Reports on Experiments 8, 9, & 10Members: Patrick Marc E. Cebedo Pamela Arguelles Marianne Arboleda Joy David Love Joy Bancayan Ana Andrales Nico Carasco Maria Rosario Andres
Experiment 8: Red Blood Cell CountHemoglobin Determination
Red Blood Cell Count The RBC is a count of the number of red blood cells per cubic millimeter of blood. In response to hypoxia, the hormone erthyropoietin, secreted by the kidneys, stimulates the bone marrow to produce red blood cells. The formation of red blood cells is known as erthyropoiesis.
Normal red blood cells values at various ages are: Newborns: 4.8 - 7.2 million Adults: (Males): 4.6 - 6.0 million (Females): 4.2-5.0 million Pregnant: slightly lower than normal adult values Children: 3.8 – 5.5 million
Hemoglobin Determination Or Hemoglobinometry The measurement of the concentration of hemoglobin in the blood. Hemoglobin’s main function in the body is to carry oxygen from the lungs to the tissues and to assist in transporting carbon dioxide from the tissues to the lungs. Hemoglobin values are affected by age, sex, pregnan cy, disease, and altitude. During pregnancy, gains in body fluids cause the red cells to become less concentrated, causing the red cell count to fall.
Experiment 8 : Research Questions What is the normal range of RBC count in man? - Male: 4.7 – 6.1 million/uL - Female: 4.2 – 5.4 million/uL - Children: 4.6 to 4.8 million/uL What is Polycythemia? - a disease state in which the proportion of blood volume that is occupied by red blood cells increases. What is Anemia? - is a decrease in number of red blood cells or less than the normal quantity of hemoglobin in the blood.
Experiment 8 : Research Questions What is the normal range of hemoglobin in man? Male: (Adult) 14-18 gm/dl (After Middle Age) 12.4 – 14.9 gm/dl Female : (Adult) 12 -16 gm/dl (After Middle Age) 11.7 – 13.8 gm/dl Conditions may lead to low Hgb content: - Anemia - Under 5 g/dl may cause heart failure
Experiment 9:White Blood Cell Count
White Blood Cell Count A WBC count is a blood test to measure the number of white blood cells (WBCs).
White blood cells help fight infections. There are five major types of white blood cells: Basophils Eosinophils Lymphocytes (T cells and B cells) Monocytes Neutrophils Normal Count: 4,500-10,000 white blood cells per microliter (mcL).
**No special preparation is usually needed. Tell your doctorabout any medications you are taking, including over-the-counter products. Certain drugs may interfere with test results. Drugs that may increase Drugs that may lower your WBC counts include: WBC count include: Allopurinol Antibiotics Aspirin Anticonvulsants Chloroform Antihistamines Corticosteroids Antithyroid drugs Epinephrine Arsenicals Heparin Barbiturates Quinine Chemotherapy drugs Triamterene Diuretics Sulfonamides
Experiment 9 : Research Questions What is the normal range of WBC count in man? - 4,300 to 10,800 cells per cubic millimeter (cmm) or 4.3 to 10.8 x 109 cells per liter. Leukocytosis: - is a raised white blood cell count above the normal range in the blood. It is frequently a sign of an inflammatory response, most commonly the result of infection, and is observed in certain parasitic infections. It may also occur after strenuous exercise, convulsions such as epilepsy, emotional stress, pregnancy and labor, anesthesia, and epinephrine administration.
Experiment 9 : Research Questions Leukopenia: - Also known as Leukocytopenia, or Leucopenia -A decrease in the number of white blood cells (leukocytes) found in the blood, which places individuals at increased risk of infection. Neutropenia is a sub-type of Leukopenia that refers to a decrease in the number of circulating neutrophil granulocytes, the most abundant white blood cells. The terms Leukopenia and Neutropenia may occasionally be used interchangeably, as the neutrophil count is the most important indicator of infection risk.
Experiment 9 : Research Questions Leukemoid Reaction: - Describes an elevated white blood cell count, or leukocytosis, that is a physiological response to stress or infection (as opposed to a primary blood malignancy, such as leukemia). -It may be lymphoid or myeloid. - Leukemoid reactions are generally benign and are not dangerous in and of themselves, although they are often a response to a significant disease state. - Leukemoid reactions can resemble more serious conditions such as chronic myelogenous leukemia (CML), which can present with identical findings on peripheral blood smear.
Experiment 9 : Research Questions Leukemia: -Type of cancer of the blood or bone marrow characterized by an abnormal increase of immature white blood cells called "blasts". -Leukemia is a broad term covering a spectrum of diseases. In turn, it is part of the even broader group of diseases affecting the blood, bone marrow and lymphoid system, which are all known as hematological neoplasms.
