cbc interpretation and cases

Complete Blood Count

1. Tanveer Tara , Lecturer IBS Sarhad University 1

2. What Is a Complete Blood Count? A  complete blood count  (CBC) is a test that measures the cells that make up your  blood : red  blood cells , white blood cells, and platelets. You might get a CBC as part of your yearly check-up. Your doctor might also order it to: It’ll also depend on you age, sex, and how high above sea level you live. Tanveer Tara , Lecturer IBS Sarhad University 2

3. Sign and symptoms Check for  anemia  ,Leucocytosis , leukemia   weakness , fever, bruising, or feeling tired Keep an eye on a blood condition you already have See how  medications  or treatments like  chemotherapy  are affecting your blood If the CBC is the only blood test you’re getting that day, you can eat or drink like you normally would. Tanveer Tara , Lecturer IBS Sarhad University 3

4. How Is a CBC Done? It’s pretty simple and takes just a few minutes. A nurse or lab tech /Phlebotomist will take a sample of blood by inserting a needle into a vein in your arm. She’ll send it to the lab for review. You can leave and get right back to your normal routine Tanveer Tara , Lecturer IBS Sarhad University 4

5. White blood cells (WBCs) . These help to fight infections. If you have high WBC levels, it tells your doctor you have  inflammation  or infection somewhere in your body. If it’s low, you could be at risk for infection. The normal range is 4,500 to 10,000 cells per microliter (cells/ mcL ). (A microliter is a very tiny amount – one millionth of a liter). Tanveer Tara , Lecturer IBS Sarhad University 5

6. RBC (red blood cell count). This is the number of red blood cells you have. These are important because they carry oxygen through your body. They also help filter  carbon dioxide . If your RBC count is too low, you may have  anemia  or another condition. (If you have anemia, your blood has fewer red blood cells than normal.) The normal range for men is 5 million to 6 million cells/ mcL ; for women it’s 4 million to 5 million cells/ mcL . Tanveer Tara , Lecturer IBS Sarhad University 6

7. Hemoglobin (Hb or Hbg ).  This is the protein in your blood that holds the oxygen. The normal range for men is 14 to 17 grams per deciliter (gm/dL); for women it’s 12 to 15 gm/dL. Hematocrit (Hct ).  How much of your blood is red blood cells. A high score could mean you’re dehydrated or have another condition. The normal range for men is between 41% and 50%. For women the range is between 36% and 44%. Tanveer Tara , Lecturer IBS Sarhad University 7

8. MCV Mean corpuscular volume HCT/RBC count= 80-100fL Small = microcytic normal = normocytic Large = macrocytic Tanveer Tara , Lecturer IBS Sarhad University 8

9. MCH The amount of hemoglobin per RBC. That’s what MCH  HB/RBC X10= 27-32 pg. Tanveer Tara , Lecturer IBS Sarhad University 9

10. MCHC Mean corpuscular hemoglobin concentration HB/HCT X 100 : 26-34% Decreased :Hypochromic Normal :Normochromic Tanveer Tara , Lecturer IBS Sarhad University 10

11. Platelets.  These play a role in clotting. This test measures the number of platelets in your blood. The normal range is 140,000 to 450,000 cells/ mcL MPV (mean platelet volume).  The size of the platelets in your blood. A  typical range  of platelet volumes is 9.4–12.3 fl (femtolitre), equivalent to spheres 2.65 to 2.9 µm in diameter. PDW (platelet distribution width).  How much your platelets vary in size. Tanveer Tara , Lecturer IBS Sarhad University 11

12. RDW (red cell distribution width).  How your much your red blood cells vary in size. Red blood cell distribution width ( RDW  or  RDW - CV  or RCDW and  RDW -SD) is a measure of the range of variation of red blood cell (RBC) volume that is reported as part of a standard complete blood count. Usually red blood cells are a standard size of about 6-8 μm in diameter. Higher RDW values indicate greater variation in size Tanveer Tara , Lecturer IBS Sarhad University 12

