A complete blood count (CBC) examines components of blood including red blood cell (RBC), white blood cell (WBC), and platelet counts. The CBC provides information about anemia, infection, blood cell production/destruction. Low or high RBC, WBC, or platelet counts can indicate conditions like bleeding, bone marrow damage, inflammation, infection, cancer, nutritional deficiencies. The CBC also measures hemoglobin, hematocrit, and RBC indices to characterize anemias and help identify their cause. An elevated erythrocyte sedimentation rate often relates to inflammation.

1. Complete Blood Count (CBC)
• Panel of tests that examine different components of the
blood.
• • CBC values
• • RBC count
• • Hemoglobin
• • Hematocrit
• • RBC indices
• • WBC count and differential
• • Platelet count

2. RBC
•NORMAL RANGE
•MALE 4.5-5.8 1012 /L
FEMALE 3.8-5.4 1012 /L

3. LOW RBC COUNT
• Known as anemia
• Acute or chronic bleeding
• RBC destruction (e.g., hemolytic anemia, etc.)
• Nutritional deficiency (e.g., iron deficiency, vitamin B12 or
folate deficiency)
• Bone marrow disorders or damage
• Chronic inflammatory disease
• Kidney failure

4. HIGH RBC COUNT
• Known as polycythemia
• Dehydration
• Pulmonary disease
• Kidney or other tumor that produces excess erythropoietin
• Smoking
• Genetic causes (altered oxygen sensing, abnormality in
hemoglobin oxygen release)
• Polycythemia vera

5. HEMOGLOBIN
• Is the protein molecule that carries
oxygen in the Red Blood Cells.
• 13.5-17.5 g/dl in males
• 12.5-15.5 g/dl in females

6. HEMATOCRIT
• Males normal 40-45%
• Females normal 37-47%
• High Hct
• PolycythemiaVera
• Erythropioten use
• Dehydration
• Capillary leak syndrome
• Sleep apnea
• Anabolic Steroid use
• Low Hct
• Due to anemia
• Anemia can be characterised by using the indices

7. • RBC indices
• Mean Corpuscular Volume (MCV ):a measurement of the average size of
RBCs Normal 80-100fL
• Low MCV indicates RBCs are smaller than normal (microcytic
• iron deficiency anemia, or thalassemias, Congenital sideroblastic
Anemia, Lead Poisoning, pyridoxine deficiency, anemia of chronic
disease
• High MCV indicates RBCs are larger than normal (macrocytic)
• MEGALOBLASTIC MACROCYTIC ANEMIAMacrocytes in bone marrow
smear
• Medications affecting folate metabolism
• Vit B12 deficiency (Pernicious Anemia)
• Folate deficiency (Alcohol related often)
• Atrophic Gastitis

8. • • Mean Corpuscular Hemoglobin (MCH): the average amount
of oxygen-carrying hemoglobin inside a RBC • Mean
Corpuscular Hemoglobin Concentration(MCHC): the average
concentration of hemoglobin inside a RBC MCH AND MCHC
• Less in Microcytic Anemias
• Normal in Macrocytic Anemias
• Elevated in hereditary spherocytosis, sickle cell disease and
Honozygous Hemoglobin C diseaseRED S

9. RBC indices
• • Red Cell Distribution Width (RDW): a variation in the size of RBCs
• Low value indicates uniformity in size of RBCs
• High value indicates mixed population of small and large
RBCs; immature RBCs tend to be larger. For example, in iron
deficiency anemia or pernicious anemia, there is high variation
(anisocytosis) in RBC size (along with variation in shape –
poikilocytosis), causing an increase in the RDW.

10. WHITE BLOOD CELL COUNT
• The normal number of WBCs in the blood is
• 4,000-10,000 white blood cells per microliter (mcL). Normal
value ranges may vary slightly among different labs.
• There are five basic white blood cell types:
• • Neutrophils 45-70%
• • Eosinophils 1-5%
• • Basophils 0-1%
• • Lymphocytes 25-45%
• • Monocytes 2-12%
Each WBC cell type has its' own unique features.

11. LEUKOPENIA
• Low white cell count may be due to acute viral infections,
such as with a cold or influenza. It can be associated with
chemotherapy, radiation
• therapy, myelofibrosis and aplastic anemia (failure of white
cell, red cell and platelet production). HIV and AIDS are also
a threat to white cells.
• Other causes of low white blood cell count include systemic
lupus erythematosus, Hodgkin's lymphoma, some types of
cancer, typhoid, malaria, tuberculosis, dengue, rickettsial
infections, enlargement of
• the spleen, folate deficiencies, psittacosis, sepsis and Lyme
disease. Many other causes exist, such as deficiency in
certain minerals, such as copperand zinc.

12. LEUKOCYTOSIS
• Known as leukocytosis Infection, most commonly
bacterial or viral
• Inflammation
• Leukemia, myeloproliferative disorders
• Allergies, asthma
• Tissue death (trauma, burns, heart attack) ¢ Intense
exercise or severe stress
• Will mention in detail in respective cell line.

13. Neutrophils
• These are the most common of the WBCs and serve as the
primary defense against infection.The typical response to
infection or serious injury is an increased production of
neutrophils.
• Bands/Stabs Early in the response to infection, immature
forms of neutrophils will be seen.These are call Stab or
Band cells.The presence of these immature cells is called a
"shift to the left" and can be the earliest sign of a WBC
response, even before the WBC becomes elevated.

16. Eosinophils
• These cells play a role in allergic disorders and in
combating parasitic infections. • Elevations in
eosinophil counts are associated with: • Allergic
reactions • Parasite infections • Chronic skin infections
• Some cancers • Decreases in eosinophil counts are
associated with: • Stress • Steroid exposure • Anything
that may suppressWBC production generally.

18. Basophils
• These cells can digest bacteria and other foreign bodies
(phagocytosis) and also have some role in allergic reactions.
• Elevations in basophil counts are associated with: • Some
cancers • Some allergic reactions • Some infections •
Radiation exposure • Diminished basophil counts are
associated with: • Stress reactions • Some allergic reactions
• Hyperthyroidism • Prolonged steroid expo

20. Monocytes
• These cells respond to inflammation, infection and foreign
bodies by ingesting and digesting the foreign material. •
Increased monocyte counts are associated with: • Recovery
from an acute infection •Viral illness • Parasitic infections •
Collagen disease • Some cancers • Decreased monocyte counts
are associated with: • HIV infection • Rheumatoid arthritis •
Steroid exposure • Some cancers

22. Lymphocytes
• These cells play both an immediate and delayed role in
response to infection or inflammation. • Increased numbers of
lymphocytes are seen in: • Most viral infections • Some
bacterial infections • Some cancers • Graves' disease •
Decreased numbers of lymphocytes are seen in: • Steroid
exposure • Some cancers • Immunodeficiency • Renal failure •
Lupus

24. Erythrocyte Sedimentation Rate
(ESR)
• ESR is high, it may be related to an inflammatory condition, such
as:
• Infection
• Rheumatoid arthritis
• Rheumatic fever
• Vascular disease
• Inflammatory bowel disease
• Heart disease
• Kidney disease
• Certain cancers