Lab investigation

Question 1

What is a full blood count(FBC)?

Answer 1

1. Hb concentration of Hb
2. Hct: percentage of blood volume as RBC
3. MCV: average size of RBC
4. MCH: average haemoglobin content of RBC
5. RDW: range of deviation around RBC size
6. reticulocyte count
7. Blood film

Question 2

What other components of blood do you look for in FBC?

Answer 2

1. WBC results
   - total WBC and differential
   - neutrophils, lymphocytes, monocytes
   - basophils, esinophils
2. platelets results
   - platelet count and size
3. other : warning flags
   - to see iff there are any morphological changes.

Question 3

What does a red blood cells blood film show?

Answer 3

1. size - anisocytosis
2. colour - Hb content
3. Shape - round, TPD, irregular, elliptocytes, poikylocytosis
4. polychromasia
5. inclusions

Question 4

What does white blood cells blood film show?

Answer 4

1. numbers - too many, too few.
2. normal morphology - dysplastic features
3. immature cells - myelocytes, precursors
4. abnormal cells - blasts atypical lymphoid cells
5. inclusions - RBC should have nothing in cell membrane

Question 5

What clinical devise is used for FBC?

Answer 5

• SGH processes ~1600 FBC samples /day

- modern FBC analyser.

Question 6

What is FBC processed and presented?

Answer 6

• optical scatter methods and presented in cytogram where population of cells are displayed in distinct cluster.
• if differentials are not displayed correctly, this alerts operator to refer to the sample for a blood smear to be examines.

Question 7

Advantages of auto haematology analyser

Answer 7

• efficient and cost effective:
  Processing of large number of samples
• accuracy and precision of quantitative blood test
  -ability to perform multiple tests in single platform
  -reduced labour requirements
• invaluable for accurate determination of red cell indices, eg. MCV

Question 8

Disadvantage of automated haematology analyser

Answer 8

• flagging of lab test results demand labour intensive manual examination of blood smear
• comments on red cell morphology cannot be generated
• platelets clumps are counted at single , so low count
• expensive with high running cost

Question 9

What types of cells does blood film of sickle cell anemia show?

Answer 9

Polychromasia = abnormal cells, blasts atypical lymphoid cells
Tear drop poikilocytes = immature cells