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Tanveer Tara , Lecturer IBS Sarhad University
1
WHAT IS A COMPLETE BLOOD COUNT?
• A complete blood count (CBC) is a test that measures the cells that make up
your blood: red blood cells, white blood cells, and platelets. You might get a
CBC as part of your yearly check-up. Your doctor might also order it to:
• It’ll also depend on you age, sex, and how high above sea level you live.
Tanveer Tara , Lecturer IBS Sarhad University
2
SIGN AND SYMPTOMS
• Check for anemia ,Leucocytosis , leukemia
• weakness, fever, bruising, or feeling tired
• Keep an eye on a blood condition you already have
• See how medications or treatments like chemotherapy are affecting your blood
• If the CBC is the only blood test you’re getting that day, you can eat or drink like
you normally would.
Tanveer Tara , Lecturer IBS Sarhad University
3
HOW IS A CBC DONE?
It’s pretty simple and takes just a few minutes. A nurse or lab tech /Phlebotomist
will take a sample of blood by inserting a needle into a vein in your arm. She’ll
send it to the lab for review. You can leave and get right back to your normal
routine
Tanveer Tara , Lecturer IBS Sarhad University
4
WHITE BLOOD CELLS (WBCS).
These help to fight infections. If you have high WBC levels, it tells your doctor you
have inflammation or infection somewhere in your body. If it’s low, you could be at
risk for infection. The normal range is 4,500 to 10,000 cells per microliter
(cells/mcL). (A microliter is a very tiny amount – one millionth of a liter).
Tanveer Tara , Lecturer IBS Sarhad University
5
RBC (RED BLOOD CELL COUNT).
This is the number of red blood cells you have. These are important because they carry
oxygen through your body. They also help filter carbon dioxide. If your RBC count is too
low, you may have anemia or another condition. (If you have anemia, your blood has
fewer red blood cells than normal.) The normal range for men is 5 million to 6 million
cells/mcL; for women it’s 4 million to 5 million cells/mcL.
Tanveer Tara , Lecturer IBS Sarhad University
6
Hemoglobin(Hb or Hbg ). This is the protein in your blood that holds the oxygen. The
normal range for men is 14 to 17 grams per deciliter (gm/dL); for women it’s 12 to 15
gm/dL.
Hematocrit (Hct ). How much of your blood is red blood cells. A high score could mean
you’re dehydrated or have another condition. The normal range for men is between 41%
and 50%. For women the range is between 36% and 44%.
Tanveer Tara , Lecturer IBS Sarhad University
7
MCV
Mean corpuscular volume
HCT/RBC count= 80-100fL
• Small = microcytic
• normal = normocytic
• Large = macrocytic
Tanveer Tara , Lecturer IBS Sarhad University
8
• MCH
• The amount of hemoglobin per RBC.
• That’s what MCH
HB/RBC X10= 27-32 pg.
Tanveer Tara , Lecturer IBS Sarhad University
9
MCHC
Mean corpuscular hemoglobin concentration
HB/HCT X 100 : 26-34%
Decreased :Hypochromic
Normal :Normochromic
Tanveer Tara , Lecturer IBS Sarhad University
10
PLATELETS.
• These play a role in clotting. This test measures the number of platelets in your
blood. The normal range is 140,000 to 450,000 cells/mcL
• MPV (mean platelet volume). The size of the platelets in your blood.
• A typical range of platelet volumes is 9.4–12.3 fl (femtolitre), equivalent to
spheres 2.65 to 2.9 µm in diameter.
• PDW (platelet distribution width). How much your platelets vary in size.
Tanveer Tara , Lecturer IBS Sarhad University
11
RDW (RED CELL DISTRIBUTION WIDTH).
• How your much your red blood cells vary in size.
• Red blood cell distribution width (RDW or RDW-CV or RCDW and RDW-SD) is a
measure of the range of variation of red blood cell (RBC) volume that is
reported as part of a standard complete blood count. Usually red blood cells are
a standard size of about 6-8 μm in diameter.
• Higher RDW values indicate greater variation in size
Tanveer Tara , Lecturer IBS Sarhad University
12
HIGH RDW
• Iron-deficiency anemia usually presents with high RDW and low MCV.
