3.2 Interpreting Full Blood Counts

Question 1

Why may results be abnormal?

Answer 1

• specimen mixing up
• technical error
• poor technique of collection

Question 2

How far around the normal range would you accept results?

Answer 2

2.5% up or down

Question 3

What would you see in a normal sample of centrifuged blood?

Answer 3

Normal haematocrit (red blood cells), small buffy coat of white cells and platelets,and then on top yellow plasma

Question 4

How would the haematocrit vary between anaemic and and polycythaemic centrifuged haemoglobin?

Answer 4

Anaemic = Low haematocrit 
Polycythaemia = elevated haematocrit

Question 5

What do you have if mean cell volume of RBC is below average?

Answer 5

Microcytic anaemia

Question 6

How can you get polycythaemia?

Answer 6

• decrease in plasma volume = higher conc in RBC

- increase in RCC

Question 7

What would be the cause of microcytic anaemia?

Answer 7

• iron deficiency anaemia
• thalassaemia
• anaemia of chronic disease

Question 8

What can cause increased and decreased mean cell haemoglobin concentration?

Answer 8

• increased in macrocytic anaemia

- reduced in iron deficiency anaemias

Question 9

What is hyperchromia?

Answer 9

Excessive pigmentation of RBC

Question 10

When would you have increased and decreased reticulocytes count?

Answer 10

Increased

• haemolytic anaemia
• recent blood loss
• response to EPO
• response to iron, b12,folate replacement

Reduced

• haematinic deficiency
• bone marrow failure

Question 11

What’s the different between hypochromic and hyperchromic RBC when looking at mean cell haemoglobin?

Answer 11

Hypochromic - pale, less HB

Hyperchromic - dense, more hb in a given volume

Question 12

What is polychromasia?

Answer 12

A abnormally high number of reticulocytes in the blood stream

Question 13

What is a target cell RBC shape?

Answer 13

RBC with a dark area in the middle of the area of central pallor

Question 14

What is poikilocytosis?

Answer 14

Abnormally shaped RBC

Question 15

What is anisocytosis?

Answer 15

Increased variability in size

Question 16

What is dimorphism?

Answer 16

Two distinct populations of red cells

Question 17

What are schistiocytes/acanthocytes?

Answer 17

Cells with pointy edges

Question 18

How would reticulocytes appear in a blood film?

Answer 18

Purple blobs

Question 19

What is basophilic stippling and how would basophilic stippling appear?

Answer 19

It is RNA inclusion in cells

Looks like granules on the edges of a RBC

Question 20

What’s spherocytosis and eliptocytosis?

Answer 20

Spherocytosis = look like circles
Eliptocytes = look like sausages

Question 21

What’s a Heinz body?

Answer 21

Denatured haemoglobin

Question 22

What’s a pappenheimer body?

Answer 22

Iron inclusions in cells - get Perl’s stain

Looks like dots on the edge of a hypochromic haemoglobin

Question 23

What would you see in an iron deficiency anaemia?

Answer 23

Hypochromic RBC

Question 24

What would you seen in a vitamin b12 deficiency blood film?

Answer 24

• oval macrocytes
• teardrop poikilocytes
• basophilic stippling
• Howell Jolly bodies