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Clinical pathology: Complete Blood count

Clinical pathology: Complete Blood count. GENERAL OBJECTIVE : After finishing lab activity of CBC, the student will be able to describe the CBC in the DMS case problem SPECIFIC OBJECTIVE : At the end of lab activity of CBC , the student will be able to interprete:

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Clinical pathology: Complete Blood count

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  1. Clinical pathology: Complete Blood count GENERAL OBJECTIVE: After finishing lab activity of CBC, the student will be able to describe the CBC in the DMS case problem SPECIFIC OBJECTIVE: At the end of lab activity of CBC , the student will be able to interprete: - the normal of CBC - the abnormal of CBC

  2. Complete Blood Count (CBC)

  3. Providing important information about the kinds and numbers of RBC, WBC and platelet. • Being part of routine physical examination • Help : • To evaluate symptoms (weakness, fatigue, bruising, fever, or weight loss) • To diagnose conditions (anemia, infection) • To diagnose diseases of the blood (leukemia) • To monitor the response to some types of drug or radiation treatment

  4. CBC usually includes : • WBC count • WBC differential • RBC count • Hematocrit • Hemoglobin • RBC indices (MCV, MCH, MCHC) • Platelet count • Blood smear ** • RDW • ESR

  5. CBC can be performed : • Manually : • Hemocytometer • Calculate from other CBC results (RBC indices) • Automatically (hematologic analyzer)

  6. WBC count • To express WBC concentration per unit volume of blood (mm3). • No distinction is made among the six normal cell types (band neutrophils,segmented neutophils, lymphocytes, monocytes, eosinophils, basophils). • Increase WBC count  leucocytosis • Decrease WBC count  leucopenia

  7. WBC Differential • 5 major kinds of WBC • Immature neutrophil, band neutrophil  include to the test. • Each type of cell plays a different role in protecting the body. • Number of each type  give important information about the immune system. • Expressed as a percentage of each type

  8. Increase/decrease number of each type  help to identify : • infection (neutrophilia, lymphocytosis) • Allergic or toxic reaction to certain medication (eosinophilia) • Malignancy (leukemia)

  9. Hemoglobin • Main component of RBC • Conjugated protein • Serves as a vehicle for the transportation of O2 and CO2. • Gives blood cell its red color • Hemoglobin test measures the amount of hemoglobin in blood. • Decrease  anemia

  10. RBC indices There are 3 RBC indices : • MCV (Mean Corpuscular Volume) • MCH (Mean Corpuscular Hemoglobin) • MCHC (Mean Corpuscular Hemoglobin Concentration). Their values are determined from other measurements noted during CBC

  11. Platelet count • expressed as concentration – platelet cells per unit volume of blood (mm3). • Decrease  thrombocytopenia • Increase  thrombocytosis

  12. RDW • Red Cell Distribution width • Reports whether all the red cells are about the same width, size, and shape. • This helps further classify the types of anemia.

  13. ErythrocyteSedimentation Rate • Measuring the sedimentation of erythrocytes in diluted human plasma over a specified time period (1 hour) • Measuring the distance from the bottom of the surface meniscus to the top of erythrocyte sedimentation in a vertical column containing diluted whole blood. • Not very specific/diagnostic test  still use in many institutions as a screening test for inflammation

  14. Factors affecting ESR • RBC size & shape • Plasma fibrinogen & globulin levels • Mechanical • Technical

  15. Factors affecting the ESR : Increase : • Rouleaux formation • Fibrinogen (elevated) • Immunoglobulin (excess) Decrease : • Microcytes • Sickle cells • Spherocytes

  16. Methods performing ESR : • Manual : • Westergren Method • Wintrobe Method • Automatic

  17. Normal values : Adult men 0-15 mm/h Adult women 0-20 mm/h

  18. Diseases associating with an elevated ESR : 1. Chronic infections(Tb) 2. Multiple Myeloma 3. Cryoglobulinemia 4. Temporal arteritis 5. Inflammatory diseases 6. Pregnancy 7. Anemia • Malignant neoplasms • Paraproteinemias • Macroglobulinemia • Hyperfibrinogenemia • Rheumatoid arthritis • Collagen disease • Polymyalgia rheumatica

  19. Results • Normal value can vary from lab to lab • Normal value for CBC tests varies, depending on age, sex, elevation above sea level, and type of sample.

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