Normal Red Blood Cells

Normal Red Blood Cells --Normal

RBC Underproduction (eg. anemia)

Anemia --Microcytic (MCV <80) ----DDx: (Mneumonic "TICS") ------T: Thalassemia ------I: Iron Deficiency ------C: Chronic Disease anemia (sometimes) ------S: Sideroblastic anemia (e.g. Pb poisonin, etc.) --Normocytic (MCV 80-100) ----DDx: ------Acute Blood Loss ------Sickle Cell Anemia ------Hemolytic Anemia ------Anemia of Chronic Disease (AKA Chronic Disease Anemia) ------Myelodysplastic Syndrome (sometimes) --Macrocytic (MCV >100) ----DDx: ------B12 Deficiency ------Folate Deficiency ------Drug-induced (e.g. Methotrexate, etc.) ------Liver Disease ------Myelodysplastic Syndrome ------Marked Reticulocytosis

Red Blood Cell Overproduction

Red Blood Cell Overproduction --Overproduction

Normal Adult Hemoglobin

Normal Adult Hemoglobin --Predominantly HgbA (2 alpha globins , 2 beta globins) ----Normally ~ 97% ----Alpha Globin ------4 genes (2 per haploid chromosome) ----Beta Globin ------2 genes (1 per haploid chromosome) ------Decreased in or abnormal Globin chains --Small amount of HgbA2 (2 alpha globins, 2 delta globins) ----Normally ~ 2% --Extremely small amount of HgbF (2 alpha globins, 2 gamma globins) ----Normally Up to 1% --Hemoglobin A1C (Glycated Hemoglobin)

Thalassemias

Thalassemias (Decreased or absence of one of the hemoglobin chains, most commonly alpha or beta chain). Even though hemoglobin may be decreased, they are functionally normal. --Alpha (Alpha decreased): Alpha Thalassemia ----1 gene muatated ------AKA "Silent Carrier" ------No Anemia nor microcytosis ------Normal Electropheresis ----2 genes mutated ------AKA "Alpha trait" ------Microcytosis & Anemia present ------Normal Electropheresis ----3 genes mutated ------AKA "Hemoglobin H" ------Excess Beta chains form tetramers ------Microcytosis & Anemia present ------Abnormal Electropheresis ----4 genes mutated ------Hydrops Fetalis (Lethal) --Beta (Beta decreased): Beta Thalassemia ----2 genes mutated ------AKA "Beta Thal." ------Abnormal electropheresis ------Mostly HgbF ----1 gene mutated ------AKA "Beta trait" ------Abnormal electropheresis ------Increase in HgbA2 (3% to 6%) ------Must test in absence of Fe def. --------Fe def. may lower HgbA2 --------Need Normal serum Ferritin ------May also have slight increase in HgbF

Hemoglobinopathies (Abnormal Hemoglobins)

Hemoglobinopathies As oppose to thalassemia, hemoglobin chains are not decreased or absent but rather abnormal. --HbS (Sickle cell) ----Mutation in Beta chain resulting in change from hydrophilic residue (Glutamate) to Hydrophobic residue (Valine) ------Sickle cell disease ------Sickle cell trait ----Mutation in Beta chain resulting in change from hydrophilic residue (Glutamate) to another Hydrophilic residue (Lysine) ------HbC ------HbE

Red Blood Cell Enzyme Deficiencies and Metabolic Disorders

Red Blood Cell Enzyme Deficiencies and Metabolic Disorders --Topics

Normal White Blood Cells

Normal White Blood Cells --Topics

Disorders of Granulocytes

Disorders of Granulocytes --Topics

Disorders of Monocytes

Disorders of Monocytes --Topics

Disorders of Lymphocytes

Disorders of Lymphocytes --Topics

Normal Hemostasis

Normal Hemostasis --Topics

Platelet/Platelet-like Disorders

Platelet/Platelet-like Disorders --Topics

Coagulation Disorders

Coagulation Disorders --Topics

Thrombotic Disorders

Thrombotic Disorders --Topics