Corrected Reticulocyte count

[RedSoxSuck]

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Has anyone come across a question in uworld , nbme or step 1 in which you had to correct the Reticulocyte count? I haven't seen any question.

 

[Phloston]

Could you please be more specific?

 

[RedSoxSuck]

Could you please be more specific?

So in pathoma and in Goljan, they talked about how in normocytic anemias you need to determine the cause of hemolysis (peripheral destruction or problem with bone marrow that it not producing RBC). So Reticulocyte count (RC) is needed to determine the cause of hemolysis.

It says in pathoma that RC is falsely elevated in anemia so it needs to be corrected. So if question says polychromasia then you need to take RC and correct it by : RC (HCT/45) = corrected RC. And if corrected RC is >3% then no problem with bone marrow but if it's less than problem with bone marrow.

So I have neve seen a question in which i had to do the above. I'm guessing you haven't either.

 

[thehundredthone]

Actually the first correction is for the fall in Hct, not polychromasia.
Corrected Retics = Retics x Hct/45

Then, if polychromasia exists, you divide by the corrected retics further by 2.

 

[AnthrMedStdnt]

I personally have not come across this question, but I left 100 unanswered questions in UWorld so maybe it was there?

 

[LuckiestOne]

I haven't seen one yet

 

[Phloston]

In ~12,000 practice questions so far, I haven't encountered that. So I'd say that topic/calculation is exceedingly low-yield.

However I have not done UWorld yet, so of course it could always be there.

 

[Kaputt]

I never needed to do the correction in UWorld. Often, they give you the absolute reticulocyte count which accomplishes the same thing as a corrected reticulocyte count.

 

[Phloston]

Totally random:

Can one of you guys remind me what the mechanism is behind why beta-blockers can increase aqueous humor secretion?

Contraction of the ciliary muscle is M3 and is unrelated, and beta-receptors aren't involved in mydriasis (as far as I'm aware).

 

[deleted103644]

I never needed to do the correction in UWorld. Often, they give you the absolute reticulocyte count which accomplishes the same thing as a corrected reticulocyte count.

No it doesn't.

Corrected reticulocyte count is accounting for the body's response to anemia, which is to produce more RBCs (among other things).

Your absolute reticulocyte count should be higher when anemic than normal if your body is responding correctly.

You can also have a high reticulocyte count and still be producing insufficient new cells (eg mixed anemia) which is why the corrected count matters.

 

[Kaputt]

No it doesn't.

Corrected reticulocyte count is accounting for the body's response to anemia, which is to produce more RBCs (among other things).

Your absolute reticulocyte count should be higher when anemic than normal if your body is responding correctly.

You can also have a high reticulocyte count and still be producing insufficient new cells (eg mixed anemia) which is why the corrected count matters.

Ahh, interesting. Thanks for that. 👍

 

[exudate]

Totally random:

Can one of you guys remind me what the mechanism is behind why beta-blockers can increase aqueous humor secretion?

Contraction of the ciliary muscle is M3 and is unrelated, and beta-receptors aren't involved in mydriasis (as far as I'm aware).

Did you mean why beta-blockers *decrease* aqueous humor secretion? If so, its because the ciliary process has beta-1 receptors. Stimulation of beta-1 receptors at the ciliary process will produce aqueous humor. So using beta-blockers will decrease production of aqueous humor, that's why beta-blockers are one of the 5 classes of drugs used to treat glaucoma.

 

[Phloston]

Yeah, sorry about that.

I've actually just started UWorld and that was, funny enough, one of the FIRST questions I encountered.

Beta-blockers act on ciliary epithelium to decrease secretion. Azetazolamide also decreases secretion here as well.

I appreciate the response.

 

[Ivancica]

No it doesn't.

Corrected reticulocyte count is accounting for the body's response to anemia, which is to produce more RBCs (among other things).

Your absolute reticulocyte count should be higher when anemic than normal if your body is responding correctly.

You can also have a high reticulocyte count and still be producing insufficient new cells (eg mixed anemia) which is why the corrected count matters.

 

[Ivancica]

Please, could you explain this more detailed. I thought that "ARC" and "corrected reticulocyte count" indicate the same thing? If occur insufficient production of red blood cells then "ARC" will be on the low level, and this will indicate the insufficient production. Am I right or? Thank you in advance.

 

[Ivancica]

Please, could you explain this more detailed. I thought that "ARC" and "corrected reticulocyte count" indicate the same thing? If occur insufficient production of red blood cells then "ARC" will be on the low level, and this will indicate the insufficient production. Am I right or? Thank you in advance.

 

[Ivancica]

No it doesn't.

Corrected reticulocyte count is accounting for the body's response to anemia, which is to produce more RBCs (among other things).

Your absolute reticulocyte count should be higher when anemic than normal if your body is responding correctly.

You can also have a high reticulocyte count and still be producing insufficient new cells (eg mixed anemia) which is why the corrected count matters.

Please, could you explain this more detailed. I thought that "ARC" and "corrected reticulocyte count" indicate the same thing? If occur insufficient production of red blood cells then "ARC" will be on the low level, and this will indicate the insufficient production. Am I right or? Thank you in advance.

 

[Ivancica]

In hospital where I work, from visual examination of a peripheral blood film, the number of reticulocytes among 1000 erythrocytes is found and expressed as counted number per 10-3/l. For example, if they found 5 reticulocytes among 1000 erythrocytes, they would express that as 5x10-3/l.

How is that possible?

Thank you very much!

 

[Ivancica]

Sorry for multiple post! 🙁

 

[aspiringmd1015]

random but with acetazolamide, it decreases the IOP bc of overall diuretic effect right? theres no carbonic anhydrase activity within the anterior chamber of the eye is there?

 

[FalconSlice]

random but with acetazolamide, it decreases the IOP bc of overall diuretic effect right? theres no carbonic anhydrase activity within the anterior chamber of the eye is there?

I believe there actually is a carbonic anhydrase rxn in the ciliary epithelium that acetazolamide inhibits leading to less humor production.

 

[Focused1]

Has anyone come across a question in uworld , nbme or step 1 in which you had to correct the Reticulocyte count? I haven't seen any question.

What is the appropriate retic count number we should use ?

GOLJAN: Corrected retic count + additional correction ?

OR

FC: corrected absolute reticulocyte count and reticulocyte production index (RPI) ?

 

[abolt18]

Has anyone come across a question in uworld , nbme or step 1 in which you had to correct the Reticulocyte count? I haven't seen any question.

I had a practice test (COMSAE A I believe) where one question gave you labs and you had to determine the cause of a patient's anemia. Correcting the RC was the only way to completely rule out aplastic anemia based on the data and hx given. So i've seen one use for it, one time.