[HEMA-LEC] INTRO TO HEMATOLOGY

Hematology

Hematology

A systematic study of blood cells that aids in the diagnosis, treatment and monitoring of diseases

70%

Percentage of diagnosis based on the Clinical Laboratory results

Complete Blood Count (CBC)

One of the most common routine laboratory procedure if we want to diagnose a certain disease

Transports oxygen from lungs to cells
Carries waste materials to lungs
Carries nutrients
Transport of waste products from cells to kidneys and lungs
Transport hormones from Endocrine to target organs
Regulates fluid and electrolytes
Regulate body and cell temperature
Protects against toxins produced by bacteria
Prevents fluid loss through clotting

Functions of Blood

Formed Elements
Fluid Portion

Composition of Blood

45%

Percentage of Formed Elements

55%

Percentage of Fluid Portion

Red blood cells

White blood cells

Platelets

Composition of Formed Elements

90% Water

10% Dissolved Substances or Analytes (Proteins, Vitamins, Hormones, Lipids, Etc.)

Composition of Fluid Portion

NOTE: In the left test tube in Figure 1, there is presence of the formed elements, therefore it is whole blood

NOTE: In the left test tube in Figure 1, there is presence of the formed elements, therefore it is whole blood

NOTE: In the right test tube in Figure 1, it is the centrifuged whole blood

NOTE: In the right test tube in Figure 1, it is the centrifuged whole blood

NOTE: The gray portion is the Buffy Coat

NOTE: The gray portion is the Buffy Coat

WBCs and Platelet

Composition of Buffy Coat

Red Blood Cells

Densest among the formed elements

5 to 6 Liters

Total Volume of Blood in Adults in Liters

7% to 8 % of body weight

Total Volume of Blood in Adults in Percentage

Hypovolemia

General decreased blood volume

Hypovolemic Shock

Can happen when organs do not receive enough oxygen

Hypervolemia

General increased blood volume

NOTE: Both hypovolemia and hypervolemic are considered to be dangerous

NOTE: Both hypovolemia and hypervolemic are considered to be dangerous

Plasma

Fluid portion of the anticoagulated blood

Serum

Fluid portion of the coagulated blood

NOTE: During coagulation, Fibrinogen is converted to fibrin

NOTE: During coagulation, Fibrinogen is converted to fibrin

Fibrinogen

A plasma protein and coagulation factor;

Seen in plasma, but absent in serum

Water
Major Proteins
Non-Protein Nitrogen (NPN)
Products of Digestion
Regulatory Substances (Enzymes and Hormones)
Electrolytes

Components of Plasma and Serum

Albumin
Globulin
Fibrinogen

Major Proteins found in Plasma and Serum

Albumin

In Major Proteins:

Controls water movement across membranes
Affects bloody viscosity, pressure, and volume
Transports substances such as drugs

Globulin

In Major Proteins:

Forms antibodies to fight bacteria and viruses

Fibrinogen

In Major Proteins:

Forms fibrin clot, together with platelets, they can coagulate blood

Urea
Uric Acid
Creatinine
Creatine
Ammonium Salts

Products of metabolism

Amino Acids
Glucose
Fatty Acids
Vitamins
Minerals

Products of Digestion

Enzymes
Hormones

Regulatory Substances

Enzymes

In Regulatory Substances:

Produced by Exocrine Glands
For cellular chemical reactions

Hormones

In Regulatory Substances:

Produced by endocrine glands
Regulate growth and development

Cations
Anions

Electrolytes

Cations

Positively Charged Electrolytes

(Sodium, Potassium, Calcium, Magnesium)

Anions

Negatively Charged Electrolytes

(Chloride, Phosphate, Sulfate, Bicarbonate)

Erythro

Word meaning Red

Cyte

Word meaning Cells

Normocytic

Normal type in terms of size or normally sized cell

7.2 um in diameter

According to Steininger:

Normal size of Erythrocytes

7 to 8 um in diameter

According to Rodak’s:

Normal size of Erythrocytes

Normochromic

Normal color

Hemoglobin

Gives the color of the Erythrocytes

NOTE: Red Cells have central pallor area

NOTE: Red Cells have central pallor area

1/3 of the cell’s diameter

Portion of central pallor area

NOTE: Central pallor usually has no color, meaning no hemoglobin

NOTE: Central pallor usually has no color, meaning no hemoglobin

Hyperchromic

In Red Blood Cell Color:

No pallor area
Over hemoglobin

Hypochromic

In Red Blood Cell Color:

Larger pallor area (No hemoglobin)
Less hemoglobin

Normochromic

In Red Blood Cell Color:

1/3 pallor area
Normal amount of Hemoglobin

Biconcave Disk

In Description of RBC:

Donut-shaped
Depressed on the top and the bottom

NOTE: It is concave so that the gas exchange is easier, and the hemoglobin is popped off closer to the surface

NOTE: It is concave so that the gas exchange is easier, and the hemoglobin is popped off closer to the surface

Anucleated

In Description of RBC:

Matured cell devoid of nucleus

Not Rigid

In Description of RBC:

Should be highly flexible and can pass through the blood vessels just like the capillaries, arterioles, venules

Hemoglobin (HgB, Hb)

A protein component that functions for oxygen transport
Acid for hematocrit

Two pairs of protein chains (Globin)
Four smaller units (Heme)

Composition of Hemoglobin

Iron
Fe2+ and Protoporphyrin

Composition of Heme

Anemia

Means loss of oxygen-carrying capacity
Often reflected in a reduced RBC count or reduced hemoglobin concentration

NOTE: Anemia is not a disease, but a manifestation of a disease

NOTE: Anemia is not a disease, but a manifestation of a disease

Polycythemia

Means increased RBC count reflecting increased body RBC mass, a condition that leads to hyperviscosity.

