Lab investigation of the Full Blood count and WBC disorders Flashcards
Where does blood cell production occur ?
Haematopoiesis takes place in the bone marrow within long bones.
Maturation occurs in the bone marrow
Once mature they enter the peripheral blood.
What are the different types of WBC ?
Lymphocytes Monocyte Eosinophil Basophil Neutrophil
What are the three types of blood cells produced ?
RBC
WBC
Platelets
Describe Haematopoiesis
The process begins with multipotential haematopoietic stem cells (hemocytoblast)
This gives rise to the common myeloid progenitor + common lymphoid progenitor.
The common myeloid progenitor forms Megakaryoblast =Thrombocytes , Proerythroblasts=Erythrocytes, Myeloblast=Basophil/Neutrophil/Eosinophil (Granulocytes)
/Monocyte, mast cells
The common lymphoid progenitor forms :
Small lymphocyte=B/T lymphocytes
/natural killer cells
What are some components in a Full Blood count ?
Hb: concentration of Haemoglobin
HCT (haematocrit): Percentage of blood volume as RBC (percentage of the blood tube that is basically blood usually use Hb to reflect this)
RBC (red blood cell count) another reflection of the Hb
MCV (Mean cell Volume): Average size of RBC
MCH (Mean Cell Hb): Average haemoglobin content of RBC
RDW (red cell distribution width): Range of deviation around RBC size
more varied cell widths the higher the RDW (e.g. B12/folate D)
If RBCs are monomorphic (each RBC is same shape/size) RDW will be small
Reticulocyte count (doesn’t come with FBC has to be requested) - baby RBC and it is used to see if the bone marrow is working
(Iron deficient patients MCV low MCH low so not much Hb but weirdly for B12 folate deficient patients they ae big and have less RBC but their MCHC (concentration of Hb in each cell is usually normal.)
Blood film
What is the WBC result?
Total WBC and differential(different types of WBC)
Neutrophils ,lymphocytes,Monocytes,Basophils and Eosinophils
Platelet results
(Platelet count and size )
What does a Blood film show ?
Morphology (Are the cells normal ?)
RBC-Size,Colour,Shape,Polychromasia(colour),Inclusions
WBC-Number,Normal morphology,Immature cells,Abnormal Cells,Inclusions
What is polychromasia?
This is a disorder where there s an abnormal amount of immature RBC this means they stain differently
What us Poikilocytosis ?
This is when RBC have different shapes
What is Anisocytosis ?
This is when the RBC are unequal in size
Describe the blood film of iron deficiency anaeima
Ovalocytes/elliptocytes Pale cell-Hypochromic Scrappy cells Different shapes +sizes Microcytic hypchromic anaemia Anisocytosis (unequal sizes)
Describe the blood film of Macrocytic Megaloblastic anaemia
Macrocytic cells -bigger size
Central pallor is big =Hypochromic
Different shapes -Tear drop
Caused by Vitamin b12 deficieny
Gastrectomy-No intirnsic factor being produced by parietal cells in stomach
Cannot uptake B12
Not taking supplements
Describe Acquired haemolytic anaemia blood film
Spherocytes -Round cells with no pale middle
Polychromasia-Many baby RBCs(reticulocytes
Nucelated RBC
Antibody which destroys the patients RBC in intravascular space
Patient is jaundiced due to cells dying quickly and releasing bilurubin
Sickle cell anaemia Blood film?
Contains sickled cells (Long and moon shape) Target cells (Centarl pallor with dot in the middle (HbSS /HbSC)
Tear drop poikilocytosis Blood film?
Tear drop cells(Infiltration of bone marrow -scarring /cancer)
Malignant diseases
Myelofibrosis(scarring)
The lady has a large spleen
