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Full Blood Count (FBC) (RBCs (MCV = Mean Corpuscle Volume (MCV = Hct/RBC)…

- - - - non-hemolytic causes
        
        CDA and malignancies
        
        acute bleeding and trauma
      - hemolytic causes
    - - megaloblastic
        
        folate deficiency
        
        B12 = cobalamin deficiency
      - normoblastic
        
        pregnancy*
        
        very common
        
        hypohyroidism
        
        alcohol/liver disease
    - - iron deficiency anemia
        
        Further Blood Tests:
        
        serum ferritin
        
        CRP
        
        TIBC = total iron binding capacity
      - ACD = Anemia of chronic disease
        
        Fam Hx
        
        CRP
      - Thalassemia
        
        inherited genetic disorder, abnormally folded globin proteins
        
        most common among people of Italian, Greek, Middle Eastern, South Asian, and African descent
      - less common causes:
        
        sideroblastic anemia (inherited genetic)
        
        lead poisoning
  - - - Look at MCV:
        
        anemia type depends on mean volume of RBC's
        --> microcyctic
        --> normocytic
        --> macrocytic
    - - primary causes
        
        Polycythemia Rubra Vera (Poly RV)
      - secondary causes
        *these are most common
        cause of polycythemia
        
        spurious (apparent)
        
        dehydration, etc.
        
        look at Hct = PCV
        
        hypoxia*
        
        COPD, smoking, cyanotic heart disease, etc.
        
        excess EPO (erythropoetin)
- - - - Infection
        
        bacterial
        
        viral
        
        parasitic
      - malignancy
        
        leukemia
        
        lymphoma
    - - not producing enough WCC
        
        bone marrow failure
        
        drugs
        
        infiltration of bone marrow
        
        fibrosis
      - WCC are being destroyed
        
        Viral Infections
        
        HIV* --> very common cause
  - - - high eosinophils
        
        allergic reactions/atopic
        
        asthma
        
        vasculitis
      - low --> note that for basophils and eosinophils it is normal to have as low as 0
    - - high basophils
        
        parasitic infections
      - low --> note that for basophils and eosinophils it is normal to have as low as 0
    - - high = lymphocytosis
        
        Viral Infections*
        
        EBV
        
        leukemia
      - low = lymphocytopenia
        
        steroids (exogenous usually)
        
        autoimmune disease
    - - high = neutrophilia
        
        Bacterial infection *
        
        Stress
        
        trauma
        
        infection
        
        surgery
        
        malignancy
        
        drugs
      - low = neutropenia
        
        Viral infection*
        
        chemotherapy drugs
        
        Splenomegaly*
        
        note that both neutrophils and monocytes are stored in the spleen and released on mass when needed
        
        malignancy
- - - - Polycythemia Rubra Vera
    - - Stress
        
        infection
        
        inflammation
        
        hemorrhage
      - malignancy
        
        reason why cancers have a tendency to thrombose
      - post splenectomy
        
        released from the spleen during its removal
  - - - splenomegaly
    - - Viral infection
      - B12/folate deficiency
      - bone marrow infiltration failure
    - - immune-mediated
        
        rheumatoid disease
        
        ITP
        
        drug-induced thrombocytopenia
      - non-immune mediated
        
        TTP
        
        DIC
        
        Prosthetic heart valves