 Welcome to nursing school explain and this video on anemia labs or as they are also called red blood cell indices So usually when we're dealing with anemia It's detected on a simple CBC complete blood count Where the hemoglobin hematocrit as well as the red cells are low and this is just on a basic CBC So now if that's occurring then we have to look a little bit further into what could be causing this anemia Now keep in mind if this is somebody who had the GI bleed then it's pretty obvious that this is a acute blood loss But if this is more something chronic then we have to look into it a little bit in more detail to see what the underlying Cost could be and these red blood blood red blood cell indices help us determine that So if we have here on a CBC red blood cells and hemoglobin and hematocrit when we're dealing with anemia These are going to be low and remember that hemoglobin concentration is is a molecule that's attached to the red blood cells So if red blood cells are low hemoglobin is low going to be low and hematocrit is going to be low as well and Just know that the hematocrit concentration is usually about three times as much as the hemoglobin So let's say hemoglobin is 10 hematocrit would typically be around 30% And then we also have reticular sites so reticular sites are immature red blood cells Produced by the bone marrow and I have a separate video that goes into erythropoiesis How red blood cells are generated but these reticular sites tell us if there are too many Circulating in the bloodstream that tells us that there is something going on either that we've lost a lot of blood or That now the body is producing too many of these blood cells and there might be something Underlying going on with the bone marrow So reticular sites are these immature blood cells that we need to take a look at if the red blood cells and hemoglobin hematocrit are low And then we have all these M values right here and I'll go into those in detail. So MCV means mean corpuscular volume and think about corpuscle like a cell and Mean corpuscular volume refers to the size of the red blood cell. So if the red blood cell has a normal size That's like this and then it's smaller. It's called Microcytics or small cell size and if it's bigger than usual, it's called Macrocytic meaning a large size in comparison to normal acidic which would fall within the normal limits and then we have mch which is the mean corpuscular Hemoglobin so again the average Hemoglobin that's available on the cell So this is the average amount of hemoglobin in a single RBC cell So how much hemoglobin is available to transport that oxygen? Then we have mchc, which is the mean corpuscular hemoglobin as up here But then now we have the concentration Which again is the average amount of hemoglobin, but by percentage in a single red cell So the concentration here refers to that percentage And so think about that hemoglobin that iron containing hemoglobin gives the cell its color and when we don't have enough of that Concentration or that percentage is low The cell is going to be pale and the word for that is hypochromic so less in color as refer to normal chromic and I don't believe there are any conditions that would ever be hyperchromic and Then we have here the RDW which is the red cell distribution with so that means the the red blood cell size Difference so we know that the red cells are supposed to be a certain diameter now if we have Microsidic or macrosidic cells then they are going to be bigger or smaller and the RDW Which just tells us that that these the size differs from what we are used to seeing or what the normal size of the blood cell should be and usually the RDW that the Size difference will be increased if we have iron deficiency anemia or B12 deficiency anemia and Then so again, this will help us determine the underlying cause now if we get back on our red cell indices that we have Microsidic and hypochromic anemia meaning that the MCV is low and Also, the MCHC is low. We know that we're dealing with iron deficiency anemia iron deficiency causes Hypochromic Microsidic anemia so pale and small blood cells and When we know that this that these two values are abnormal Then we have to do the iron studies and iron studies here Iron deficiency anemia is the most common cause of anemia So, of course, we're going to measure the iron that circulates in the blood Then we're going to measure TIBC, which is the total iron binding Capacity, which just means that how many proteins do we actually have available because even if we have iron available But we don't have the pro the carrier proteins. We're not going to be able to transport the oxygen to the tissues And then we have a word called ferritin and that is sometimes Mistaken for iron. So there's a little bit of a difference here. So the ferritin is the concentration in the blood That's proportional to the stored iron. So that is just how much is available in the blood Versus how much is stored in the in the liver? Or yeah, that's why it's mostly stored. And so this will just tell us a proportion of what is available Now the other studies that we can do here is B12 and folate which are other causes for anemia that these are minerals and vitamins that are required for erythropoiesis for the production of the red blood cells and B12 and folate deficiency cause Macrocytic anemia. So now the cells will be big and so our MCV will be elevated. So when the MCV is elevated We should think of B12 and folate deficiency and measure those two in the blood that way we know which one is the patient deficient of Which treatment do we have to initiate? So I hope that this has helped you kind of understand these lab values a little bit in more detail Remember to always go back to the physiology What's required to produce red blood cells that way, you know What's missing as part of that synthesis to to kind of go through the different steps and figure out What is going on these lab values just help us? Identify certain causes and of course that's always going to be a little bit more investigation needed Please also check out the other videos on the particular types of anemia So more so the iron deficiency, which is the most common type of anemia Thanks for watching nursing school explained. See you soon