Practical Hematology Lab LAB 1 Introduction The complete blood count CBC is one of the most commonly ordered blood tests The complete blood count is the calculation of the cellular formed elements of blood ID: 249659
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Slide1
Blood CELLS COUNT
Practical Hematology Lab
- LAB 1 -Slide2
Introduction
The complete blood count (CBC) is one of the most commonly ordered blood tests. The
complete blood count is the calculation of the cellular (formed elements) of blood.
These
calculations are generally determined by special machines that analyze the different components of blood in less than a minute.
A major portion of the complete blood count is the measure of the concentration of white blood cells, red blood cells, and platelets in the blood.Slide3
When CBC is ordered
CBC may be ordered when a person has any number of signs and
symptoms that may be related to disorders that affect blood cells.
When
an individual has fatigue or weakness
infection
inflammation
bruising, or
bleeding
a doctor may order a CBC to help diagnose the cause and/or determine its severity
.Slide4
When a person has been diagnosed with a disease known to affect blood cells, a CBC will often be ordered on a regular basis to monitor their condition. Likewise, if someone is receiving treatment for a blood-related disorder, then a CBC may be performed frequently to determine if the treatment is effective.
Some therapies, such as chemotherapy, can affect bone marrow production of cells. Some medications can decrease WBCs count overall. A CBC may be ordered on a regular basis to monitor these drug treatments.Slide5
Parameters of CBC
The complete blood count, or CBC, lists a number of many important values. Typically, it includes the following:White blood cell count (WBC or leukocyte count)
WBC differential count
Red blood cell count (RBC or erythrocyte count)
Hematocrit
(
Hct
)
Hemoglobin (
Hbg
)
Mean corpuscular volume (MCV)
Mean corpuscular hemoglobin (MCH)
Mean corpuscular hemoglobin concentration (MCHC)
Red cell distribution width (RDW)
Platelet count
Mean Platelet Volume (MPV)Slide6
White blood cells count (WBCs)
Evaluation of white blood cells, the cells that are part of the body's defense system against infections and cancer and also play a role in allergies
and inflammation
White blood cell (WBC) count
is a count of the total number of white blood cells in a person's sample of blood.
The normal number of WBCs in the blood is 4,500-11,000 white blood cells per
microliter
(
mcL
).
Neutrophils
40-75% of WBCs.
Lymphocytes
20-45% of WBCs.
Eosinophils
1-6% of WBCs.
Monocytes
2-10% of WBCs.
Basophils
0-1% of WBCs.Slide7
White Blood Cell Differential
May or may not be included as part of the panel of tests. It identifies and counts the number of the various types of white blood cells present. May be done as part of or in follow up to CBC)Slide8
Leukopenia
Caused by :Bone marrow disorders
or damageAutoimmune conditions as rheumatoid arthritis and systemic lupus
erthrymatosus
(SLE)
Severe infections
(sepsis)
Lymphoma
or other cancer that spread to the
bone marrow
Diseases of immune system (
e.g
.,HIV
)Slide9
leukocytosis
Caused by :Infection, most commonly
bacterial
Inflammation
Leukemia,
Myeloprolifrtive
disorders
Allergies, asthma
Tissue death (trauma, burns,
heart attack)
Intense exercise or severe stressSlide10
Erythrocyte count (RBCs)
Evaluation of red blood cells, the cells that transport oxygen throughout the body:Red blood cell (RBC) count
is a count of
the
actual number of red blood cells in a person's sample of blood
.
Normal RBC range is:
Male: 4.7 to 6.1 million cells per
microliter
(cells/
mcL
)
Female: 4.2 to 5.4 million cells/
mcL
Hemoglobin
measures
the amount of the oxygen-carrying protein in the blood
.
normal values:
13.0-18.0 g/
dL
in adult males
11.5-16.5 g/
dL
in adult, non-pregnant females.Slide11
Hematocrit measures the percentage of a person's blood that consists of red blood cells.normal values (
Hct):
0.40-0.52 in adult males 0.36-0.47 in adult females.Slide12
Decrease blood oxygen carrying
components (anemia)Acute
or chronic bleedingRBC destruction (e.g.,
hemolytic anemia,
etc.)
Nutritional deficiency (e.g., iron deficiency, vitamin B12 or
folate
deficiency)
Bone marrow disorders or damage
Chronic inflammatory disease
Kidney failureSlide13
DehydrationLung (pulmonary) disease
Kidney or other tumor that produces excess erythropoietinSmokingGenetic causes (altered oxygen sensing, abnormality in hemoglobin oxygen release)
Polycythemia vera
—a rare
(malignant) disease
Increase blood oxygen carrying components (polycythemia)Slide14
Red Blood Cell Indices
Red blood cell indices are calculations that provide information on the physical characteristics of the RBCs:Mean corpuscular volume
(MCV) is a measurement of the average size of RBCs.
Mean corpuscular hemoglobin
(MCH) is a calculation of the average amount of oxygen-carrying hemoglobin inside a red blood cell.
Mean corpuscular hemoglobin concentration
(MCHC) is a calculation of the average percentage of hemoglobin inside a red cell.
