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NORMAL BLOOD VALUES

NORMAL BLOOD VALUES. NORMAL HEMATOLOGICAL VALUES. SHEIKHA. 10 trillion “10 13 ” new blood cells must be replaced Each day to maintain steady state blood counts! This is equivalent to an annual number of cells approximating the total body weight, but the total

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NORMAL BLOOD VALUES

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  1. NORMAL BLOOD VALUES

  2. NORMAL HEMATOLOGICAL VALUES SHEIKHA

  3. 10 trillion “1013” new blood cells must be replaced Each day to maintain steady state blood counts! This is equivalent to an annual number of cells approximating the total body weight, but the total bone marrow of an adult human contains around 1012 cells, 10 fold less than the daily need! Marrow contains 1 stem cell per 20 million nucleated cells

  4. The Sheikhas 18 1800 kilos 18 cubic meters

  5. Normal Values SHEIKHA Mean Cell Volume M CV = ------------ = ------------ = = ------------ = -------- = 90 fL 0.45 L 1 L PCV 5 X 1012 RCC 5.0 x 1012 0.45 x 1015 fL 450 5.0 5.0 x 1012 0.45 L NORMAL MCV = 76 – 96 fL

  6. Normal Values SHEIKHA Mean Cell Hemoglobin M CH = ------------ = ------------ = = ----------- = ------------ = 30 pg 15 gm/dL Hb 1 Liter RCC 5.0 x 1012/L 15 gm/dL 150 gm/L 150 x 1012 pg 5 trillion 5.0 x 1012/L 5.0 x 1012/L NORMAL MCH = 27 – 32 pg

  7. Normal Values SHEIKHA Mean Cell Volume M CH C = ------------ = ------------ = = 333 g/L = 33 g/dL 150 g/L Hb PCV 0.45 L/L 0.45 150 gm NORMAL MCHC IN ADULTS & CHILDREN = 32 – 36 g/dL

  8. RETICULOCYTE COUNT 0.2 to 2.0% = 10,000 to 100,000/uL (Adults & Children) 2.0 to 6.0% Mean = 150,000 (Infants/ Cord Blood)

  9. BLOOD VOLUME60 to 80 ml/Kg PLASMA 40 to 50 ml/Kg 55% 45% Men: 25 to 35 ml/Kg Women: 20 to 30 ml/Kg PCV SHEIKHA

  10. Differential White Cell Counts Total WBC: 4.0 to 11.0 X 109 / L 4,000 to 11,000 / uL Neutrophils Lymphocytes 2,000 to 7,500/uL Monocytes 1,500 to 4,000/uL Eosinophils 200 to 800 40 to 440 Basophils <100 SHEIKHA

  11. BLOOD CELLS LIFE SPAN WBC RBC 120 days T1/2 7 hours 10 days Platelet SHEIKHA

  12. Iron status SHEIKHA TIBC Serum Iron UIBC 13 – 32 umol /L 100 ug /L 45 – 70 umol /L 300 ug /L FERRITIN Male: 30-300 ug/L Female: 15-200

  13. CBC

  14. 200 X 109/L X 5 fL= 1000 X 109 fL of platelets/L of blood = 1.0 X 1012 fL/L = 1 ml of platelets/L of blood = 0.1% 400 X 109/L X 8 fL= 3200 X 109 fL of platelets/L of blood = 3.2 X 1012 fL/L = 3.2 ml of platelets/L of blood = 0.3% Total Platelet Mass in an adult ~ 5 to 20 mls

  15. CASES CLINICAL AND LAB. DATA

  16. Case 1 HAYASA 50 years Patient: Back Pain Smear: Rouleaux Marrow: 80% PCs ESR: 110 mm/hr ? Dx:

  17. Case 1 HAYASA 50 years Patient: Back Pain Smear: Rouleaux Marrow: 80% PCs ESR: 110 mm/hr ? Dx:

  18. Case 1 HAYASA 50 years Patient: Back Pain Smear: Rouleaux Marrow: 80% PCs ESR: 110 mm/hr MULTIPLE MYELOMA ? Dx:

  19. CASE 2 ALI HADI 3 years Bruises Epistaxis Hematuria Mild splenomegaly Marrow full of Megakaryocytes Smear: Few Giant platelets

  20. CASE 2 ALI HADI 3 years Bruises Epistaxis Hematuria Mild splenomegaly Marrow full of Megakaryocytes Smear: Few Giant platelets I T P

