[04.11a] Interpretation of the Complete Blood Count V2.pdf

History Taking, Physical Examination, and Laboratory Tests

What three elements are needed to arrive at a diagnosis for hematological conditions?

To confirm the diagnosis

What is the purpose of performing laboratory tests in the context of hematological conditions?

Complete Blood Count (CBC)

What specific laboratory test is often performed for patients presenting with possible hematological conditions?

Quantification of cellular elements of blood

What is the primary function of the Complete Blood Count (CBC)?

An "average estimate" of the cellular characteristics of blood elements

What does the CBC provide regarding blood elements?

Automated or manual methods

What are the two general methods by which a CBC may be done?

Hematology analyzer

What is the modern method used for automatic CBC determination?

Ethylenediaminetetraacetic acid (EDTA) tube

Into what container is blood drawn for analysis in the CBC machine?

Red blood cells

What component of the CBC should be looked at first when systematically reading the results?

White blood cells

What component of the CBC should be looked at second, after red blood cells, when systematically reading the results?

Platelets

What component of the CBC should be looked at last when systematically reading the results?

Number of RBCs

What does the RBC Count parameter describe?

4.5 to 5.9 times 10 to the power of 12 per Liter

What is the normal value range for RBC Count in males?

4.0 to 5.2 times 10 to the power of 12 per Liter

What is the normal value range for RBC Count in females?

The protein inside the RBC that carries oxygen, indicating the blood’s oxygen carrying capacity

What is the description of Hemoglobin in the CBC?

13 to 16.5 grams per deciliter

What is the normal value range for Hemoglobin in males?

12 to 16 grams per deciliter

What is the normal value range for Hemoglobin in females?

Percentage of red cells present

What does the Hematocrit parameter describe?

41 to 53 percent

What is the normal value range for Hematocrit in males?

36 to 46 percent

What is the normal value range for Hematocrit in females?

Average volume or size of red cells

What does the Mean Corpuscular Volume (MCV) parameter describe?

80 to 100 fL

What is the normal value range for Mean Corpuscular Volume (MCV)?

Average amount of hemoglobin per cell

What does the Mean Corpuscular Hemoglobin (MCH) parameter describe?

26 to 34 pg

What is the normal value range for Mean Corpuscular Hemoglobin (MCH)?

Average concentration of hemoglobin in a given volume

What does the Mean Corpuscular Hemoglobin Concentration (MCHC) parameter describe?

31 to 37 grams per deciliter

What is the normal value range for Mean Corpuscular Hemoglobin Concentration (MCHC)?

Variance of sizes between individual cells

What does the Red Cell Distribution Width (RDW) parameter describe?

11 to 14 percent

What is the normal value range for Red Cell Distribution Width (RDW)?

Number of WBCs

What does the WBC Count parameter describe?

4.0 to 11.0 times 10 to the power of 9 per Liter

What is the normal value range for WBC Count?

Relative percentages of different WBC types

What does the WBC Differential Count describe?

Neutrophils or Segmenters

Which WBC type has a normal relative percentage of 50-70 percent?

Lymphocytes

Which WBC type has a normal relative percentage of 20-50 percent?

Monocytes

Which WBC type has a normal relative percentage of 0-12 percent?

Eosinophils

Which WBC type has a normal relative percentage of 0-4 percent?

Basophils

Which WBC type has a normal relative percentage of 0-2 percent?

Number of platelets

What does the Platelet Count parameter describe?

150 to 450 times 10 to the power of 9 per Liter

What is the normal value range for Platelet Count?

Average volume or size of platelets

What does the Mean Platelet Volume (MPV) parameter describe?

7.5 to 11.5 fL

What is the normal value range for Mean Platelet Volume (MPV)?

They have just been released from the bone marrow

What does it mean if platelets are big, suggesting a reactive process?

Dengue

In what condition are large platelets sometimes seen, possibly due to an autoimmune condition causing platelet destruction?

Plasma

What component of blood in a capillary tube is described as the watery part?

Red blood cells

Which blood cells are heavier and are found at the bottom of the capillary tube when assessing hematocrit?

Neutrophils

Which white blood cell is normally the most abundant in peripheral blood?

Myelocytes, Metamyelocytes, Myeloblast

Name two types of cells of the myeloid lineage that are not normally seen in peripheral blood.

Pathologic conditions like leukemia

What may be indicated if cells like myeloblasts are seen in the peripheral blood?

WBC times (percent neutrophils plus percent stabs) times 1000

What is the formula for the Absolute Neutrophil Count?