• Folate- and vitamin B12-deficiency anemia usually present with high RDW and
high MCV.
• Mixed-deficiency (iron + B12 or folate) anemia usually presents with high RDW
and variable MCV.
• Recent hemorrhages typically present with high RDW and normal MCV.
• A false high RDW reading can occur if EDTA anticoagulated blood is used
instead of citrated blood.
Tanveer Tara , Lecturer IBS Sarhad University
13
Tanveer Tara , Lecturer IBS Sarhad University
14
• This important value is needed in the evaluation
of any anemia.
• Normal range 1-2%
• Retic count goes up with
– Hemolytic anemia
• Retic goes down with
– Nutritional deficiencies
_ Diseases of the bone marrow itself
Tanveer Tara , Lecturer IBS Sarhad University
15
RETICULOCYTES
Leishman’sSupravital
Tanveer Tara , Lecturer IBS Sarhad University
16
Tanveer Tara , Lecturer IBS Sarhad University
17
Tanveer Tara , Lecturer IBS Sarhad University
18
What is corrected reticulocyte count?
Tanveer Tara , Lecturer IBS Sarhad University
19
Tanveer Tara , Lecturer IBS Sarhad University
20
Tanveer Tara , Lecturer IBS Sarhad University
21
THE THREE BASIC MEASURES
Measurement Normal Range
A. RBC count 5 million 4 to 6
B. Hemoglobin 15 g/dl 12 to 17
C. Hematocrit 45 % 38 to 50
Check whether this holds good in given results
If not -indicates micro or macrocytosis or hypochromia.
Tanveer Tara , Lecturer IBS Sarhad University
22
NORMAL CBC
Tanveer Tara , Lecturer IBS Sarhad University
23
WORKUP – SECOND TEST
• The next step is ‘What is the size of RBC’ ?
• MCV indicates the Red cell volume (size)
• Both the MCH & MCHC tell Hb content of RBC
• If the Retic count is 2 or less
• We are dealing with either
• Hypoproliferative anaemia (lack of raw material)
• Maturation defect with less production
• Bone marrow suppression (primary/ secondary)
Tanveer Tara , Lecturer IBS Sarhad University
24
ANAEMIA WORKUP - MCV
Microcytic
MCV
Normocytic Macrocytic
Iron Deficiency IDA
Chronic Infections
Thalassemia's
Hemoglobinopathies
Sideroblastic Anemia
Chronic disease
Early IDA
Hemoglobinopathies
Primary marrow disorders
Combined deficiencies
Increased destruction
Megaloblastic anemias
Liver disease/alcohol
Hemoglobinopathies
Metabolic disorders
Marrow disorders
Increased destruction
Tanveer Tara , Lecturer IBS Sarhad University
25
MEAN CELL VOLUME (MCV)
• RBC volume (rather) is measured by
• The Mean Cell Volume or MCV and RDW
Microcytic
< 80 fl
MCV
Normocytic Macrocytic
80 -100 fl > 100 fl
Tanveer Tara , Lecturer IBS Sarhad University
26
RED CELL DISTRIBUTION WIDTH - RDW
Normal
Population
Uniform
RDW
High
Population
Double
Tanveer Tara , Lecturer IBS Sarhad University
27
IDA -CBC
Tanveer Tara , Lecturer IBS Sarhad University
28
MICROCYTIC HYPOCHROMIC - IDA
Tanveer Tara , Lecturer IBS Sarhad University
29
ANEMIA - MACROCYTIC (MCV > 100)
MCV 100-110 fl
must look for other causes of macrocytosis
MCV > 110 fl
almost always folate or B12 deficiency
Tanveer Tara , Lecturer IBS Sarhad University
30
MBA
Tanveer Tara , Lecturer IBS Sarhad University
31
MACROCYTOSIS -MBA
Tanveer Tara , Lecturer IBS Sarhad University
32
MBA
Tanveer Tara , Lecturer IBS Sarhad University
33
Tanveer Tara , Lecturer IBS Sarhad University
34

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cbc interpretation and cases

  • 1. Tanveer Tara , Lecturer IBS Sarhad University 1
  • 2. WHAT IS A COMPLETE BLOOD COUNT? • A complete blood count (CBC) is a test that measures the cells that make up your blood: red blood cells, white blood cells, and platelets. You might get a CBC as part of your yearly check-up. Your doctor might also order it to: • It’ll also depend on you age, sex, and how high above sea level you live. Tanveer Tara , Lecturer IBS Sarhad University 2
