These lab videos with case studies are amazing! I am 3/4 through NP school and these videos are the best resource I have found. I feel like I am so ahead of the game now, thank you!
Hello, I work in a Heme/Onc group and see all new Heme patients. Thank you so much for this video. I love nursing as we learn something new everyday. I have cheat sheets for new heme patients.. Leukocytosis workups for me include the four S's...Smoker? Steroids? Severe Stress? Of course any recent infection? (if >3 infections per season, I check an IgG with subclasses to r/o hypogammaglobulinemia). Also iron deficiency can cause mildly elevated WBC this so we check iron panel and ferritin. If any lymphocytes are present on the diff (#, not %) then my doc prefers FLOW cytometry + BCR-ABL. If WBC high with high platelets, then he wants a JAK2 mutation drawn (even if knowledge of asplenia). I also ask the "fever, chills, weakness, weight loss, loss of appetite or drenching night sweats (which happens with lymphomas, so add an LDH to the pile). If it appears to be a mild cause, chronic smoker etc...establish a trend of CBC monthly x 3 and order a smear as well. Our hospital asks for smear first before any FLOW or BCR-ABL for financial queries but the smear can lead directionally if pathology sees blasts or anything else that's crazy. No need to order a smear though if you are ordering a FLOW because it is redundant. Just my two cents to help add info!
I have limited experience with heme/onc so I very much appreciate your step/step analysis. Your video content and delivery is great! Would you be able to do one on renal disease? Ie when to refer, what to do/look for with rising bun/cr, analyzing microalbumin, etc. Appreciate you for time, expertise and love for new grads!!
Absolutely! You're so welcome and thanks so much for those kind words! Renal is a HUGE topic but I will definitely work on narrowing it down for a video. Also, I'll be doing an overview of all the main labs in primary care in the Lab Interpretation Crash Course that will be released in a few weeks, so stay tuned!
Very helpful! I have a pretty good relationship with local heme/onc but tbh I have had conversations even with the RN's that work there. I work in a collaborative state and my collab physician is quick to refer. Of course I have done that in appropriate situations but have never before ordered flow cytometry. It seems obvious this could save some times when patients gets over to heme/oncology so I'll definitely consider this test in the future. Thanks for your lead on this!
Absolutely!! And totally up to your comfort level. I'd let the patient know myself that I was ordering it for their expert interpretation and wouldn't necessarily have results to share until they got to their appointment (to decrease patient anxiety).
Thank you so much for this video. I'm currently an RN, and I'm thinking about pursing the NP field. Videos like this help me a ton because I'm able to see indirectly what you guys deal with on a daily basis. This helps me understand do I like this kind of problem solving, and if its something I want to pursue in the long term. Could you possible make a video about why you wanted to become an NP?
Thank you for the information! Question, can excessive Cold Plunges (3 days/week @ 6 minutes per plunge) cause elevated WBC? How about Sauna's (4 days/week @ 20 minutes per sauna)?
It sounds like there isn't enough evidence to definitively support that - been some research supporting that it can elevate WBCs but others that haven't. I'd rule out other conditions before concluding that was the cause.
Great information, and very informative. Thank you for providing this. Would it be possible to speak slower? Some of the information is review, some of it is new information. Thank you!
Hey! Great question, unfortunately I can't comment on that here, but I do lab reviews inside the Lab Interpretation Crash Course if you'd like to join us! www.realworldnp.com/labs
I am sorry, but for legal and safety reasons I can't advise on your personal case. I always suggest you speak to your primary care provider since they know your history.
Could something like Rheumatoid arthritis affect wbc's, specifically ( Lymphocytes)? Currently seeing a Hematologist and he even seems perplexed with the causation.
For legal and safety reasons, I don't comment on specific cases since I don't know your history and you aren't my patient. I am sorry I can't advise - I always refer people back to their primary care provider.
I had a UTI in my first month of pregnancy I took antibiotics and thought it was gone my first tests showed high neutrophils and low lymphocytes during the uti , 3 months later at 18 weeks pregnant I did another round of testing and now it show high white blood cell count but no infection the doctor kind of scared me and now I’m in panic mode not sure what is happening . Is it dangerous ?
Hi Rana - I am really sorry, but for legal and safety reasons I can't advise on your personal case. I always suggest you refer to your primary care provider who knows your history. Good luck!
These lab videos with case studies are amazing! I am 3/4 through NP school and these videos are the best resource I have found. I feel like I am so ahead of the game now, thank you!
Shelby that's amazing! I'm so, so glad to hear that. You're welcome!
Hello, I work in a Heme/Onc group and see all new Heme patients. Thank you so much for this video. I love nursing as we learn something new everyday. I have cheat sheets for new heme patients.. Leukocytosis workups for me include the four S's...Smoker? Steroids? Severe Stress? Of course any recent infection? (if >3 infections per season, I check an IgG with subclasses to r/o hypogammaglobulinemia). Also iron deficiency can cause mildly elevated WBC this so we check iron panel and ferritin. If any lymphocytes are present on the diff (#, not %) then my doc prefers FLOW cytometry + BCR-ABL. If WBC high with high platelets, then he wants a JAK2 mutation drawn (even if knowledge of asplenia). I also ask the "fever, chills, weakness, weight loss, loss of appetite or drenching night sweats (which happens with lymphomas, so add an LDH to the pile).