WBC times percent lymphocytes times 1000

What is the formula for the Absolute Lymphocyte Count?

Red blood cell (RBC)

What does the prefix "Erythro-" refer to?

White blood cell (WBC)

What does the prefix "Leuko-" refer to?

Platelets

What does the prefix "Thrombo-" or "Thrombocyto-" refer to?

Blood

What does the prefix "Heme-" or "Hema-" refer to?

Increased number

What does the suffix "-cytosis" or "-philia" indicate?

Decreased number

What does the suffix "-penia" indicate?

Cell size or volume

What does the suffix "-cytic" refer to, necessitating looking at the MCV?

Hemoglobin content

What does the suffix "-chromic" refer to, necessitating looking at the MCH?

Different cell sizes

What is Anisocytosis?

Same cell sizes

What is Isocytosis?

Different cell shapes

What is Poikilocytosis?

Different cell sizes and shapes

What is Anisopoikilocytosis?

Leukopenia

What term describes a decreased number of WBCs?

Thrombocytopenia

What term describes a decreased number of platelets?

Anemia

What term describes a decreased number of RBCs or a low amount of hemoglobin?

Bicytopenia

What term describes a decreased number of two cell lines?

Pancytopenia

What term describes a decreased number of all cell lines?

Leukocytosis

What term describes an increased number of WBCs?

Thrombocythemia or Thrombocytosis

What term describes an increased number of platelets?

Polycythemia or Erythrocytosis

What term describes an increased number of RBCs or a high amount of hemoglobin?

Polycythemia or Panmyelosis

What term describes an increased number of all cell lines?

Increased number of marrow cells

What does Panmyelosis strictly refer to?

Microcytic

What term describes small cell size?

Macrocytic

What term describes large cell size?

Normocytic

What term describes normal cell size?

Hypochromic

What term describes "pale" cells or low cell hemoglobin?

Normochromic

What term describes normal cell hemoglobin?

MCV less than 80 um3

What is the MCV characteristic of Microcytic Anemia?

Iron deficiency anemia

What is a common cause of microcytic anemia due to lack of iron resulting in small RBCs?

Anemia of chronic disease

What is a cause of microcytic anemia besides iron deficiency?

Thalassemia (alpha and beta)

What is a cause of microcytic anemia due to a deficiency in alpha or beta chains leading to deformed hemoglobin and damaged RBC membrane?

Sideroblastic anemia

What is a rare cause of microcytic anemia?

Mentzer Index

What tool can be solved for to differentiate between iron-deficiency anemia and Thalassemia?

MCV divided by RBC Count

What is the formula for the Mentzer Index?

Iron-deficiency anemia

What is more likely if the Mentzer Index score is greater than 13?

Thalassemia

What is more likely if the Mentzer Index score is less than 13?

The problem lies with how much RBCs can be produced, which is lower than normal

What is the clarified issue regarding RBC production in iron-deficiency anemia?

MCV 80-100 um3

What is the MCV characteristic of Normocytic Anemia?

MCV greater than 100 um3

What is the MCV characteristic of Macrocytic Anemia?

Defective DNA synthesis

What leads to the defective maturation of RBCs, immature RBCs in peripheral blood, and large RBCs in Megaloblastic Anemia?

Folate deficiency and Vitamin B12 (cobalamin) deficiency

What are two causes of defective DNA synthesis leading to Megaloblastic Anemia?

In immature RBCs

When does DNA synthesis happen in RBCs?

Liver disease, Alcoholism, and Reticulocytosis

Name two non-megaloblastic causes of Macrocytic Anemia.

Drastically increased erythropoiesis leading to the early release of reticulocytes

What causes Reticulocytosis as a compensatory mechanism?

Severe blood loss or Hemolytic state

What are two conditions that trigger Reticulocytosis as a compensatory mechanism?

Increased elevation and increased breakdown of RBCs (Hemolysis)

What are two conditions that lead to increased reticulocytes?

The size of the reticulocytes being produced

What characteristic of reticulocytes results in macrocytic anemia and can increase the MCV value on a CBC?

MCHC (Mean Corpuscular Hemoglobin Concentration)

Which CBC component indicates the average concentration of hemoglobin in a given volume?

Macrocytic megaloblastic anemia

What type of anemia presents with the release of immature RBCs, referring to the immature RBCs (megaloblasts) resulting from defective maturation?

Polycythemia or Erythrocytosis

What refers to an increased number of RBCs and a high amount of hemoglobin?

To examine the actual morphology of blood samples and counter check abnormalities observed in the CBC

What is the purpose of performing a Peripheral Blood Smear (PBS)?