  • 3. SIGN AND SYMPTOMS • Check for anemia ,Leucocytosis , leukemia • weakness, fever, bruising, or feeling tired • Keep an eye on a blood condition you already have • See how medications or treatments like chemotherapy are affecting your blood • If the CBC is the only blood test you’re getting that day, you can eat or drink like you normally would. Tanveer Tara , Lecturer IBS Sarhad University 3
  • 4. HOW IS A CBC DONE? It’s pretty simple and takes just a few minutes. A nurse or lab tech /Phlebotomist will take a sample of blood by inserting a needle into a vein in your arm. She’ll send it to the lab for review. You can leave and get right back to your normal routine Tanveer Tara , Lecturer IBS Sarhad University 4
  • 5. WHITE BLOOD CELLS (WBCS). These help to fight infections. If you have high WBC levels, it tells your doctor you have inflammation or infection somewhere in your body. If it’s low, you could be at risk for infection. The normal range is 4,500 to 10,000 cells per microliter (cells/mcL). (A microliter is a very tiny amount – one millionth of a liter). Tanveer Tara , Lecturer IBS Sarhad University 5
  • 6. RBC (RED BLOOD CELL COUNT). This is the number of red blood cells you have. These are important because they carry oxygen through your body. They also help filter carbon dioxide. If your RBC count is too low, you may have anemia or another condition. (If you have anemia, your blood has fewer red blood cells than normal.) The normal range for men is 5 million to 6 million cells/mcL; for women it’s 4 million to 5 million cells/mcL. Tanveer Tara , Lecturer IBS Sarhad University 6
  • 7. Hemoglobin(Hb or Hbg ). This is the protein in your blood that holds the oxygen. The normal range for men is 14 to 17 grams per deciliter (gm/dL); for women it’s 12 to 15 gm/dL. Hematocrit (Hct ). How much of your blood is red blood cells. A high score could mean you’re dehydrated or have another condition. The normal range for men is between 41% and 50%. For women the range is between 36% and 44%. Tanveer Tara , Lecturer IBS Sarhad University 7
  • 8. MCV Mean corpuscular volume HCT/RBC count= 80-100fL • Small = microcytic • normal = normocytic • Large = macrocytic Tanveer Tara , Lecturer IBS Sarhad University 8
  • 9. • MCH • The amount of hemoglobin per RBC. • That’s what MCH HB/RBC X10= 27-32 pg. Tanveer Tara , Lecturer IBS Sarhad University 9
  • 10. MCHC Mean corpuscular hemoglobin concentration HB/HCT X 100 : 26-34% Decreased :Hypochromic Normal :Normochromic Tanveer Tara , Lecturer IBS Sarhad University 10
  • 11. PLATELETS. • These play a role in clotting. This test measures the number of platelets in your blood. The normal range is 140,000 to 450,000 cells/mcL • MPV (mean platelet volume). The size of the platelets in your blood. • A typical range of platelet volumes is 9.4–12.3 fl (femtolitre), equivalent to spheres 2.65 to 2.9 µm in diameter. • PDW (platelet distribution width). How much your platelets vary in size. Tanveer Tara , Lecturer IBS Sarhad University 11
  • 12. RDW (RED CELL DISTRIBUTION WIDTH). • How your much your red blood cells vary in size. • Red blood cell distribution width (RDW or RDW-CV or RCDW and RDW-SD) is a measure of the range of variation of red blood cell (RBC) volume that is reported as part of a standard complete blood count. Usually red blood cells are a standard size of about 6-8 μm in diameter. • Higher RDW values indicate greater variation in size Tanveer Tara , Lecturer IBS Sarhad University 12
