Diagnostic Laboratory Blood Tests Complete Blood Count and Blood Chemistry Profiles

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<ul><li> Slide 1 </li> <li> Diagnostic Laboratory Blood Tests Complete Blood Count and Blood Chemistry Profiles </li> <li> Slide 2 </li> <li> Blood Counts </li> <li> Slide 3 </li> <li> Complete Blood Count Evaluations of cellular parameters Evaluations of cellular parameters Types of cells Types of cells Numbers of cells Numbers of cells Size and volume of cells Size and volume of cells </li> <li> Slide 4 </li> <li> CBC Provides a snap shot of the hematopoietic system at a specific point in time. Provides a snap shot of the hematopoietic system at a specific point in time. </li> <li> Slide 5 </li> <li> CBC Components White blood cell count White blood cell count Differential count Differential count Red blood cell count Red blood cell count Hematocrit Hematocrit Hemoglobin Hemoglobin Mean corpuscular volume Mean corpuscular volume Mean corpuscular hemoglobin Mean corpuscular hemoglobin Mean corpuscular hemoglobin concentration Mean corpuscular hemoglobin concentration </li> <li> Slide 6 </li> <li> White Blood Count (WBC) White blood cells (leukocytes) are the disease fighting cells of the immune system. White blood cells (leukocytes) are the disease fighting cells of the immune system. Only about 1% of blood cells are WBCs Only about 1% of blood cells are WBCs Large numbers of WBCs can be produced rapidly if needed Large numbers of WBCs can be produced rapidly if needed </li> <li> Slide 7 </li> <li> White Blood Count (WBC) The WBC tells the total number of white cells present in a specified volume of blood The WBC tells the total number of white cells present in a specified volume of blood Different disease states affect the WBC in different ways Different disease states affect the WBC in different ways </li> <li> Slide 8 </li> <li> WBC Methods Hemocytometer Hemocytometer Automated cell counters Automated cell counters Quantitative Buffy Coat Analysis Quantitative Buffy Coat Analysis </li> <li> Slide 9 </li> <li> Manual Hemocytometer Manual counting is the oldest and most time consuming method of determining cell counts Manual counting is the oldest and most time consuming method of determining cell counts Special slides and diluting fluids are required Special slides and diluting fluids are required Method can be used for counting cells in other body fluids and effusions Method can be used for counting cells in other body fluids and effusions </li> <li> Slide 10 </li> <li> Advantages of Manual Counts Manual counting is the least expensive in terms of equipment and supplies Manual counting is the least expensive in terms of equipment and supplies Can be performed in a mobile clinic Can be performed in a mobile clinic </li> <li> Slide 11 </li> <li> Limitations of Manual Counts Time consuming (staff expense) Time consuming (staff expense) Inherent error (20%), even with skilled staff Inherent error (20%), even with skilled staff Requires well trained and meticulous personnel Requires well trained and meticulous personnel </li> <li> Slide 12 </li> <li> Manual Counts WBC count is the most frequently performed hemocytometer count WBC count is the most frequently performed hemocytometer count RBC counts are very inaccurate RBC counts are very inaccurate Meticulous attention to detail is necessary to achieve consistent cell count results when using manual methods Meticulous attention to detail is necessary to achieve consistent cell count results when using manual methods </li> <li> Slide 13 </li> <li> Hemocytometer </li> <li> Slide 14 </li> <li> Slide 15 </li> <li> Slide 16 </li> <li> Automated Cell Counter Several types now available for use in vet settings Several types now available for use in vet settings All types are more accurate than manual methods All types are more accurate than manual methods Results are obtained rapidly Results are obtained rapidly </li> <li> Slide 17 </li> <li> Types Semi-automated requires some sample preparation by technical staff Semi-automated requires some sample preparation by technical staff Fully automated performs all steps itself Fully automated performs all steps itself </li> <li> Slide 18 </li> <li> Automated Cell Counter </li> <li> Slide 19 </li> <li> Impedance methods All make use of Coulter principle All make use of Coulter principle </li> <li> Slide 20 </li> <li> Slide 21 </li> <li> Advantages Faster and more effective use of staff time Faster and more effective use of staff time Newer models store calibrations for multiple species Newer models store calibrations for multiple species Can perform most of components of a complete blood count Can perform most of components of a complete blood count </li> <li> Slide 22 </li> <li> Limitations Cannot perform differential counts Cannot perform differential counts Cannot recognize reticulocytes Cannot recognize reticulocytes Cannot reliably differentiate between WBCs and nucleated RBCs Cannot reliably differentiate between WBCs and