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Introduction to Haematology. Dr Kate Foley ST5 Haematology. Definitions. Haematology- ‘ the branch of medical science concerned with diseases of the blood and blood-forming tissues. ’. This includes. Disorders of red cells, white cells and platelets Disorders of coagulation factors
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Introduction to Haematology Dr Kate Foley ST5 Haematology
Definitions • Haematology- ‘the branch of medical science concerned with diseases of the blood and blood-forming tissues.’
This includes... • Disorders of red cells, white cells and platelets • Disorders of coagulation factors • Transfusion • Malignancies related to blood, bone marrow and lymphatic tissue. • Stem cell transplantation • Paediatric Haematology
Role of a Haematologist • Working as part of a clinical team looking after patients with a spectrum of haematological disorders • Clinical interpretation of laboratory data and morphology of blood and bone marrow • Advisory and consultancy service for hospital clinicians and GPs • Clinical responsibility for the haematology and transfusion laboratory • Holistic approach to clinical care
Whole Blood Plasma Formed Elements Nitrogenous Waste Platelets Erythrocytes Amino acids Electrolytes Leukocytes Nutrients Gases Myelocytes Proteins Lymphocytes Neutrophils T Cell Albumins Eosinophils B cell Monocytes Globulins NK Cell Basophils Fibrinogen
Neutrophil Erythrocyte Platelet
Eosinophil Lymphocyte Neutrophil Basophil Monocyte
Full blood count • Manual • WBC and RBC counted using neubauer chamber • Differential, platelets and morphology on thin smear • RBC indices calculated using formulas • Automated • Computerised multichannel analysers sort and size cells on the basis of changes in electrical impedence or light pulses as the cells pass in front of a laser.
Full Blood Count • Normal Ranges • Group of normal subjects sampled under strict conditions • Mean +/- 2SD range (95%) • BUT counts also influenced by age, gender, build, ethnic origin, environment • Need to make sure the reference range is appropriate for your patient.
Interpretation • Right patient? • Clinical information • Pregnancy, surgery, known comorbidities, smoker, ETOH XS • Any abnormal values • One or more cell lines abnormal • High/low • Sampling errors
Blood Film • Smear made from FBC sample. • Look at the number and appearance of red cells, white cells and platelets. • Film comment usually appears at end of FBC • Can give useful information and clinical advice
Blood Film Comment • ‘Neutrophilia and mild thrombocytosis with toxic granulation and left shift.’
Conclusion • Haematology is a diverse speciality bringing together laboratory and clinical aspects • Blood results more informative within clinical context • Have a systematic approach • Ask a friendly Haematologist!