Hemotologic Parameters Part 1

The study of the physiology of the blood, its components and the diseases that affect them

Hematology

CBC evaluates what

oxygen carrying capacity, infection, coagulation status, bone marrow function

CBC Is indicative of ____ of patient

overall health

CBC with differential is an ____ that can guide diagnosis

expanded panel

fill out the tree

1. HgB

2. Plt

3. Hct

4. WBC  

*Red Blood Cell Count (RBC)

*Hemoglobin (Hgb)

*Hematocrit (Hct)

*Red Blood Cell Indices

*White Blood Cell Count (WBC)

*Platelet Count

CBC

what speciality test measures % of types of WBC?

CBC with differential

other specialty test:

1. ______

2. _____

• determine shape and size

reticulocyte count, peripheral blood smear

____:Production of RBC

1. Kidney senses a decrease in oxygen.

2. Kidney primarily (liver to a minor degree)

stimulates release of erythropoietin (EPO).

3. EPO stimulate the release of

reticulocytes from the bone marrow.

4. Reticulocytes mature into erythrocytes.

5. Increased erythrocytes to carry O2 will

turn off EPO stimulation until more RBC

are needed.

Erythropoiesis

Blood cell

• Bone Marrow

• Kidney

• EPO

• Iron, Folic Acid

• B12

• GI function

Production

Blood cell

• Circulate ~ 120 days

• Deliver O2

• Consistent size & shape

• Flexibility

• Adequate hemoglobin, Iron, Folic Acid, B12

Function

Blood cells

Hemolysis

Trauma

• GI bleeding

• Old / damaged

removed by the

Reticuloendothelial system (RES)

Destruction/Loss

Hematocrit (hct): Measures the volume occupied by red blood cells. Measured as a percent

of total volume.

Normal range

• female: ____

• male: ____

female 36-46%, males 37-49%

hemoglobin (Hgb): Measures the oxygen carrying capacity of blood. Measured weight/100ml(dl) of whole blood

Normal range

• females: _____

• males: ______

females: 12-16 g/dL, males: 13-18 g/dL

Generally ____ is considered more reliable than ____ in determining status of RBC because 

• If patient volume depleted due to

trauma or dehydration, then value

could be falsely high (normal value

when patient is anemic)

• If patient volume overloaded then value

could be falsely low (anemic value

when patient is normal)

Hgb, Hct 

iron exist in the body as _____ and in ____

functional (HgB), storage

iron is stored inside ___ inside macrophages and in ____ in liver, bone marrow, spleen

ferritin, hemosiderin

iron is transported via _____ a protein found in _____

transferin, plasma

Total iron binding capacity (TIBC)= amount of iron that can bind to transferrin to give 100% of saturation

• has a ___ to iron

inverse relationship, low iron level =more site available to bind = higher TIBC

measures ferritin (serum, reflects total body stores), iron (circulating in serum, bound to transferrin), transferrin (serum), total iron binding capacity (TIBC), and percent transferrin saturation (extent transferrin sites are filled with iron → ratio of serum iron: TIBC x 100)

iron studies

Red Blood Cell Indices

• Mean Corpuscular Volume (MCV)

  • Hct of one red blood cell (erythrocyte)

  • Average size of RBCs

• MCV <78 fl (indicates iron deficiency)

microcytic

Red Blood Cell Indices

Mean Corpuscular Volume (MCV)

• Hct of one red blood cell (erythrocyte)

• Average size of RBCs

• MCV 78-100 fl                                                                                                                                                                                                                                                                                

normocytic 

Red Blood Cell Indices

Mean Corpuscular Volume (MCV)

• Hct of one red blood cell (erythrocyte)

• Average size of RBCs

MCV >100 fl (indicates deficiency in nutrients)

macrocytic

• production regulated by megakaryocyte colony stimulating factor and thrombopoietin

• activated by vascular injury by collagen and thrombin

• thrombocytopenia: low ___ count

platelets

responsible for immune system function

• CBC with differential: neutrophils, bands (immature neutrophils), eosinophils, basophils, lymphocytes, monocytes

white blood cells

increased in WBCs

Leukocytosis

______: very low WBCs

• Indicates bone marrow failure

Leukopenia

list the granulocytes (leukocytes with granules in the cytoplasm)

neutrophils, eosinophils, basophils

Granulocytes: Synthesis stimulated by the ______ for

granulocytes G-CSF and granulocytes and monocytes GM-CSF

• Stored in marrow for up to 8 days

  Released within minutes of stimuli

  Circulate for less than one day

hormone colony-simulating factor

Neutrophils/Bands

45-75% of leukocytes

• Also called Polymorphonuclear leukocytes (PMN),

“Polys” or “segs”

• 0-5% of leukocytes are bands (immature

neutrophils)

• “________” means an increase in the

number of bands, characteristic of infection

• Absolute Neutrophil count = Number of Segs &

bands, not %

 ANC = WBC x (%Neutrophils + % Bands) / 100

A shift to the left

______ move

towards tissue damage

or foreign material in

blood stream and Phagocytize and

enzymatically destroy

microorganisms or

other materials

Neutrophils

0-8% of leukocytes

Phagocytosis but not bactericidal

Primarily active against large invaders; like parasites

Effective in immunologically mediated inflammation

Elevated in parasitic and allergic diseases

Eosinophils

0 - 3% of leukocytes

May form plasma cells which are not normally

found in blood

Basophils in tissue are called mast cells

Have IgE receptors on membranes, releases

histamine, role in allergic reactions

Basophils

16-46% of leukocytes

T cells, B cells, Natural Killer cells

Involved in regulating the immune system, fighting viruses and

tumor cells.

May form plasma cells which are not usually found in blood (found in

patients with neoplasms, infections, allergic states etc.; are part of

immune defense)

Lymphocytes

4-11% of leukocytes

Circulate briefly, enter tissue, transform into macrophages

Remain up to several months

Synthesize biologically active compounds

Important role in defense and hematopoiesis

Part of RES

Monocytes

CBC obtained to

evaluate effectiveness/adverse effect of some medications

platelets are measured in ___

CBC