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

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Presentation on theme: "HEMATOLOGY Jane Finley, BS MT (ASCP) Nov 1, 2004."— Presentation transcript:

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

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

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5 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

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

7 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)

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

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

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13 Cell Counts: Number of cells per liter of whole blood WBC x 10 9 /L RBC Males: x10 12 /L Females: “ Plt x10 9 /L Terms Leukocytosis Erythrocytosis Erythropenia Thrombocytosis Thrombopenia

14 Hemoglobin Heme + protein (globulin) Main purpose is to carry O 2 Three main types Variants result in identifiable disorders Normal ranges are age and gender related

15 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

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

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

18 Mean Corpuscular hemoglobin (MCH)  The average hemoglobin content of a RBC.  Normal values: pg.  MCH (in pg) = hemoglobin x 10 rbc count

19 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]

20 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: %

21 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

22 Lab Language: Indices Anemia Microcytic Macrocytic Hypochromic normochromic

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

24 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

25 Anemia Classifications Microcytic, hypochromic Microcytic, normochromic Normocytic, normochromic Macrocytic, normochromic

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

27 MICROCYTIC, HYPOCHROMIC ANEMIA MCV decreased MCHC decreased Examples: –iron deficiency –thalassemia –lead poisoning –anemia of chronic disease

28 MICROCYTIC, NORMOCHROMIC ANEMIA MCV decreased MCHC normal Examples: –mid-stage iron deficiency –thalassemia

29 MACROCYTIC, NORMOCHROMIC ANEMIA MCV increased MCHC normal Examples: –folate deficiency –vitamin B 12 deficiency –pernicious anemia

30 Hemoglobin & Hematocrit Normal Ranges Cord blood: - Hb ± 3 g/dl - Hct - 51 ± 9 % years: - Hb: 12.0 ± 1.5g /dl - Hct - 36 ± 3 % yrs: Female: -Hb 14.0 ± 2 g/dl -Hct 41 ± 4% Male: -Hb 14.5 ± 1 g/dl - Hct 43 ± 6%

31 Hemoglobin & Hematocrit Adult Normal Ranges – Male:Hb 15.5 ± 2 g/dl Hct 47 ± 6% –Female:Hb 14.0 ± 2 g/dl Hct 41 ± 5%

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

33 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)

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

35 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 CBC 1

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

38 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 CBC 2

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

41 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 CBC 3

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

44 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 CBC 4

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