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HEMATOLOGY

HEMATOLOGY. Jane Finley, BS MT (ASCP) Nov 1, 2004. Blood Serum Plasma Erythrocytes (RBC) Granulocytes (WBC) Platelets (Plt). HEMATOLOGY AND LAB LANGUAGE. Lab Language: Hematology Testing. Complete Blood Count (CBC) Erythrocyte Sedimentation Rate (ESR) Sickle Cell Screening

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HEMATOLOGY

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  1. HEMATOLOGY Jane Finley, BS MT (ASCP) Nov 1, 2004

  2. Blood Serum Plasma Erythrocytes (RBC) Granulocytes (WBC) Platelets (Plt) HEMATOLOGY AND LAB LANGUAGE

  3. Lab Language: Hematology Testing • Complete Blood Count (CBC) • Erythrocyte Sedimentation Rate (ESR) • Sickle Cell Screening • Hemoglobin Electrophoresis • Ferritin • Iron • Total Iron Binding Capacity (TIBC) • Transferrin

  4. Hemoglobin Hematocrit RBC WBC Plt ct RDW MCV MCH MCHC Segmented Neutrophil Lymphocyte Monocyte Eosinophil Basophil Reticulocyte Reticulcyte Production Index (RPI) Lab Language : CBC

  5. Complete Blood Count • White Blood Count (WBC) • Red Blood Cell Count (RBC) • Platelet Count (Plt) • Hemoglobin (Hb or Hgb) • Hematocrit (Hct) • Red Cell Indices (MCV,MCHC,MCH) • Red Cell Distribution Width (RDW) • Differential Count (Diff)

  6. Segs Lymphs/Atypical Mono’s Eo’s Baso’s Bands Metamyelocyte Myelocyte Promyelocyte Blast CBC Differential -WBC

  7. Anisocytosis Microcytes Macrocytes Nucleated RBC Howell Jolly Bodies Basophilic Stippling Hypochromia Riticulocytes Poikilocytosis Teardrop Ovalocytes Helmet cells Sickle Cells CBC Differential-RBC

  8. WBC 4.5-11.0 x 109/L RBC Males: 4.3-5.7 x1012/L Females: 3.8-5.1 “ Plt 150-400 x109/L Terms Leukocytosis Erythrocytosis Erythropenia Thrombocytosis Thrombopenia Cell Counts:Number of cells per liter of whole blood

  9. Hemoglobin • Heme + protein (globulin) • Main purpose is to carry O2 • Three main types • Variants result in identifiable disorders • Normal ranges are age and gender related

  10. Hematocrit • Packed Cell Volume • Measures what percentage of whole blood is represented by RBC • Compares RBC and hemoglobin • Normal ranges are age and gender related

  11. Lab Language: Red Cell Indices • MCV- Mean Corpuscular Volume • MCH-Mean Corpuscular Hemoglobin • MCHC-Mean Corpuscular Hemoglobin Concentration • RDW-Red Cell Distribution Width

  12. Mean Corpuscular Volume (MCV) • The average size (volume) of an RBC. • MCV (in fL) = (hematocrit x 10) • (rbc count [in millions/µL]) • Normal values: 80-100 fL • The MCV is a useful tool in the differential diagnosis of anemia

  13. Mean Corpuscular hemoglobin (MCH) • The average hemoglobin content of a RBC. • Normal values: 26-34 pg. • MCH (in pg) = hemoglobin x 10 • rbc count

  14. Mean Corpuscular Hemoglobin Concentration (MCHC) • The percentage of a RBC's volume which contains hemoglobin. • Normal values: Usually between 31-37%. • MCHC may be decreased with severe iron deficiency anemia. • MCHC [in g/dL] = hemoglobin [in g/dL] hematocrit [in L/L]

  15. RED CELL DISTRIBUTION WIDTH(RDW) • Degree of Red Cell size variability in a blood sample • Coefficient of variation of the size of the RBCs • Expressed as % • Derived from automated instruments that can directly measure the MVC • Normal: 11-15 %

  16. Using the RBC Indices • MCV reveals the average size of the RBCs • RDW reveals a variation in size among the RBCs • MCHC reveals how much of the cell is being taken up by hemoglobin • Together can reveal anemia or physiologic disorders that affect quality of life

