1. Clinical pathology: Complete Blood count
GENERAL OBJECTIVE:
After finishing lab activity of CBC, the student will be able to describe the CBC in the DMS case problem
SPECIFIC OBJECTIVE:
At the end of lab activity of CBC , the student will be able to interprete:
- the normal of CBC
- the abnormal of CBC

2. Complete Blood Count (CBC)

3. Being part of routine physical examination Help :
Providing important information about the kinds and numbers of RBC, WBC and platelet.
Being part of routine physical examination
Help :
To evaluate symptoms (weakness, fatigue, bruising, fever, or weight loss)
To diagnose conditions (anemia, infection)
To diagnose diseases of the blood (leukemia)
To monitor the response to some types of drug or radiation treatment

4. CBC usually includes : WBC count WBC differential RBC count Hematocrit
Hemoglobin
RBC indices (MCV, MCH, MCHC)
Platelet count
Blood smear **
RDW
ESR

5. CBC can be performed : Manually : Automatically (hematologic analyzer)
Hemocytometer
Calculate from other CBC results (RBC indices)
Automatically (hematologic analyzer)

8. WBC count To express WBC concentration per unit volume of blood (mm3).
No distinction is made among the six normal cell types (band neutrophils,segmented neutophils, lymphocytes, monocytes, eosinophils, basophils).
Increase WBC count  leucocytosis
Decrease WBC count  leucopenia

9. WBC Differential 5 major kinds of WBC
Immature neutrophil, band neutrophil  include to the test.
Each type of cell plays a different role in protecting the body.
Number of each type  give important information about the immune system.
Expressed as a percentage of each type

10. Increase/decrease number of each type  help to identify :
infection (neutrophilia, lymphocytosis)
Allergic or toxic reaction to certain medication (eosinophilia)
Malignancy (leukemia)

11. Hemoglobin Main component of RBC Conjugated protein
Serves as a vehicle for the transportation of O2 and CO2.
Gives blood cell its red color
Hemoglobin test measures the amount of hemoglobin in blood.
Decrease  anemia

12. RBC indices There are 3 RBC indices : MCV (Mean Corpuscular Volume)
MCH (Mean Corpuscular Hemoglobin)
MCHC (Mean Corpuscular Hemoglobin Concentration).
Their values are determined from other measurements noted during CBC

13. Platelet count
expressed as concentration – platelet cells per unit volume of blood (mm3).
Decrease  thrombocytopenia
Increase  thrombocytosis

14. RDW Red Cell Distribution width
Reports whether all the red cells are about the same width, size, and shape.
This helps further classify the types of anemia.

15. Erythrocyte Sedimentation Rate
Measuring the sedimentation of erythrocytes in
diluted human plasma over a specified time period (1 hour)
Measuring the distance from the bottom of the surface meniscus to the top of erythrocyte sedimentation in a vertical column containing diluted whole blood.
Not very specific/diagnostic test  still use in many institutions as a screening test for inflammation

16. Factors affecting ESR RBC size & shape
Plasma fibrinogen & globulin levels
Mechanical
Technical

17. Factors affecting the ESR :
Increase :
Rouleaux formation
Fibrinogen (elevated)
Immunoglobulin (excess)
Decrease :
Microcytes
Sickle cells
Spherocytes

18. Methods performing ESR :
Manual :
Westergren Method
Wintrobe Method
Automatic

19. Normal values :
Adult men 0-15 mm/h Adult women 0-20 mm/h

20. Diseases associating with an elevated ESR :
1. Chronic infections(Tb) 2. Multiple Myeloma 3. Cryoglobulinemia 4. Temporal arteritis 5. Inflammatory diseases 6. Pregnancy 7. Anemia
Malignant neoplasms
Paraproteinemias
Macroglobulinemia
Hyperfibrinogenemia
Rheumatoid arthritis
Collagen disease
Polymyalgia rheumatica

21. Results Normal value can vary from lab to lab
Normal value for CBC tests varies, depending on age, sex, elevation above sea level, and type of sample.