Clinical pathology: Clinical pathology: Complete Blood countComplete Blood count

GENERAL OBJECTIVEGENERAL OBJECTIVE:: After finishing lab activity of CBC, the After finishing lab activity of CBC, the student will be able to describe the CBC in student will be able to describe the CBC in the DMS case problemthe DMS case problemSPECIFIC OBJECTIVESPECIFIC OBJECTIVE:: At the end of lab activity of CBC , the At the end of lab activity of CBC , the student will be able to interprete: student will be able to interprete: - the normal of CBC- the normal of CBC - the abnormal of CBC- the abnormal of CBC

Complete Blood Count (CBC)

Providing important information about the kinds and numbers of RBC, WBC and platelet.

Being part of routine physical examination

Help :To evaluate symptoms (weakness, fatigue,

bruising, fever, or weight loss)To diagnose conditions (anemia, infection)To diagnose diseases of the blood (leukemia)To monitor the response to some types of drug

or radiation treatment

CBC usually includes :1. WBC count2. WBC differential3. RBC count4. Hematocrit5. Hemoglobin6. RBC indices (MCV, MCH, MCHC)7. Platelet count8. Blood smear **9. RDW10. ESR

CBC can be performed :Manually :

HemocytometerCalculate from other CBC results (RBC indices)

Automatically (hematologic analyzer)

WBC countTo express WBC concentration per unit volume

of blood (mm3).No distinction is made among the six normal

cell types (band neutrophils,segmented neutophils, lymphocytes, monocytes, eosinophils, basophils).

Increase WBC count leucocytosisDecrease WBC count leucopenia

WBC Differential5 major kinds of WBCImmature neutrophil, band neutrophil

include to the test.Each type of cell plays a different role in

protecting the body.Number of each type give important

information about the immune system.Expressed as a percentage of each type

Increase/decrease number of each type help to identify :infection (neutrophilia, lymphocytosis)Allergic or toxic reaction to certain medication

(eosinophilia)Malignancy (leukemia)

HemoglobinMain component of RBCConjugated proteinServes as a vehicle for the transportation of

O2 and CO2.Gives blood cell its red colorHemoglobin test measures the amount of

hemoglobin in blood.Decrease anemia

RBC indicesThere are 3 RBC indices :1. MCV (Mean Corpuscular Volume)2. MCH (Mean Corpuscular Hemoglobin)3. MCHC (Mean Corpuscular Hemoglobin

Concentration).

Their values are determined from other measurements noted during CBC

Platelet countexpressed as concentration – platelet cells

per unit volume of blood (mm3).Decrease thrombocytopeniaIncrease thrombocytosis

RDWRed Cell Distribution widthReports whether all the red cells are about

the same width, size, and shape.This helps further classify the types of

anemia.

Erythrocyte Sedimentation RateMeasuring the sedimentation of erythrocytes in

diluted human plasma over a specified time period (1 hour)

Measuring the distance from the bottom of the surface meniscus to the top of erythrocyte sedimentation in a vertical column containing diluted whole blood.

Not very specific/diagnostic test still use in many institutions as a screening test for inflammation

Factors affecting ESRRBC size & shapePlasma fibrinogen & globulin levelsMechanicalTechnical

Factors affecting the ESR :Increase :1. Rouleaux

formation2. Fibrinogen

(elevated)3. Immunoglobulin

(excess)

Decrease :1. Microcytes2. Sickle cells3. Spherocytes

Methods performing ESR :Manual :

Westergren MethodWintrobe Method

Automatic

Normal values :Adult men 0-15 mm/hAdult women 0-20 mm/h

Diseases associating with an elevated ESR :

1. Chronic infections(Tb)

2. Multiple Myeloma3. Cryoglobulinemia4. Temporal arteritis5. Inflammatory

diseases6. Pregnancy7. Anemia

8. Malignant neoplasms9. Paraproteinemias10.Macroglobulinemia11.Hyperfibrinogenemia12.Rheumatoid arthritis13.Collagen disease14.Polymyalgia

rheumatica

ResultsNormal value can vary from lab to labNormal value for CBC tests varies, depending

on age, sex, elevation above sea level, and type of sample.