If it appears to be a mild cause, chronic smoker etc...establish a trend of CBC monthly x 3 and order a smear as well. Our hospital asks for smear first before any FLOW or BCR-ABL for financial queries but the smear can lead directionally if pathology sees blasts or anything else that's crazy. No need to order a smear though if you are ordering a FLOW because it is redundant.
Just my two cents to help add info!
Oh I love this!! Thank you so much!
I have limited experience with heme/onc so I very much appreciate your step/step analysis. Your video content and delivery is great! Would you be able to do one on renal disease? Ie when to refer, what to do/look for with rising bun/cr, analyzing microalbumin, etc. Appreciate you for time, expertise and love for new grads!!
Absolutely! You're so welcome and thanks so much for those kind words! Renal is a HUGE topic but I will definitely work on narrowing it down for a video. Also, I'll be doing an overview of all the main labs in primary care in the Lab Interpretation Crash Course that will be released in a few weeks, so stay tuned!
Very helpful! I have a pretty good relationship with local heme/onc but tbh I have had conversations even with the RN's that work there. I work in a collaborative state and my collab physician is quick to refer. Of course I have done that in appropriate situations but have never before ordered flow cytometry. It seems obvious this could save some times when patients gets over to heme/oncology so I'll definitely consider this test in the future. Thanks for your lead on this!
Absolutely!! And totally up to your comfort level. I'd let the patient know myself that I was ordering it for their expert interpretation and wouldn't necessarily have results to share until they got to their appointment (to decrease patient anxiety).
That was great presentation! Thank you
Glad you enjoyed it!
PNP here. Thanks for the review. Very helpful and clear.
Glad it was helpful!
Thank you so much! Very clear presentation. This really helps me understand my lab results better.
Glad it was helpful!
Thank you so much for this video. I'm currently an RN, and I'm thinking about pursing the NP field. Videos like this help me a ton because I'm able to see indirectly what you guys deal with on a daily basis. This helps me understand do I like this kind of problem solving, and if its something I want to pursue in the long term.
Could you possible make a video about why you wanted to become an NP?
Awesome!! Absolutely! I'm planning on doing a "day in the life" video at some point so hopefully that will help, too!
You’re a god-send! Thank you for these videos :)
Oh my gosh, thank you so much! It is most appreciated!
Thank you for the information! Question, can excessive Cold Plunges (3 days/week @ 6 minutes per plunge) cause elevated WBC? How about Sauna's (4 days/week @ 20 minutes per sauna)?
It sounds like there isn't enough evidence to definitively support that - been some research supporting that it can elevate WBCs but others that haven't. I'd rule out other conditions before concluding that was the cause.
Thank you for this.
You are so welcome!
Great video! Thx for sharing
Thanks for watching!
Great information, and very informative. Thank you for providing this. Would it be possible to speak slower? Some of the information is review, some of it is new information. Thank you!
If you click the wrench under the video you can adjust the playback speed to your preference. Hope this helps.
I did do that
Thanks great information
My pleasure
Thank you!
You're welcome!
Do kidney stones elevate lymphocytes? I read something like that and didn't understand how that would happen.
If the kidney stones are causing an obstruction and therefore and inflammatory response.
What is your opinion of high WBC and RBC both with immature cells?
Hey! Great question, unfortunately I can't comment on that here, but I do lab reviews inside the Lab Interpretation Crash Course if you'd like to join us! www.realworldnp.com/labs
Low white blood cells i have would you explain this to me
Do you have a specific question?
My lymphocytes level is 3.8 now and 20 days ago 2.6 plz tell me dr is normal
I am sorry, but for legal and safety reasons I can't advise on your personal case. I always suggest you speak to your primary care provider since they know your history.
Can dental issues cause elevated wbc?
Yes it could especially if a patient has very poor dentition and/or and abscess.
Could something like Rheumatoid arthritis affect wbc's, specifically ( Lymphocytes)? Currently seeing a Hematologist and he even seems perplexed with the causation.
For legal and safety reasons, I don't comment on specific cases since I don't know your history and you aren't my patient. I am sorry I can't advise - I always refer people back to their primary care provider.
I had a UTI in my first month of pregnancy I took antibiotics and thought it was gone my first tests showed high neutrophils and low lymphocytes during the uti , 3 months later at 18 weeks pregnant I did another round of testing and now it show high white blood cell count but no infection the doctor kind of scared me and now I’m in panic mode not sure what is happening . Is it dangerous ?
Hi Rana - I am really sorry, but for legal and safety reasons I can't advise on your personal case. I always suggest you refer to your primary care provider who knows your history. Good luck!
mam my wbc 11.35 any problem please reply me
I am sorry, but for legal and safety reasons I can't advise on this.
I need to slow down playback speed
Click on the gear icon for settings under the video, and select playback speed. You can slow it down. Thanks for watching!