoms that a patient might demonstrate given these values.

So as indicated in my last post, a CBC has 3 main blood types being evaluated. Red blood cells, white blood cells, and platelets. But of those 3 categories, there are subdivisions that are evaluated, resulting in a total of 16 components to be evaluated. Below is a brief description of each of these components.

Red Blood Cells
- The cells that transport oxygen throughout the body
- Red Blood Cell Count is the total number of red blood cells in a person's sample of blood.
1. Hemoglobin (Hb) - Measures the total amount of the oxygen-carrying protein in the blood, which generally reflects the number of red blood cells in the blood.
2. Hematocrit (Hct) - measures the percentage of a person's total blood volume that consists of red blood cells.
3. Mean Corpuscular Volume (MCV) - A measurement of the average size of the red blood cell.
4. Mean Corpuscular Hemoglobin (MCH) - A calculation of the average amount of hemoglobin inside a red blood cell. 
5. Mean Corpuscular Hemoglobin Concentration (MCHC) - A calculation of the average concentration of hemoglobin inside a single red blood cell.
6. Red Blood Cell Distribution Width (RDW) - A calculation of the variation in the size of red blood cells.
7. Reticulocytes (not always done, but will still talk about it) - A measurement of the absolute count or percentage of young red blood cells in the blood.

White Blood Cells
- The cells that are part of the body's defense system against infections and cancer. Play a role in allergies and inflammation.
- White Blood Cell Count is the total number of white blood cells in a person's sample of blood.
8. White Blood Cell Differential (Diff) - May or may not be included as part of the panel or test. But if is, identifies and counts the number of various types of white blood cells present. There are 5 subtypes: neutrophils, lymphocytes, monocytes, eosinophils, and basophils.
9. Absolute Neutrophil Count (Neu, PMN, polys) - A measurement of the amount of neutrophils in the blood.
10. Absolute Lymphocyte Count (Lymph) - A measurement of lymphocytes in the blood.
11. Absolute Monocyte Count (Mono) - A number of monocytes in the blood.
12. Absolute Eosinophil Count (Eos) - A number of eosinophils in the blood.
13. Absolute Basophil Count (Baso) - A number of basophils in the blood.

** Keep in mind the functions of white blood cells. They are activated during innate and adaptive immunity or primarily when an infection occurs. An increased value of any WBC indicates some type of pathogenic invasion. Each of the WBC's listed above will be present when an infection is present, and which one is more numerous, can help indicate the type of infection.

Platelets
- Cell fragments that are vital for normal blood clotting.
14. Platelet Count (Plt) - The number of platelets in a person's sample of blood.
15. Mean Platelet Volume (MPV) - May be reported with a CBC. The calculation of the average size of platelets.
16. Platelet Distribution Width (PDW, not always reported, but will still talk about) - May be reported with a CBC. Reflects how uniform platelets are in size.

I will explain later what the normal range of these values are, abnormal values, the disease process that may be related to the abnormal value, and possibly signs and symptoms an individual would show related to the abnormal values.