Adrenal gland

Anatomy

  • medulla == inner layer == catecholamines
  • cortex == outer layer   divides into 1. zona glomerulosa == mineralocorticoids 2. zona fasciculata == glucorticoid 3. inner zona reticularis == androgens  

 

Pheochromocytoma = catecholamine producing == VMA,metanephrine,

test metanephrine levels plasma and urine

Source:

Henry’s Clinical Diagnosis and Management by Laboratory Methods 21 edition

p.342

Anemia Classification

IDA ( Iron Deficiency Anemia )

  • 1 ml of RBC == 1 mg of Fe
  • Ferritin ↓– storage Iron along with hemosiderin . This is a complex of ferric salt and apoferritin ,protein . differentiates it from ACD,thallasemia,Sideroblastic
  • transferrin –  transport protein = TIBC ↑
  • characterized by hypochromic, microcytic anemia
  • MCV ↓ , HCT & HgB ↓

Megaloblastic Anemia

  • Macrocytic
  • MCV ↑
  • B12 and Folic deficiency
  • Pernicious Anemia – failure of the gastric mucosa to secrete intrinsic factor  

 

Anemia of Chronic Diseases(ACD)

  • Normocytic,normochromic  although 20 – 50 % would be microcytic hypochromic
  • SI ↓, TIBC normal/↓ ,Ferritin ↑

 

Sideroblastic Anemia

  • Hypochromic, often microcytic mixed with normochromic = dimorphic
  • SI ↑, TIBC ↓, % SAT ↑↑
  • ring sideroblasts” in marrow

 

Blood Loss Anemia

  • Acute – normocytic, normochromic
  • Chronic – microcytic then hypochromic

 

—————————————————————————————————————————–

Macrocytic Anemia(Increased MCV)

normochromic base on the film and by the MCHC

  • Megaloblastic
  • Non-Megaloblastic
Microcytic and Hypochromic Anemias(Decreased MCV and MCH)

MCHC = normal

  • IDA
  • ACD
  • Thallasemia
  • Sideroblastic
Normocytic and Normochromic Anemia(Normal MCV)

check Reticulocyte production index and Bone marrow

DAT

hemolytic anemias

 

SOURCE:

Source:

Henry’s Clinical Diagnosis and Management by Laboratory Methods 21 edition

Chapter 31

RBC Indeces

Here are the formulas for RBC indeces:

  • Mean Cell Volume(MCV)    MCV=Hct x 10 / RBC in millions/ mm3                                         Normal=82-92 femtoliters  or base on clin diag 80 – 96 fL or µm3
  • Mean Cell Hemoglobin(MCH)    MCH=gm Hgb /dL x 10 / RBC in millions/mm3                              Normal=27-32 micromicrograms | clin diag 27.5 – 33.2 pg
  • Mean Cell Hemoglobin Concentration(MCHC)    MCHC=gm Hgb/dL x 100 /Hct %                                                                                        Normal=32-36 % | clin diag 33.4 – 35.5

Typical Red Cell count

Men 4.5 – 5.9 x 10 6 /µL

Female 4.5 – 5.1

Hematocrit

Male  41.5 – 50.4 %

Female  35.9 – 44.6

Hemoglobin

Male 14 – 17.5 g/dL

Female  12.3 – 15.3

Source:

Henry’s Clinical Diagnosis and Management by Laboratory Methods 21 edition

p.460,1414