Experiment 10:Coagulation and Bleeding time ABO Blood Typing
Coagulation• The time required by shed blood to clot that is a measure of the normality of the blood
Procedures:I. Coagulation Time (Slide Method) 1. Sterilize the subject’s finger with 70% alcohol and allow to dry. 2. Prick the finger tip using a sterile lancet. 3. Place a large drop on a glass slide. 4. At intervals of 10 sec., draw a pin from a center of the drop of blood to the periphery to see if any fibrin strands goes with the pin. 5. Coagulation has occurred if fibrin strands are seen to go with the pin. 6. Note the time interval from pricking to formation of fibrin strands with the pin. This is your coagulation time.
Result:4 minutes and 36 seconds (4 mins. 36 secs.)
Coagulation Time Research Questions: What is the normal coagulation time using the slide method? The expected coagulation time is 4-10 minutes.
Coagulation Time Research Questions: What are the factors that may influence the coagulation process? -Factor I - fibrinogen -Factor II - prothrombin -Factor III - tissue thromboplastin (tissue factor) -Factor IV - ionized calcium ( Ca++ ) -Factor V - labile factor or proaccelerin -Factor VI - unassigned -Factor VII - stable factor or proconvertin -Factor VIII - antihemophilic factor -Factor IX - plasma thromboplastin component, Christmas factor - Factor X - Stuart-Prower factor - Factor XI - plasma thromboplastin antecedent - Factor XII - Hageman factor - Factor XIII - fibrin-stabilizing factor
Coagulation Time Research Questions: Why does circulating blood remain in its fluid form? Because of its basic composition (cells surrounded by a matrix), development, and ability to modify into other forms of connective tissues. It contains 90% plasma and 10% only for formed elements so it remains fluid.
Bleeding Time Is a blood test that looks at how fast small blood vessels in the skin close to stop you from bleeding. This test helps diagnose bleeding problems. Bleeding normally stops within 1 to 9 minutes. **However, values may vary from lab to lab.
Procedures:II. Bleeding Time 1. Prepare a clean piece of filter paper. 2. Sterilize the subject’s finger tip with 70% alcohol and let it dry. 3. Prick the sterilized finger with a blood lancet. Take note of the time and DO NOT SQUEEZE THE FINGER. 4. Using clean piece of filter paper, gently wipe the blood away every 15 seconds until no more blood stains are picked up on the filter paper. 5. Note how long the bleeding lasts. This is your bleeding time.
Bleeding Time Research Questions: What is the normal value for bleeding time? When is it advisable to request for bleeding time? What is the significance of this experiment in dentistry? Differentiate bleeding time from clotting time.
What is the normal value forbleeding time? 1-3 minutes
When is it advisable to request forbleeding time? Bleeding time test may be performed immediately in an emergency, or tests may be delayed as a condition is treated or monitored. A test may be suggested or become necessary when certain signs or symptoms of a disease appear.
What is the significance of thisexperiment in dentistry? It is very important for patients with bleeding problems to maintain periodontal health as hyperemic soft tissues are at a greater risk of bleeding. Periodontal issues also warrant extractions which can lead to complications. Perio probing, supragingival scaling and polishing can be performed with no risk of significant bleeding while deep scaling and root planning may require replacement therapy. When tissue is severely inflamed, chlorhexadine rinse and gross debridement are indicated to reduce inflammation prior to scaling and root planning. Perio dressings and stents may be needed to aid in hemostasis.
Differentiate bleeding time fromclotting time. BLEEDING TIME CLOTTING TIME• a medical test done on •The time required for asomeone to assess sample of blood to coagulatetheir platelet function in vitro under standard conditions especially• a blood test that looks at through capillary tubehow fast small blood vessels method used to diagnose ifin the skin close to stop you clotting or coagulatingfrom bleeding. disorders are present.
Blood Typing A method to tell what specific type of blood you have. What type you have depends on whether or not there are certain proteins, called antigens, on your red blood cells. Blood is often grouped according to the ABO blood typing system. This method breaks blood types down into four categories: Type A Type B Type AB Type O Your blood type (or blood group) depends on the types that are been passed down to you from your parents. This test is done to determine a persons blood type. Health care providers need to know your blood type when you get a blood transfusion or transplant, because not all blood types are compatible with each other.
Procedures:III. Blood Typing 1. Prepare a clean glass slide with 2 concavities 2. Label the upper portion of the slide at the left “anti-A” and at the right “anti-B”. 3. Place one drop of anti-A serum and one drop of anti-B serum into the concavities 4. Sterilize the subject’s finger with alcohol. 5. Prick the finger using the sterilized lancet . 6. Put one drop of blood each into the concavities. 7. Mix each preparation; Use one end of the applicator stick for anti-A and other for anti-B. 8. Observe the presence of aglutination.
