hgdال

بسم هللا الرحمن الرحیم

In the name of ALLAH

DIAGRAMATIC REPRESENTATION OF BONE MARROW PLURIPOTENT

PCV or Hematocrit

• 57% Plasma

• 1% Buffy coat – WBC

• 42% RBCs

Blood components

Interpretation of

CBC- complete blood count

Component of the CBC

White Blood Cells (WBCs)

Red Blood Cells (RBCs)

Hemoglobin (Hgb)

Hematocrit (Hct)

Mean Corpuscular Volume (MCV)

mean corpuscular hemoglobin(MCH)

Mean Corpuscular Hemoglobin Concentration (MCHC)

Red cell distribution width (RDW)

Platelet ( PLT )

• RBC (varies with altitude):

M: 4.7 to 6.1 x10^12 /L

F : 4.2 to 5.4 x10^12 /L

In : 4.8 to 7.1 x10^12 /L

• Function: - transport hemoglobin which carries oxygen from the lung to the tissues

-acid –base buffer.

(Hgb/Hb)

M: 14 to 18 g/dL

F : 12 to 16 g/dL

In: 14 to 24 g/dl

5>Hgb>20 Emergency

Hematocrit(HCT /PCV)

It is ratio of the volume of red cell to the volume of

whole blood.

M: 42 to 52 %

F : 37 to 47 %

In: 44 to 64 %

15>Hct>60 Emergency

– MCV = mean corpuscular volume HCT/RBC count = 80-100fL• small = microcytic

• normal = normocytic

• large = macrocytic

– MCHC= mean corpuscular hemoglobin concentration HB/RBC count = 26-34%• decreased = hypochromic

• normal = normochromic

• MCH (mean corpuscular hemoglobin)

HB/HCT = 27-32 pg

• RDW (red cell distribution width)

• It is correlates with the degree of anisocytosis

_ Normal range from 10-15%

ADULT REFERENCES OF RED BLOOD CELLS

_________________________________________________

Male Female_________________________________________________Hemoglobin (g/dl) 14 –18 12 – 16

Hematocrit ; PCV (%) 42 -52 37 – 47

RBC count(X1012/l) 4.5 – 6.2 4– 5.5

Mean Cell Volume 80 -95 80 - 95MCV (fl)

Mean Cell Hemoglobin 27 -34 27 - 34MCH (pg)

Mean Cell Hemoglobin 30 -35 30 -35Concentration(MCHC)

Normal CBC

RBC

Physiological responseHypoxiaPOLYCYTHEMIA VERAAcute dehydration

RBC

AnemiaHemorrhage.

nutritional deficiency Kidney diseaseLeukemia

Anaemia

Hypoproliferative Hemolytic

Retics < 2 Retics > 2

Hb% < 12, Hct < 38%

Anaemia Workup - MCV

Microcytic

MCV

Normocytic Macrocytic

Iron Deficiency -IDA

Chronic Infections

Thalassemias

Sideroblastic Anemia

Chronic disease

Early IDA

Hemoglobinopathies

Primary marrow disorders

Combined deficiencies

Increased destruction

Megaloblastic anemias

Liver disease/alcohol

Metabolic disorders

The causes of a hypochromic microcytic anaemia. These include lack of iron(iron deficiency), or of iron release from macrophages to serum (anaemia ofchronic inflammation or malignancy). Failure of protoporphyrin synthesis(sideroblastic anaemia) or of globin synthesis (Alpha or Beta Thalassaemia).

RDW

Megaloblastic anemias

IDA

Hemoglobinopathies

Hemolotic anemia

Microcytic Hypochromic - IDA

Macrocytosis -MBA

Norms of leukocytes(WBC)

30000<WBC<2500

Emergency

Normal CBC

• Leukocytosis increase WBCs.>11000

• Leukopenia decrease WBCs.<4000

• Granulocytosis neutrophilia

• Granulocytopenia neutropenia<2000/cmm

• Agranulocytosis neutropenia<500/cmm

The type of cell affected depends upon its primary

function:

In bacterial infections, neutrophils are most

commonly affected

In viral infections, lymphocytes are most

commonly affected

In parasitic infections, eosinophils are most

commonly affected.

Abnormal result of WBC

Leukocytosis

_ Infectious diseases

_Inflammatory disease(such as RA &allergy)

_Leukemia

_Severe emotional or physical stress

_Tissue damage (e.g. necrosis,or burns)

Leukopenia:

Decreased WBC production from BM

Irradiation

Exposure to chemical or drugs

Autoimmune disease

Acute infection

• Function: Phagocytosis of bacteria

and cell debris

Neutrophilia

– Conditions associated with :

1-Bacterial infections (most common cause)

2-Tissue destruction

e.g. tissue infarctions, burns.

3- leukemoid reaction

4-Leukemia

Neutropenia

– this may result from:

1-Decreased bone marrow production

e.g. BM hypoplasia.

2-Ineffective bone marrow production

–E.g. megaloblastic anemias and

myelodysplastic syndromes.

3- post acute infection

_ e.g. typhoid fever, brucellosis.

• Function: Involved in allergy

, parasitic infections

Eosinophilia

may be found in

• Parasitic infections

• Allergic conditions and hypersensitivity

reaction

Basophilia.

Most uncommon

Seen in systemic hypersensitivity.

• T cells: cellular

(for viral infections)

• B cells: humoral(antibody)

• Natural Killer Cells

Lymphocytosis

_ Viral infection

e.g. Infectious mononucleosis, CMV or pertussis.

_ Bacterial infection

e.g. TB

Lymphopenia

_Stress

_Steroid therapy

_ Irradiation & immunodeficincy disease

•Normal range; 150-400x10^3 /mm3

•Destroyed by macrophage cells in

the spleen.

•Function; involved in coagulation and

blood haemostasis.

50000 >PLT>1x10^6 Emergency

Thrombocytosis• Exercise.

• High attitudes.

• Splenectomy

• RA

Thrombocytopenia• Hypersplenism

• Haemorrhage.

• Bone marrow destruction or suppression e.g. Leukemia

• DIC

• Anemia

• Petechial hemorhage.

• Easy bruising.

• Mucosal bleeding

e.g. _ epistaxes.

_ gum bleeding

PANCYTOPENIA

1. Aplastic Anaemia

2. Megloblastic Anaemia

3. Bone marrow infiltration by leukaemias, lymphomas, multiple myeloma etc.

4. Myelofibrosis

5. Hypersplenism( peripheral blood pancytopenia with normocellular or hypercellular marrow and splenomegaly)

Case 1

Case 2

Any Question ?

Tnx4 yrattention

Be happy