Red cell distribution width
(RDW), which may be included in a CBC, is a calculation of the variation in the size of RBCs
.Slide15
Mean Corpuscular Volume (MCV)
The MCV indicates the average volume of the red blood cells.MCV =
= (fl)
Normal value for the MCV : 80~97
fl
Volume of RBC in
femtoliters
(
fl
) /
μ
l of blood
RBC /
μ
l of blood
Hematocrit
* 10
RBC count in millions
1
μl = 10
9
flSlide16
If the MCV is less than 80 fl, the RBCs are are
smaller than normal (microcytic); caused by
iron deficiency anemia
or
thalassemia
,
for example.
If
the MCV is greater than 97 fl, the RBCs are
larger
than normal (
macrocytic
), for example
in anemia caused by vitamin B 12 or
folate
deficiency.
If
the MCV is within the normal range, the RBCs are
normocytic Slide17
Mean Corpuscular Hemoglobin Concentration (MCHC)
The MCHC is an expression of the average concentration of hemoglobin in the red blood cells. It gives the ratio of the weight of hemoglobin to the volume of the red blood cells.
MCHC =
=
Normal value for the MCHC : 32~36 %
Hemoglobin in g/dl
Hematocrit
/dl
* 100 (to convert to %)
Hemoglobin * 100
Hematocrit
%Slide18
An MCHC below 32% indicates hypochromia
, that may be when MCV is
low which is seen in conditions such as iron deficiency anemia and
thalassemia
.
An MCHC above 36% indicates
hyperchromia
which is
seen in conditions where the hemoglobin is more concentrated inside the red cells, such
as
Autoimmune
hemolytic
anemia
Burn patients
Hereditary
spherocytosis, a rare congenital
disorder.
and
Red blood cells with a normal MCHC are termed
normochromic
.
Please note that an MCHC above 38% should not occur. Slide19
Mean Corpuscular Hemoglobin (MCH)
The MCH indicates the average weight of hemoglobin in the red blood cells.MCH =
=
Normal value for the MCH : 27~31
pg
An MCH lower than 27
pg
is found in microcytic anemia and also with normocytic, hypochromic RBCs.
An elevated MCH occurs in macrocytic anemia and in some cases of spherocytosis in which
hyperchromia
may be present.
Weight of hemoglobin in 1
μ
l of blood
Number of red blood cells in 1
μ
l of blood
Hemoglobin * 10
Red blood cell count in millions
(
pg
)
1 g = 10
12
pg
1 ml = 10
3
μ
lSlide20
Red cell distribution width (RDW)
RDW is an index of the variation of red cell size (volume) in a specimen of blood
RDW=
Size at 80% tile – size
zt
20% tile
Size at 80% tile + size
zt
20% tile
Normal range :
13 ± 1.5 %Slide21
Advantages of having RDW :
1. Recognize RBC abnormality from CBC 2. Assist in differential diagnosis
3. Following the course of a diseaseSlide22
An example of Complete Blood Count (CBC)Slide23
Low value indicates uniformity in size of RBCsHigh value Indicates
mixed population of small and large RBCs; immature RBCs tend to be larger.
For example, in iron deficiency anemia or pernicious anemia, there is high variation (
anisocytosis
) in RBC size Slide24
Plateletes
Platelets, also called "
thrombocytes", are blood cells whose function (along with the coagulation factors) is to stop bleeding.
Platelets have no nucleus: they are fragments of cytoplasm which are derived from the
megakaryocyte
of the bone marrow, and then enter the circulation.
On a stained blood smear, platelets appear as dark purple spots, about 20% the diameter of red blood cells. The smear is used to examine platelets for size, shape, qualitative number, and clumping. The ratio of platelets to red blood cells in a healthy adult is 1:10 to 1:20.Slide25
Low platelet concentration is thrombocytopenia and is due to either
decreased production or increased destruction. Elevated platelet concentration is
thrombocytosis and is either
congenital
,
reactive
(to cytokines), or due to
unregulated production
: one of the
myeloprolerative
neoplasms
or certain other myeloid
neoplasms
. A disorder of platelet function is a
thrombocytopathy
.
Platelet concentration is measured either manually using a
hemacytometer
, or by placing blood in an automated platelet analyzer using electrical impedance, such as a coulter counter.
The normal range for platelets in healthy Caucasians is 150,000 to 400,000 per cubic millimeterSlide26
Increased Platelete Count
Known
as thrombocytosis
caused by :
Cancer
(lung, gastrointestinal,
breast, ovarian,
lymphoma)
Rheumatoid arthritis, inflammatory bowel disease, lupus
Iron deficiency anemia
Hemolytic anemia
Myeloproliferative
disorder (e.g., essential
thrombocythemia
)Slide27
Decreased Platelete Count
Known as thrombocytopenia caused by:
Viral
infection (
mononucleosis
,
measles
, hepatitis)
Rocky mountain spotted fever
Platelet autoantibody
Drugs (acetaminophen, quinidine, sulfa drugs)
Cirrhosis
Autoimmune disorders
Sepsis
Leukemia, lymphoma
Myelodysplasia
Chemo or radiation therapy