Complete blood count Flashcards
Flow Cytometry - what is it and how it works
Hydrodynamic focusing and passes cells through probe in single file line –> voltage drop –> relates to cell size and counts cells
Units of RBC count, HGB, HCT, WBC
x10^6/uL or 10^12/L
g/dL or g/L
Percent
thousands per uL or millions per L
Define MCV
mean size of red cells femptoliters
Define MCH
mean corpuscular hemoglobin (amount of hemoglobin in a single red cell) pg
Define MCHC
Average concentration of hgb in cell (g/dL or g/L0
Equation to find MCHC
MCHC = HGB/HCT
Equation for MCV
MCV = HCT/RBC x 100
Morphology: neutrophils
9-15 um cytoplasm acidophilic very fine granules 2-5 nuclear segment/lobes WBC: 4 - 11.1 N% 39.7 - 72.11 N: 1.8-6.6
Morphology: Eosinophils
12-17 um
Numerous large, round, red-orange granules
1-4 nuclear lobes (typically 2)
Note (Stimu by IL5) - parasite killers
Morphology Basophil
12 um
Numerous large/round purple black bytoplasmic granules
2 nuclear lobe - may be covered by granules
Morphology Monocyte
15-20 uM Large eccentric nucleus, round kidney/horseshoe shaped/lobulated Chromatin lacy appearance Abundant cytoplasm, azurophilic granules intracytoplasmic vacuoles
Morphology Lymphocyte
7-12 um
Condensed chromatin
Scanty bluish cytoplasm, few azurophilic granules
nucleus round/slightly indented (cell mostly nucleus)
Morphology platelets
small 2-3 um 7-8 fl irregular outline light blue cytoplasm small azurophilic granules
Morphology - iron deficiency anemia
RBC small - large central pale area, target cells
Morphology spherocytes
spherical, no central pallor, decrease cell membrane, increase MCHC
Immune hemolytic anemia, hereditary spherocytosis
Morphology bite cells
bite like detect - removal of heinz body in spleen
G6PH deficiency
Schistocytes morphology
Fragmented RBC, helmet cells
Burns, HUS, TTP, DIC, HELLP, mechanical heart valves
Target cell morphology
Central hemoglobin, target shape
Thalassemia, hemoglobin C, iron deficiency, liver disease
Sickle cell
Bannana shape
Basophilic stippling
Evenly dispersed fine blue granules in RBC - aggregated rNRA
Lead poisoning, porphyria, pryimidine 5’ nucleotidase deficiency
Hemoglobinopathies, thalassemia
Myelodysplasia, sideroblastic anemia
Infection
Howell Jolly Bodies
Single dense, blue dot
Nuclear DNA remnant
Post-splenectomy, functional asplenia , megaloblastic anemia, myelodysplasia
Heinz body
Not visible on wright-diemsa stain - need to stay with supravital dye/crystal violet
Denatured/oxidized hemoglobin attached to inner cell membrane –> G6PH deficiency
Associated with bite cell
Dohl Body
WBC - pale blue inclusion at periphery of cytoplasm
infection, inflammation, burns, pregnancy
condensed RNA
Toxic granulation/hypergranularity
WBC - increase number and primary granules - due to trapid cell division
Bacterial infection, marrow recovery, GM-CSF
Hypersegmented neutrophils
More than 5 lobes, megaloblastic anemia
Microcytic/hypochromatic RBC
RBC smaller with larger central pale area - iron deficiency anemia
Elliptocytosis
elliptical - defective spectrin alpha chain
Ovalocyte
large, ovoid RBC - B12/folate deficiency
teardrop cells
pear shaped - myelophthistic changes
Stomatocyte
elongated central pallor
alcohol, dilantin, Rh null, hereditary stomatocytosis
Echinocytes (Burr cell)
Shape projection, evenly distributed
Increase in outer lipid bilayer
acute renal failure, pyruvate kinase deficiency
Acanthocytes (Spurr)
few blunt projection, irregularly distributed, no central pallor,
Abetalipoproteinemia
liver disease
Rouleaux formation
Loss of RBC replusion/negative charge - large asymmetrical proteins - fibrinogen/immunoglobulin
Stacked of coins - increase sedimentation
Cold agglutinin
RBC clumping, corrected by warming
Pappenheimer body
multiple blue dots, irregular size - iron - iron overload, postsplenectomy, asplenia
Histoplasma
2-4 um, halo like effect with nucleus, no kinetoplast
