CBC interpretation

cbc interpretation

by: amin ghorbani ( nurse student )

1. hgd ال بسم الله الرحمن الرحیم In the name of ALLAH

2. DIAGRAMATIC REPRESENTATION OF BONE MARROW PLURIPOTENT

3. PCV or Hematocrit 57% Plasma 1% Buffy coat – WBC 42% RBCs Blood components

4. Interpretation of CBC- complete blood count

5. Results of lab.tests May be affected by Activity Diet Stress Geography medications Time of the day

6. Component of the CBC White Blood Cells ( WBC s) Red Blood Cells ( RBC s) Hemoglobin ( Hgb ) Hematocrit ( Hct ) Mean Corpuscular Volume ( MCV ) mean corpuscular hemoglobin( MCH ) Mean Corpuscular Hemoglobin Concentration ( MCHC ) Red cell distribution width ( RDW ) Platelet ( PLT )

7. RBC 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.

8. ( Hgb / Hb ) M: 14 to 18 g/ dL F : 12 to 16 g/ dL In: 14 to 24 g/dl 5> Hgb >20 Emergency Hemoglobin

9. 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

10. 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 MCV&MCHC

11. 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% MCH & RDW

12. ADULT REFERENCES OF RED BLOOD CELLS _________________________________________________ Male Female _________________________________________________ Hemoglobin (g/dl) 14 –18 12 – 16 Hematocrit ; PCV (%) 42 -52 37 – 47 RBC count(X10 12 /l) 4.5 – 6.2 4– 5.5 Mean Cell Volume 80 -95 80 - 95 MCV (fl) Mean Cell Hemoglobin 27 -34 27 - 34 MCH (pg) Mean Cell Hemoglobin 30 -35 30 -35 Concentration(MCHC)

13. Normal CBC

14. RBC Physiological response Hypoxia POLYCYTHEMIA VERA Acute dehydration RBC Anemia Hemorrhage . nutritional deficiency Kidney disease Leukemia

15. Anaemia Hypoproliferative Hemolytic Retics < 2 Retics > 2 Hb % < 12, Hct < 38%

16. 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

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

18. RDW Megaloblastic anemias IDA Hemoglobinopathies Hemolotic anemia

19. Microcytic Hypochromic - IDA

20. Macrocytosis -MBA

21. Norms of leukocytes(WBC) A :4-11000/mm3 In:9-30000/mm3 30000<WBC<2500 Emergency

22. WBC-Diff neutrophil (60%) lymphocyte(30%) monocyte (6%) Esonopihle (3%) basophil (1%)

23. Normal CBC

24. definitions Leukocytosis increase WBCs.>11000 Leukopenia decrease WBCs.<4000 Granulocytosis neutrophilia Granulocytopenia neutropenia <2000/ cmm Agranulocytosis neutropenia <500/ cmm

25. WBC 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.

26. 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)

27. Leukopenia : Decreased WBC production from BM Irradiation Exposure to chemical or drugs Autoimmune disease Acute infection

28. Function: Phagocytosis of bacteria and cell debris Neutrophil

29. Neutrophilia Conditions associated with : 1-Bacterial infections (most common cause) 2-Tissue destruction e.g. tissue infarctions, burns. 3- leukemoid reaction 4-Leukemia

30. 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.

31. Eosinophil Function: Involved in allergy , parasitic infections

32. Eosinophilia may be found in Parasitic infections Allergic conditions and hypersensitivity reaction

33. Basophilia . Most uncommon Seen in systemic hypersensitivity.

34. T cells: cellular ( for viral infections) B cells: humoral (antibody) Natural Killer Cells Lymphocyte

35. Lymphocytosis _ Viral infection e.g. Infectious mononucleosis, CMV or pertussis . _ Bacterial infection e.g. TB Lymphopenia _Stress _Steroid therapy _ Irradiation & immunodeficincy disease

36. Platelets Nor mal range; 150-400x10^3 /mm3 Destroyed by macrophage cells in the spleen . Function; involved in coagulation and blood haemostasis . 50000 >PLT>1x10^6 Emergency

37.   Thrombocytosis Exercise . High attitudes. Splenectomy RA Thrombocytopenia Hypersplenism Haemorrhage. Bone marrow destruction or suppression e.g. Leukemia DIC Anemia   Platelets

38. Petechial hemorhage . Easy bruising. Mucosal bleeding e.g. _ epistaxes . _ gum bleeding Manifestation of thrombocytopenia

39. PANCYTOPENIA 1. Aplastic Anaemia 2. Megloblastic Anaemia Bone marrow infiltration by leukaemias , lymphomas, multiple myeloma etc. 4. Myelofibrosis 5. Hypersplenism ( peripheral blood pancytopenia with normocellular or hypercellular marrow and splenomegaly )

40. Case 1

41. Case 2

42. Tnx 4 yr attention Be happy