nucleated RBCs Several artifacts can create false counts Several artifacts can create false counts </li> <li> Slide 23 </li> <li> Quantitative Buffy Coat Analysis QBC is based on differential centrifugation QBC is based on differential centrifugation Uses special tubes that contain a float that has the same density as the buffy coat Uses special tubes that contain a float that has the same density as the buffy coat When spun under high speed, the buffy coat components are separated out by density (weight) When spun under high speed, the buffy coat components are separated out by density (weight) Automated reader scans buffy coat and records percentages of aggregates Automated reader scans buffy coat and records percentages of aggregates </li> <li> Slide 24 </li> <li> Slide 25 </li> <li> Advantages of QBC Analysis Efficient and economical method Efficient and economical method Simple to operate Simple to operate Good for rapid screening in office Good for rapid screening in office The system flags abnormal or unexpected results The system flags abnormal or unexpected results </li> <li> Slide 26 </li> <li> Limitations of QBC Analysis Cannot produce a complete differential count Cannot produce a complete differential count Cannot distinguish between lymphocytes and monocytes Cannot distinguish between lymphocytes and monocytes Does not distinguish between segs and bands Does not distinguish between segs and bands </li> <li> Slide 27 </li> <li> Increased WBCs Bacterial infections generally increase the numbers of white cells present Bacterial infections generally increase the numbers of white cells present Pyometra Pyometra Bacterial pneumonia Bacterial pneumonia Peritonitis Peritonitis </li> <li> Slide 28 </li> <li> Decreased WBCs Viral infections tend to reduce numbers of WBCs Viral infections tend to reduce numbers of WBCs Parvovirus Parvovirus Canine Distemper Canine Distemper Feline panleukopenia Feline panleukopenia </li> <li> Slide 29 </li> <li> Decreased WBCs Immune system inadequacy Immune system inadequacy Bone marrow disease Bone marrow disease Overwhelming bacterial infection Overwhelming bacterial infection </li> <li> Slide 30 </li> <li> Differential Counts Important in order to interpret the WBC results Important in order to interpret the WBC results Gives much of the information needed to interpret WBCs Gives much of the information needed to interpret WBCs To date, no machine is able to perform this task adequately and completely To date, no machine is able to perform this task adequately and completely </li> <li> Slide 31 </li> <li> Red Blood Cell Count The measurement of RBCs is a way of evaluating the bloods ability to deliver oxygen to tissues and to carry carbon dioxide away The measurement of RBCs is a way of evaluating the bloods ability to deliver oxygen to tissues and to carry carbon dioxide away Changes in the morphology of RBCs can give information about bone marrow function Changes in the morphology of RBCs can give information about bone marrow function Some infectious agents or parasites may be seen on the RBC surface Some infectious agents or parasites may be seen on the RBC surface </li> <li> Slide 32 </li> <li> Hematocrit Measures the percentage of RBCs in the total blood Measures the percentage of RBCs in the total blood Can give information about the animals state of hydration Can give information about the animals state of hydration May show evidence of RBC destruction in the spleen May show evidence of RBC destruction in the spleen </li> <li> Slide 33 </li> <li> Hemoglobin Hemoglobin is the oxygen carrying protein in the RBC Hemoglobin is the oxygen carrying protein in the RBC Low levels of Hgb indicate genetic problems, inadequate iron, inadequate B vitamins Low levels of Hgb indicate genetic problems, inadequate iron, inadequate B vitamins High levels of Hgb may indicate abnormalities such as high iron intake, a toxin, or internal organ malfunction High levels of Hgb may indicate abnormalities such as high iron intake, a toxin, or internal organ malfunction </li> <li> Slide 34 </li> <li> Mean Corpuscular Volume MCV MCV Measures the size of the RBCs Measures the size of the RBCs </li> <li> Slide 35 </li> <li> Mean Corpuscular Hemoglobin MCH MCH Reflects the average weight of the hemoglobin in the RBCs Reflects the average weight of the hemoglobin in the RBCs </li> <li> Slide 36 </li> <li> Mean Corpuscular Hemoglobin concentration MCHC MCHC Measures the amount of hemoglobin in a given volume of packed red cells Measures the amount of hemoglobin in a given volume of packed red cells </li> <li> Slide 37 </li> <li> Blood Chemistry </li> <li> Slide 38 </li> <li> Blood Chemistry Values Blood chemistry panels measure a variety of substances dissolved in the plasma of blood Blood chemistry panels measure a variety of substances dissolved in the plasma of blood Nutrients Carrying agents Catalysts Waste matter </li> <li> Slide 39 </li> <li> Blood Chemistry Substances are present in minute amounts Substances are present in minute