13. High RDW Iron-deficiency anemia  usually presents with high RDW and low MCV. Folate- and vitamin B12-deficiency anemia usually present with high RDW and high MCV. Mixed-deficiency (iron + B12 or folate) anemia usually presents with high RDW and variable MCV. Recent hemorrhages typically present with high RDW and normal MCV. A false high RDW reading can occur if EDTA anticoagulated blood is used instead of citrated blood. Tanveer Tara , Lecturer IBS Sarhad University 13

14. Tanveer Tara , Lecturer IBS Sarhad University 14

15. This important value is needed in the evaluation of any anemia. Normal range 1-2%  Retic count goes up with Hemolytic anemia Retic goes down with  Nutritional deficiencies _ Diseases of the bone marrow itself The Reticulocyte Count Tanveer Tara , Lecturer IBS Sarhad University 15

16. Reticulocytes Leishman’s Supravital Tanveer Tara , Lecturer IBS Sarhad University 16

17. Tanveer Tara , Lecturer IBS Sarhad University 17

18. Tanveer Tara , Lecturer IBS Sarhad University 18

19. What is corrected reticulocyte count? Tanveer Tara , Lecturer IBS Sarhad University 19

20. Tanveer Tara , Lecturer IBS Sarhad University 20

21. Tanveer Tara , Lecturer IBS Sarhad University 21

22. The Three Basic Measures Measurement Normal Range RBC count 5 million 4 to 6 Hemoglobin 15 g/dl 12 to 17 Hematocrit 45 % 38 to 50 Check whether this holds good in given results If not -indicates micro or macrocytosis or hypochromia. Tanveer Tara , Lecturer IBS Sarhad University 22

23. Normal CBC Tanveer Tara , Lecturer IBS Sarhad University 23

24. Workup – Second Test The next step is ‘What is the size of RBC’ ? MCV indicates the Red cell volume (size) Both the MCH & MCHC tell Hb content of RBC If the Retic count is 2 or less We are dealing with either Hypoproliferative anaemia (lack of raw material) Maturation defect with less production Bone marrow suppression (primary/ secondary) Tanveer Tara , Lecturer IBS Sarhad University 24

25. Anaemia Workup - MCV Microcytic MCV Normocytic Macrocytic Iron Deficiency IDA Chronic Infections Thalassemia's Hemoglobinopathies Sideroblastic Anemia Chronic disease Early IDA Hemoglobinopathies Primary marrow disorders Combined deficiencies Increased destruction Megaloblastic anemias Liver disease/alcohol Hemoglobinopathies Metabolic disorders Marrow disorders Increased destruction Tanveer Tara , Lecturer IBS Sarhad University 25

26. Mean Cell Volume (MCV) RBC volume (rather) is measured by The Mean Cell Volume or MCV and RDW Microcytic < 80 fl MCV Normocytic Macrocytic 80 -100 fl > 100 fl Tanveer Tara , Lecturer IBS Sarhad University 26

27. Red cell Distribution Width - RDW Normal Population Uniform RDW High Population Double Tanveer Tara , Lecturer IBS Sarhad University 27

28. IDA -CBC Tanveer Tara , Lecturer IBS Sarhad University 28

29. Microcytic Hypochromic - IDA Tanveer Tara , Lecturer IBS Sarhad University 29

30. Anemia - Macrocytic (MCV > 100) MCV 100-110 fl must look for other causes of macrocytosis MCV > 110 fl almost always folate or B 12 deficiency Tanveer Tara , Lecturer IBS Sarhad University 30

31. MBA Tanveer Tara , Lecturer IBS Sarhad University 31

32. Macrocytosis -MBA Tanveer Tara , Lecturer IBS Sarhad University 32

33. MBA Tanveer Tara , Lecturer IBS Sarhad University 33

34. Tanveer Tara , Lecturer IBS Sarhad University 34