NOTE: Polycythemia can cause uncontrolled erection of penis; treated by Therapeutic Phlebotomy

NOTE: Polycythemia can cause uncontrolled erection of penis; treated by Therapeutic Phlebotomy

Hematocrit

Ratio of the blood volume of packed RBCs to the whole blood

Packed Cell Volume (PCV)
Erythrocyte Volume Fraction (EVF)

Another term for Hematocrit

Mean cell/corpuscular volume (MCV)
Mean cell/corpuscular hemoglobin concentration (MCHC)
Mean cell/corpuscular hemoglobin (MCH)

Red blood cell indices

Reticulocytes

Small or premature RBCs
Contains RNA

Polychromatic (polychromatophilic)

RBCs newly released from the Bone Marrow

NOTE: Reticulocytes are not visible in Wright Stain

NOTE: Reticulocytes are not visible in Wright Stain

NOTE: Difference between Reticulocytes and RBCs are Reticulocytes have RNA remnants.

NOTE: Difference between Reticulocytes and RBCs are Reticulocytes have RNA remnants.

Supravital Stain

Stain used to visualized Reticulocytes

New Methylene Blue
Brilliant Cresyl Blue

Dyes in Supravital Stain

Neutrophils
Monocytes
Eosinophils
Basophil
Lymphocytes

Types of Leukocytes or White Blood Cells

Neutrophil

Type of Leukocyte that is:

Segmented neutrophils / segmenters / Polymorphonuclear cells (PMN)
Phagocytic Cells
Attacks bacteria

NOTE: Neutrophils are the most abundant WBC in adults

NOTE: Neutrophils are the most abundant WBC in adults

Band Cells

In Neutrophil:

Less matured forms; non-segmented
U or S Shaped nucleus or C-Shaped in other references

Stab Cells or Staff Cells

Another term for Band Cells

Shift to the Left

When there is an increase in Band Cells; indication of bacterial infection

Neutropenia

Decrease in Neutrophil count

Neutrophilia

Increase in Neutrophil count

Eosinophil

Type of Leukocyte that is:

Cells with round, bright orange-red cytoplasmic granules filled with protein (One of the proteins: MBP – major basic protein)
Indicates parasitic or allergies

Eosinophilia

Increase in Eosinophil counts
Indicative of allergic reactions or parasitic (helminthic) infections

NOTE: Eosinophil does not increase with other type of parasitic infections like protozoa, flagellates, etc.

NOTE: Eosinophil does not increase with other type of parasitic infections like protozoa, flagellates, etc.

Eosinopenia

Low count of Eosinophils
Theoretical and not used

NOTE: Eosinophil conditions are only significant when there is a high count

NOTE: Eosinophil conditions are only significant when there is a high count

Basophil

Type of Leukocyte that is:

Cells with dark purple, irregular cytoplasmic granules that contain histamine and heparin
Sometimes, the nucleus (lobed) is not visible due to the granules
Metachromatic granules
Indicative of allergies

Basophilia

Increase in Basophil count
Indicative of an allergic reaction or hypersensitivity reactions

Degranulation

Releasing of Granules (Histamine and Heparin)

Basopenia

Low amount of Basophil
Theoretical; not used since Basophil is the least abundant

NOTE: Degranulation releases histamine, the reason why people take antihistamine when allergic reaction occurs

NOTE: Degranulation releases histamine, the reason why people take antihistamine when allergic reaction occurs

Lymphocytes

Type of Leukocyte that is:

Smallest WBC
Provides host immunity by recognizing foreign antigens and mounting humoral (antibodies) and cell-mediated responses

Humoral

Mechanism of the body to produce antibodies directed against antigens

Lymphocytosis

Increase in Lymphocyte count

Lymphopenia/Lymphocytopenia

Decrease in Lymphocyte count

Monocyte

Type of Leukocyte that is:

Largest cell in the circulation
Immature macrophage
May be motile or immobilized
Identify and phagocytize foreign particles

Monocyte

Monocyte that:

Resides in the blood

Macrophages

Monocyte that:

Already migrated to the tissues they are needed at

Monocytosis

Increase in Monocyte count

Monocytopenia

Decrease in Monocyte count

Granulocytes (Neutrophil, Eosinophil, Basophil)
Macrophages (Monocyte)

In Category of WBCs by Function:

Defense Cells; Phagocytes

Lymphocytes
Plasma Cells

In Category of WBCs by Function:

Immune cells or cells that produce antibodies

Neutrophil

In Category of WBCs by Shape of Nucleus:

Polymorphonuclear