  • 13. HIGH RDW • Iron-deficiency anemia usually presents with high RDW and low MCV. • Folate- and vitamin B12-deficiency anemia usually present with high RDW and high MCV. • Mixed-deficiency (iron + B12 or folate) anemia usually presents with high RDW and variable MCV. • Recent hemorrhages typically present with high RDW and normal MCV. • A false high RDW reading can occur if EDTA anticoagulated blood is used instead of citrated blood. Tanveer Tara , Lecturer IBS Sarhad University 13
  • 14. Tanveer Tara , Lecturer IBS Sarhad University 14
  • 15. • This important value is needed in the evaluation of any anemia. • Normal range 1-2% • Retic count goes up with – Hemolytic anemia • Retic goes down with – Nutritional deficiencies _ Diseases of the bone marrow itself Tanveer Tara , Lecturer IBS Sarhad University 15
  • 16. RETICULOCYTES Leishman’sSupravital Tanveer Tara , Lecturer IBS Sarhad University 16
  • 17. Tanveer Tara , Lecturer IBS Sarhad University 17
  • 18. Tanveer Tara , Lecturer IBS Sarhad University 18
  • 19. What is corrected reticulocyte count? Tanveer Tara , Lecturer IBS Sarhad University 19
  • 20. Tanveer Tara , Lecturer IBS Sarhad University 20
  • 21. Tanveer Tara , Lecturer IBS Sarhad University 21
  • 22. THE THREE BASIC MEASURES Measurement Normal Range A. RBC count 5 million 4 to 6 B. Hemoglobin 15 g/dl 12 to 17 C. Hematocrit 45 % 38 to 50 Check whether this holds good in given results If not -indicates micro or macrocytosis or hypochromia. Tanveer Tara , Lecturer IBS Sarhad University 22
  • 23. NORMAL CBC Tanveer Tara , Lecturer IBS Sarhad University 23
  • 24. WORKUP – SECOND TEST • The next step is ‘What is the size of RBC’ ? • MCV indicates the Red cell volume (size) • Both the MCH & MCHC tell Hb content of RBC • If the Retic count is 2 or less • We are dealing with either • Hypoproliferative anaemia (lack of raw material) • Maturation defect with less production • Bone marrow suppression (primary/ secondary) Tanveer Tara , Lecturer IBS Sarhad University 24
  • 25. ANAEMIA WORKUP - MCV Microcytic MCV Normocytic Macrocytic Iron Deficiency IDA Chronic Infections Thalassemia's Hemoglobinopathies Sideroblastic Anemia Chronic disease Early IDA Hemoglobinopathies Primary marrow disorders Combined deficiencies Increased destruction Megaloblastic anemias Liver disease/alcohol Hemoglobinopathies Metabolic disorders Marrow disorders Increased destruction Tanveer Tara , Lecturer IBS Sarhad University 25
  • 26. MEAN CELL VOLUME (MCV) • RBC volume (rather) is measured by • The Mean Cell Volume or MCV and RDW Microcytic < 80 fl MCV Normocytic Macrocytic 80 -100 fl > 100 fl Tanveer Tara , Lecturer IBS Sarhad University 26
  • 27. RED CELL DISTRIBUTION WIDTH - RDW Normal Population Uniform RDW High Population Double Tanveer Tara , Lecturer IBS Sarhad University 27
  • 28. IDA -CBC Tanveer Tara , Lecturer IBS Sarhad University 28
  • 29. MICROCYTIC HYPOCHROMIC - IDA Tanveer Tara , Lecturer IBS Sarhad University 29
  • 30. ANEMIA - MACROCYTIC (MCV > 100) MCV 100-110 fl must look for other causes of macrocytosis MCV > 110 fl almost always folate or B12 deficiency Tanveer Tara , Lecturer IBS Sarhad University 30
  • 31. MBA Tanveer Tara , Lecturer IBS Sarhad University 31
  • 32. MACROCYTOSIS -MBA Tanveer Tara , Lecturer IBS Sarhad University 32
  • 33. MBA Tanveer Tara , Lecturer IBS Sarhad University 33
  • 34. Tanveer Tara , Lecturer IBS Sarhad University 34