Result:(+) presence of agglutination(-) absence of agglutinationAnti-A serum plus corpuscle X = (-)Anti-B serum plus corpuscle X = (-)Blood Type : O
Blood Typing Research Questions: ABO Blood Types
Blood Typing Research Questions: Uses of blood typing Blood Transfusion - involves testing blood from both donors and recipients to ensure that every individual recipient is given blood that is compatible and is as safe as possible. Hemolytic disease of the newborn (HDN) Blood Products Red blood cell compatibility Plasma Compatibility
Blood Typing Research Questions: What are the dangers of blood transfusion? Acute hemolytic reactions Occur with transfusion of red blood cells, and occurs in about 0.016 percent of transfusions, with about 0.003 percent being fatal. This is due to destruction of donor erythrocytes by preformed recipient antibodies. Most often this occurs due to clerical errors or improper typing and crossmatching. Symptoms include fever, chills, chest pain, back pain, hemorrhage, increased heart rate, shortness of breath, and rapid drop in blood pressure. Kidney injury may occur due to the effects of the hemolytic reaction (pigment nephropathy).
Blood Typing Research Questions: Delayed hemolytic reactions Occur more frequently (about 0.025 percent of transfusions) and are due to the same mechanism as in acute hemolytic reactions. However, the consequences are generally mild and a great proportion of patients may not have symptoms. Evidence of hemolysis and falling hemoglobin levels may still occur. Febrile nonhemolytic reactions Due to recipient antibodies to donor white blood cells, and occurs in about 7% of transfusions. This may occur after exposure from previous transfusions. Fever is generally short lived and is treated with antipyretics, and transfusions may be finished as long as an acute hemolytic reaction is excluded.
Blood Typing Research Questions: Allergic reactions May occur when the recipient has preformed antibodies to certain chemicals in the donor blood, and does not require prior exposure to transfusions. Symptoms include urticaria, pruritus, and may proceed to anaphylactic shock. A small population (0.13%) of patients are deficient in the immunoglobin IgA, and upon exposure to IgA-containing blood, may develop an anaphylactic reaction.
Blood Typing Research Questions: Posttransfusion purpura - A rare complication that occurs after transfusion containing platelets that express a surface protein HPA- 1a. Recipients who lack this protein develop sensitization to this protein from prior transfusions, and develop thrombocytopenia about 7–10 days after subsequent transfusions. Treatment is with intravenous immunoglobulin, and recipients should only receive future transfusions with washed cells or HPA-1a negative cells.
Blood Typing Research Questions: Transfusion-Associated acute Lung Injury (TRALI) A syndrome of acute respiratory distress, often associated with fever, non-cardiogenic pulmonary edema, and hypotension, which may occur as often as 1 in 2000 transfusions. Symptoms can range from mild to life- threatening, but most patients recover fully within 96 hours, and the mortality rate from this condition is less than 10%. TRALI is typically associated with plasma components rather than packed red blood cells (RBCs), though there is some residual plasma in RBC units.
Blood Typing Research Questions: What is Rh factor? Rhesus factor Strictly refers only to the most immunogenic D antigen of the Rh blood group system, or the Rh- blood group system. The status is usually indicated by Rh positive (Rh+, does have the D antigen) or Rh negative (Rh-, does not have the D antigen) suffix to the ABO blood type. In contrast to the ABO blood group, immunization against Rh can generally only occur through blood transfusion or placental exposure during pregnancy.
Crossmatching Cross-matching blood, in transfusion medicine, refers to the complex testing that is performed prior to a blood transfusion, to determine if the donors blood is compatible with the blood of an intended recipient, or to identify matches for organ transplants. Cross-matching is usually performed only after other, less complex tests have not excluded compatibility. Blood compatibility has many aspects, and is determined not only by the blood types (O, A, B, AB), but also by blood factors, (Rh, Kell, etc.). Cross-matching is done by a certified laboratory technologist, in a laboratory. It can be done electronically, with a computer database, orserologically. Simpler tests may be used to determine blood type (only), or to screen for antibodies (only).
Cross Matching Research Questions: Why is cross matching a must before blood transfusion? - That is performed prior to a blood transfusion, to determine if the donors blood is compatible with the blood of an intended recipient Explain the discrepancy in your results, if any.
Fragility of Erythrocytes Osmotic Fragility A test to detect whether red blood cells are more likely to break down. This test is performed to detect hereditary spherocytosis and thalassemia. Hereditary spherocytosis makes red blood cells more fragile than normal. Some red blood cells in patients with thalassemia are more fragile than normal, but a larger number are less fragile than normal. A negative test is normal. Normal value ranges may vary slightly among different laboratories. Some labs use different measurements or test different samples.
Fragility of Erythrocytes Research Questions: Give the significance of the osmotic fragility test. - This test is performed to detect Hereditary spherocytosis and Thalassemia. Hereditary spherocytosis makes red blood cells more fragile than normal. Some red blood cells in patients with Thalassemia are more fragile than normal, but a larger number are less fragile than normal.
Fragility of Erythrocytes Research Questions: What is Hemolysis? - Is the rupturing of red blood cells and the release of their contents (hemoglobin) into surrounding fluid. What is Crenation? - The contraction of a cell after exposure to a hypertonic solution, due to the loss of water through osmosis. The word is from the Latin "crenatus" meaning scalloped or notched, and is named for the scalloped- edged shape the cells take on when crenated.