Routine blood tests.pptx

by dr mamta
routine blood investigation

1. ROUTINE BLOOD TESTS DR. Mamta Pankaj Lothe M.D.Pathology

2. COMPONENT OF CBC • Red Blood Cells (RBCs) • Hematocrit ( Hct ) • Hemoglobin (Hb) • Mean Corpuscular Volume (MCV) Mean Corpuscular Haemoglobin (MCH) • Mean Corpuscular Hemoglobin Concentration (MCHC) Red cell distribution width (RDW) • White Blood Cells (WBCs) • Platelet

3. NORMAL CBC

4. NORMAL VALUES Hematocrit = 40 to 54 % Hemoglobin = 13.0 to 18.0 g/L Red Cells = 4.6 to 6.3 x 106 cells / L White Cells = 4.5 to 11 x 103 cells / L Platelets = 150 to 450 x 103 cells / L

5. NORMAL VALUES Mean Corpuscular Volume (MCV) =80 to 90 fl Mean Corpuscular Hemoglobin (MCH) =26 to 32 pg MHC Concentration (MCHC) =32 to 36% Red Cell Distribution Width =11.6 to14.6% Reticulocyte Count =0.5 to 2.5 %

6. INCREASED HB Dengue fever Policythemia vera. myeloproliferative disorder High altitude COPD CHD right to left shunt Smoking Neoplasm Familial erytrocytosis Dehydrated

7. DECREASED HB Anaemia Haemodilution Overhydration

8. RED BLOOD CELL COUNT (RBC) Normal value = 4.6 to 6.2 x 106 cells/L Decreased with anemia Increased with erythrocytotic states such as polycythemia vera, erythrocytosis of chronic hypoxia, dehydration, stress polycythemia, and thalassemia minor.

9. Decreased MCV and Decreased MCHC Microcytic/Hypochromic Anemia –Iron deficiency –Thalassemia –Anemia of chronic disease –Sideroblastic anemia –Lead poisoning –Hemoglobin E trait or disease

10. Increased MCV and Decreased MCHC Macrocytic/Normochromic Anemia –Folate deficiency –B12 deficiency –Myelodysplastic syndromes –Hypothyroidism

11. Normal MCV and Normal MCHC •Normochromic/Normocytic Anemia – With Elevated Reticulocytes : Normoregenerative anemias such as immunohemolytic anemia, Glucose-6-phosphate dehydrogenase deficiency, Hemoglobin S or C, hereditary spherocytosis, microangiopathic hemolytic anemia, and paroxysmal hemoglobinuria. – With Low or Normal Reticulocytes : Hyporegenerative normocytic anemias such as chronic disease, chronic renal failure, aplastic anemia.

12. WHITE BLOOD CELL COUNT (WBC) The normal range: 4 – 11x10^9 /L Two types of WBC: 1) Granulocytes consist of: Neutrophils: 50 - 70% Eosinophils: 1 - 5% Basophils: up to 1% 2) Agranulocytes consist of: - Lymphocytes: 20 - 40% Monocytes : 1 - 6%

13. NEUTROPHIL Neutrophilia – an increase in neutrophils Conditions associated with neutrophilia are: 1-Bacterial infections (most common cause) 2-Tissue destruction e.g. tissue infarctions, burns. 3- leukemoid reaction 4-Leukemia

14. 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.

15. LYMPHOCYTE Lymphocytosis – may indicate Viral infection e.g. Infectious mononucleosis, CMV or pertussis. Bacterial infection e.g. TB Lymphopenia – caused by Stress. Steroid therapy Irradiation

16. EOSINOPHILIA Causes Parasitic infections, Allergic diseases, Collagen-vascular diseases, Malignant neoplasms, Hypereosinophilic syndrome. Drugs

17. MONOCYTOSIS Causes- 1. Infections –malaria ,typhoid , TB,kala azar 2. Haematologic malignancies –acute and chronic myelomonocytic leukemia,AML ,myeloproliferative disorder 3. Others- sarcoidosis,ulcerative colitis,carcinoma

18. BASOPHILIA Causes- 1.Myeloproliferative disorders 2. Ig E Mediated allergic disorders 3. Ulcerative colitis 4. Hypothyroidism

19. PLATELET COUNT Normal Range = 150 to 450 x 103 cells/L Thrombocytosis –inflammatory disorders –myeloproliferative states –acute blood loss –hemolytic anemias –carcinomatosis –status post-splenectomy

20. Thrombocytopenia –Production defects such as aplastic anemia, marrow replacement, megaloblastic and severe iron deficiency anemias , Wiskott-Aldritch syndrome, Bernard- Soulier syndrome, Chediak -Higashi anomaly. –Consumption defects - autoimmune thrombocytopenia, DIC, TTP, hypersplenism, massive hemorrhage , congenital hemangiomas

21. BLEEDING TIME Measures the time for haematostatic plug formation Normal bleeding time :2-7 min Prolonged in Thrombocytopenia Acute leukemia Aplastic anaemia Liver disorders

22. Clotting Time Measures the time required for formation of first clot Screening test for coagulation disorders Normal BT: 4-14 min

23. Blood Sugar Level (BSL) Fasting: 70-90 mg/100 ml Random: 110-130 mg/100 ml Post Prandial: < 140 mg /100 ml HIGH : Diabetes mellitus , Cushing disease, Corticosteroids LOW : Addison disease ,Pituitary hypofunction , Insulin secreting tumours

24. LIVER FUNCTION TESTS Bilirubin : 0-1 mg/dl SGOT : 10-40 IU /L SGPT : 10-40 IU/L Alkaline phosphatase :40-120 U /L Total Protein : 6-8 g/dl

25. RENAL FUNCTION TESTS Urea : 15-40 mg/dl Creatinine : 0.6 – 1.2 mg/dl Uric acid : 4-7 mg/dl

26. LIPID PROFILE Cholesterol : < 200 mg/dl HDL : 40-60 mg /dl LDL : 70-130 mg /dl Triglycerides : 40-150 mg/dl Cholesterol/HDL ratio : 4.0

27. URINE ANALYSIS Physical Examination: VOLUME :600-2000 ml ODOUR : Aromatic COLOUR : Pale Yellow Appearance : Clear Specific gravity : 1.016 – 1.022

28. Chemical Examination PH : 4.6 – 8.0 Proteins : 50- 150 mg/day Sugar : 0.01-0.03 gm% Ketones Bile salts Bile pigments Blood

29. MICROSCOPIC EXAMINATION Epithelial cells RBC ‘s Pus cells Casts Crystals URINE CULTURE