  21. Case 3 Abu Bakr 30 years Indian Severe pallor Given 3 units of RBC Marrow devoid of RBC precursors

  22. Case 3 Abu Bakr 30 years Indian Severe pallor Given 3 units of RBC Marrow devoid of RBC precursors PRCA Pure Red Cell Aplasia

  23. Case 4 Sultan 48 years Loss of weight Moderate splenomegaly Mild hepatomegaly Positive Philadelphia chromosome

  24. Case 4 Sultan 48 years Loss of weight Moderate splenomegaly Mild hepatomegaly Positive Philadelphia chromosome CML

  25. Case 5 Yahia 20 years Hyperpyrexia Streptococcal tonsillitis High NAP score

  26. Case 5 Yahia 20 years Hyperpyrexia Streptococcal tonsillitis High NAP score LEUKEMOID REACTION

  27. Case 6 FAHAD 8 YEARS Fever Chest Infection Gum Bleeding Pallor Blood smear & marrow are full of PAS +ve blasts

  28. Case 6 FAHAD 8 YEARS Fever Chest Infection Gum Bleeding Pallor Blood smear & marrow are full of PAS +ve blasts ALL

  29. Case 7 Abdul Rahman 16 Years Anemia not responding to R Hypogranular neutrophils Hypercellular marrow 12% Marrow Blasts

  30. Case 7 Abdul Rahman 16 Years Anemia not responding to R Hypogranular neutrophils Hypercellular marrow 12% Marrow Blasts RAEB

  31. Case 8 SHADI 8 Years Hypochromic microcytic red cells Target cells Marked increase of nRBC HbF= 100% Splenectomized

  32. Case 8 SHADI 8 Years Hypochromic microcytic red cells Target cells Marked increase of nRBC HbF= 100% Splenectomized β- THALASSEMIA MAJOR

  33. Case 9 SAUD NAIF 60 Years Perianal abscess Marrow: Hypercellular; Abnormal pronormoblasts & myeloblasts forming majority of the cells

  34. Case 9 SAUD NAIF 60 Years Perianal abscess Marrow: Hypercellular; Abnormal pronormoblasts & myeloblasts forming majority of the cells Erythroleukemia (AML M6)

  35. Case 10 MAHA RUSHDI 17 Years Mild Pallor & Jaundice Positive Family history Smear: Small & hyper- chromic red cells High MCHC + Osmotic Fragility Test Moderate splenomegaly

  36. Case 10 MAHA RUSHDI 17 Years Mild Pallor & Jaundice Positive Family history Smear: Small & hyper- chromic red cells High MCHC + Osmotic Fragility Test Moderate splenomegaly HEREDITARY SPHEROCYTOSIS

  37. Case 11 SAED AL-NAMI 70 Years Massive splenomegaly Negative Ph’ Chromosome Marrow: Hypercellular with agranular & hypogranular neutrophils

  38. Case 11 SAED AL-NAMI 70 Years Massive splenomegaly Negative Ph’ Chromosome Marrow: Hypercellular with agranular & hypogranular neutrophils CMML

  39. Case 12 HUDA RDENY 20 Years Severe back pain Splenic atrophy Hb-electrophoresis is pending Targets & sickle cells

  40. Case 12 HUDA RDENY 20 Years Severe back pain Splenic atrophy Hb-electrophoresis is pending Targets & sickle cells Hb SS

  41. Case 13 ABDU ABDU24 Years Massive splenomegaly + Ph’ Chromosome Started on Hydrea

  42. Case 13 ABDU ABDU24 Years Massive splenomegaly + Ph’ Chromosome Started on Hydrea CML “Accelerated Phase”

  43. Case 14 Al-Hifzi 18 Years Hemarthrosis Normal P.T. Prolonged APTT Normal Bleeding Time HIV Positive

  44. Case 14 Al-Hifzi 18 Years Hemarthrosis Normal P.T. Prolonged APTT Normal Bleeding Time HIV Positive HEMOPHILIA A

  45. Case 15 AISHA 17 Years Huge Spleen Fever Marrow was requested to exclude an intracellular parasitic disease

  46. Case 15 AISHA 17 Years Huge Spleen Fever Marrow was requested to exclude an intracellular parasitic disease Kala Azar “Visceral Leishmaniasis”

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