  17. Lab Language: Indices • Anemia • Microcytic • Macrocytic • Hypochromic • normochromic

  18. ERYTHROCYTOSIS • Polycythemia vera • Secondary Polycythemia -COPD -Inappropriate stimulation of erythropoietin, such as tumors • Relative Polycythemia -dehydration, -severe burns

  19. ERYTHROPENIA (ANEMIA) • Anemias - may result from: • chronic or acute blood loss • decreased synthesis • increased destruction or decreased survival • dilutional effect: • postural (lower in recumbent position) • overhydration

  20. Anemia Classifications • Microcytic, hypochromic • Microcytic, normochromic • Normocytic, normochromic • Macrocytic, normochromic

  21. NORMOCYTIC, NORMOCHROMIC ANEMIA • MCV normal • MCHC normal • Examples: • acute blood loss • aplastic anemia • most leukemia's • bone marrow infiltration

  22. MICROCYTIC, HYPOCHROMIC ANEMIA • MCV decreased • MCHC decreased • Examples: • iron deficiency • thalassemia • lead poisoning • anemia of chronic disease

  23. MICROCYTIC, NORMOCHROMIC ANEMIA • MCV decreased • MCHC normal • Examples: • mid-stage iron deficiency • thalassemia

  24. MACROCYTIC, NORMOCHROMIC ANEMIA • MCV increased • MCHC normal • Examples: • folate deficiency • vitamin B12 deficiency • pernicious anemia

  25. Cord blood: - Hb - 16.5 ± 3 g/dl - Hct - 51 ± 9 % 0.5-2 years: - Hb: 12.0 ± 1.5g /dl - Hct - 36 ± 3 % 12-16 yrs: Female: -Hb 14.0 ± 2 g/dl -Hct 41 ± 4% Male: -Hb 14.5 ± 1 g/dl - Hct 43 ± 6% Hemoglobin & HematocritNormal Ranges

  26. Hemoglobin & HematocritAdult Normal Ranges • Male: Hb 15.5 ± 2 g/dl Hct 47 ± 6% • Female: Hb 14.0 ± 2 g/dl Hct 41 ± 5%

  27. RULES OF THREE • Used for quality control • Hb X 3 = Hct ± 3% • RBC X 3 = Hb • Hct X 100,000 = RBC

  28. Complete Blood Count • White Blood Count (WBC) • Red Blood Cell Count (RBC) • Platelet Count (Plt) • Hemoglobin (Hb or Hgb) • Hematocrit (Hct) • Red Cell Indices (MCV,MCHC,MCH) • Red Cell Distribution Width (RDW) • Differential Count (Diff)

  29. CBC 1 RBC 5.25 x 10[12]/L HGB 15.4 g/dL HCT 46.1 % MCV ______ MCH _____ MCHC ______ RDW _____

  30. CBC 1 RBC 5.25 x 10[12]/L HGB 15.4 g/dL HCT 46.1 % MCV 87.9 fL MCH 29.3 pg MCHC 33.4 g/dL RDW 12.2

  31. CBC 1

  32. CBC 2 RBC 3.71 x 10[12]/L HGB 5.9 g/dL HCT 20.9 % MCV ______ MCH ______ MCHC ______ RDW ______

  33. CBC 2 RBC 3.71 x 10[12]/L HGB 5.9 g/dL HCT 20.9 % MCV 56.2 fL MCH 15.9 pg MCHC 28.3 g/dL RDW 20.2

  34. CBC 2

  35. CBC 3 RBC 3.36 x 10[12]/L HGB 10.9 g/dL HCT 31.2 % MCV _______ MCH ________ MCHC ________

  36. CBC 3 RBC 3.36 x 10[12]/L HGB 10.9 g/dL HCT 31.2 % MCV 92.8 fL MCH 32.4 pg MCHC 34.9 g/dL

  37. CBC 3

  38. CBC 4 RBC 1.26 x 10[12]/L HGB 5.7 g/dL HCT 16.3 % MCV ________ MCH ________ MCHC ________ RDW 18.1

  39. CBC 4 RBC 1.26 x 10[12]/L HGB 5.7 g/dL HCT 16.3 % MCV 130 fL MCH 45.2 pg MCHC 34.9 g/dL

  40. CBC 4

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