Unit #5B – Clinical Laboratory Testing Basic Hematology

1. Unit #5B – Clinical Laboratory TestingBasic Hematology Cecile Sanders, M.Ed., MLS(ASCP)

2. Unit #5B – Clinical Laboratory Testing – Basic Hematology • Department of Hematology • Study of formed elements of blood and blood forming tissues • Screen, diagnosis and monitor hematologic diseases (anemias, leukemias, etc.) and also give a general idea of overall health

3. Unit #5B – Clinical Laboratory Testing – Basic Hematology • Composition of Blood - blood is 6-8% of total body weight and equals approximately 5 liters (think about 5 liter bottles of Coke) • Serum vs Plasma – • Both are fluid portions of blood • Serum is from clotted blood, has no clotting factors (used up in the clotting process) • Plasma is from anticoagulated blood, has clotting factors, makes up about 45-60% of blood’s volume

4. Unit #5B – Clinical Laboratory Testing – Basic Hematology • Cellular Elements – make up the remainder of the blood volume • Erythrocytes / RBCs • ~ 4-6 million/µL • Transport oxygen and carbon dioxide Electron Micrograph Stained Blood Smear Viewed by Microscope

5. Unit #5B – Clinical Laboratory Testing – Basic Hematology • Leukocytes / WBCs • ~ 4,800-10,800 /µL in circulating blood; many more in tissues • Function in immunity and defense against bacteria, viruses and all other foreign materials (includes allergens like pollen, etc.) Illustration of WBC Stained WBC Viewed Under Microscope

6. Unit #5B – Clinical Laboratory Testing – Basic Hematology • Types of WBCs: • Granulocytes (neutrophils, basophils, & eosinophils) Drawing Stained Granulocytes Viewed Under Microscope

7. Unit #5B – Clinical Laboratory Testing – Basic Hematology • Lymphocytes (On blood smear) • Monocytes (On blood smear)

8. Unit #5B – Clinical Laboratory Testing – Basic Hematology • Platelets / Thrombocytes • Pieces of a bone marrow cell known as a megakaryocyte • Function to stop bleeding by forming a plug and also release coagulation factors Platelets on blood smear (very small “dots” among RBC)

9. Unit #5B – Clinical Laboratory Testing – Basic Hematology • Common Hematology Laboratory Tests • Complete Blood Count (CBC) includes: • RBC count • WBC count • Hemoglobin • Hematocrit • WBC Differential • Platelet count • Additional information on size and appearance of blood cells

10. Unit #5B – Clinical Laboratory Testing – Basic Hematology • Common Hematology Laboratory Tests • Erythrocyte Sedimentation Rate (ESR) • Reticulocyte Count • Sickle Cell Testing • Coagulation Tests include: • Prothrombin Time (PT) • Partial Thromboplastin Time (PTT) • Fibrinogen • Factor Analysis

11. Unit #5B – Clinical Laboratory Testing – Basic Hematology • Hematological Diseases (Diseases may be classified in more than one category) • Diseases of improper or insufficient production • Anemias – Examples include iron deficiency anemia and aplastic anemia, among others • Leukemias – WBC production is affected and defective. Examples include acute and chronic leukemias • Thrombocytopenia – Decreased platelets. Patient may have bleeding problems

12. Unit #5B – Clinical Laboratory Testing – Basic Hematology • Diseases of defective cell function • May be combination of improper cell production and defective function • Examples include iron deficiency anemia and certain leukemias • Inherited hematological diseases • Examples include hemophilia, sickle cell anemia, G6PD deficiency, thalassemias • Secondary or acquired hematological diseases • Examples include hemolytic disease due to renal pathologies or atypical lymphocytes due to viral infections

13. Unit #5B – Clinical Laboratory Testing – Basic Hematology • Resources • Basic Clinical Laboratory Techniques, Estridge and Reynolds, Thomson/Delmar Learning, Fifth Edition, 2008