Download Complete Blood Count (CBC)

Clinical pathology:
Complete Blood count
GENERAL OBJECTIVE:
After finishing lab activity of CBC, the
student will be able to describe the CBC in
the DMS case problem
SPECIFIC OBJECTIVE:
At the end of lab activity of CBC , the
student will be able to interprete:
- the normal of CBC
- the abnormal of CBC
Complete Blood Count (CBC)
 Providing important information about the kinds
and numbers of RBC, WBC and platelet.
 Being part of routine physical examination
 Help :
 To evaluate symptoms (weakness, fatigue, bruising,
fever, or weight loss)
 To diagnose conditions (anemia, infection)
 To diagnose diseases of the blood (leukemia)
 To monitor the response to some types of drug or
radiation treatment
CBC usually includes :
WBC count
2. WBC differential
3. RBC count
4. Hematocrit
5. Hemoglobin
6. RBC indices (MCV, MCH, MCHC)
7. Platelet count
8. Blood smear **
9. RDW
10. ESR
1.
CBC can be performed :
 Manually :
 Hemocytometer
 Calculate from other CBC results (RBC indices)
 Automatically (hematologic analyzer)
WBC count
 To express WBC concentration per unit volume of blood
(mm3).
 No distinction is made among the six normal cell types
(band neutrophils,segmented neutophils, lymphocytes,
monocytes, eosinophils, basophils).
 Increase WBC count  leucocytosis
 Decrease WBC count  leucopenia
WBC Differential
 5 major kinds of WBC
 Immature neutrophil, band neutrophil  include to
the test.
 Each type of cell plays a different role in protecting the
body.
 Number of each type  give important information
about the immune system.
 Expressed as a percentage of each type
 Increase/decrease number of each type  help to
identify :
 infection (neutrophilia, lymphocytosis)
 Allergic or toxic reaction to certain medication
(eosinophilia)
 Malignancy (leukemia)
Hemoglobin
 Main component of RBC
 Conjugated protein
 Serves as a vehicle for the transportation of O2 and
CO2.
 Gives blood cell its red color
 Hemoglobin test measures the amount of hemoglobin
in blood.
 Decrease  anemia
RBC indices
There are 3 RBC indices :
1. MCV (Mean Corpuscular Volume)
2. MCH (Mean Corpuscular Hemoglobin)
3. MCHC (Mean Corpuscular Hemoglobin
Concentration).
Their values are determined from other
measurements noted during CBC
Platelet count
 expressed as concentration – platelet cells per unit
volume of blood (mm3).
 Decrease  thrombocytopenia
 Increase  thrombocytosis
RDW
 Red Cell Distribution width
 Reports whether all the red cells are about the same
width, size, and shape.
 This helps further classify the types of anemia.
Erythrocyte Sedimentation Rate
 Measuring the sedimentation of erythrocytes in
diluted human plasma over a specified time period (1 hour)
 Measuring the distance from the bottom of the surface
meniscus to the top of erythrocyte sedimentation in a
vertical column containing diluted whole blood.
 Not very specific/diagnostic test  still use in many
institutions as a screening test for inflammation
Factors affecting ESR
 RBC size & shape
 Plasma fibrinogen & globulin levels
 Mechanical
 Technical
Factors affecting the ESR :
Increase :
1. Rouleaux formation
2. Fibrinogen (elevated)
3. Immunoglobulin
(excess)
Decrease :
1. Microcytes
2. Sickle cells
3. Spherocytes
Methods performing ESR :
 Manual :
 Westergren Method
 Wintrobe Method
 Automatic
Normal values :
Adult men
Adult women
0-15 mm/h
0-20 mm/h
Diseases associating with an
elevated ESR :
1. Chronic infections(Tb)
2. Multiple Myeloma
3. Cryoglobulinemia
4. Temporal arteritis
5. Inflammatory diseases
6. Pregnancy
7. Anemia
8. Malignant neoplasms
9. Paraproteinemias
10. Macroglobulinemia
11. Hyperfibrinogenemia
12. Rheumatoid arthritis
13. Collagen disease
14. Polymyalgia
rheumatica
Results
 Normal value can vary from lab to lab
 Normal value for CBC tests varies, depending on age,
sex, elevation above sea level, and type of sample.