amounts Each substance contributes to the overall health of the patient Each substance contributes to the overall health of the patient Increases or decreases of chemicals can be good indicators of the patients condition Increases or decreases of chemicals can be good indicators of the patients condition Can give valuable aid in making a diagnosis Can give valuable aid in making a diagnosis </li> <li> Slide 40 </li> <li> Slide 41 </li> <li> Slide 42 </li> <li> Aspartate Aminotransferase AST AST Formerly called serum glutamic oxaloacetic transaminase (SGOT) Formerly called serum glutamic oxaloacetic transaminase (SGOT) Enzyme Enzyme Levels increase with liver or severe muscle injury Levels increase with liver or severe muscle injury </li> <li> Slide 43 </li> <li> Alanine Aminotransferase ALT ALT Formerly known as serum glutamic pyruvate transaminase Formerly known as serum glutamic pyruvate transaminase Enzyme Enzyme Levels increase in general liver injury Levels increase in general liver injury </li> <li> Slide 44 </li> <li> Total Bilirubin T Bili T Bili Measures the total amount of all bilirubin in the serum Measures the total amount of all bilirubin in the serum Bilirubin is a pigment released in the destruction of RBCs Bilirubin is a pigment released in the destruction of RBCs Increased levels: Increased levels: Intravascular hemolysis Primary liver or bile duct disease </li> <li> Slide 45 </li> <li> Direct Bilirubin D Bili D Bili Conjugated bilirubin Conjugated bilirubin Bilirubin that has been combined with other compounds by the liver Bilirubin that has been combined with other compounds by the liver Increases levels often associated with primary liver disease Increases levels often associated with primary liver disease </li> <li> Slide 46 </li> <li> Indirect Bilirubin I Bili I Bili Unconjugated bilirubin Unconjugated bilirubin Bilirubin that has not yet been combined with other substances Bilirubin that has not yet been combined with other substances Increased levels usually associated with abnormal hemolysis Increased levels usually associated with abnormal hemolysis </li> <li> Slide 47 </li> <li> Alkaline Phosphatase Alk Phos Alk Phos Enzyme Enzyme Related to bone, liver, bile duct system Related to bone, liver, bile duct system Increased levels: Increased levels: Young, growing animals Bone disease Liver disease Bile duct blockage Steroids and anticonvulsants </li> <li> Slide 48 </li> <li> Total Protein T Prot or TP T Prot or TP Measure both albumin and globulin Measure both albumin and globulin Gives very general information Gives very general information Further division of proteins needed for meaningful interpretation Further division of proteins needed for meaningful interpretation </li> <li> Slide 49 </li> <li> Albumin ALB ALB Major plasma protein Major plasma protein Transports substances throughout body Transports substances throughout body Increases: Increases: Dehydration Decreases: Decreases: Reduced production by liver Malnutrition Chronic liver disease Kidney disease Tissue fluid loss from wounds, burns </li> <li> Slide 50 </li> <li> Globulin GLOB GLOB Blood protein Blood protein Antibodies Antibodies Indicator of immune function Indicator of immune function </li> <li> Slide 51 </li> <li> Cholesterol Chol Chol Increases due to Increases due to Liver disease Diet Thyroid disease Genetic abnormalities </li> <li> Slide 52 </li> <li> Blood Urea Nitrogen BUN BUN Associated with kidney function Associated with kidney function Levels increase with: Levels increase with: Dehydration High dietary protein Small Bowel hemorrhage Kidney disease </li> <li> Slide 53 </li> <li> Creatinine Creat Creat Breakdown product of skeletal muscle metabolism Breakdown product of skeletal muscle metabolism Creatinine is filtered out by the kidneys Used with BUN to determine kidney function Not influenced by diet or GI bleeding </li> <li> Slide 54 </li> <li> Phosphorus Phos Phos Mineral Mineral Levels are regulated by the kidneys Levels are regulated by the kidneys Linked with calcium, vitamin D, parathormone Linked with calcium, vitamin D, parathormone Increased in young, growing animals Increased in young, growing animals Increases occur with aging kidneys and kidney failure Increases occur with aging kidneys and kidney failure </li> <li> Slide 55 </li> <li> Calcium Ca+ Ca+ Mineral Mineral Important for skeletal strength Important for skeletal strength Needed for nervous system function Needed for nervous system function Regulated by parathyroid glands Regulated by parathyroid glands Linked to Vit D, calcitonin, and others Linked to Vit D, calcitonin, and others </li> <li> Slide 56 </li> <li> Glucose Gluc Gluc Essential source of energy for all cells Essential source of energy for all cells Reacts to: Reacts to: Insulin levels Diet Glucagon Liver function </li> <li> Slide 57 </li> <li> Glucose increases Hyperglycemia Hyperglycemia After eating After eating Stress Stress Exercise Exercise Acute pancreatitis Acute pancreatitis Some drugs Some dr...</li></ul>